What are the symptoms of alcohol withdrawal?

Alcohol Withdrawal Symptoms

Symptoms of alcohol withdrawal can be one of the hardest to get through. If alcohol consumption is heavy and prolonged, it can be life-threatening.

Alcohol withdrawal can be categorized by its symptoms from mild to severe. Delirium tremens is the most dangerous of these.

Minor withdrawal symptoms can include symptoms like anxiety, agitation, and insomnia. (6–12 hours after last drink)

In alcoholic hallucinosis, people might begin to hear things that aren’t really there, like sounds or voices. They can also feel or see things that aren’t real, but this happens less often than hearing things. (48–72 hours after last drink):

Delirium tremens is characterized by confusion, hallucinations, and severe tremors. (48–72 hours after last drink)

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Some Symptoms of Alcohol Withdrawal

These symptoms happen when someone who has been drinking a lot for a long time suddenly stops or drastically cuts down their consumption. Medical supervision during this process is not just beneficial, but highly recommended for your safety and well-being.

Here is a breakdown:

Mild Symptoms:

- Anxiety or nervousness
- Irritability or agitation
- Fatigue
- Depression
- Mood swings
- Difficulty concentrating
- Nausea and vomiting
- Loss of appetite
- Headache
- Sweating
- Insomnia or disrupted sleep patterns
- Tremors (shakiness) in the hands or other parts of the body

Moderate to Severe Symptoms:

- Increased heart rate
- High blood pressure
- Fever
- Rapid breathing
- Confusion or disorientation
- Hallucinations (seeing or hearing things that are not there)
- Seizures

Severe Symptoms (Delirium Tremens, DTs):

- Severe confusion and agitation
- Severe tremors
- Profound disorientation
- Hallucinations
- Profuse sweating
- High fever
- Rapid heart rate
- High blood pressure
- Seizures

More on Alcohol Withdrawal: Delirium Tremens (DTs)

As mentioned above, delirium tremens can be life-threatening. It happens when an individuals has a long history of heavy and prolonged alcohol use who suddenly stop or significantly reduce their alcohol intake.

DTs generally develop 2 to 5 days after the last drink. However, in some cases, it can appear as early as 24 hours after the last drink or up to 7–10 days later.

Symptoms

The symptoms of delirium tremens are intense and include:

Severe Agitation: Extreme restlessness and irritability.
Confusion and Disorientation: Difficulty recognizing familiar people or places, severe cognitive impairment.
Severe Tremors: Uncontrollable shaking, often of the hands, but can affect other body parts.
Hallucinations: Seeing, hearing, or feeling things that are not present, often vivid and disturbing.
High Fever: Elevated body temperature exceeding 103°F (39.4°C).
Profuse Sweating: Excessive sweating, often accompanied by clammy skin.
Rapid Heart Rate: Tachycardia, which can lead to arrhythmias.
High Blood Pressure: Hypertension, which can exacerbate other symptoms.
Seizures: Convulsions that can lead to further complications, including injury.

Why do People Experience DTs?

Delirium tremens happens when someone who has been drinking heavily suddenly stops, causing the brain to become unbalanced. Long-term alcohol use increases the calming effects of a brain chemical called GABA.

It reduces the activity of another chemical, glutamate, which makes the brain more active. When drinking stops suddenly, the calming effects of GABA drop and the brain becomes overly excited due to too much glutamate activity. This leads to an overactive nervous system, which can cause serious symptoms.

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Who is at Risk?

History of heavy alcohol use: Typically, individuals who consume large amounts of alcohol over long periods.
Previous withdrawal episodes: Those who have experienced withdrawal symptoms or DTs in the past.
Coexisting medical conditions include liver disease, infections, or electrolyte imbalances.

It’s important to remember that withdrawal without medical supervision increases the risk of severe symptoms. Medical detox can help you prepare for the necessary medical support to ensure a safe and more manageable withdrawal process.

How is DT Treated?

Delirium tremens is a medical emergency requiring immediate treatment. Management often includes:

Hospitalization: In a setting where vital signs and symptoms can be closely monitored.
Medications: Benzodiazepines are commonly used to help calm people down, prevent seizures, and relieve other withdrawal symptoms. They work by boosting the brain’s natural calming chemicals. In more serious cases, drugs like haloperidol might be given.
Supportive Care: Includes hydration, electrolyte correction, and nutrition.
Monitoring: Includes monitoring of heart rate, blood pressure, and temperature.

Predicted Outcome for DTs

With fast and appropriate treatment, the outcome for delirium tremens can be good. Without treatment, DTs can be fatal up to 15-20%, but with medical intervention, it drops to 1-4%.

So, for heavy longtime users, preventing DT withdrawal involves medical withdrawal supervision, medication and monitoring.