Alcohol Withdrawal: Learn the Symptoms and Signs

Following successful completion of detox, an inpatient or outpatient rehabilitation program may be recommended to allow further work toward recovery and relapse prevention. Most alcohol abusers who are having withdrawal symptoms have a shortage of several vitamins and minerals and can benefit from nutritional supplements. In particular, alcohol abuse can create a shortage of folate, thiamine, magnesium, zinc and phosphate. Edward M. Sellers, https://ecosoberhouse.com/article/13-actionable-tips-to-stay-sober-at-different-times/ MD, PhD, FRCPC, FACP, is the president and principal of DL Global Partners Inc., which specializes in clinical psychopharmacology and pharmacogenetics for substance abuse. He is also professor emeritus at the University of Toronto and helped establish its clinical psychopharmacology unit. Dr. Sellers has received several awards for his research in pharmacology and drug dependence, including the Rawls-Palmer Award given by the ASCPT.

As a result, the brain so continues to produce stimulating neurotransmitters. Because alcohol is legal to consume and socially acceptable, physical and psychological dependence can develop quickly. People may drink heavily in the normal course of one’s social engagements. Since alcohol is socially acceptable, people may not view their drinking as problematic. So, alcohol detox and withdrawal information are vitally important for individuals (and their loved ones) struggling with alcohol addiction. A doctor or other treatment professional may evaluate for the above factors prior to making a recommendation for the level of detox care and detox timeline needed to keep a person safe and comfortable.

What Is Alcoholism?

If the alcohol is withdrawn suddenly, the brain is like an accelerated vehicle that has lost its brakes. Not surprisingly, most symptoms of withdrawal are symptoms that occur when the brain is overstimulated. An important concept in both alcohol craving and alcohol withdrawal is the “kindling” phenomenon; the term refers to long-term changes that occur in neurons after repeated detoxifications. Recurrent detoxifications are postulated to increase obsessive thoughts or alcohol craving.5 Kindling explains the observation that subsequent episodes of alcohol withdrawal tend to progressively worsen. Hospitals and detox centers have experienced staff who are familiar with these symptoms and have the tools to provide appropriate treatment. Excessive drinking is defined by the CDC as heavy drinking, binge drinking, or drinking that’s done by anyone who is pregnant or under the age of 21.

Management of patients today is potentially more complicated than it was when the CIWA-Ar was developed because of a very high incidence of other drug abuse. Detailed histories, careful clinical examination, and urine drug screens can help sort out more complex patients. The CIWA-Ar is a shortened version of a previous 15 item scale CIWA (see Sullivan 1989).

Take control of your life

While the journey includes many other steps, they can’t be completed until this first one is completed. The recovery can’t move forward until a person has reduced their physical dependence and overcome the alcohol withdrawal symptoms. Even a casual drinker will experience the symptoms of alcohol withdrawal after having a few drinks.

Alcohol withdrawal is common, but delirium tremens only occurs in 5% of people who have alcohol withdrawal. Delirium tremens is dangerous, killing as many as 1 out of every 20 people who develop its symptoms. If you have an alcohol dependency problem and have decided to stop drinking, call your doctor for help. Your doctor can advise you and can prescribe medicines to make withdrawal symptoms more tolerable if they occur. Your doctor can also put you in touch with local resources that will help you to stay alcohol free.

alcohol withdrawal seizures

The main inhibitory neurotransmitter is γ-amino-butyric acid (GABA), which acts through the GABA-alpha (GABA-A) neuroreceptor. One of the major excitatory neurotransmitters is glutamate, which acts through the N-methyl-D-aspartate (NMDA) neuroreceptor. Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss…from exercises to build a stronger core to advice on treating cataracts. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts.

A “new normal”—physically and psychologically—will be established over the next few weeks. For most people going through detox, alcohol withdrawal symptoms will begin within the first eight hours. For individuals who experience delirium tremens (DTs)—these symptoms usually appear hours after heavy drinking has ceased. If you have a sibling or parent with alcoholism, then you are three or four times more likely than average to develop alcoholism. Some people with family histories of alcoholism choose to abstain from drinking since this is a guaranteed way to avoid developing alcohol dependence.

