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Alcohol Withdrawal – Symptoms, Stages, Treatment and Prevention

alcohol withdrawal

What is Alcohol Withdrawal?

When you stop drinking for a while, your body experiences certain symptoms. The process happens if you’ve been drinking every single day within the last few months or years, and you suddenly stop or lower your drinking. Now, your body is used to the substance that you’ve been consuming, and your brain is used to the amount of alcohol you’ve been intaking. At the beginning, when people start consuming alcohol, they suppress the activity of the neurotransmitter that produces the feeling of relaxation. The more the person drinks, the more tolerant becomes. Consequently, the amount of alcohol, after a while, is not enough to trigger the initial feeling, so the person starts drinking more.

Also, heavy drinking suppresses the function of glutamate – the neurotransmitter that produces feelings of excitability. So, when the person quits drinking, within a couple of days – more or less – they will start to experience withdrawal symptoms. Alcohol withdrawal is the process when the alcohol starts to leave the body, the neurotransmitters relieve from the suppression, causing brain hyperexcitability. The symptoms of the withdrawal may vary from mild to more severe, and even life-threatening. It depends on the timeframe of the alcohol abuse, whether they are regular abusers and if they have any medical condition.

alcohol withdrawal

Symptoms of Alcohol Withdrawal

The symptoms may persist for two weeks and worsen within two or three days since the last intake. It’s important to know and recognize these symptoms because many people decide to go ‘cold turkey’, which is a sudden stop of drinking that can have a fatal outcome. Therefore, friends and family should be prepared for withdrawal symptoms if their loved one is a heavy alcoholic and has tried to quit several times. Alcohol detox takes a lot of lives annually because of alcohol withdrawal complications. Some of the symptoms of acute alcohol withdrawal include:

  • Shaky hands
  • Nausea
  • Mild anxiety
  • Sweating
  • Vomiting
  • Headache
  • Insomnia
  • Mood swings
  • Irritability
  • Nightmares
  • Fatigue
  • Confusion

alcohol withdrawal symptomsRecognize the stages

The process of withdrawal goes through three stages. Every patient does not go through each stage. The symptoms lose their effect after 5-7 days, except if the person is a heavy drinker and develops the most severe manifestation – Delirium Tremens. Even if that is not the case, and the person has been drinking excessively, the symptoms may continue a few months after the acute withdrawal ends.

Stage 1

The first stage starts approximately 6-8 hours after the last drink. It is characterized by symptoms such as anxiety, insomnia, tremor, and abdominal pain. These symptoms are mild and you can recognize them when you start losing your appetite or feel dizzy.

Stage 2

The second stage starts 24-72 hours after the last drink. The symptoms include increased body temperature, confusion, increased heart rate and high blood pressure.

Stage 3

The third stage starts after 72 hours after the last drink and includes symptoms such as fever, hallucinations – which are not severe as in delirium tremens because the patient is aware what causes the hallucinations – also, seizure and agitation.

alcohol withdrawalStage 4 – Delirium Tremens

Delirium tremens is the most serious type of alcohol withdrawal. According to New England Journal of Medicine delirium tremens occurs in only 3-5 percent of individuals, and if left untreated, can be fatal. Delirium tremens might start after two or three days after the last drink. Usually, it happens without any warning and can expand quickly. If you or someone you know experiences this kind of symptoms, immediately call for help! The symptoms are very serious and include:

  • Fever
  • Hallucinations (in this stage, the patients aren’t aware of their surrounding and start seeing things that don’t exist. These hallucinations are more intense than the ones in the third stage). The hallucinations can include a sense of numbness, itching, burning, and hearing or seeing images that don’t exist.
  • Severe confusion
  • Seizures
  • Extreme agitation

Post-Acute Withdrawal Syndrome (PAWS)

Not all alcohol abusers experience the syndrome. It usually starts after the initial alcohol withdrawal symptoms subside. Consequently, PAWS lasts from a few weeks to one year. It depends on the severity of the acute withdrawal symptoms and can include anxiety, fatigue, dizziness, delayed reflexes, insomnia, memory issues, and irritability.

Can you prevent alcohol withdrawal?

People that drink alcohol excessively are in the major risk group of alcohol withdrawal. A mild withdrawal can happen after a night of drinking, including, headache, vomiting, and dehydration. In this case, one prevents alcohol withdrawal by avoiding heavy drinking. For alcoholics, alcohol withdrawal can be avoided by gradually decreasing the alcohol dependence and get to the final goal of quitting. Accordingly, the person can have several abstinence days every week or drink every day and not exceed the standard drink per day.

Studies show that “oral benzodiazepines are the best-assessed drugs for preventing a severe alcohol withdrawal syndrome, particularly the risk of seizures. When given for a maximum of 7 days, the adverse effects are usually mild.”

alcohol withdrawal

Alcohol Withdrawal Treatment Approach

The goal of the treatment is to reduce the intensity of the withdrawal symptoms, prevent complications, and provide adequate therapy.

People with more severe symptoms might need inpatient treatment at a facility that treats alcohol withdrawal. After arrival, patients are watched closely, the medical staff monitors their blood pressure, body temperature, and heart rate. The staff checks the patient’s blood levels of alcohol and other chemicals. Depends on the type of hospital, the person might be medicated (sedated) until the end of the withdrawal.

If the person experiences mild to moderate symptoms, they can be treated in their home (outpatient treatment), by having someone to supervise. They’ll be required to visit the medical facility daily, get regular blood tests, medications to ease symptoms, and enroll in family counseling. Therefore, families need to be extremely supportive and create an environment where the person feels accepted.

Part of the treatment includes attending sober facilities, support groups, such as:

The combination of family counseling, support groups, and group and individual therapy is crucial for the alcoholics’ recovery and relapse prevention. After the withdrawal is over, symptoms such as mood swings, fatigue, or sleep changes may last for months.

alcohol withdrawalImportant things to remember:

  • If you have been using alcohol for a long time and suddenly stop, please visit your health care provider. In case you start experiencing withdrawal symptoms, you are at risk of developing delirium tremens, which is a serious condition that may end up fatal.
  • If you see a loved one develop symptoms described above, please call the healthcare provider. Many people are not aware of the seriousness of the situation and the complications that can happen.
  • If you want to stop drinking or reduce alcohol intake, please consult your healthcare provider. The alcohol abuse or eventual dependence sometimes contribute to developing a medical condition that needs immediate attention.

For more information please call our Addiction Treatment Helpline at (844) 439-4765. This is a Free and completely confidential call. We are available 24/7. In many cases, your health insurance company will cover 100% of the treatment cost. So please call now.

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