Alcohol withdrawal
From Drug Rehab Wiki
Alcohol withdrawal refers to what happens when a person who is physically dependent on alcohol stops drinking. If the person was not a particularly heavy drinker, or has not been drinking for years, he may experience very few symptoms. However, for the person who has been drinking in large amounts for many years, alcohol withdrawal can be extremely unpleasant and even life-threatening.
Symptoms usually begin within five to ten hours after the last drink, though in some people, they may take several days to start. These may be anxiety, depression, tiredness, jumpiness, shakiness, irritability, mood swings, foggy thinking, and nightmares. Some people have clammy skin, dilated pupils, headaches, loss of appetite, nausea, vomiting, pale skin, rapid heartbeat, sweating, and tremors. More severe symptoms can be agitation, hallucinations, confusion, convulsions, blackouts, fever, and seizures. The severity of symptoms depends on the age, weight, and medical condition of the person as well as how long and how much she has been drinking. Children can experience alcohol withdrawal.
Alcohol withdrawal can be life-threatening for several reasons. First, people who experience seizures and delirium tremors have about a 5% death rate even when they are medically supervised, and higher if they try to do it alone. Some people have injured themselves during seizures or convulsions, and others experienced difficult complications, such as Wernicke's or Korsakoff's syndromes, explained below. Medical professionals can monitor the person undergoing withdrawal to prevent accidents, and may prescribe sedatives such as benzodiazepines or anti-seizure medications that can ease symptoms.
Delirium tremens (DTs) is the most serious aspect of alcohol withdrawal. DTs are the result of alterations in the way receptor cells function in the brain. Alcohol affects the way nerve cells communicate with one another by interfering with the function of neurotransmitters such as GABA and glutamate. When alcohol is withdrawn, the brain cells begin to work in a more normal way without the inhibitory effects of alcohol, and the result is a normal activity level becomes extreme. The person's brain cells become overwhelmed, and DTs result. The person will experience tremor, hallucinations, disorientation, agitation, seizures, and increases in heart rate, breathing rate, pulse, and blood pressure. DTs are more likely to occur among patients who have certain pre-existing medical conditions, and there are medications such as haloperidol that can be helpful.
Although the DTs occur in only 5% of patients and seizures occur in only 25% of patients undergoing withdrawal, these are be serious conditions that require medical interventions. Patients who are pregnant, have histories of seizures, alcoholic delirium tremens or psychiatric illnesses, or who lack social support should always have professional support during withdrawal.
The electrolytes in the bodies of alcoholics are often not in balance, and patients withdrawing from alcohol can develop life-threatening metabolic abnormalities. People who try to do it alone can die from extreme dehydration resulting from vomiting, diarrhea, sweating and fever. On the other hand, some patients retain too much water and die if they receive intravenous administration of liquids.
Alcoholics often have vitamin deficiencies, which is why physicians sometimes administer vitamins, especially vitamin B and Thiamine, during withdrawal. Wernicke's and Korsakoff's syndromes are the result of nutritional deficiencies, and can occur during alcohol withdrawal. Wernicke's syndrome involves disorientation, cognitive impairment, inattentiveness and sometimes agitated delirium, and it can lead to a disabling memory disorder known as Korsakoff's syndrome. This disorder can include severe amnesia and problems in short-term memory.
After a person has physically withdrawn from alcohol, she may experience psychiatric problems that can last for days or even up to a year, such as anxiety, depression, and sleep disturbances, including frequent waking, restless sleep, insomnia, and night terrors. Other symptoms of prolonged withdrawal can be tremors, increased breathing rate, high body temperature and blood pressure, and rapid pulse.
Alcoholics need support to achieve withdrawal and maintain sobriety, and many require changes in lifestyle taught in all-day or residential treatment centers. Through intensive counseling, many people find out that they need a totally new direction in life, such as changing their career paths or learning new ways of relating to people they have known all their lives. They learn life skills such as improving communication and managing stress and anger. Usually, family members and loved ones are deeply involved in the rehabilitation process. Some alcoholics live in sober-free residences for as long as a year, where they can practice what they learned with support from others in the same process. Usually, recovering alcoholics benefit from attending 12-Step or other self-help support groups.
