Alcohol addiction is potentially devastating, but so many people continue with problematic drinking simply because they’re scared at the thought of alcohol withdrawal.
Is this a justifiable fear, though, and can alcohol withdrawal really be dangerous?
We’ll be diving deep into this knotty issue today, and it’s essential to do so with 50% of those with alcohol use disorder experiencing withdrawal symptoms during the detox phase of rehab. For a successful recovery to get off the ground, managing this issue is key, then.
Before we explore the dangers of alcohol withdrawal syndrome, what is precisely and why should you care?
What Is AWS (Alcohol Withdrawal Syndrome)?
Alcohol withdrawal syndrome (AWS) refers to the withdrawal symptoms experienced by a heavy drinker if they suddenly stop drinking, or dramatically slash consumption.
Withdrawal symptoms can be either physical or emotional.
Someone experiencing mild withdrawal symptoms may feel anxious, fatigued, or nauseous. If symptoms of AWS become more severe, they can include seizures and hallucinations. In some drastic cases, alcohol withdrawal improperly managed can even be fatal.
Why, then, do these symptoms manifest when someone stops drinking heavily?
What Causes AWS?
If you drink excessively, this brings about pronounced changes to the central nervous system.
Alcohol has a sedating effect on your brain. If you start drinking heavily or over the long-term, you’ll be almost continuously exposed to a depressant effect. Your brain doesn’t take this imbalance lying down and produces chemicals that counteract this sluggishness induced by heavy drinking.
For an active drinker, both serotonin and norepinephrine are present at higher levels than normal. When you abruptly remove alcohol from the equation, the brain is left suddenly overstimulated.
The brain now running overtime and the CNS struggling to cope with the unexpected absence of alcohol, it’s now that AWS can develop. Symptoms manifest when the alcohol-induced neural signaling becomes excited, but there’s now not any alcohol to calibrate things.
So, it’s the lack of alcohol that leads to AWS in problem drinkers. Before we take a broader look at the potential dangers of alcohol withdrawal, what’s the expected duration of these symptoms?
How Long Does It Last?
Roughly half of all problematic drinkers will suffer from alcohol withdrawal symptoms to at least some extent.
Symptoms typically develop anywhere from 5 to 24 hours after cutting down or discontinuing alcohol consumption.
In the case of mild or moderate symptoms, these can usually be self-managed. They will also tend to fade away after no more than a week.
With severe AWS, though, medical treatment is invariably the most appropriate option. As you would expect, symptoms tend to linger for longer, too. The most severe effects for this type of drinker will usually manifest within a few days of abstinence.
How, then, can you determine whether you’re liking to suffer from alcohol withdrawal syndrome.
Alcohol Withdrawal: Diagnosis
Do you have a drinking problem? Are you alcohol dependent?
If you answered “Yes” to either of these questions, you should speak with your healthcare provider if you’re planning to stop drinking. Abruptly stopping without any assistance is inadvisable.
Your doctor can examine your medical history, and perform a routine physical examination.
If there’s an excessive amount of alcohol in your system, the doctor could request a toxicology screen as well.
To measure AWS, a doctor uses questions from the CIWA-Ar, a shortened version of the previous 15-point scale (CIWA).
This scale assesses 10 symptoms:
- Agitation
- Anxiety
- Auditory disturbances
- Headache
- Inability to think clearly
- Nausea and vomiting
- Sweating
- Tactile disturbances
- Tremor
- Visual disturbances
Often, you’ll also be asked some simple accompanying questions to establish if you’re thinking lucidly or not.
Your doctor will be looking for some broad symptoms like dehydration, fever, hand tremors, or irregular heart rate.
Now, you might initially find it hard to open up to your healthcare provider. Total transparency is crucial, though. If you’ve been drinking so much that it triggers withdrawal symptoms when you stop, there’s every chance you’ve created further damage inside your body. You should get a comprehensive check-up along with some blood tests to assess the extent of any damage.
