Alcohol is one of the most severe consequences of alcohol dependence is the withdrawal syndrome, for which benzodiazepines are the most popular current treatment.
- There are a number of disadvantages in using these agents (Benzodiazepines). This includes excessive sedation, delays in entering the long-term treatment of alcohol dependence
- Most importantly the development of dependence on the benzodiazepines. People dependent on alcohol are prone to secondary benzodiazepine abuse, although the exact extent or prevalence of such secondary addiction is not known.
(PAN) – Psychotropic Analgesis Nitrous Oxide
An alternative method to benzodiazepine employs psychotropic analgesic nitrous oxide (PAN)
- PAN has an excellent safety record, but can cause minor side effects such as nausea, vomiting, headache and dizziness.
- There appears to be a link between craving and relapse in patients who have a problem with substance abuse
- The treatment effectively eliminates or reduces alcohol craving in 98% of cases reporting craving.
The Air4Life Method is based on extensive research of Psychotropic Analgesic Nitrous Oxide (PAN) for treating alcohol withdrawal, with over 90,000 successful treatments
Dramatically reduces requirements for addictive sedative medications, greatly diminishing the dangers of secondary addiction.
Controlled Studies of Psychotropic Analgesis Nitrous Oxide treatment
In randomised controlled studies (Lichtigfeld 1989; Lichtigfeld 1989a; Gillman 2002; Gillman 2004), patients responding positively to PAN improved by 50% or more of an alcoholic withdrawal rating scale. More than 90% of patients that recovered within the first 60 minutes required no further gas exposure (Gillman 1991; Gillman 2002; Ojutkangas 1994). For this reason the PAN therapy would seem to offer an extremely rapid screening test to distinguish those patients requiring more intensive therapy, including in-patient therapy, when the rapid therapeutic response does not occur (Gillman 1990).
Effects of Interventions Outcomes
- PAN significantly favoured a positive response
- Difficult emotional swings: Anxiety, Depression, Guilt, Psychomotor functioning, Craving
- Eurological Screening Test (QNST) and found that the PAN was significantly better than the sedative group (WMD -8.71; 95% CI -13.71 to -3.71) (Analysis 1.3).
- There are some evidence that the PAN method leads to a more rapid amelioration of the withdrawal state than benzodiazepines (Gillman 2004) when the effects are measured with a withdrawal instrument measuring a composite range of different signs and symptoms.
- The rapidity of the response observed (Gillman 2004) support other work where the speed of the beneficial response of PAN after single exposure to the gas, within 60 minutes, with lasting effect was noted (Lichtigfeld 1982; Daynes 1989; Gillman 1990; Gillman 1991; Gillman 2002).
Other sedatives were seldom required after the fifth day of therapy, following a single 20 minute PAN exposure (on admission day only, in most cases) (De Rooster 1983; Gillman 1986a; Gillman 2004), it is possible that patients treated on an inpatient basis with PAN can be discharged earlier than those receiving benzodiazepines and other sedatives. The reduction in sedative requirements, in particular benzodiazepines, is advantageous because of the problems associated with secondary abuse of the benzodiazepines by alcoholic subjects (Gillman 1986a; Ross 1993; O’Brien 1996; Gillman 2002). Furthermore, the side effects of the benzodiazepines can be troublesome. These include syncope, confusion, motor incoordination resulting in accidents and oversedation (Gillman 1986a; Hobbs 1996).
Patient rapidity of the response to PAN and the limited reliance on sedative medications renders the patient more amenable to psychological manipulation, which has been shown to be of importance in the treatment of the alcohol withdrawal states (Madden 1979; Whitfield 1980; Lichtigfeld 1982; Gillman 1986a; Ntais 2006).
Discussion on Psychotropic Analgesis Nitrous Oxide
- In contrast, De Rooster 1983 demonstrated a statistically significant decrease in anxiety in the PAN group as compared to the benzodiazepine group over all testing times.
- De Rooster’s work (De Rooster 1983) also gives further support to the therapeutic effects of PAN in relieving anxiety in alcohol withdrawal states, which has been shown repeatedly in other stress provoking situations e.g. dentistry (Clark 1999).
- Mild to moderate alcohol withdrawal states usually peak at between 24-48 hours and tends to abate over the next day or so, even without therapy (O’Brien 1996; Shaw 1982) and thus one can expect the disappearance of effects at day seven.
Conclusions on Psychotropic Analgesis Nitrous Oxide
Implications for practice
- These results indicate that PAN may be a rapidly effective treatment of the mild to moderate alcoholic withdrawal state, with minimal sedative requirements.
- The rapidity of the therapeutic effect of the PAN therapy coupled with the minimal sedative requirements and concomitant sedation, may enable patients to enter the psychological treatment phase more quickly than those on sedative regimens, thus accelerating the patient’s recovery.
- Our review does not provide evidence neither does the review indicate any causes for concern that PAN is more harmful than the benzodiazepines. Clinicians wishing to use PAN may initially wish to do so within trial settings.