Gabapentin Versus Lorazepam: Which Drug Is More Effective in the Treatment of Alcohol Withdrawal?

Substance use disorder also has neurological factors, such as dopamine and endogenous opioids being affected by use, creating an extremely pleasurable high (Rosenberg and Kosslyn, 2011). Though, this effect on neurotransmitters creates a difficulty when chronic drinkers try to quit. When one’s body gets used to the addition of alcohol to one’s system their body will no longer produce these endogenous opioids without it, creating intense and painful withdrawal symptoms (Rosenberg & Kosslyn 2011). These factors make alcohol extremely difficult to quit.

With the possibility of drugs capable of suppressing the urge to consume alcohol in addicts, many people who normally would not be helped by a simple 12 step program, could use such drugs in combination with standard treatment in the future to help combat their addiction.

Client reported alcohol as his drug of choice with the last use date of March, 2017. No acute intoxication or withdrawal symptoms were reported. No treatment plan was developed in this dimension. Client appears to be stable at this time.

Alcoholism is a prominent substance abuse issue in Western society. The treatment method of controlled drinking as opposed to abstinence is a continuing cause of controversy in alcohol research to this day. The US is different from Europe in its acceptance of controlled drinking as a goal of treatment: “in the US alcohol dependence is typically depicted as a ‘recurring disease’ and the ‘successful abstainer’ as a ‘recovering’ though never ‘recovered’ alcoholic” (Coldwell, 2005). Depending on the alcohol abuse patient’s individual characteristics, either controlled drinking or abstinence is chosen as a treatment.

Treatment guidelines from the Substance Abuse and Mental Health Services Administration indicate that treatment should include age-appropriate group therapy, and teach skills to rebuild social support networks (Trevisan, 2008). Staff need to be experienced in working with the elderly and use a slower pace and age-appropriate content. Respect with an atmosphere of support and change rather than confrontation should be created in the therapeutic setting. Three medications have been approved for treatment of alcohol problems; however, there are few pharmacological treatment studies of alcohol dependence in older adults and no know studies of other drugs of abuse (Trevisan, 2008). These three medications include Disulfiram, Naltrexone, and Acamprosate (Trevisan, 2008).

A broad range of medical and psychological therapies is currently available for people who struggle with substance addictions. The scientific community is working on evaluation of various treatments to determine which strategies offer the best chances of successful outcome. People who need treatment for alcoholism and drug use are very diverse group. Addiction is a disorder that requires an individual case approach; therefore, different ways to

The Louis de la Parte Florida Mental Health Institute (2002) states that substance abuse can occur in many clients who also have anxiety/stress disorders. The user believes that using alcohol or drugs will help lessen the feelings they have and somehow enable them to “cope” (The Louis de la Parte Florida Mental Health Institute, 2002). Unfortunately, most users like James are unable to realize the substances are not helping their problems. Most people with alcohol and other drug use disorders who also suffer from other mental health disorders require an integrated care plan for the best chance at recovery (Sterling, Chi, & Hinman, 2011).

Equally, Hon (2003) reported that, “The active ingredients of effective treatment for alcohol problems have been distilled from several generations of research into the treatment of alcohol abuse and dependence” (2003, p.

To get started the alcoholic will need to want to help themselves. If they don't want to get better, the treatment will do nothing for them. After they know they are ready to change and understand the treatment plan, step two, detoxification, can start. Detoxification is when the patient stops using alcohol. Medication can help this stage by making the

Carson-Dewitt, Rosalyn MD. Encyclopedia of Drugs and Alcohol & Addictive Behavior. Second Edition, Vol. II, E-Q, Macmillan Reference Center, 2001, pages 702-712.

Many areas are assessed when it comes to alcohol withdrawal. According to Carolyn Jarvis (2016) the most common assessment tool used, is the CIWA (clinical institute withdrawal assessment of alcohol scale) (pg. 96). The CIWA assess both objective and subjective data. The objective data includes agitation, tremors, and paroxysmal sweats. The subjective data incudes nausea/vomiting, tactile disturbances, auditory disturbances, anxiety, visual disturbances, orientation/clouding of sensorium, and headache (often described as fullness in head). Each of these areas has a rating scale from 1-7 (with the exception of the orientation which is still 1-4). If a patient gets a score of 0-9 it means that withdrawal is absent or minimal, if it is 10-19

Unfortunately the pharmacologic treatment of drug dependency has largely been disappointing, and thus new therapeutic targets and hypotheses are need of the hour. There is escalating evidence indicating a central role

H., & Driessen, M. (1997). A New Rating Scale for the Assessment of the Alcohol-Withdrawal Syndrome (Aws Scale). Retrieved from

Physicians have several options for treating alcohol use disorders. Behavioral therapy can help alcoholics recognize and avoid high-risk situations, and referral to programs that provide peer support, such as Alcoholics Anonymous, can increase a person’s chance of recovery. Therapists can also prescribe medications that decrease the appeal of alcohol. Studies show disulfiram, acamprosate and naltrexone help most people abstain from alcohol. Disulfiram causes unpleasant side effects such as sweating, nausea, headache, vomiting and chest pain when patients consume alcohol. The severity of the effects differs among patients, and is correlated with the amount of alcohol consumed. Naltrexone inhibits euphoric effects or feelings of intoxication

Alcoholism is a prominent substance abuse issue in Western society. The treatment method of controlled drinking as opposed to abstinence is a continuing cause of controversy in alcohol research to this day. The US is different from Europe in its acceptance of controlled drinking as a goal of treatment: “in the US alcohol dependence is typically depicted as a ‘recurring disease’ and the ‘successful abstainer’ as a ‘recovering’ though never ‘recovered’ alcoholic” (Coldwell, 2005). Depending on the alcohol abuse patient’s individual characteristics, either controlled drinking or abstinence is chosen as a treatment.