Understanding Alcohol Withdrawal Symptoms: Recognizing Risks and Effective Management

InnerBalance Health Center

April 5, 2024

Alcohol withdrawal symptoms can range from mild discomfort to life-threatening conditions, posing significant risks to individuals with alcohol use disorder (AUD). This expert article delves into the spectrum of alcohol withdrawal symptoms, their underlying mechanisms, risk factors, and strategies for effective management. By enhancing awareness and knowledge, healthcare professionals and caregivers can better support individuals navigating through alcohol withdrawal.

Table of Contents:

  1. Where do alcohol withdrawal symptoms come from?
  2. Alcohol withdrawal symptoms – what causes them?
  3. Alcohol withdrawal symptoms – who is at risk?
  4. What are the symptoms of alcohol withdrawal?
  5. When do alcohol withdrawal symptoms appear?
  6. Alcohol withdrawal symptoms vs. possible complications
  7. Alcohol withdrawal symptoms vs. diagnosis
  8. How to treat alcohol withdrawal symptoms?
  9. How to diagnose alcohol withdrawal?
  10. How to deal with alcohol withdrawal symptoms?

Summary:

  • Alcohol withdrawal symptoms occur after the cessation of long-term and heavy alcohol consumption.
  • During the first days of alcohol withdrawal by an alcoholic, we may have elevated blood pressure, headaches, accelerated heartbeat, or dizziness. Seizures, vomiting, nausea, nausea, abdominal pain, and trouble sleeping compound this.
  • Many alcoholics also complain of memory lapses, trouble concentrating, hallucinations, delusions, alcoholic hallucinosis, delirium, and to top it off, psychomotor agitation.
  • The body of an alcohol-dependent person needs time to adapt to functioning without alcohol.
  • The most vulnerable to severe alcohol withdrawal symptoms are daily drinkers and alcoholics.
  • Alcohol withdrawal symptoms can be divided into mild, severe, and life-threatening symptoms.

Where do alcohol withdrawal symptoms come from?

According to a 2015 article published in the scientific journal Drugs, alcohol withdrawal symptoms refer to the physical and psychological effects a person feels after stopping long-term and heavy alcohol consumption. People who abruptly stop drinking, or try to cut down on the amount of alcohol they consume, may struggle with alcohol withdrawal symptoms because the body needs time to get used to functioning without alcohol.


This can then be referred to as alcohol withdrawal syndrome. Depending on how long a person has been drinking alcohol and how much they usually drink, the severity of symptoms can range from mild to severe. Worse, alcohol withdrawal symptoms can lead to life-threatening health complications. Therefore, those trying to quit drinking are strongly advised to seek professional care at a specialized rehab facility, as withdrawal can be extremely difficult and dangerous.

Alcohol withdrawal symptoms – what causes them?

When a person drinks alcohol for a long time, and then stops, his body will react to the lack of alcohol. It should be noted that, according to researchers, chronic drinking of alcohol causes changes in brain chemistry. The idea is that alcohol has a calming effect, so the body responds by producing more stimulant chemicals, including the neurotransmitters dopamine and gamma-aminobutyric acid (GABA).


According to a 2015 study published in the Journal of Clinical and Diagnostic Research, a temporary chemical balance is then restored to counteract the effects of long-term alcohol consumption on the brain. Unfortunately, over time the body becomes resistant to alcohol and such a person may have to drink more and more to get the same effect. At the same time, the brain produces more and more neurotransmitters, further exacerbating the imbalance. Then, if such a person quits alcohol, there is a period in which his brain has not yet received the message about this and continues to produce excessive production of stimulating chemicals. However, already without alcohol, the aforementioned substances lead to the development of withdrawal symptoms.

Alcohol withdrawal symptoms – who is at risk?

It should be noted that alcohol withdrawal symptoms can occur in anyone, but they are usually related to the degree of alcohol dependence. Those most at risk are alcohol abusers who drink regularly on any occasion.

Delirium Tremens (DTs; lit. ‘shaking frenzy’) stands as one of the most perilous symptoms associated with alcohol withdrawal. Without prompt diagnosis and immediate treatment from a physician, it poses a significant risk of fatality for the patient. While relatively rare, with less than a 1% occurrence in the general population, its prevalence spikes to nearly 2% among individuals struggling with alcohol addiction according to a 2018 study published in the Journal of Clinical and Experimental Hepatology.

