THE BLOG
06/04/2012 12:47 pm ET Updated Aug 04, 2012

A Holistic Approach to Health in Early Recovery: Withdrawal and Insomnia

These days, we all know someone affected by addiction. If it's not something we ourselves grapple with, then it's a friend, sibling, or parent. If you're lucky enough to not be personally affected by the disease of addiction, you need look no further than the tabloids to witness the latest celebrity entering rehab. How many people who try to get sober stay that way? In their latest census, Alcoholics Anonymous reports a whopping 80 percent dropout rate in the first year. [1] This statistic is alarming in its illustration of how difficult it is to get and stay sober. The odds are stacked against an early recovering addict or alcoholic for a myriad of reasons that range from grappling with cravings, to picking up the pieces of broken relationships, to healing a broken body.

In early recovery, an addict/alcoholic will often begin attending 12-step meetings, therapy, and perhaps taking some pharmaceuticals to ease the physical and psychological burden of coming off drugs and alcohol. Natural medicine dovetails nicely with these interventions: proper nutrition, herbal medicine, homeopathy, amino acid therapy, mind-body approaches and exercise are all part of the programs that I prescribe to my patients in early recovery. My goal is always to decrease the probability of relapse and to get the addict/alcoholic on the road to healthy, fulfilling and functional life as soon as possible. In this first of a two-part series on natural approaches to early recovery from substance abuse, I discuss the first and foremost issues that most in the first days of sobriety struggle with: withdrawal and the accompanying insomnia.

Withdrawal

The severity of withdrawal can vary greatly depending on how long the person has been actively in addiction, how much he or she drinks, the extent of the physical and metabolic damage, and the individual's biochemistry. There is no real way to predict its course. If left untreated, withdrawal can progress through or stop at one of four stages.

Holistic medicine is most effective during the first stage, whereas higher levels of withdrawal require more conventional forms of intervention. Stage one starts two to six hours after the alcoholic's last drink. It's marked by mild agitation, anxiety, restlessness, tremors, loss of appetite, insomnia, racing heartbeat, and high blood pressure. [2] Neurotransmitters are the chemicals the body makes to allow nerve cells to pass messages (of pain, touch, and thought) from cell to cell. Amino acids are the precursors of these neurotransmitters. When addicts/alcoholics are low in particular amino acids from burning through them during their substance abuse, symptoms of withdrawal increase -- especially cravings for their substance of choice. The goal in this stage is to support the body as it begins to clear itself of alcohol and drugs and to decrease cravings as much as possible. [3]

In double-blind research, alcoholics treated with DLPA (D, L-phenylalanine) combined with L-tyrosine, L-glutamine, prescription L-tryptophan, plus a multivitamin, had reduced withdrawal symptoms and decreased stress. One study suggests that kudzu, used in traditional Chinese medicine to treat alcohol abuse, might help reduce cravings and the patients that I've treated with it respond with fewer cravings [4].

Homeopathy is also incredibly effective for supporting patients in the early stages of recovery. By its nature non-toxic, homeopathy stimulates a person's bodily systems to deal with stress and illness more efficiently. Research is currently being undertaken to understand how and why these remedies work on the mental and physical level. Specific homeopathic remedies may be helpful during the period of withdrawal from alcohol or drugs. Remedies are chosen on a highly-individualized basis. But there are a few main remedies that help the addict going through withdrawal, including Arsenicum album, Nux vomica and Lachesis.

At this stage of withdrawal, most alcoholics and addicts have some degree of adrenal burnout from chronically producing excess cortisol, which is the body's stress hormone. Alcohol, carbohydrate and stimulant cravings are the body's desperate calls for quick energy that result from adrenal fatigue. Therefore, supporting adrenal function is important both for long-term sobriety and to decrease feelings of withdrawal. For adrenal support, I recommend the herbs ashwagandha, rhodiola and ginseng as well as the amino acid tyrosine.

For the extreme fatigue of detoxification, I have patients take daily greens drinks, especially those containing chlorella, which contains high levels of chlorophyll that assists with oxygen uptake at the level of the red blood cells. It also contains magnesium that the body needs to produce energy and support the pathways of detoxification in the liver, especially important for the early recovering alcoholic. Lastly, electrolyte imbalance can occur in withdrawal. A lemon has about the same amount of potassium in a cup of standard sports drink, so I have patients squeeze the juice of a lemon with a teaspoon of salt, some Stevia and seltzer or water.

Insomnia

A full recovery will not happen without consistent and good quality sleep. Traditional Chinese Medicine tells us that the liver does most of its repair work between the hours of 1 a.m and 3 a.m. -- adrenal repair also occurs during this time. The digestive system, too, prepares the body to eliminate toxins during sleep. And proper brain function does not occur without ample sleep. A recent study showed that sleep deprivation results in anxiety and depression, which puts the recovering addict closer to relapse. [5]

For all of these reasons, I like to get my patients sleeping eight to nine hours a night. I recommend phosphatidyl serine for patients who have trouble falling asleep due to the elevated stress hormone cortisol. L-theanine, a calming amino acid found in green tea, increases dopamine, serotonin and the inhibitory neurotransmitter glycine. [6] Melatonin, the primary hormone of the pineal gland, regulates the circadian sleep/wake cycle. Alcoholics and addicts, in particular, have dysregulated sleep/wake patterns and often their bodies don't know the right time to sleep because their melatonin production is either inhibited or low. Short-term melatonin administration can correct that. Lastly, I often recommend herbal combinations such as valerian, lavender, passionflower, lemon balm and skullcap. The proper homeopathic can be extremely helpful for insomnia, as well.

For the alcoholic or addict who's just put down their drink or drug of choice, it seems like life is about to end. What they will eventually realize, if they stay sober, is that life is just beginning. In the second half of this two-part series, I'll talk about how diet and proper vitamin supplementation can increase the likelihood of getting and staying sober.

References

1). Comments On A.A. Triennial Surveys. Alcoholics Anonymous World Services. December 1990.

2). Family Practice Notebook. 2012. Family Practice Notebook, LLC. 6 May 2012. http://www.fpnotebook.com.

3). Blum K. A commentary on neurotransmitter restoration as a common mode of treatment for alcohol, cocaine and opiate abuse. Integr Psychiatr 1986;6:199-204.

4). Benlhabib, et al. "Kudzu root extract suppresses voluntary alcohol intake and alcohol withdrawal symptoms in P rats receiving free access to water and alcohol." J Med Food. 2004 Summer; 7 (2): 168-179.

5). Babson, et al. "A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms." J of Behavior Therapy and Experimental Psychiatry. Vol 41, Issue 3; 297-303, Sept 2010.

6). Nathan, et al. "The neuropharmacology of L-theanine: a possible neuroprotective and cognitive enhancing agent." J Herb Pharmacotherapy. 2006; 6(2): 21-30.

For more by Maura Henninger, N.D., click here.

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