What Is It Like to Experience Alcohol Withdrawal?
Every year, around 1.5 million people in the United States seek alcoholism treatment or are hospitalized in a general hospital due to the medical effects of alcoholism. These individuals, as well as a significant proportion of other people who stop drinking without seeking professional help, experience alcohol withdrawal.
Alcohol withdrawal is a set of signs and symptoms that occur when an individual stops drinking after having been dependent on alcohol in some way (either as a regular drinker or as an alcohol abuser). It is also possible for people to go into alcohol withdrawal if they drink less than usual, but that does not happen as often. When it does happen, it is typically in people who are long-time heavy drinkers and have developed tolerance to the sedative effects of alcohol.
Frequent alcohol consumption can become a habit that becomes very difficult to break because the brain develops a dependency on it. These symptoms are more pronounced depending on how long the person has been a heavy drinker. But what exactly causes these symptoms?
What Causes Withdrawals?
When you frequently consume alcohol, it’s natural for your body to get used to having a certain amount of it. But when you quit drinking suddenly, the brain is not accustomed to the lack of alcohol and needs time to adjust. The imbalance between the amount of alcohol you consume and your body’s ability to process it can cause uncomfortable symptoms after your last drink.
Additionally, your central nervous system (CNS) will go through withdrawal. The CNS is primarily responsible for regulating the rest and activity of your body’s organs, including your liver. Alcohol affects the central nervous system by slowing communication between nerve cells and eventually damaging some. When you quit drinking, especially abruptly, these damaged nerve cells will initially overcompensate with their signals as they try to function normally again.
Alcohol Withdrawal Symptoms
With your CNS in such a state, your body’s organs try to compensate. This leads to physical symptoms that develop in a timeline. Mild symptoms generally begin in the first few hours and can include nausea, shakiness, and anxiety. You may also experience sweating and an increased or irregular heartbeat.
After 12-48 hours, your symptoms can become more severe. You may experience hallucinations and seizures and have difficulty staying conscious. At this point, you should seek medical help to treat the withdrawals. After 48-72 hours, about 2% of people experience delirium tremens (DTs). These symptoms include delirium, increased heart rate, high blood pressure, tremors, sweating, vivid hallucinations, and anxiety.
How long your withdrawal symptoms last can depend on how long you have been drinking, your daily consumption rate, and the amount of alcohol you consume when you stop. But how are these symptoms diagnosed?
If you’re experiencing more severe symptoms, you may want to talk to your doctor and get evaluated for alcohol withdrawal. If you have an established history of using alcohol in excess and regularly experience severe symptoms, your dependence is likely severe enough for a doctor to diagnose it.
You may also be asked to take a screening test to determine your level of alcohol dependence. The Alcohol Use Disorders Identification Test (AUDIT) is one such screening test used by doctors to determine the severity of your alcohol use and whether or not you need medical attention. Once it has been determined that you have an alcohol dependency, it would be best to commit to an appropriate treatment plan.
For individuals with mild to moderate alcohol dependencies, doctors may recommend supportive therapy or counseling through intravenous rehydration or electrolyte correction. Clients may also be given a “banana bag,” a cocktail of folate, thiamine, dextrose-containing fluids, and a multivitamin.
It is worth noting that even though you may be experiencing mild withdrawal symptoms, it is essential to seek medical attention because recurring symptoms can cause other health complications. Repeated withdrawal episodes may make the brain more vulnerable to the hyperexcitability that results from alcohol withdrawal. This is referred to as kindling.
According to clinical research, individuals who have a history of numerous withdrawal episodes are more likely to suffer seizures than individuals who are having their first withdrawal episode. Thus, even in individuals with mild symptoms, withdrawal therapy may theoretically avoid the development of complex, more severe withdrawal symptoms during the later stages of withdrawal.
Pharmacotherapy may be necessary for individuals suffering from severe withdrawal, especially DTs and seizures. You may be administered benzodiazepines to control your symptoms while in the medical facility. Benzodiazepines are short-acting and commonly used when treating anxiety disorders because they can effectively calm the nervous system. The most common benzodiazepines used to treat alcohol withdrawal are intravenous diazepam or lorazepam.
Because their effects are similar, benzodiazepines and alcohol are cross-tolerant. This means that someone tolerant of alcohol is also tolerant of benzodiazepines. Cross-tolerance also indicates that when one substance is deficient, the other agent might act as a replacement, ultimately reducing withdrawal symptoms.
Benzodiazepines not only ease alcohol withdrawal symptoms, but they also lessen the occurrence of DTs and seizures. Furthermore, they are typically safe and can be administered frequently over many hours. These medications must be administered in decreasingly lower dosages before being withdrawn so as to avoid the recurrence of withdrawal symptoms. There are two approaches to administering them:
1. Fixed-Schedule Approach
In this approach, the client takes a specified dose of the drug every six hours for two to three days, regardless of the existence or severity of symptoms.
