Signs And Symptoms Of Alcohol Withdrawal

The signs and symptoms of alcohol withdrawal can vary depending on the individual. In most cases, a combination of medication-assisted treatment and behavioral therapy is needed to fully recover from an alcohol use disorder.

InpatientDrugRehab.org Signs And Symptoms Of Alcohol Withdrawal

Anyone who consumes alcohol on a regular basis and suddenly reduces the amount of alcohol consumed or stops drinking altogether may experience alcohol withdrawal symptoms. The exact symptoms someone experiences during alcohol withdrawal depends on the severity of their alcohol abuse, the type of alcohol consumed, their tolerance to said alcohol, and other individual characteristics, such as gender and ethnicity.

Alcohol Withdrawal Symptoms

Signs and symptoms of alcohol withdrawal may occur as early as two hours after the last drink up to a few days later. This usually includes two or more of the following:

Possible psychological signs of alcohol withdrawal:

  • anxiety or nervousness
  • depression
  • fatigue
  • irritability
  • jumpiness or shakiness
  • mood swings
  • nightmares
  • inability to think clearly

InpatientDrugRehab.org Signs And Symptoms Of Alcohol Withdrawal Two Hours After The Last Drink

Possible physical signs of alcohol withdrawal:

  • excess sweating or clammy skin
  • enlarged or dilated pupils
  • a headache
  • insomnia
  • loss of appetite
  • nausea and vomiting
  • rapid heart rate
  • tremors of the hands or other body parts

What Is Severe Alcohol Withdrawal?

Severe alcohol withdrawal also referred to as delirium tremens, may occur when someone has become tolerant to large amounts of alcohol and suddenly stops drinking. This can shock the body into an unpleasant state and cause symptoms, such as:

  • agitation
  • fever
  • seeing or feeling things that aren’t there (hallucinations)
  • seizures
  • severe confusion

Delirium tremens may also be caused by head injury, infection, or illness in people with a history of heavy alcohol use, and often involves sudden mental or nervous system changes. This type of alcohol withdrawal is more common in individuals who have abused alcohol for more than 10 years and have also gone through previous periods of withdrawing from the substance.

What Causes Alcohol Withdrawal?

There are a number of things that cause alcohol withdrawal. To start, alcohol enhances the effects of the GABA neurotransmitter (chemical) in the brain. Which produces feelings of calm and relaxation.

When someone chronically abuses alcohol, eventually the GABA activity is suppressed, resulting in the need for more frequent and larger amounts of alcohol to achieve the same desired effects. This is also referred to as tolerance.

To maintain an equilibrium, the brain works to produce more glutamate (GABA) in people who drink chronically, compared to those who do not. When someone who compulsively drinks stops drinking, the suppressed neurotransmitters rebound, causing a state of hyperexcitability. This creates withdrawal effects that are often the direct opposite of those associated with drinking alcohol.

How Long Does It Take To Withdrawal From Alcohol?

The length of time alcohol withdrawal symptoms persist can vary from person-to-person. Alcohol withdrawal symptoms can be broken down into two stages; acute withdrawal and post-acute withdrawal. In most cases, acute withdrawal symptoms last about a week or two. However, post-acute withdrawal symptoms, such as alcohol cravings and other minor side effects may continue for months, sometimes years after someone stops drinking. Usually, post-acute withdrawal symptoms peak around six months and decrease in intensity from then on.

InpatientDrugRehab.org Signs And Symptoms Of Alcohol Withdrawal Resemble The Flu

Acute withdrawal, in most cases, consists mainly of physical symptoms that can resemble the flu. Post-acute withdrawal symptoms, or PAWS, tend to be less severe and consist mainly of psychological symptoms, such as issues with concentration.

Possible symptoms of PAWS include:

  • fuzzy thinking (brain fog)
  • problems with memory
  • inability to develop a normal sleeping pattern
  • trouble managing stress
  • feelings of depression, anxiety, or guilt
  • alcohol cravings
  • feeling tired all the time
  • difficulty experiencing pleasure (anhedonia)
  • problems getting along with other people

Severe emotional swings are one of the most common symptoms of PAWS. During early recovery, individuals may swing from feelings of happiness to despair in a matter of minutes. These intense fluctuations in mood can be very troublesome for someone who may be accustomed to turning to alcohol abuse to deal with difficult feelings.

How Post-Acute Withdrawal Symptoms (PAWS) Threaten Recovery

PAWS can be dangerous for individuals going through alcohol withdrawal because they may decide that not having alcohol in their life is not satisfying, and use these symptoms as a way to justify relapse. Anyone who does relapse, may not be willing to enroll in treatment again due to their negative experience in the past.

People suffering from PAWS may also adopt other negative behaviors, such as workaholism or another addiction. Some individuals may even use PAWS as an excuse to not put any effort into their recovery, resulting in dry drunk syndrome. This is when someone is physically sober but they behave in a similar manner to when they were addicted.

Inpatient care can help individuals struggling with PAWS avoid falling back into the trap of alcohol addiction.

Understanding Alcohol Withdrawal Syndrome

An estimated 18 million people in the U.S. had an alcohol use disorder in 2012, according to the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorders encompass a wide spectrum of different levels of alcohol abuse that can include; occasional alcohol abuse, binge drinking, and alcoholism (the most serious form of alcohol use disorder).

Often, individuals who are suffering from alcoholism spend their time ensuring access to alcohol or recovering from the effects of the substance. When someone is struggling with alcoholism, they are physically dependent on the substance. Individuals who are dependent on alcohol rely on it to function normally. Meaning they feel physically compelled to drink more and more alcohol, despite possible risks of self-harm and harm to others.

People who are physically dependent on alcohol may develop alcohol withdrawal syndrome if they dramatically cut down on their drinking or attempt to stop. Alcohol withdrawal syndrome is a potentially life-threatening condition that occurs when people have been heavily drinking for extended periods of time and abruptly stop their alcohol intake.

Alcohol withdrawal syndrome affects an estimated 2 million people in the United States each year, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Alcoholism is a chronic, generally progressive disease that often requires formal intervention to recover from.

What Does Heavy Drinking Mean?

The Center for Disease Control and Prevention (CDC) defines heavy drinking as more than eight drinks per week for women, and more than 15 drinks per week for men. The following are how a standard drink is measured in the U.S.:

  • 1.5 ounces of distilled spirits or liquor, i.e. gin, rum, etc. (40 percent alcohol content)
  • 5 ounces of wine (12 percent alcohol content)
  • 8 ounces of malt liquor (7 percent alcohol content)
  • 12 ounce of beer (5 percent alcohol content)

The most common form of heavy drinking is binge drinking. This is defined as four or more drinks in a two-hour window for women, and five or more drinks in a two-hour window for men.

Finding Treatment For Alcohol Withdrawal

Addressing alcohol use disorders with medically-assisted treatment (MAT) is encouraged by SAMHSA. MAT usually consists of a combination of approved medications (naltrexone, disulfiram, acamprosate) and behavioral therapy to address both physical and psychological aspects of addiction.

Inpatient treatment gives individuals the greatest chance of successful recovery from alcohol addiction because it supplies a new, supportive environment, where individuals can focus solely on their recovery.

To learn more about the signs and symptoms of alcohol withdrawal and treatment for alcohol use disorders, contact us today.

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Sources

National Institute on Alcohol Abuse and Alcoholism—Complications Of Alcohol Withdrawal
U.S. National Library of Medicine, MedlinePlus—Alcohol Withdrawal

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