Signs | Symptoms | Treatments
Table of Contents
What is Alcohol Withdrawal
Alcohol withdrawal is the change the body goes through when a person suddenly stops drinking after prolonged and/or heavy alcohol use. Alcohol has a depressant effect on the brain. In a frequent, long-term, or heavy drinker the brain is almost constantly experiencing the depressant effect of alcohol.
The brain adjusts to this exposure by producing more stimulating neurotransmitters (like serotonin or norepinephrine). If alcohol is removed abruptly, the brain is accelerated because of the chemicals it has been producing in excess to counteract the alcohol. The resulting imbalance causes many of the symptoms of withdrawal.
Prevalence Of Alcohol Abuse
Causes of Alcohol Withdrawal
Large intake and continual use of alcohol will disrupt the brain’s natural circuits that release endorphins and other chemicals that reward the body for healthy behaviors. Substance abuse takes control of the brain’s circuitry that produces pleasure and joy, rewiring it to reward the body only when there is an intake of alcohol. Once tolerance is gained, a higher intake of alcohol is then required to sustain those feelings of pleasure.
Related Illnesses & Co-occurring Disorders
Increased Heart Rate
Visual and Auditory Hallucinations
Hospitalization may be required if symptoms become too severe.
Doctors will be able to supervise the patient and manage any complications that might occur.
Symptoms of Alcohol Withdrawal
A person who drinks alcohol will inevitably experience symptoms of alcohol withdrawal. The mild, short term symptoms of withdrawal are commonly called a “Hangover.” When a person overindulges, even just for one evening, their bodies react to the metabolization of alcohol by producing feelings of general discomfort.
Most Common symptoms of a hangover include:
Hangovers are a small sample of the effects that alcohol withdrawal can produce in a person who has become physically dependent on alcohol. It is important to note how many systems within the body are affected by alcohol. This shortlist of mild symptoms include negative effects on a person’s mood, motor skills, cognitive abilities, and gastrointestinal system.
As the body adjusts to the chronic influx of alcohol, numerous internal systems must adapt to the presence of alcohol and the byproducts that are created once it is broken down by the liver.
The symptoms of alcohol withdrawal are often categorized into three groups:
- Autonomic Hyperactivity
- Cognitive and Perceptual
The symptoms of alcohol withdrawal syndrome can be temporary and mostly benign in casual drinkers. But the more dependent a person is on alcohol, the more severe and dangerous their withdrawal can be. The severity of alcohol addiction can also affect when a person begins to experience withdrawal. In some heavy drinkers, the symptoms of withdrawal can begin before a person’s blood-alcohol level lowers to zero.
Alcohol withdrawal side effects and symptoms are categorized into 3 stages:
Stage 1: Approximately 8 hours after the last drink. Common symptoms include: Anxiety, insomnia, nausea, and abdominal pain.
Stage 2: Approximately 24 to 48 hours after the last drink. Common symptoms include: High blood pressure, increased body temperature, unusual heart rate, and confusion.
Stage 3: Approximately 2 to 4 days after the last drink. Common symptoms include: Hallucinations, fever, seizures, and agitation.
*Symptoms typically decrease after 5 to 7 days.
Increased Heart Rate
Alcohol causes a person’s heart rate to increase by disrupting the electric signals that travel to the heart from the brain. After a prolonged period of alcohol abuse, this increased activity can lead to atrial fibrillation (AFib). AFib causes a person’s heart to be more erratically which makes a person more prone to Blood Clots, Strokes, and Heart Failure.
High Blood Pressure
According to The National Child Traumatic Stress Network, an estimated 45 to 66 percent of young people had a substance abuse disorder before they experienced some kind of trauma, such as sexual or physical abuse. Unfortunately, a person with a substance abuse disorder typically has an even harder time coping with their recovery. Some experts say this is because people who abuse substances may have a hard time coping with stress and trauma.
Irregular Heart Rate
Chronic Alcoholism often leads to dehydration. Dehydration leads to a drop in Electrolytes which regulate a person’s heart rate. Alcohol abuse can also cause a person to have artery spasms that cause blood vessels to narrow suddenly. This can cause heart and chest, neck and arm pain during the alcohol withdrawal process.
Fevers are typically a symptom of a viral infection. When fighting off the virus, a person’s body raises its core temperature to stop the spread of the infection. Alcohol withdrawal causes the immune system to react in a similar way. The process triggers the production of cytokines. These small proteins help cells within the immune system communicate with one another, but also cause inflammation which can result in fever, fatigue, muscle aches, nausea, and headaches.
Alcohol that is not absorbed by the intestines is excreted from the body through feces and urine. Alcohol increases the speed that the colon muscles contract. This forces water to be processed faster, which reduces the amount of water that can be absorbed. This causes feces to be more watery than normal, resulting in diarrhea. Alcohol also irritates the digestive tract, making diarrhea worse. This process can cause a person to become dehydrated, which can cause or contribute to other withdrawal symptoms.
The gastrointestinal system breaks alcohol down into acetaldehyde. In normal circumstances, the liver neutralizes acetaldehyde with an antioxidant called glutathione. When a person becomes physically dependent on alcohol, their liver is not able to produce enough glutathione to balance out the other chemical. This excess of acetaldehyde causes irritation to mucous membranes in the stomach. In these cases, the liver will signal the body to expel the acetaldehyde through vomiting.
