Alcohol Addiction Treatment

Alcohol Withdrawal Symptoms: What You Need To Know

When going through alcohol detox, harmful toxins are flushed from the body, leaving patients with uncomfortable withdrawal symptoms that can be challenging at best and dangerous at worst. Each day, 380 people die of excessive alcohol use and the complications that stem from it. Whether you’re experiencing alcohol withdrawal yourself or helping someone else through the process, we’ve gathered everything you need to know about the symptoms of this difficult, life-threatening experience.

Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms typically occur when a person who’s been consuming alcohol on a regular basis suddenly stops or significantly reduces their intake. We’ve broken the symptoms down into three stages: mild, moderate, and severe:

Mild Symptoms

Mild alcohol withdrawal symptoms typically begin within six to 12 hours after the last drink and may include:

  • Anxiety and restlessness

  • Mild tremors
  • Sweating
  • Headache
  • Nausea
  • Insomnia
  • Increased heart rate

Moderate Symptoms

Moderate alcohol withdrawal symptoms usually appear 12 to 48 hours after the last drink and may include:

  • Confusion
  • Rapid breathing
  • Increased blood pressure
  • Mild fever
  • Excessive sweating
  • Irritability
  • Mood swings

Severe Symptoms

Severe alcohol withdrawal symptoms, which can develop 48 to 96 hours after the last drink, may include:

  • Hallucinations
  • Seizures
  • Severe disorientation
  • Agitation
  • High fever
  • Severe tremors

Not everyone will experience all of these symptoms, and the severity can vary greatly from person to person. No matter the severity of your symptoms, we at Caron strongly advise you to seek professional help in case of complications or a sudden increase in severity.

Special Case: Delirium Tremens

Alcohol withdrawal delirium, or “delirium tremens (DTs),” is the most severe form of alcohol withdrawal and can be life-threatening if not properly treated.

According to the National Institutes of Health (NIH), this type of withdrawal typically occurs in about 3%-5% of individuals going through alcohol detox, and it typically impacts those with a long history of heavy drinking or previous episodes of withdrawal.

Symptoms of DTs include:

  • Severe confusion and disorientation

  • Intense hallucinations (visual, auditory or tactile)

  • Extreme agitation
  • High fever
  • Seizures
  • Rapid heart rate
  • Excessive sweating
  • High blood pressure
  • Severe tremors

Delirium tremens is a medical emergency that requires immediate hospitalization and intensive care. Even with proper treatment, the mortality rate for DTs can be as high as 15%. In the early 2000s, the mortality rate was as high as 35%, especially when compounded by other complications, like advanced fever or “hyperthermia.” This suggests that if delirium tremens is left untreated, the risk of death could be just as high — if not higher.

Early detection and immediate medical intervention are crucial to avoid a medical emergency, but the best course of action is to seek professional medical help when attempting to stop drinking, especially for those with a history of heavy alcohol use.

Causes of Alcohol Withdrawal

Why does alcohol withdrawal happen, and what effect does it have on the brain and body?

Alcohol is a depressant, meaning it slows down the central nervous system. It can rewire our neurotransmitters, which are responsible for sending chemical messages in our brains. Over time, as someone drinks regularly, the brain adjusts to this rewiring to keep things balanced.

Alcohol also boosts the effects of GABA, a neurotransmitter that helps calm the brain, while reducing glutamate, a neurotransmitter that makes the brain more active. As a result, the brain lowers its GABA levels and increases glutamate to adapt.

When drinking suddenly stops or is cut back, the brain struggles to adjust, creating an imbalance of neurotransmitters. This can lead to an overactive brain, causing withdrawal symptoms and other health issues that may need immediate medical attention.

This neurochemical imbalance is why alcohol can be so addictive: The body becomes dependent on alcohol to maintain a sense of normalcy. The withdrawal symptoms are essentially our brain’s way of trying to bring us back to a normal balance. However, this can cause our neurotransmitters to send off signals that take a severe toll on our bodies and even become deadly.

