Alcohol withdrawal syndrome is a collection of withdrawal symptoms that occur when someone who is addicted to alcohol quits drinking. Some of these symptoms may be related to a life-threatening condition known as delirium tremens, or DTs, which usually occurs in those who have a history of seizures related to alcohol withdrawal or who have abnormal liver function or a serious medical illness. Advancing age is also a risk factor for this condition.
Alcohol withdrawal symptoms usually set in between 6 and 12 hours after the last drink, and it’s due to the changes in brain function that characterize physical addiction.
Initially, drinking alcohol increases the effects of the neurotransmitter GABA, which produces feelings of calm and relaxation. But heavy drinking eventually begins to suppress the activity of GABA, and as a result, the body needs more and more alcohol to increase GABA activity to produce the feelings of relaxation. This is known as building up a tolerance.
At the same time, alcohol suppresses the activity of a neurotransmitter known as glutamate, which is responsible for feelings of excitement. This suppression leads the glutamate system to operate at a higher level than is normal.
When someone with an alcohol addiction stops drinking, neurotransmitter activity rebounds, flooding the brain with chemicals that were previously suppressed by the alcohol. It’s this elevated brain activity that causes withdrawal symptoms.
The symptoms associated with quitting alcohol typically occur in a set pattern, but not all patients will experience all of the withdrawal symptoms, and the symptoms may range in severity from very mild to extremely intense.
Within six to 12 hours after the last drink, minor symptoms will usually appear. These include shakiness, mild anxiety, sweating, headache, insomnia, nausea, and vomiting.
Within 12 and 24 hours after the last drink, hallucinations may occur. These include auditory, visual, and tactile hallucinations, which patients generally understand are only hallucinations. These usually end within 48 hours.
Within 48 to 72 hours after the last drink, delirium tremens may occur, and this condition is dangerous and potentially fatal. Symptoms of delirium tremens include disorientation, severe anxiety, visual hallucinations that seem very real, seizures, high blood pressure, and an irregular heartbeat. DTs usually peak around the five day mark.
Medical detoxification is the process of breaking the physical addiction to alcohol, and it’s supervised by physicians, who administer medications as needed to prevent dangerous symptoms and alleviate discomfort during the detox process. Since around five percent of people who experience the onset of DTs without medical supervision die from this condition, medical detox is essential for safe withdrawal. It also helps patients make it through the detox process without lapsing due to excruciating discomfort.
Some of the medications used during medical detox include Paxil, which helps alleviate insomnia and depression, Neurotonin to prevent or treat seizures and help restore normal brain function, and Chantix, which alleviates intense cravings.
Alcohol rehab is available as both inpatient and outpatient programs. A addiction specialist can help you decide which might be the best type of program based on your needs and particular issues surrounding the addiction.
Inpatient drug treatment is generally the most ideal type of program, since patients live at the facility and are able to focus solely on recovery without the stresses and triggers in “real” life that can contribute to a lapse. Those with a long history of alcohol abuse or who have a co-occurring mental illness should always choose inpatient treatment.
Outpatient treatment can also be successful, but only if the patient is personally motivated to recover and has a support system in place at home. Outpatient treatment provides more privacy and allows patients to continue working or attending school.