ALCOHOL-WITHDRAWAL - AN ADAPTATION TO HEAVY DRINKING OF NO PRACTICAL SIGNIFICANCE

Markedly differing views can be found among both clinicians and resear chers regarding whether alcohol withdrawal is a phenomenon of any prac tical or theoretical importance. Evidence has mounted that alcohol wit hdrawal, even in a severe form, is rarely life-threatening and the gre at majority of cases can be managed in non-medical settings, including the home. There is also a widely held view among clinicians that with drawal symptoms have little motivational significance and may be best regarded as but epiphenomena of prolonged heavy drinking. There are al so experimental data from both human and animal laboratory studies to the effect that withdrawal symptoms do not readily trigger further alc ohol consumption. Against this most unpromising background a case is p resented for alcohol withdrawal being but one manifestation of importa nt biological and psychological adaptive processes which occur almost whenever alcohol is consumed with any regularity. It is proposed that understanding this more general phenomenon is critical to a better und erstanding of the factors which maintain heavy and problematic drinkin g. Recent evidence also suggests that minor alcohol withdrawal symptom s are far more common in the general population than had previously be en realized, and that this has important implications for prevention p olicy.