Risk Factors for Alcohol Withdrawal

Several factors, such as behavior and demographics, can increase the likelihood of experiencing alcohol withdrawal symptoms and make them more severe. Risk factors include:

  • Duration and frequency of alcohol use: The longer and more frequently a person has been drinking, the more likely they are to experience severe withdrawal symptoms. Heavy drinking is one of many signs of alcohol use disorder and puts individuals at the highest risk.
  • Previous withdrawal experiences: Individuals who have gone through alcohol withdrawal before are more likely to experience alcohol withdrawal symptoms in subsequent, intense episodes, a phenomenon known as “kindling.”
  • Age: Older individuals may be at higher risk for severe withdrawal symptoms due to decreased liver function and other age-related health issues.
  • Genetics: A family history of alcohol or substance use disorder with withdrawal complications can increase an individual’s susceptibility to alcohol addiction and dependency.
  • Co-occurring medical conditions: Certain medical conditions, such as liver disease, heart problems, or nutritional deficiencies, can exacerbate withdrawal symptoms and increase the risk of complications.
  • Co-occurring mental health disorders: Individuals with anxiety, depression, or other mental disorders and health conditions may experience more severe withdrawal symptoms and are at higher risk for complications.
  • Substance Use: Using other substances alongside alcohol can complicate the withdrawal process and increase the risk of severe symptoms.

Knowing these factors can help individuals and their addiction treatment teams come up with a proper plan to mitigate the effects of alcohol withdrawal and soften its severity.

Diagnosis of Alcohol Withdrawal

At Caron, to know whether or not alcohol withdrawal symptoms are mild, moderate, or severe, our healthcare professionals diagnose patients using the following methods:

  • Gathering medical history: The health care provider gathers information about the individual’s drinking habits, including the frequency of consumption and the difference between real and perceived amounts of alcohol ingested. They cover previous withdrawal experiences and any co-occurring medical or mental health conditions.

  • Conducting a physical examination: A thorough physical exam is conducted to identify any signs of alcohol withdrawal or related health problems.

  • Using a clinical evaluation: The examiner uses standardized assessment tools, such as the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale, to evaluate the severity of withdrawal symptoms.

  • Running laboratory tests: Blood and urine tests may be ordered to check liver and kidney function, electrolyte levels, and other markers that can indicate alcohol-related health issues or withdrawal complications.

  • Administering a psychological assessment: A mental health evaluation may be conducted to identify any co-occurring mental health disorders that could affect treatment.

  • Using imaging studies: In some cases, brain imaging tests like CT scans or MRIs may be ordered to rule out other neurological conditions or assess for alcohol-related brain damage.

Once an accurate diagnosis is made, the treatment team can determine the best treatment plan for the patient’s safety.

Treatment of Alcohol Withdrawal

Finding the right treatment program can help manage alcohol withdrawal symptoms, prevent life-threatening complications, and provide a foundation for long-term recovery. However, not all treatments are the same, so it’s important to chat with a healthcare provider before getting started.

At Caron, we offer a range of alcohol treatment programs, including:

Medical Detoxification

For moderate to severe alcohol withdrawal, medical detoxification in a supervised setting is often necessary. This process typically involves dedicated medical care and supervision as well as medications to manage symptoms and prevent complications. The team or healthcare provider will usually supply intravenous fluids to stave off dehydration and electrolyte imbalances. They will also provide meal plans once any nausea subsides and the individual is able to eat again.

Medication-Assisted Treatment

Benzodiazepines are the primary medications used to treat alcohol withdrawal. They help reduce anxiety, prevent alcohol withdrawal seizures, and manage other symptoms. However, there are several other medications that can play a part in a healthy recovery.

Thiamine, also known as vitamin B1, is often administered to prevent Wernicke-Korsakoff syndrome, which affects neurological function. Antipsychotics can also be used in some cases to manage severe agitation or hallucinations, and anticonvulsants help prevent seizures.

In the long term, individuals may continue their medical-assisted treatment to curb future cravings. They can also be prescribed medications like Vivitrol which blocks alcohol from producing euphoric effects.

Therapeutic Support and Counseling

While medical treatment is vital for managing withdrawal symptoms, emotional and psychological support is equally important for long-term recovery. Individual counseling and group therapy provide a safe space for individuals to process their experiences, explore the root causes of their alcohol dependence, and develop healthy coping mechanisms.

