What Causes Alcohol Withdrawal?
People who drink heavily over an extended period of time develop a tolerance to alcohol. When this happens, an individual has to drink more and more to feel alcohol’s effects. Eventually, someone with a tolerance to alcohol can develop a physical and mental dependency on it. This means that a person must then constantly drink to prevent withdrawal. The symptoms of alcohol withdrawal can be intense and even deadly. Because of this, medically-supervised detox is always recommended for alcohol withdrawal
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Alcohol Withdrawal Symptoms
Symptoms of withdrawal can be psychological and physical. How much, how often and for how long someone consumed alcohol impacts their withdrawal symptoms. People who drink often and a lot experience the most extreme withdrawal symptoms.
Common symptoms include:
- Nausea and vomiting
- Rapid heart rate
- Changes in body temperature
- Appetite loss
- Mood swings
- Cognitive issues
Delirium tremens is a severe form of alcohol withdrawal that causes confusion, tremors and hallucinations.
Delirium tremens is most common in people who drink the equivalent of one pint of liquor every day for several months.
Delirium tremens are life-threatening. It can cause heart problems and fatal injuries from sudden seizures. Seizures may occur 12 to 48 hours after stopping drinking. Approximately 1 out of every 20 people who experience withdrawal will suffer from delirium tremens.
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Factors that Influence Alcohol Withdrawal
Whether or not an individual experiences alcohol withdrawal, and the severity of symptoms they experience, is determined by a number of factors. These factors include:
- Duration of alcohol abuse
- Severity of alcohol abuse
- Going “cold-turkey” vs tapering off
- Body weight
- Underlying mental health concerns
- Abuse of other substances
Duration of Withdrawal
The first symptoms of withdrawal usually appear within the first 5 to 10 hours after the last drink. Tremors or shakes are common first signs of withdrawal. In severe cases, seizures and hallucinations follow.
Alcohol withdrawal is the worst a day or two after the last drink. Symptoms start subsiding throughout the following week.
Physical symptoms taper off sooner than psychological ones do. Long-term effects can last for months or even years after the last drink. These may include sleep disturbances or lingering depression.
Alcohol Withdrawal Timeline
|First 12 hours||Heavy drinkers experience tremors a few hours after their last drink. Symptoms during the first 12 hours include sweating, irritability, rapid heartbeat, high blood pressure, nausea, vomiting and insomnia.|
|Days 1-2||Symptoms peak 24 to 48 hours after the last drink. Symptoms are most severe and may include seizures, night terrors, hallucinations and panic attacks.|
|Days 3-5||Ongoing feelings of nervousness, shakiness and mood swings can last up to a week after the last drink. Delirium tremens may occur during this time as well.|
|Days 6+||After detox, some former heavy drinkers experience longer-lasting effects of withdrawal. Symptoms are mostly psychological. They may include mood swings, anxiety, irritability, changing levels of energy and trouble sleeping. These symptoms come in waves and can last for months after the last drink.|
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Detox returns a heavy drinker’s system to normal after extended alcohol abuse. People who have been drinking heavily for a long time may experience intense side effects from detox. It is important to detox from alcohol under the supervision of a medical professional. Medical detox ensures careful monitoring and supervised medication when needed.
In the cases of long-term alcohol abusers, detoxing “cold turkey” can be dangerous and even fatal.
Although rare, some of the severe side effects of alcohol detox include heart arrhythmias, seizures, kidney or liver dysfunction, and hallucinations.
Medications Used in Detox
Keeping the patient’s system in balance and preventing complications is a major part of alcohol detox. Sometimes prescribed medications from a medical professional are necessary to do this.
Medications used during detox include drugs that prevent seizures, reduce cravings and treat co-occurring disorders. Benzodiazepines, or “benzos,” are one type of drug that reduces psychological withdrawal symptoms, such as anxiety. Sedation with benzos, including Librium, Valium, and Ativan, allows people to detox without the risk of seizure. Anticonvulsants or anti-seizure medications, such as Keppra, may also be used in addition to benzodiazepines.
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Treatment for Alcohol Addiction
Detox is the first step in treating an alcohol addiction. Alcohol treatment centers create healthy environments for detox and withdrawal as part of an inpatient rehabilitation program. Outpatient detox is also an option for those with a mild alcohol addiction. Outpatient clinics provide medications and support during the withdrawal period. After detox, ongoing therapy and support groups can help recovering alcoholics learn how to cope without alcohol.
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