Acetaldehyde is a carcinogenic chemical that can be found in ripe fruits, vegetables, cigarette smoke, and gasoline. Exposure to acetaldehyde vapors often results in irritation of the eyes, skin, and lungs. Large doses may cause death from respiratory paralysis.
Large quantities of alcohol and the alcohol by-product, acetaldehyde, are irritants that aggravate the stomach lining. An excess of these substances causes a person to feel nauseated. Over time, this stomach irritation can cause alcohol gastritis an erosion of the stomach lining. This condition can lead to chronic nausea, heartburn, acid reflux, and ulcers.
Loss of Appetite
Agitation & Irritability
Serotonin has an impact on almost every part of the body. It affects everything from digestion to emotions and motor skills. Serotonin is a natural mood stabilizer. It helps a person sleep, eat, and heal.
Gamma-aminobutyric Acid (GABA)
GABA is a naturally-occurring amino acid that functions as an “inhibitory” neurotransmitter. It suppresses brain signals and decreases activity in the nervous system. When GABA attaches to the GABA receptors in the brain, it produces a calming effect. Increasing the production of GABA in the brain helps to soothe anxiety, stress, and fear. Some people take GABA supplements to counteract seizures, Parkinson’s disease, Panic Disorder, and ADHD.
Post-Acute Withdrawal Symptoms:
Froggy Thinking / Trouble Remembering
Urges and Cravings
Irritability or Hostility
Sleep Disturbances – Insomnia or Vivid Dreams
Issues with Fine Motor Coordination
Anxiety or Panic
Lack of Initiative
Impaired Ability to Focus
Alcohol Withdrawal Treatments
Detoxification from alcohol is the process of removing alcohol from ones body. There are various means to detox safely often times a medical or clinical detoxification is recommended.
Clinical detox includes a combination of medication followed by various behavioral therapies and continuing care to alleviate distressing mental, emotional, and physical symptoms.
Detoxing from alcohol includes acute withdrawal symptoms, lasting days or weeks, depending on:
- How much of the alcohol was used
- How frequently they used alcohol
Those who find themselves physically dependent on alcohol are often best suited for attending a clinical detoxification program. Detox usually begins with an initial evaluation by psychiatric and medical professionals, followed by a stabilization period.
A vital component of the medical detox process is the use of medications to alleviate withdrawal and reduce risk of major complications.
Naltrexone is a drug that is approved to treat alcohol use disorder and works by blocking the opioid receptors in an alcoholic’s brain. There is convincing data that naltrexone can significantly reduce alcoholic relapses and studies suggest it can help someone control the number of alcoholic drinks they ingest, and even the severity of their cravings. 20
Another perk of naltrexone is that it isn’t addictive and has no have adverse effects with alcohol.
Other medications might be used temporarily in a detox process to prevent life-threatening symptoms, such as seizures. This is up to the provider’s discretion and dependent upon the patient’s choice.
Commonly referred to as residential treatment, inpatient rehabilitation provides structure to recovering addicts that are seeking to extend their treatment after any acute withdrawal symptoms subside.
In doing so, they can form new lifestyle habits free from alcohol under the direct care of addiction and mental health professionals. Inpatient rehabs utilize therapies such as cognitive behavioral therapy, dialectical behavioral therapy, medications, and group therapy to encourage synergistic healing through 24/7 care.
Around two-thirds of people tend to complete their stay at a residential facility after detoxification.
Outpatient treatment happens after residential treatment. In this setting patients attend groups during the day usually 3-6 hours per day.
Outpatient care tends to be longer than inpatient care. Once an alcoholic is physically, mentally, and emotionally stable, they may transition to an outpatient care center where they can continue to work, go to school, and socialize outside of the treatment program.
Aftercare planning consists of the organization of living arrangements, doctor scheduling, and other planning for success after one leaves treatment.
Resources are available for those who leave treatment, including AA meetings, SMART recovery meetings, sober living homes, psychiatric or therapist referrals, and more.
Holistic Home Remedies
Some people decide they would rather detox from their own home than in an accredited facility. There are many reasons for this, including that going through such a process in one’s home can allow them to feel more secure and in control of their recovery, or relieve any financial burdens.
Medical professionals generally do not recommend detoxing from home due to the steep health risks of acute withdrawal. Not only this but due to the frequent uncomfortably of withdrawal symptoms, many people can acquire multiple failed attempts at quitting their drug.
Despite the health and relapse risks, if someone chooses to detox from home, there are a few options available.
Detox kits, for example, can aid in the expulsion of toxins from one’s body. However, these kits aren’t synonymous with medical care from a health professional. Due to the fact that they are unregulated, detox kits bought in stores or online claiming to eradicate any trace of alcohol.
Some researchers believe the following vitamins, herbs, and supplements may also support the successful aridification of a drug from one’s body:
- Vitamin B
- Milk Thistle
- Vitamin C
- Cranberry extract
- Apple Cider Vinegar
- Maintain a balanced diet
- Prioritize hydration and
- drink plenty of fluids
- Remain in contact with a physician in case any medical emergency should arise
- Substance Abuse and Mental Health Services Administration (SAMHSA)