Alcohol withdrawal is a necessary step on a path to recovery and away from a pattern of alcoholism. However, it can range widely between uncomfortable and agonizing. In some cases, alcohol withdrawal symptoms can be fatal without supervision.
You may eventually go into withdrawal unintentionally. With symptoms setting in as short as a few hours after your last drink, you may experience withdrawal just because you can’t access alcohol in time. Long flights, medical procedures, work, and many other settings can lead to going into withdrawal.
But what is alcohol withdrawal syndrome and what makes it so dangerous? How can you detox safely?
Alcohol is the most commonly used addictive substance in the United States. Almost 18 million people suffer from alcoholism , which equates to 1 in every 12 adults. The technical term for alcoholism is Alcohol Use Disorder and it is defined by “compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.”
A number of factors are taken into account when it comes to determining what can cause alcoholism in someone. Environmental, physical, psychological, social, and genetic variables are among the most influential factors, but some of these factors have more influence over other ones. For example, the risk of becoming an alcoholic is three to four times greater if their parent is an alcoholic, evidence of strong environmental influence.
Alcohol withdrawal syndrome can occur when a period of alcohol intake is stopped or significantly reduced. Alcohol withdrawal symptoms occur in people who have become chemically dependent on the drug. When the brain and body begin to rely on the active ingredients of alcohol and drinking is abruptly stopped, your brain’s GABA receptors decrease their response. Symptoms may start within six hours of the initial cessation.
In some mild cases, symptoms may subside after a few days, even without medical treatment. However, in cases where a person has more heavily abused alcohol for an extended period, symptoms can become more severe.
Alcohol withdrawal can be initiated intentionally as a way to detox from the drug and break a pattern of addiction. In that case, it’s important to detox with medical supervision, especially if you’ve detoxed before. Withdrawal often occurs after accidental cessation of alcohol use. For instance, symptoms usually occur when an alcoholic goes in for medical treatment or surgery and has to stop.
The symptoms primarily depend on the severity of the dependency. Your experience may range from mild discomfort to life-threatening medical complications. Either way, symptoms will begin to occur within 24 hours and will peak after a day or two. Mild symptoms can occur within six to 12 hours that include:
In 10 percent of people going through alcohol withdrawal, more severe symptoms occur, particularly after the first 24 hours. If acute symptoms start to manifest, medical supervision and treatment may be necessary. These intense symptoms include:
In the period after 24 hours, if you start to experience the above symptoms you may be at risk for more life-threatening effects of alcohol withdrawal.
Having your alcohol withdrawal symptoms medically supervised during the detox process is perhaps the most important aspect. Because of the effect that alcohol has on your system, there are very real dangers associated with trying to stop cold turkey.
Alcoholism is dangerous, that is common knowledge. Unfortunately, many people realize they suffer from addiction, but less than 10 percent of them seek professional help. This leaves the other 90 percent to either continue their alcoholism or, in some cases, they try to quit cold turkey.
“Cold turkey” refers to the quitting of all intake of certain substances in an attempt to treat their addiction. Quitting cold turkey leads to serious side effects, and we highly advise against it. Instead, seeking professional help can result in treatment in the safest, most comfortable way.
Alcohol is a depressant; it slows body function and nerve communication. Continuous alcohol abuse forces your nervous system to adjust. Under constant depressive effects, your body works overtime to stay awake and keep your body functioning. Your body needs time to readjust when your alcohol level drops to zero, and quitting cold turkey gives your body no time to readjust, which commonly causes withdrawal symptoms.
Delirium tremens is a symptom of alcohol withdrawal syndrome that is characterized by mental confusion, hallucinations, disorientation, and anxiety. It can also manifest in physical symptoms like shivers, tremors, sweating, and an irregular heart rate. It can occur three days after your last drink and can last for up to three days. Because of delirium tremens, alcohol is one of the most dangerous drugs from which to withdrawal.
In fact, five to 25 percent of people going through withdrawal die due to complications that come from delirium tremens. However, that percentage is significantly reduced in people that seek medical treatment.
Delirium tremens is caused by hyperactivity of the autonomic nervous system after the use of a substance that tranquilizes the nervous system like alcohol, barbiturates, or benzodiazepines is suddenly stopped. This leads to the unhindered nervous system going into overdrive.
However, with medical supervision, doctors can provide medicine like benzodiazepines to counteract the effects of delirium tremens and tranquilize your overactive nerves. High doses have even been used to prevent death.
Tonic-clonic seizures, also called grand mal seizures, are another potentially life-threatening symptom of alcohol withdrawal syndrome. Seizures are characterized by convulsions and muscular contractions which can cause falling, confusion, or temporary amnesia. Approximately 90 percent of tonic-clonic seizures occur within 48 hours of alcohol cessation. However, three percent can come as late as five to 20 days later.
Seizures come in two phases. The first stage, known as the tonic phase, comes on quickly. It may start with the patient losing consciousness, and then muscles will tense, pulling extremities in or forcing them out rapidly. After a few seconds, the patient will enter the clonic phase. This second stage is characterized by muscles quickly contracting and relaxing, causing convulsions.
Seizures can be followed by a period of confusion and amnesia that gradually subsides. The strain from a seizure can lead to mental and physical exhaustion that causes labored breathing, nausea, and drowsiness.
Tonic-clonic seizures are rarely fatal except when they are experienced during sleep. Without medical supervision, a person in the middle of a seizure can die, especially when sleeping on their stomachs.
If you are thinking of going through withdrawal on your own because you’ve done it before and you know the drill, it may be more difficult than you think. Alcohol withdrawal symptoms seem to worsen with each time a person goes through withdrawal. People who experience extreme symptoms like tonic-clonic seizures and delirium tremens are likely to have gone through withdrawal before.
One possible explanation of this is the kindling theory. Kindling is increased sensitivity to withdrawal after each successive detox. A person’s first time going through withdrawal may only manifest as mild discomfort, the second time involves more nausea and anxiety, and the third time comes with a seizure.
Kindling occurs because the limbic system undergoes permanent changes that lead to hyperirritability. The changes lead to neuronal excitability, which triggers symptoms involving overactive nervous systems.
Because of kindling, if you’ve ever gone through detox or withdrawal before, it’s even more critical that you seek medical help to detox.
Now that you’ve successfully completed your medical detox from alcohol, it’s time to work on kicking the habit for good. The detox cleansed your body from the substance, but you also need to cleanse it from you mind. The best way to do that is to move straight from detox to an inpatient program. There, you’ll be able to deal with the psychological effects of post acute withdrawal syndrome and utilize therapeutic methods to combat the root of your addiction.
After that, outpatient programs are available to keep you connected to the recovery community after you’ve gone home. If staying at home is too much, then you can always opt for a sober living home so that you can have a safe environment to practice your sobriety.
Here at The Palm Beach Institute, we offer recovery aftercare for those that have graduated from their inpatient or outpatient program in the form of our Addiction Recovery Alumni Program. The alumni program at PBI provides graduates the support that they need to reintegrate back into their everyday life. From employment to housing, our aftercare specialists will go above and beyond the call of duty.