DT manifests as a blend of severe alcohol withdrawal symptoms coupled with delirium, often accompanied by agitation and occasional hallucinations. It presents with a swift onset and an unpredictable trajectory, impacting levels of consciousness, cognition, motor function, and sleep patterns. Notably, individuals with alcohol-induced liver disease frequently experience DT, which plays a pivotal role in guiding treatment decisions and influencing overall outcomes.

Researchers agree that daily drinkers and alcoholics are most likely to experience severe alcohol withdrawal symptoms and alcoholic mayhem. Interestingly, however, for each such person, alcohol withdrawal symptoms can be different.

How do you recognize that a person may be suffering from alcoholism?

Three things can usually be noticed in such a person.

  • First, the person cannot stop drinking, despite the negative impact it may have on his or her relationships, health, work, school and other areas of life.
  • Second, the person’s alcohol tolerance has increased, so he or she has to drink more to get the same effect.
  • Finally, thirdly, the person finds it hard to think about anything other than alcohol.

What are the symptoms of alcohol withdrawal?

Alcohol withdrawal symptoms can be generally divided into mild symptoms and severe and life-threatening symptoms.

Mild alcohol withdrawal symptoms include:
anxiety;
feelings of anxiety;
brain fog;
depression;
fatigue;
headaches;
insomnia;
irritability;
tremor (mild to moderate);
nausea;
nightmares;
night sweats.

In contrast, severe alcohol withdrawal symptoms include:
dilated pupils;
increased agitation;
accelerated heart rate;
loss of appetite;
nausea and vomiting;
pallor;
severe shaking;
sweating;
trembling of the hands or other parts of the body.

Symptoms of alcoholic mayhem include severe alcohol withdrawal symptoms and a sudden and severe change in mental state resulted in:
Arrhythmia (irregular heartbeat);
fever;
hallucinations;
sensitivity to touch, light and/or sound;
severe agitation.


To make matters worse, alcoholic delirium may lead to death, so if you weigh the symptoms of this disorder, you should go to the emergency room immediately. A person with alcoholic mayhem must be hospitalized until the symptoms are under control. [CTA]

When do alcohol withdrawal symptoms appear?

Alcohol withdrawal symptoms can also be divided according to the time that has elapsed since the person stopped drinking. It should be noted, however, that these symptoms and the time they appear can vary from person to person, as factors such as the level of alcohol dependence play a role.

Alcohol withdrawal symptoms within 8 hours
According to researchers, alcohol withdrawal symptoms usually appear within the first eight hours after drinking the last portion of alcohol. These symptoms are also usually mild and appear gradually. They may include:
feelings of restlessness;
moist or pale skin;
irritability;
nervousness;
loss of appetite;
tremor;
nausea.

Alcohol withdrawal symptoms within the first 24 hours
Symptoms between 12 and 24 hours after the last drink of alcohol are usually more noticeable. They, too, may be mild, but earlier symptoms at this stage may worsen. These symptoms may include:
mood swings;
night sweats;
nightmares;
depression;
brain fog;
headaches or migraines;
insomnia;
vomiting.
Interestingly, some people may experience alcohol withdrawal symptoms of hallucinations just at this stage.

Alcohol withdrawal symptoms in the first 24 to 72 hours
According to experts, within the first 24 to 72 hours of alcohol withdrawal, symptoms can reach their peak. At this stage, expect the most severe symptoms, which may include:
nausea;
vomiting;
tremors;
excitement;
hallucinations.
Alcoholic delirium can also develop during this period, so it is best for the person who has decided to quit alcohol to be under the constant care of a doctor in case immediate medical attention is required.

Alcohol withdrawal symptoms in the first 3 days
It is understood that alcohol withdrawal symptoms usually begin to subside after three days. If this does not happen after this time, it is advisable to contact a doctor.
This is a particularly important stage, because people who have a problem with alcohol, and who have already felt better, may underestimate the earlier symptoms and, in effect, start drinking again. Therefore, it is at this point that the patient should try hardest not to drink alcohol. Specialists recommend making a list of reasons for alcohol withdrawal and the difficulties associated with it while they are still “fresh” in the mind.

Symptoms of alcohol withdrawal in the first few weeks
Although it has been a long time since alcohol withdrawal, for some people, alcohol withdrawal symptoms can persist for many weeks. When this happens, he says, it’s called post-acute withdrawal syndrome (PAWS), which symptoms include:
anxiety;
cognitive dysfunction;
desire to drink alcohol;
depression;
fatigue;
irritability;
sleep disturbances.

