Addiction A-Z

Alcohol withdrawal

Alcohol withdrawal refers to the physical effects experienced when a person who is physically dependent on alcohol stops drinking. If the person was not a particularly heavy drinker, or has not been drinking for years, they may experience very few symptoms. However, for the person who has been drinking in large amounts for many years, alcohol withdrawal can be extremely unpleasant and even life-threatening.

Symptoms usually begin within five to ten hours after the last drink, though in some people, they may take several days to start. Common symptoms are:

  • anxiety
  • depression
  • tiredness
  • jumpiness
  • shakiness
  • irritability
  • mood swings
  • foggy thinking
  • nightmares

Some people have:

  • clammy skin
  • dilated pupils
  • headaches
  • loss of appetite
  • nausea
  • vomiting
  • pale skin
  • rapid heartbeat
  • sweating
  • tremors

More severe symptoms can be:

  • agitation
  • hallucinations
  • confusion
  • convulsions
  • blackouts
  • fever
  • seizures

The severity of symptoms depends on the age, weight and medical condition of the person as well as how long and how much she has been drinking. Children can also experience alcohol withdrawal.

Major health threats

Alcohol withdrawal can be life-threatening for several reasons. People who experience delirium tremens have a 5-25% chance of dying if they are not medically supervised. Some people have injured themselves during seizures or convulsions, and others experienced difficult complications, such as Wernicke’s or Korsakoff’s syndromes, explained below. Medical professionals can monitor the person undergoing withdrawal to prevent accidents, and may prescribe sedatives such as benzodiazepines or anti-seizure medications that can ease symptoms.

Delirium tremens (DTs) is the most serious aspect of alcohol withdrawal, with symptoms including tremors, hallucinations, disorientation, agitation, seizures and increases in heart rate, breathing rate, pulse and blood pressure. DTs are the result of alterations in the way receptor cells function in the brain. Alcohol affects the way nerve cells communicate with one another by interfering with the function of neurotransmitters. When alcohol is withdrawn, the brain cells begin working normally, but that normal activity level becomes overwhelming, and DTs result. There are medications, such as haloperidol, that can be helpful.

Wernicke’s and Korsakoff’s syndromes are the result of nutritional deficiencies, and can occur during alcohol withdrawal. Wernicke’s syndrome involves disorientation, cognitive impairment, inattentiveness and sometimes agitated delirium, and it can lead to a disabling memory disorder known as Korsakoff’s syndrome. This disorder can include severe amnesia and problems in short-term memory.

After a person has physically withdrawn from alcohol, she may experience psychiatric problems that can last for days or even up to a year, such as anxiety, depression and sleep disturbances, including frequent waking, restless sleep, insomnia and night terrors. Other symptoms of prolonged withdrawal can be tremors, increased breathing rate, high body temperature and blood pressure and rapid pulse.

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