Treatment of Alcohol Withdrawal Syndrome

Call for an appointment with your provider if symptoms persist after treatment. This depends on the individual and the results of laboratory tests that their doctor may order. In general, blood work will test serum magnesium, and replacements will occur if indicated. The person should also try to eat three well-balanced meals per day and drink enough water to remain hydrated. When this happens, your central nervous system can no longer adapt easily to the lack of alcohol. If you suddenly stop drinking or significantly reduce the amount of alcohol you drink, it can cause AWS.

• Patients who do not respond adequately to benzodiazepine therapy, who miss an appointment, or who resume drinking should be referred to an addiction specialist or inpatient treatment program.
• It’s also possible, however, for withdrawal symptoms to continue for several weeks.
• The most dangerous form of alcohol withdrawal occurs in about 1 out of every 20 people who have withdrawal symptoms.
• Screening patients for alcohol misuse can be eye-opening and beneficial for some patients in changing their drinking habits before any complications such as alcohol withdrawal syndrome (AWS) arise.
• Treatment providers are available 24/7 to answer your questions about rehab, whether it’s for you or a loved one.
• Alcohol withdrawal syndrome affects nearly two million Americans each year.

The majority of people experience a full recovery from alcohol withdrawal symptoms. Some people continue to have disruptive symptoms known as post-acute withdrawal for months such as difficulty sleeping, fatigue, mood swings, and fatigue. If you’ve been regularly drinking excessively, when you stop drinking all of a sudden, you may experience one or more alcohol withdrawal symptoms. Depending on your past alcohol use, these symptoms can range from mild and uncomfortable to severe and potentially life-threatening. Alcoholism is a very serious addiction, and it can be very difficult to overcome. This is especially true during alcohol withdrawal, a potentially dangerous time that should be monitored by medical professionals.

Benzodiazepines, the agents of choice, may be administered on a fixed or symptom-triggered schedule. Carbamazepine is an appropriate alternative to a benzodiazepine in the outpatient treatment of patients with mild to moderate alcohol withdrawal symptoms. Medications such as haloperidol, beta blockers, clonidine, and phenytoin may be used as adjuncts to a benzodiazepine in the treatment of complications of withdrawal. Treatment of alcohol withdrawal should be followed by treatment for alcohol dependence. Over the course of the first few days and weeks after someone stops drinking alcohol, he or she may experience acute alcohol withdrawal symptoms. Acute alcohol withdrawal syndrome refers to the common withdrawal symptoms a heavy drinker experiences when they suddenly reduce the amount of alcohol they drink after prolonged periods of heavy use.

• This phase is less common and is known as post-acute withdrawal syndrome (PAWS).
• On average, an alcoholic who doesn’t stop drinking can expect to decrease his or her life expectancy by at least 15 years.
• If your home environment is not supportive for staying sober, talk with your doctor.
• For patients without support, a social worker should be involved to help facilitate addiction rehabilitation.
• The prognosis often depends on the severity of alcohol withdrawal syndrome.

Additionally, some may cause reactions when used in combination with other alcohol treatment medications. For these reasons, they should only be taken under the supervision and prescription of a licensed medical professional; an inpatient alcohol detox and rehabilitation setting may be best. However, Benzodiazepines are frequently prescribed successfully in outpatient settings as well. Dizziness is one of the more common withdrawal symptoms in alcohol addiction. It is during the initial stages of withdrawal that people may go into a state where they experience feelings of disorientation and vertigo. This can occur because the body is not able to regulate blood pressure and heart rate well enough to function normally.

When in doubt about whether the patient truly has alcohol withdrawal symptoms, the patient should be thoughtfully re-assessed. The clinical presentation consists of a spectrum of signs and symptoms, including autonomic hyperactivity, tremulousness, restlessness, seizures, and potentially life-threatening alcohol withdrawal delirium. The safest way to address alcohol abuse and begin detox is to consult with a medical professional or seek professional treatment. When speaking with your medical professional about how to detox from alcohol, they will tell you it’s the first step of a comprehensive rehab program. If you are facing withdrawal symptoms, you should address the root of the problem by getting professional help and undergoing treatment after detox.