2. Symptom-Triggered Approach
In this approach, the client takes the drug as needed. The symptom criteria determine if and when to take the medication. Clients who have no symptoms are not given any medicine. This method of dosing benzodiazepines during alcohol withdrawal is efficient since it lets the physician deliver the appropriate treatment for the client’s symptoms. Furthermore, symptom-triggered dosage distributes less medicine over a shorter period than fixed-schedule dosing.
Management of Alcohol Withdrawals
Clients undergoing alcohol withdrawal usually receive treatments in hospitals and inpatient alcohol and other drugs (AOD) treatment programs. General hospitals and even critical care units are acceptable for people experiencing severe withdrawal symptoms and having concurrent medical, surgical, or psychological disorders that necessitate hospitalization.
Outpatient AOD treatment settings are acceptable for people who do not have significant withdrawal symptoms or aggravating conditions. Furthermore, detoxification can be effectively completed in the client’s home. However, withdrawal in settings with less intense supervision should be approached with caution.
Preventing Alcohol Withdrawal
Although alcohol withdrawal is a natural and involuntary process, you can take steps to lessen your risk of developing it. The following tips may help:
1. Avoid Alcohol
By drinking alcohol, you increase your risk of self-medicating or taking temporary relief from anxiety. This is because alcohol is a depressant drug that slows down the central nervous system. By decreasing anxiety and keeping your mind occupied through drinking alcohol, you might be preventing yourself from recognizing when or how much you are drinking. Therefore, it is essential to quit drinking if you want to keep your decision-making abilities intact.
2. Avoid Binge Drinking
If avoiding alcohol consumption is impossible, it is undoubtedly safer to drink in moderation. Binge drinking often carries many health risks and should be avoided at all costs. Binge drinking is usually defined as drinking five or more units of alcohol on a single occasion. It is essential to understand that it’s not the amount of alcohol consumed when you’re binge drinking that causes problems but how often you do it.
For starters, due to the high concentration of alcohol, binge drinking increases your risk for accidents. Accidents may endanger the lives of you and others around you.
Furthermore, binge drinking might lead to alcohol overdose. Alcohol overdose is usually accompanied by altered mental status and unconsciousness. If left untreated, it may even lead to death as a result of respiratory system failure or alcohol poisoning.
Relapsing after developing alcohol dependence is a common phenomenon. There are three stages of alcohol relapse that an individual must undergo:
1. Emotional Relapse
This is the first stage of relapse. Emotional relapses happen because users don’t accept that they are an alcoholic. During an emotional relapse, individuals are aware of their last relapse episode. However, they are in denial because they don’t want to acknowledge their relapse.
They end up bottling up their negative emotions, leading to depression. Depression is what prompts and encourages alcohol relapse because people who are depressed feel like they deserve it, and they see no way out of their dilemma.
Friends and family members are usually encouraged to help the individual at risk of emotional relapse. In this stage, it is crucial for individuals to seek professional guidance because they need therapy to help them overcome their addiction and depression.
Therapy helps you address any underlying emotional issues that may have been causing or contributing to the addiction. The focus of therapy is to help individuals learn how to cope with their emotions and deal with their problems in a healthy way rather than by drinking.
2. Mental Relapse
This is the second stage of relapse. Mental relapses occur when the individual is capable of comprehending the negative behaviors they have exhibited recently. The first step in this stage is to admit to yourself and others that you did something wrong and take responsibility for your actions. Mental relapses are more dangerous than emotional relapses because they can lead to alcohol use disorder.
Individuals may be motivated to drink to compensate for their fear of rejection or to relieve feelings of guilt about their relapse episode. During this stage, clients need to avoid stressful situations and focus on relaxing activities such as eating well, exercising, and resting. They should also find a trusted friend or family member to help them stay sober and attend meetings or support groups.
3. Physical Relapse
This is the final stage of relapse. Physical relapses occur when users have not yet resolved their emotional and mental issues. Once a person lapses and drinks again, that one drink can lead to a return to uncontrollable drinking. It can also lead to obsessive thinking about drinking again, which eventually turns into continued use.
In this stage, it is vital for clients to seek professional help. It is also essential for them to have family or friends as their support system so that they have the will and motivation to commit to treatment.
Preventing relapse can be difficult. It’s important to understand that relapse is common and does not mean that clients have failed in their recovery journey. The key to preventing relapse is to become aware of the triggers and emotions that led them back to drinking in the first place.
A support group and a list of coping skills can help significantly with this. If you find yourself obsessing over alcohol, seeking out your support network and talking about your issues will help you find an alternative way to cope with whatever situation you are dealing with.
Alternatively, you can commit yourself to a facility that will help you manage your cravings and help you avoid the triggers that will lead you back to alcohol use. Remember that the best way to fight alcohol addiction is to commit to sobriety fully with the help of a qualified treatment center.
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