Alcohol Withdrawal

What is alcohol withdrawal?

Alcohol withdrawal is physical symptoms and emotions you have if you drink heavily or frequently and suddenly stop drinking. It can also happen if you drink much less than you are used to drinking. You are most likely to have withdrawal problems 1 to 7 days after your last drink.

How does it occur?

If you are an alcoholic, you may have withdrawal if:

• You decide to stop drinking.
• You are in a situation where you can't drink alcohol, such as at a hospital, treatment center, or jail.

What are the symptoms?

The effects of alcohol withdrawal vary greatly. Most people with mild to moderate alcohol dependence have one or more of these symptoms:

• headache
• dizziness
• nausea and vomiting
• shaking
• sweating
• restlessness
• seizures
• increased heart rate or blood pressure
• trouble sleeping or concentrating
• strong desire to drink to relieve the symptoms of withdrawal

A few alcoholics experience a life-threatening condition called delirium tremens (DTs) when they stop drinking alcohol. This is a medical emergency. The symptoms may include:

• confusion
• hallucinations
• agitation
• seizures
• memory problems
• fever
• very high heart rate and blood pressure.

How is it diagnosed?

Your healthcare provider will review your symptoms, examine you, and ask about your medical history and memory.

You may have one or more of these tests:

• urine and blood tests to check for the level of alcohol and other drugs in your body
• blood tests to measure blood count and other substances in your blood to find out how your liver and kidneys are working
• X-rays to check for broken bones from a fall or other health problems.

How are alcoholism and withdrawal treated?

If you are an alcoholic, you must first admit that you have a problem. You must take responsibility for it. Some people know they have an alcohol problem but deny that they need help to stop drinking. When you can take responsibility for your problem and admit you need help, call your healthcare provider.

Many alcoholics cannot admit that they have a problem. Loved ones, employers, or others may then have the painful task of committing the alcoholic to treatment. This is very tough but necessary. To say the alcoholic can't be helped until he or she wants help is not true.

Detoxification:
Detoxification is also known as "drying out." It means that you stop using alcohol completely. Detoxification can be done as an outpatient, or in a hospital or drug treatment facility. Which choice is best for you depends on how much and how long you have been drinking. It also depends on other medical problems that you may have.

Treatment for withdrawal symptoms may include:

• tranquilizers
• blood pressure medicine
• anticonvulsants
• vitamins
• intravenous (IV) fluids.

Detoxification may take 3 to 4 days.

Long-Term Treatment:
After detoxification, you will need long-term treatment. This may include social, medical, and psychological therapy.

• Social treatment involves family members and focuses on problems in the home and at work.
• To discourage you from drinking again, your healthcare provider may prescribe the medicines disulfiram, acamprosate, or naltrexone. These medicines work best as one part of a full treatment program.
  • Disulfiram (Antabuse) will make you feel sick if you drink alcohol after taking the medicine. Knowing you will have this reaction will discourage you from drinking.
  • Naltrexone (ReVia or Depade) or acamprosate (Campral) can help stop drinking by reducing the craving for alcohol.
• Psychological therapy usually involves group therapy sessions to understand the illness and why you drink.

Self-help support groups such as Alcoholics Anonymous (AA) can be very helpful. At local chapter meetings you can meet other alcoholics, share experiences, and receive encouragement. It does not cost anything to join AA. Meetings are open to anyone who has a drinking problem and wants to become and stay sober. Phone numbers for local chapters of AA are usually listed in the phone book.

Families of alcoholics can join a related organization called Al-Anon. For families of someone who does not recognize his or her drinking problem, Al-Anon meetings can help build understanding and strength before forcing the person into treatment. It's very hard to keep denying an alcohol problem if your family is attending Al-Anon.

How long will the effects last?

The severe shakes and hallucinations of delirium tremens (DTs) may last 1 to 5 days. Alcohol has long-lasting effects. It can take weeks or months before you feel more clear-headed, less depressed, less anxious, and have more energy. Delirium tremens can be fatal if it is not treated.

How can I take care of myself?

If you are an alcoholic, the most important thing you can do is to admit the problem and ask for help. If you decide to stop drinking alcohol or are in a situation in which you cannot drink (such as in a hospital), ask for medical help. You may not need hospital treatment for withdrawal symptoms, but you should be where someone can get help for you if you need it.

While you are having treatment for withdrawal:

• Take the full course of treatment your healthcare provider prescribes.
• Follow your provider's advice for treatment of any other medical problems.
• Have 3 meals a day.
• Take a multivitamin.
• If possible, avoid drinking coffee and smoking.
• Get enough sleep and stay as active as possible during the day.
• Attend AA meetings often.

What can be done to help prevent alcohol withdrawal?

If you are physically dependent on alcohol, you will have withdrawal symptoms when you quit drinking. Seek treatment so that you can withdraw safely and with much less discomfort.