Alcohol Withdrawal Symptoms

By Kayla Loibl | Last Edited: November 04, 2020 | 4 Sources

Signs of Alcohol Withdrawal
Alcohol Withdrawals
Treatment for Alcohol Withdrawals
Severe Alcohol Withdrawal

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Alcohol Withdrawal Symptoms

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Learn the possible complications of alcohol withdrawals, as severe alcohol withdrawal can be fatal

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Alcohol withdrawal is the different changes a person’s body goes through when he or she suddenly stops drinking alcohol after heavy and prolonged alcohol use.

The process of cleaning the body from the alcohol substance to overcome its addiction is called alcoholism detox. Detox is the first (necessary) step in overcoming alcohol dependence. 

Not everyone who stops drinking experiences withdrawal symptoms, but most people who have been drinking a high quantity for an extended period of time will experience some form of withdrawal symptoms if they stop drinking suddenly.

Understanding the alcohol withdrawal symptoms that may follow the short term and long term stopping of drinking is critical for avoiding unnecessary complications and dangers. For more on the treatment of alcohol withdrawals read Diazepam and alcohol withdrawals.

The Severity Of Alcohol Withdrawal...

The severity of alcohol withdrawal symptoms depends on various factors including age, genetics, and, most importantly, degree of alcohol intake, length of time the individual has been misusing alcohol and number of previous alcohol detoxes.

The period of time in which the symptoms occur and peak range from 5 - 10 hours after the last drink (drinkers in the early stages of alcoholism) up to 48 - 72 hours (for alcoholics in the advanced stages) and may persist for weeks and even months. 

 

Mild to Moderate Psychological Symptoms

• Anxiety or nervousness
• Depression
• Difficulty thinking clearly
• Fatigue
• Irritability or easy excitability
• Jumpiness or shakiness
• Nightmares
• Rapid emotional changes
• Anxious

Mild to Moderate Physical Symptoms

• Clammy skin
• Enlarged (dilated) pupils
• Headache
• Insomnia - Sleeping difficulty
• Loss of appetite
• Nausea and vomiting
• Pallor - An abnormal loss of color from normal skin
• Rapid heart rate
• Sweating
• Tremor of the hands or other body parts

The Severe Alcohol Withdrawal Symptoms

• Agitation - An unpleasant state of extreme arousal (stirred up or excited), increased tension, and irritability. May also be easily confused
• Delirium Tremens - Withdrawal has a wide range of symptoms starting from mild tremors to a severe condition called delirium tremens. This condition results in in seizures and could even progress to death if not identified and treated promptly. It is a state of severe confusion, visual hallucinations, physical shaking, high blood pressure.
• Fever
• Alcohol Withdrawal Seizures - The physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. Alcohol seizures can lead to serious complications such as death.

Alcohol Withdrawal Symptoms

Prolonged Alcohol Withdrawal

Prolonged alcohol withdrawal syndrome occurs in many alcoholics where alcohol withdrawal symptoms continue beyond the acute withdrawal stage (the first 72 hours) but usually at a sub-acute level of intensity and gradually decreasing with severity over time.

Some withdrawal symptoms can linger for at least a year after discontinuation of alcohol. Symptoms can include:

• Craving for alcohol.
• Inability to feel pleasure from normally pleasurable things (also known asanhedonia).
• Clouding of sensorium.
• Disorientation
• Nausea and vomiting or headache.
• Insomnia

In addition to the amount of alcohol consumed and the duration of the alcohol intake just before cessation of drinking - a history of withdrawal episodes appears to be a critical factor in the intensity of withdrawal symptoms.

The Kindling Graph

Many alcoholics experience numerous withdrawal episodes during the course of their illness. This is a common characteristic of a chronic and progressive disease. Kindling is the phenomenon where repeated alcohol detoxifications lead to an increased severity of the alcohol withdrawal symptoms.

For example, binge drinkers may initially experience no alcohol withdrawal symptoms but with each period of resumption of drinking followed by abstinence, their withdrawal symptoms intensify in severity and may eventually result in full blown delirium tremens with convulsive alcohol withdrawal seizures.

This effect can also be observed in those who fall into the advanced alcoholic category.

 

Given the high rate of regressions among alcoholics, each withdrawal episode may perhaps best be viewed not as an isolated event but as part of a potentially long-term process that can lead to dangerous exacerbation of withdrawal symptoms with each subsequent episode.

The harsh reality is that alcohol relapses are a common experience. Addiction research has shown that 50%-90% of alcoholics relapse.

 

Treatment for Alcohol Withdrawals

If alcohol withdrawal symptoms are not treated correctly or in time - they may rapidly become life threatening.

Call your health care provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Do not minimize symptoms you are experiencing. Doing so, would interfere with your health care provider’s ability to identify an appropriate course of action.

Call for an appointment with your health care provider if symptoms persist after treatment. Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur.

It is essential that you only attempt to withdraw from alcohol under medical supervision. This which will help you relax ensuring that you do not have alcohol withdrawal anxiety and, more importantly, you don't suffer from alcohol withdrawal seizures which can be fatal.

Detoxification means weaning a patient from a psychoactive substance in an effective and safe manner by progressively removing the dependence producing substance.

There are three treatment options when considering detoxification:

1. Outpatient Detox- This would be appropriate for individual who fall into the low and moderate risk level for withdrawal symptoms. These individuals would be seen by their provider with frequent check-ups. Your provider may provide medications that would ease the symptoms of withdrawal.

2. Medically Monitored Detox- This option would be appropriate for individuals who fall into the moderate to severe risk level of withdrawal. This option would include being in a medical facility for a brief period of time, around 24 hours, while being consistently monitored by medical doctors as well as nurses. Again, medications would likely be provided to ease the symptoms of withdrawal.

3. Medically Managed Inpatient Detox- This option would be appropriate for individuals who fall into the sever risk level of withdrawal. Individuals who are at risk of severe withdrawal, or those who suffer from concurrent serious psychiatric or physical disorders, or who do not have adequate support, should ideally be managed in an inpatient setting. This option would include staying in an inpatient setting, possibly a rehabilitation center, for several days. Common medications that may be used for individuals at this level of risk include:

· Anticonvulsants

· Antinausea medications

· Blood Pressure medications

· Sedatives to help reduce anxiety

· Benzodiazepines

 

Options After Detox

After a person completes detox, the automatic question is what now?

There are several options available, which can accommodate those who are willing to stop drinking and those who are not. It is important to be honest with oneself about their motivation for recovery. There are two forms of motivation; internal and external.

• Internal motivation could be a person wanting to be healthier, to improve relationships, improve job functioning. 
• External motivation would be outside factors such as pending legal concerns, being told they could lose their job if they continue and if a spouse threatens to leave if something doesn’t change.

For those who are not ready to stop drinking, they may consider a harm reduction approach. Further information about this can be located throughout this guide.

From a clinical stand point, if a person experiences alcohol withdrawal, one could assume that they have seen negative impacts of their drinking on their physical health and other areas of their life. If this is true, it may be time to begin considering a sober lifestyle.

A common recommendation for individuals after completing detox programs is a rehabilitation program. The hope for these programs is that a person will come out with a better understanding of addiction, addictive behaviors, their triggers and have a better idea of how to cope. For individuals with co-occurring mental health concerns, psychotherapy may be a healthy option as this likely had an impact on their drinking behaviors.

Recovery, similarly to addiction, looks different for every alcoholic. Options for approaches to recovery and further information on treatment options can be located throughout this website.

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