Primary Addiction Medicine Care of Connecticut well recognizes that active addiction and early recovery may induce temporary derangements in blood pressure, cholesterol, and blood sugar control.

We can diagnosis these problems and offer an approach focused on treating the underlying cause of the metabolic derangement rather than treat the derangement itself.  In medicine, this is the philosophy of treating the underlying etiology of disease and not just one of the manifestations.

For example, a patient with active alcohol addiction may have very high Triglycerides of 400 mg/dL and a high bad LDL cholesterol of 150 mg/dL.  The solution would not be to treat high cholesterol parameters with a statin medication but rather treat the alcohol use disorder.   Once the patient achieves sobriety the cholesterol profile would most likely normalize, saving the patient from unnecessary medication.

Or that same patient with alcohol addiction, may have Hypertension (HTN) in acute alcohol withdrawal, which is a transient, self-limited phenomenon caused by sympathetic nervous system hyperactivity, usually occurring 6–24 hours after stopping heavy alcohol intake. It is commonly accompanied by tachycardia, sweating, and agitation, often resolving within 3 days as withdrawal stabilizes.

Key Aspects of HTN in Acute Withdrawal

  • Pathophysiology: Abrupt cessation of alcohol (a depressant) leads to a sympathetic “rebound” effect, causing increased heart rate, vasoconstriction, and blood pressure elevations.
  • Timeframe: Hypertension typically peaks in the first 24 hours of withdrawal and often resolves on its own or through detoxification treatment within 3-5 days.
  • Management:
    • Benzodiazepines: These are the first-line treatment as they treat the underlying withdrawal syndrome (agitation, tremor) and secondarily manage hypertension.
    • Adrenergic Blockers: Clonidine or beta-blockers may be used for symptom management, particularly for tachycardia and high blood pressure

During our initial screenings, we do occasionally identify underlying chronic conditions that necessitate evaluation and management by a primary care provider. We are not primary care providers and do not offer chronic care management.

For instance, should we detect a new diagnosis of uncontrolled diabetes, it is in the patient’s best interest to ensure access to the comprehensive resources available through primary care practice or a patient-centered medical home.

Patients with chronic conditions (e.g. hypertension, diabetes, coronary artery disease, COPD/emphysema, peripheral vascular disease) or those needing long-term prescriptions must establish a PCP to participate in our addiction services.