What Is Alcohol Withdrawal?

Withdrawal refers to a set of physical and mental symptoms experienced when someone quits or reduces their consumption of a substance on which they have become dependent.

People who develop alcohol dependence face the prospect of going through alcohol withdrawal should they want to quit drinking. Symptoms can be unpleasant and, in some instances, dangerous. Alcohol withdrawal can be challenging to endure; however, successful management of the withdrawal period can play a crucial role in early recovery from alcoholism. Professional supervision and medical care can make the process of withdrawal safer and less painful.1

Alcohol Withdrawal Symptoms

Man feeling sick

Alcohol withdrawal produces a broad range of symptoms.2 It is difficult to predict how severe someone’s withdrawal from alcohol will be and who will experience severe symptoms, which is why medical supervision during detox is often advised.1,3

Symptoms of alcohol withdrawal may include:3,4

  • Anxiety.
  • Irritability.
  • Insomnia.
  • Headache.
  • Sweating.
  • Elevated heart rate.
  • Loss of appetite.
  • Nausea.
  • Vomiting.
  • Alcohol cravings.
  • Tremors.
  • Auditory and visual hallucinations.

Alcohol withdrawal may progress to seizures or in rare cases, delirium tremens (DTs).  Delirium tremens is the most severe form of alcohol withdrawal; it is characterized by profoundly altered consciousness (i.e., delirium) and significant autonomic nervous system dysfunction. It is an emergency that requires immediate medical aid and monitoring.2 As many as half of those who experience a withdrawal seizure will go on to develop delirium tremens.2

What Are Delirium Tremens?

Delirium tremens, or “DTs”—is a severe form of alcohol withdrawal characterized by the sudden onset of extreme agitated confusion (delirium) and other severe symptoms.5

About 3-5% of people in alcohol withdrawal will experience delirium tremens.6 Treatment is crucial for those who suffer from DTs; without appropriate treatment, it’s been estimated that as many as 37%  of those with delirium tremens may die.6,7

Though delirium tremens is rare, it may be more common in people who’ve had a previous history of seizures or DTs, who have detoxed from alcohol before, who have underlying medical or mental health conditions, or who have been abusing alcohol for more than 10 years. 6,8

Those who chronically abuse alcohol have a 5-10% chance of developing DTs in their lifetime.6

Symptoms of Delirium Tremens

Delirium tremens is a life-threatening condition marked by severe symptoms such as:2,9

  • Profound confusion.
  • Changing mental status.
  • Extreme agitation.
  • Sensitivity to light, sound, and touch.
  • Rapid heart rate and breathing.
  • High blood pressure.
  • High body temperature.
  • Profuse sweating.
  • Hallucinations.
  • Tremors.
  • Seizures.

Alcohol Withdrawal Timeline

Woman in distress

The alcohol withdrawal timelines may vary greatly from person to person. The following is a very general guideline:1,4,6,9,10

  • The first symptoms may arise within 6 to 24 hours.
  • These initial symptoms often peak in severity and then begin to resolve over the next 24 to 48 hours.
  • Should seizures occur, they usually do so within 24 to 48 hours of the last drink.
  • If DTs develop, symptoms tend to arise within 2 to 4 days of the last drink, though DTs remain a risk for up to 10 days. Symptoms may last up to 5 days.

In most cases, withdrawal symptoms subside in a matter of days. However, they may remain for weeks in some cases.8

Medications Used for Alcohol Withdrawal

Medication can help manage acute alcohol withdrawal by reducing the risk and severity of seizures and making the patient more comfortable.

Medications can prevent complications and life-threatening symptoms from arising or help to address them if they do. As part of a professional medical detox protocol, medications and medical monitoring can be provided in both inpatient and outpatient settings, depending on patient needs.1

Long-acting benzodiazepines, including diazepam (Valium) and chlordiazepoxide (Librium), are commonly used to treat alcohol withdrawal because they mitigate withdrawal symptoms and reduce the risk of seizures. After the patient’s withdrawal symptoms have improved and stabilized, gradual tapering of benzodiazepines may begin.

Other medications that are sometimes used to manage alcohol withdrawal are: 1

  • Barbiturates. Though increasingly rarely used due to the risk of overdose, toxicity, and inherent abuse potential, drugs like phenobarbital may still be used in highly supervised environments to treat alcohol withdrawal.
  • Antipsychotics. These may be given to manage extreme agitation and delirium, as well as some of the features of psychosis—such as acute delusions and hallucinations—that sometimes arise during alcohol withdrawal. Care must be taken when used, as some antipsychotics lower seizure thresholds.
  • Beta blockers and alpha adrenergic agonists (e.g., clonidine). These may be used to manage some symptoms that might not have responded well to other treatment agents, such as rapid heart rate and high blood pressure. Their effects are modest, however, and do not prevent seizures or delirium.

Are There Home Remedies for Alcohol Withdrawal?

The Substance Abuse and Mental Health Services Administration advises against attempting to detox in nonmedical settings if you’re at risk for moderate to severe alcohol withdrawal.1 Unfortunately, identifying those people who will eventually experience significantly severe alcohol withdrawal beforehand is not always straightforward. Such predictions are based on many variables, some of which are difficult to ascertain, especially for a patient themselves or non-specialists.1,11 A doctor or addiction treatment professional can review your alcohol use history, general health, and previous withdrawal experiences and help you decide on the safest course of treatment.1

Safe detoxification can be achieved in both inpatient and outpatient settings depending on the patient’s needs.2 The treatment team at a medical detox program can help to reduce severity of withdrawal by monitoring and treating physical and mental health symptoms, safely prescribing medication, and making adjustments to the treatment regimen if necessary.1

Patients experiencing or expected to experience more severe alcohol withdrawal may benefit from the 24/7 care provided at an inpatient facility and the presence of hospital staff to immediately respond to medical emergencies.3

After Alcohol Withdrawal: Rehabilitation Treatment

Woman with doctor

When conducted properly, detoxification allows patients to safely overcome their physical dependence on alcohol. Breaking the physical hold of alcohol abuse clears the way for mental health professionals to step in and help individuals develop the skills necessary for long-term recovery.1

Alcohol addiction is a complex but treatable disease that encompasses much more than physical dependence.12 Once withdrawal symptoms are managed and the patient is stabilized, they then need to confront the issues that led them to drink.13 This process may begin during detox and continue in another a rehabilitation setting. Further treatment may involve the use of various methods of therapy, non-addictive relapse prevention medications, alcohol abuse education, life skills training, and 12-step or other mutual support groups.13

Treatment programs offered at Desert Hope incorporate all of these. Our mission is to help you recover, and we’re available 24/7 to talk you through your detox and treatment options for alcohol recovery. Call us now at .

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