It should be added that the symptoms of PAWS subside gradually over time. According to a study published in 2021 in JAMA Psychiatry, the first weeks after alcohol withdrawal are the most difficult, as the risk of relapse is greatest then.


What are the Complications of Alcohol Withdrawal?

According to specialists, sudden alcohol withdrawal can be extremely dangerous and even fatal! Moderate or heavy drinkers can usually withdraw from alcohol on their own, but in the acute phase of withdrawal, complications can occur.
Therefore, people who drink daily or almost daily should not be left alone for the first few days after quitting alcohol. Alcohol withdrawal symptoms can quickly turn from a hangover into a serious medical situation. It is advisable to consult a doctor if you are withdrawing from alcohol or experiencing more severe withdrawal symptoms.
However, if you develop symptoms such as high blood pressure, accelerated heart rate, repeated vomiting, severe headache, tremors, or a strong need to drink alcohol, you should contact your doctor as soon as possible. If symptoms such as fever, hallucinations or irregular heartbeat develop, call an ambulance or go to the emergency room.

What are the complications of alcohol withdrawal for the partner of an addict?

We would like to touch on one more thing related to how the struggling addict affects those around him. This is a topic that is often silenced or overlooked and such people also often require psychological help to persevere through this difficult period and to be a support for the addict. For the partner of an addict, the complications of alcohol withdrawal can be multifaceted and emotionally taxing.

Here are some potential complications:

  • Emotional Distress: Witnessing a loved one go through alcohol withdrawal can evoke feelings of anxiety, fear, frustration, and helplessness. The uncertainty surrounding the severity of withdrawal symptoms and the duration of the recovery process can exacerbate these emotions, leading to significant stress for the partner.

  • Relationship Strain: Alcohol withdrawal can strain relationships as the partner may struggle to understand and cope with the addict’s symptoms and behaviors. Communication breakdowns, conflicts, and feelings of resentment or abandonment may arise, further complicating the dynamics of the relationship.

  • Caregiver Burden: Partners often take on the role of caregivers during alcohol withdrawal, providing physical and emotional support to their loved one. This responsibility can be overwhelming, especially if the partner lacks the necessary resources, knowledge, or support system to effectively manage the challenges of withdrawal.

  • Codependency: In some cases, partners may develop codependent tendencies, prioritizing the needs of the addict over their own well-being. This pattern of behavior can perpetuate unhealthy dynamics within the relationship and hinder both partners’ ability to seek help and establish boundaries.

  • Impact on Mental Health: The stress and strain of supporting an addict through alcohol withdrawal can take a toll on the partner’s mental health. Feelings of depression, anxiety, and burnout are common, and the partner may neglect their own self-care and emotional needs in the process.

  • Social Isolation: Partners may experience social isolation as they navigate the challenges of alcohol withdrawal alongside their loved one. They may withdraw from social activities, hobbies, and support networks, feeling ashamed or embarrassed about their partner’s addiction and withdrawal symptoms.

  • Financial Strain: Alcohol addiction and withdrawal can have significant financial implications, including medical expenses, lost income due to missed work, and costs associated with treatment and recovery. Partners may bear the brunt of these financial burdens, further adding to their stress and anxiety.

It’s essential for partners of addicts to prioritize their own well-being and seek support from friends, family, and professional resources. Engaging in self-care practices, setting boundaries, and accessing therapy or support groups can help partners navigate the complexities of alcohol withdrawal and maintain their own emotional and mental health. Call us today at 1-800-900-2252 to learn more about how we can support you through this challenging process with our holistic approach and help you build a brighter, sober future.


How to diagnose alcohol withdrawal?

Alcohol withdrawal symptoms are diagnosed based on a thorough medical history and physical examination. Occasionally, other tests may also be performed to assess the underlying alcohol use disorder, check for possible complications, and rule out other conditions.

Such additional tests may include:
blood tests – in particular, liver and kidney function tests, as well as glucose and serum alcohol levels;
urine testing – for the presence of drugs especially for benzodiazepines, cocaine and opioids;
CT scan – performed if, for example, mental changes are not typical of withdrawal syndrome or if head trauma is likely.
For the elderly, an electrocardiogram (ECG) is also performed.

How to treat alcohol withdrawal symptoms?

With proper medical care, alcohol withdrawal symptoms can be significantly reduced or even eliminated. This is because there are special treatments for anyone who wants to stop drinking (even after long-term, chronic alcohol consumption).

