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QUESTION
My cousin had an alcohol problem for 10 years. He got married and stopped drinking "cold-turkey," and for the two months since then, he has had a terrible headache. An MRI test and other exams have not found a cause; could this headache be due to his alcohol addiction?


ANSWER
Interesting and, I'm sure, a perplexing question. There are a number of known alcohol withdrawal syndromes (see Dr Bob, June 2004 for details); these, however, are time-limited and over within several days. A headache can be a part of these syndromes, but not at the current time. A prolonged abstinence (withdrawal) syndrome persists for some persons and may result in chronic anxiety, jitteriness, insomnia with some associated physical symptoms. In my experience however, headache is not severe during this time.

Hypertension (high blood pressure), occassionally unmasked by withdrawal, may trigger headache. Other issues which occur to me include a previous history of headache, for example a migraine history, which may now be more disabling in part because of the abscence of alcohol which covered the symptoms while drinking. Many alcoholics smoke and drink loads of coffee; if he stopped coffee or a medicine containing caffeine, a headache could result but, again, it should not be very severe 2 months later.

As a clinician, I must also wonder whether or not he is having trouble with his sobriety now? Perhaps he resents it, is angry about it, maybe wishing he could drink? Blaming the headache on his sobriety might prove a convenient excuse to resume drinking. If this is at all an issue, he should get to some recovery group meetings and/or consider contacting a counselor. One should never ignore a significant symptom, and if it persists, ongoing medical monitoring/study should continue.

Thanks and good luck!

Dr. Bob



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Dr. Bob does not provide specific medical advice or a medical diagnosis for any particular condition described, nor verify the authenticity of any information described in the questions presented. Patients should always consult their physician to discuss any specific symptoms, conditions, or modes of therapy for any particular mental or physical difficulties, diseases or conditions.

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