At this stage, it’s commonplace for your doctor to address nutrition. Many heavy drinkers eat poorly and insufficiently, so take any of these pointers on board and try to implement the advice.
Now, assuming you have a diagnosis of alcohol withdrawal syndrome, what sort of symptoms can you expect?
3 Stages of AWS Symptoms
The symptoms of alcohol withdrawal depend on the severity of AWS.
There are 3 core stages to alcohol withdrawal syndrome:
- Mild AWS: Stage 1
- Moderate AWS: Stage 2
- Severe AWS (delirium tremens): Stage 3
Mild AWS: Stage 1
With mild alcohol withdrawal syndrome, symptoms are correspondingly mild. You can expect to experience headaches, tremors, and anxiety. Insomnia, abdominal pain, and gastrointestinal issues are all common symptoms at the milder end of the AWS spectrum.
Many patients will also find they vomit or experience a loss of appetite.
Even with mild AWS, you’re likely to feel a sense of depression wash over you at first. This is normal and should not endure.
How about when things are more severe?
Moderate AWS: Stage 2
With moderate AWS, you will find more withdrawal symptoms manifest on top of those listed above.
Rapid heartbeat and hyperthermia (raised body temperature) are common at stage 2.
Shallow breathing and sweating regularly accompany stage 2 AWS as well as a rise in you systolic blood pressure.
Expect to feel a sense of confusion undercutting these physical symptoms. You should also be prepared for pronounced mood swings and irritability.
Severe AWS (delirium tremens): Stage 3
Hallucinations and disorientation characterize the DTs (delirium tremens) of latter stage AWS. This can be dangerous if you’re not in a secure environment.
Severe alcohol withdrawal syndrome can even lead to seizures.
Here are some of the variables that will influence the extent of these withdrawal symptoms:
- The length of time you’ve been drinking
- How much you’ve been drinking
- Your stress levels
- Any relevant medical history
- Family history of addiction
- Co-occurring mental disorders
Now, not all symptoms will develop in all patients. That said, alcohol withdrawal tends to follow a fairly predictable pattern once you’ve flushed the alcohol through your system.
Timeline and Dangers of Alcohol Withdrawal
Although the specifics of the timeline vary slightly, here’s how a week after stopping drinking typically pans out:
- 1 day after your last drink: The first stage of alcohol withdrawal can kick in at any stage after the first 8 hours
- 1 to 3 days after your last drink: Symptoms normally peak. Stage 3 symptoms can also manifest after this point
- 5 to 7 days after your last drink: During this phase, you can expect symptoms to lessen in intensity
- 7 days and more after your last drink: Most physical withdrawal symptoms should be gone a week into sobriety. Possibly, psychological effects will continue for weeks if not properly managed and treated
We’ll look at these symptoms in a bit more detail now, and we’ll also examine when they occur on the withdrawal timeline.
- Tremors: A few hours after your list drink, it’s common to experience tremors and shaking. This will usually subside after the first 2 or 3 days. You might also find your pulse rate and blood pressure rising. Breathing if often rapid, and you’ll frequently sweat copiously. You could vomit or feel nauseous. There are also psychological effects like vivid dreams, nightmares, insomnia, hyper-alertness, or anxiety
- Hallucination: At some stage in the first 24 hours of sobriety, you could experience vivid hallucinations lasting up to 48 hours. From visions to the sensation of insects crawling on the skin, you need to be supervised if hallucinations strike
- Seizures: 24 hours after your last drink, your risk of seizure peaks. There’s still a slight chance of seizure over the following day. This is the primary danger of alcohol withdrawal
- Delirium Tremens: DTs (delirium tremens) can start at any time in the first week of withdrawal. On most occasions, DTs kick in on day 2 or 3. DTs happen in anything from 3% to 5% of cases and call for close medical supervision. From dangerous spikes in blood pressure and a racing heart through to dramatic shifts in your breathing, circulation, and temperature issues, DTs could even interfere with blood flow to your brain. Irrational behavior and hallucinations are commonplace
How, then, should you best approach detoxing from alcohol while mitigating withdrawal symptoms?