It is worth noting, however, that treatment methods can vary depending on the severity of alcohol withdrawal symptoms. For example, people experiencing mild to moderate alcohol withdrawal symptoms often receive outpatient care, meaning they do not need to stay in a hospital or facility for an extended period of time. However, it is recommended that they be accompanied by someone who can help them during the recovery period. In such cases, the doctor may set up daily visits for the patient, during which he or she is likely to conduct blood tests and monitor vital signs until symptoms stabilize.


In the case of alcohol withdrawal symptoms, the patient may be prescribed sedatives such as benzodiazepines to relieve withdrawal symptoms (such as feelings of anxiety or agitation). Benzodiazepines such as chlordiazepoxide and lorazepam may also help prevent the worsening of minor withdrawal symptoms. Other medications your doctor may prescribe include anti-anxiety medications, vitamins, and suboxone.

However, for those with moderate to severe alcohol withdrawal symptoms, inpatient treatment may be necessary to monitor the patient for alcoholic delirium or hallucinations, and to administer intravenous fluids or medications. At this point, it should be added that during treatment, other conditions that may cause similar alcohol withdrawal symptoms or that occur concurrently with alcohol withdrawal symptoms may need to be ruled out. These conditions include gastrointestinal bleeding, infection, intracranial hemorrhage, and liver failure.

How to deal with alcohol withdrawal symptoms?

People after alcohol withdrawal should know that there are several methods of coping not only with alcohol withdrawal symptoms, but also with reducing the risk for a return to drinking.

It is good if such a person can count on the support of loved ones. This means a supportive friend or family member who will be by the alcoholic’s side (while he or she is struggling with his or her addiction) and support him or her in his or her new non-drinking lifestyle. This is of great importance, because according to a 2018 study published in the scientific journal Addiction Research & Theory, those with a wider circle of support are more likely to stay sober. Such a circle of support can be obtained by making new contacts and joining social media communities dedicated to living without alcohol.


It’s also a good idea to enroll in a support group such as AA (Alcoholics Anonymous), because according to a study published a year earlier in Addictive Behaviors Reports, support groups play a crucial role in helping people develop healthy social networks that result in continued sobriety.

It also turns out that for people who want to fight addiction, behavioral psychotherapy can be helpful. This is a type of psychotherapy that involves working with a team of mental health professionals in a group and individual setting. Psychotherapy helps patients learn to better identify negative and self-destructive thoughts and actions that may be contributing to their drinking. It is a short-term, targeted therapeutic approach to help addicts achieve abstinence.

Self-Care Strategies for the Individual Struggling with Alcohol Addiction:

  • Hydration and Nutrition: Prioritize staying hydrated by drinking plenty of water and consuming nutritious meals rich in vitamins and minerals. Alcohol withdrawal can deplete the body of essential nutrients, so replenishing them is crucial for supporting overall health and recovery.
  • Rest and Relaxation: Establish a regular sleep schedule and practice relaxation techniques such as deep breathing exercises, meditation, or gentle yoga. Quality sleep and stress reduction play key roles in alleviating withdrawal symptoms and promoting emotional well-being.
  • Seeking Support: Reach out to trusted friends, family members, or support groups for encouragement and guidance. Connecting with others who understand your struggle can provide valuable emotional support and motivation during challenging times. Alcohol withdrawal can be overwhelming, but you don’t have to go through it without guidance. Call us today at 1-800-900-2252 to learn more about how we can support you through this challenging process with our holistic approach and help you build a brighter, sober future.

Supporting a Spouse Through Alcohol Withdrawal:

  • Encouraging Professional Help: Gently encourage your spouse to seek professional assistance from healthcare providers or addiction specialists. Offer to accompany them to appointments and provide reassurance throughout the process. Emphasize the importance of medical supervision and tailored treatment to ensure their safety and well-being. If your partner are experiencing alcohol withdrawal symptoms and seeking support, InnerBalanceHealthCenter offers compassionate and holistic treatment programs to help you navigate this challenging journey towards sobriety. Contact us today at 1-800-900-2252 to speak with our experienced team of therapists and addiction specialists, and take the first step towards reclaiming your and your loved one’s health and well-being.
  • Creating a Supportive Environment: Foster a supportive and nurturing atmosphere at home by minimizing stressors and creating a structured routine. Encourage healthy habits such as regular meals, exercise, and adequate sleep to promote physical and emotional stability.
  • Open Communication: Maintain open and honest communication with your spouse about their withdrawal symptoms, concerns, and treatment options. Listen actively, validate their experiences, and offer nonjudgmental support. Let them know that you’re there to assist them every step of the way on their journey to sobriety.

 

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