At Caron, our cognitive-behavioral therapy (CBT) and motivational interviewing techniques help individuals address negative thought patterns and behaviors that contribute to alcohol use. Additionally, family therapy can be a key part of healing, helping rebuild relationships and offering loved ones the tools to support recovery.

Prevention of Alcohol Withdrawal

The safest way to prevent alcohol withdrawal is to avoid developing alcohol dependence altogether. However, for those already struggling, there are steps to reduce the risk and severity of withdrawal symptoms:

  • Seek professional help: Always contact a licensed healthcare provider before trying to quit or cut back on alcohol. Attempting to stop on your own, especially through “cold turkey” methods, can be dangerous—particularly for heavy drinkers or those who have experienced alcohol withdrawal before.
  • Medical detox and medication: These treatments help manage withdrawal symptoms as they occur, providing a safer way to detox.
  • Gradual tapering: With medical supervision, gradually reducing alcohol intake over time can help prevent severe withdrawal by allowing the brain to slowly readjust its GABA and glutamate levels.

Complications of Untreated Alcohol Withdrawal

Untreated alcohol withdrawal can have severe and life-threatening consequences. It often causes autonomic hyperactivity, a condition that disrupts vital functions like body temperature, heart rate, and digestion. In serious cases, this can lead to dangerous symptoms of withdrawal, such as:

  • High fevers and excessive sweating

  • Heart palpitations and dangerously high blood pressure

  • Vomiting and diarrhea

These symptoms cause rapid fluid loss, which can result in severe dehydration and electrolyte imbalances. Since alcohol can stay in your body for days, this can lead to hallucinations, seizures, and even death without medical intervention.

Another critical concern is thiamine deficiency (vitamin B1), which is common in individuals with alcohol use disorder. Alcohol interferes with nutrient absorption and accelerates the loss of this essential vitamin during withdrawal. A lack of thiamine can lead to Wernicke-Korsakoff syndrome, a serious condition that affects brain function, causing memory loss and permanent neurological damage.

Ongoing Treatment and Aftercare

Getting through alcohol withdrawal is just the first step. Long-term recovery requires continued treatment and support beyond detox to help maintain sobriety and prevent relapse. Without ongoing care, the risk of falling back into old habits remains high.

Ongoing care may include:

  • Therapy: Helps identify triggers, develop coping strategies, and stay committed to sobriety.
  • Support groups: Peer groups like Alcoholics Anonymous or SMART Recovery offer accountability and community, which are essential for lasting recovery.
  • Lifestyle changes: Regular exercise, meditation, healthy eating, and good sleep habits can reduce stress, improve overall health, and lower the risk of relapse.

Knowing When To Seek Help

If you or someone you know is concerned about alcohol use disorder or experiencing symptoms of alcohol withdrawal, the best time to seek help is now. Even if you're unsure how serious the issue is or which type of alcoholism is at play, a healthcare provider can help guide you in the right direction.

Here are key signs that it’s time to seek medical advice:

  • Heavy drinking over a long period: If you've been drinking alcohol heavily or find it difficult to cut back, it’s important to get medical advice before trying to quit.
  • Negative impact on life: If your alcohol use is affecting your relationships, work, or other aspects of your life, it may be time to seek treatment. This is also true if stress in these areas leads to a strong urge to drink.
  • Pregnancy concerns: If you're pregnant or planning to get pregnant and struggling with alcohol use, it’s critical to seek immediate medical attention for both your health and your baby’s safety. Detox can be especially challenging and should be managed by a trained practitioner.

Caron’s Treatment for Alcohol Withdrawal and Recovery

At Caron, we understand how difficult and overwhelming alcohol withdrawal can be. No one should have to experience withdrawals or detox alone.

We offer inpatient, outpatient, and partial hospitalization programs for alcohol withdrawal, as well as long-term support and medical supervision following detox. Our evidence-based practices are designed to help you enter the next chapter of your life with confidence.

If you or a loved one is struggling with alcohol use or experiencing withdrawal symptoms, don’t hesitate to reach out for help. Our team is here to support you every step of the way. Contact Caron today.

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