Treatment: Alcohol Detox
If you don’t have any serious underlying health conditions, and you don’t have any previous experience of AWS, you may be able to detox at home if you have a mild case and a supportive environment. This should be somewhere with subdued lighting and limited exposure to other people. You should, though, have support in place if you need it.
Stock up on healthful food and supplements. You might have a mineral or vitamin deficiency through drinking heavily, so consider supplementing magnesium, zinc, thiamine, and folate. It’s highly likely your blood sugar levels will be out of whack, too.
Hydration is vital, so ensure you have a ready supply of fresh water.
Now, home treatment is by no means usually the best option for withdrawing from alcohol dependence. It’s often preferable to seek supervised care in a formal treatment center where all your needs will be met.
Medication can be used to reduce anxiety and to counter insomnia. Benzodiazepines work effectively for minimizing acute symptoms of AWS, and making them more manageable. Anti-psychotic drugs and anti-seizure medications can also be administered in hospital.
Getting this first and pivotal step of recovery right is the foundation you need to build on.
Who should pay particular care to the issue of alcohol withdrawal, then?
Who Is At Risk From Alcohol Withdrawal?
If you drink regularly or heavily, you could be at risk of AWS.
Anyone with alcohol use disorder is at heightened risk.
This risk of alcohol withdrawal is further exacerbated if you have tried to detox from alcohol before and suffered withdrawal symptoms.
Is It Possible to Avoid Alcohol Withdrawal?
The only reliable way to prevent alcohol withdrawal from happening is to avoid heavy drinking and binge drinking.
If it’s too late and you’re already dependent on alcohol, gradually taper off rather than stopping abruptly. This will go at least some way toward lessening the severity of the symptoms.
Prognosis
Alcohol withdrawal might be pretty commonplace, but the more severe manifestation of DTs will only happen in around 5% of all cases. Unfortunately, of this small segment, up to 15% of those experiencing symptoms will die.
It’s mainly for this reason, then, that medically-supervised detox is crucial in all cases of severe alcohol dependence. Throw in the chance of seizures, and it’s paramount that you detox in a safe setting with medical help on hand.
If you decide to stop drinking on your own at home and you notice any symptoms of DTs, you need to seek immediate medical attention. Doing so will minimize the risk of any life-threatening complications from delirium tremens.
Now, keep uppermost in mind that the vast bulk of people suffering from AWS bounce back and fully recover. Simply remaining sober is all that’s required to keep symptoms at bay once you enter your second sober week. That said, you should be prepared for disturbed sleep, fatigue, and irritability to be a potential menace for months.
When you take the right precautions, withdrawing from alcohol might be uncomfortable, but it’s unlikely to be dangerous, with the above caveats set aside.
How about if you’ve come all this way and you’re still unsure about making the necessary lifestyle changes to get sober?
Well, consider this: an alcoholic who keeps on drinking can expect a life expectancy reduced by anywhere up to 15 years. Is a drink really worth quite that much? Ultimately only you can decide.
But there is some good news…
Get Help With District Recovery
You should remember that withdrawal is just the first step on a lifelong journey to recovery. There is no one-size-fits-all solution for alcohol use disorder. Bear this in mind, though: only 20% of alcoholics abstain permanently from drinking without undergoing some form of treatment or self-help program.
With 12-step programs like AA, on the other hand, 50% of members who remain sober for a year stay sober for another year. This figure climbs beyond 90% when someone has followed the AA program for 5 years while remaining abstinent throughout.
You should ensure you take a personalized approach to alcohol withdrawal that best meshes with your drinking habits. Remember: DTs along with severe AWS can be lethal.
Take heart, though…
For most heavy drinkers, withdrawal is just an inconvenient and mildly uncomfortable pitstop on the road to a fruitful journey and a much better life.
If you’re struggling to cope alone, call us today at 844.287.8506 and we’ll help you get right back on track.
