Alcohol is a psychoactive substance that depresses the central nervous system. Despite its legality in most places, it is the cause of a staggering three million deaths every year. Alcohol consumption starts to become alcohol abuse when:
- You are struggling to function without alcohol (alcohol dependence)
- You regularly drink more than 14 units per week
- You experience health problems caused by alcohol
- Your mood changes frequently, including irritability and mood swings
Alcohol use disorder affects over 6% of the USA’s adult population but with only less than 10% receiving treatment, it is an ongoing issue. The future health implications that long term heavy drinking can have are:
- High blood pressure
What is Alcohol Withdrawal?
Alcohol is typically used to gain feelings of relaxation and euphoria. This occurs due to the increase of GABA, a neurotransmitter that promotes the calming feelings when alcohol is consumed. Unfortunately, when you drink alcohol it also decreases the neurotransmitter, glutamate, responsible for creating excitability.
When alcohol use becomes heavier, the increase of GABA becomes more and more difficult to obtain, leaving individuals in a constant battle to get that euphoric, relaxed feeling and remove that excitable feeling that the increase of glutamate is producing.
When you stop drinking alcohol, these two neurotransmitters are not being impacted but your body still overproduces glutamate and underproduces GABA. This neural imbalance leaves those on an alcohol detox with excitatory symptoms like increased heart rates and sleep disturbances. Depending on how much of a heavy drinker you are, these excitatory symptoms may have a more severe form like confusion, seizures, hallucinations. These are symptoms of alcohol withdrawal syndrome.
Alcohol Withdrawal Treatment
Dependant on the symptoms and their severity, the treatment process will vary. a medical professional will assess the individual’s needs and decide on either a pharmaceutical, psychological or combined therapy approach.
If someone is experiencing milder withdrawal symptoms, they may be okay to withdraw at home. This is not always the case if someone is experiencing moderate to severe alcohol detox symptoms as these can be extremely dangerous. A doctor may prescribe medications to moderate withdrawal symptoms such as:
- Benzodiazepines. Doctors prescribe benzodiazepines like diazepam (Valium), alprazolam (Xanax) and lorazepam (Ativan) to reduce the likelihood of seizures, a severe form or alcohol withdrawal symptoms. However, it is important to note the risk of dependancy of these drugs, therefore they should be taken with caution.
- Nutritional Support. Nutrients like thiamine, folic acid and magnesium can be prescribed by doctors to aid withdrawal symptoms and to repair the nutritional loss that is caused by drinking alcohol. This is also used to avoid developing a condition called Wernicke-Korsakoff’s syndrome.
- Neuroleptic medications. Doctors can prescribe these to help depress the nervous system, reducing the likelihood of seizures or agitation.
- Beta-Blockers. These medications are used to reduce withdrawal symptoms like high blood pressure. Propranolol is one example of a beta-blocker.
Treatment after the alcohol detox
Once those experiencing withdrawal symptoms have improved, doctors might then prescribe medication that will reduce alcohol cravings. Certain drugs used in alcohol addiction treatment may include:
- Naltrexone (ReVia). This can be used to inhibit alcohol cravings and maintain a person’s abstinence from alcohol by blocking the opioid receptors in the body (responsible for the feel-good experience when taking drugs).
- Disulfiram (Antabuse). This drug is prescribed due to its abilities to reduce alcohol cravings and produce a sick feeling if a person were to drink alcohol.
Alongside pharmaceuticals, additional alcohol addiction treatment is vital to avoid relapses and a healthy recovery. Therapeutic interventions are important to get to the root of the issue and improve the psychological wellbeing of the individual. Some therapies that are used to help overcome substance abuse are:
- Group therapy
- Individual therapy
- Cognitive-Behavioral Therapy (CBT)
- Support Groups
Home Detox vs. Medical Detox Program
Detoxing from alcohol can be difficult and potentially unsuccessful if not under medical supervision. Obviously, not everyone can access medical detoxes due to factors like family commitments, it is still recommended to have assisted treatment. The risks of attempting to withdraw from alcohol alone at home are mentioned below.
- Delirium Tremens – experiencing this could lead to life threatening implications and possibly death
- Relapse – without any support or medication to assist with cravings, there is a higher chance of going for another drink
- Self-Harm – there is a higher risk of harming oneself if unattended and feeling emotions like anxiety and depression.
Alcohol Withdrawal Symptoms
Due to the body’s natural response to maintain balance, when alcohol depresses the nervous system, the brain signals excitatory neurotransmitters to be released. Consequently, the withdrawal symptoms can be over-stimulating.
Symptoms of alcohol withdrawal can range from mild to more severe forms, dependant on multiple factors like when your last drink was and the severity of substance abuse. Quitting alcohol cold turkey can be difficult but the longer it is avoided, the less the chance of experiencing severe, life threatening symptoms.
Mild Alcohol Withdrawal Symptoms
Severe Alcohol Withdrawal Symptoms
In severe cases, you may experience delirium tremens (DTs) or alcohol withdrawal delirium, medical professionals associate DTs with the following symptoms:
- Extreme agitation
- High body temperature
- High blood pressure
Severe alcohol withdrawal symptoms can be life-threatening and require immediate medical attention. Medical professionals consider a multitude of factors to determine what symptoms an individual may experience and the severity.
It is very rare to experience DTs, however there are some risk factors that may increase your chance of developing this serious health condition.
risk factors for experiencing delirium tremens
- History of DTs
- Low sodium/potassium levels
- History of seizures with alcohol withdrawal
- Other substance abuse
Alcohol Withdrawal Timeline
How long does it take to withdraw from alcohol? Well, there are typically four stages to alcohol withdrawal, according to a recent study, this is the general consensus for the alcohol detox timeline.
Stage One (6 to 12 Hours)
Within 6 to 12 hours after your last drink, minor symptoms like trembling hands and anxiety will usually occur. However, seizures can be apparent in heavy drinkers.
Stage Two (12 to 24 Hours)
This is where the mild symptoms tend to continue and if you have acute alcohol withdrawal symptoms, they will most likely peak here.
Stage Three (24 to 72 Hours)
During this period, individuals may experience more severe withdrawal symptoms of alcohol. This is where the delirium tremens may occur, which may present in high heart rate, seizures and other detox symptoms. Severe symptoms are experienced by only around an estimate of 3-5% of individuals, but if they are apparent then medical supervision is advised.
Stage Four (After 72 Hours)
At this stage, symptoms of withdrawal should start to calm down and after a week, symptoms usually disappear. In rare cases, those with moderate to severe withdrawal symptoms (including increased heart rate and hallucinations) can last up to a month.
Get Help Today
Although alcohol use disorder is difficult to overcome and potentially life threatening, with the right detox process, you can maintain a healthy life without relapsing. We know that alcohol withdrawal can be mentally and physically demanding but with the professional care at the NP Addiction Clinic, we can provide a person-centred approach that will tailor treatment specific to your needs.
We are aware of the struggle of withdrawing from alcohol, however our alcohol detox process offers a strong network of support alongside your journey. Addiction usually coincides with other mental health disorders, which is why why we offer a dual diagnosis treatment to combat everything that may trigger relapses in the future.