For centuries, alcohol has been a part of celebrations and social situations. Since it’s legal for individuals over the age of 21 to drink alcohol, many people think this feel-good substance is relatively harmless. However, it can be just as addictive as any other drug, which is why understanding alcohol withdrawal symptoms is so important.

Alcohol contains a water-soluble substance known as ethanol. When you consume alcohol, the ethanol enters your digestive system. From there, it travels to your bloodstream where it passes through your cells and makes its way to your organs. Once it reaches your brain, it acts as a central nervous system depressant. At this point, your brain releases dopamine, while the ethanol deactivates glutamate (which slows the brain’s response to stimuli) and binds to gamma aminobutyric acid or GABA (which makes people feel calm and sleepy).

Most people can enjoy alcohol without becoming addicted to the substance. However, not everyone is so fortunate. When your alcohol consumption is excessive, you may receive a diagnosis of alcohol use disorder (AUD).

The current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) states that you can be diagnosed with an AUD if you meet two out of 11 criteria within a 12-month period. The diagnostic criteria include the following questions:

•       Have you ended up drinking more or longer than you intended?
•       More than once, have you unsuccessfully tried to reduce or stop drinking?
•       Have you spent a lot of time drinking or recovering from its aftereffects?
•       Have you experienced a strong urge to drink?
•       Does drinking or its aftereffects often interfere with your responsibilities?
•       Have you continued to drink even though it causes problems?
•       Have you given up on activities you enjoy in order to drink?
•       More than once, have you gotten into a dangerous situation as a result of drinking?
•       Have you continued to drink after experiencing health problems or a blackout?
•       Do you need to drink more than you used to in order to get the same effect?
•       Have you experienced withdrawal symptoms when you stop drinking?

In 2012, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) released informative statistics about the number of Americans with an AUD.

•       In the United States, 7.2% or 17 million adults (ages 18 and older) had an AUD. Of this number, 11.2 million were men and 5.7 million were women.
•       855,000 teens between the ages of 12 and 17 had an AUD.

One of the most startling statistics is how few people seek treatment. In 2012, only 1.4 million out of the 17 million adults with an AUD received treatment at a specialized facility.

With the right treatment and support in place sobriety is not out of reach for most people.

Having medical support is especially important during the detox process when withdrawal symptoms can derail your entire recovery process.

Alcohol Addiction – Tolerance and Dependence

Alcohol can be addictive with excessive and extended use. When you consume large quantities of alcohol for a prolonged period of time you can develop serious and long-lasting changes in the brain and body. One of the changes that people with an AUD notice is an increased tolerance. This means that you need to consume more alcohol over time to achieve the same effect.

Another change that alcohol addiction triggers is physical dependence, which means that you need to keep using alcohol to prevent the onset of withdrawal symptoms. These unpleasant symptoms can occur within two hours of the last drink and they can persist for weeks.

The Symptoms of Alcohol Withdrawal – Mild to Severe

When a person with an alcohol use disorder cuts back or stops drinking, they will experience withdrawal symptoms. The severity of the symptoms varies from mild to potentially life-threatening.

The severity, length, and type of symptoms vary from person to person based on several factors:

•       How long a person has been drinking
•       How much a person has been drinking
•       Age and overall health of the person
•       Whether the person has experienced withdrawal symptoms before

Since withdrawal symptoms can be very unpleasant, some people give up on trying to get sober in an effort to avoid feeling the effects of withdrawal. By understanding alcohol withdrawal symptoms and seeking appropriate medical treatment, you are more likely to make it through the first hours, days, and weeks of alcohol detox and recovery.

More minor alcoholism withdrawal symptoms usually start five to 10 hours after a person’s last drink, and they usually peak at 24 to 48 hours. These symptoms can include:

•       Anxiety
•       Headache
•       Insomnia
•       Irritability
•       Nausea and vomiting
•       Nightmares or vivid dreams
•       Rapid breathing and pulse
•       Sweating
•       Tremors

Approximately 12 to 24 hours after your last drink, you may begin to experience moderate symptoms of alcohol withdrawal, including auditory, tactile, or visual hallucinations. Some of the most common visual hallucinations include seeing multiple, small moving objects, such as insects or coins. While most patients realize that their hallucinations are not real, the experience is vivid and it can be very distressing. Within 48 hours, these hallucinations often cease.

A more serious symptom is withdrawal seizures. Patients who experience this symptom often do so six to 48 hours after they stop drinking, with the risk peaking at 24 hours. However, withdrawal seizures can occur as soon as two hours after the last drink. You have an increased risk of experiencing withdrawal seizures if you have undergone multiple rounds of detox.

The most severe symptom of alcohol withdrawal is delirium tremens (DTs), which has a 1% to 5% death rate. This symptom strikes 48 to 72 hours after the last drink, and it typically peaks at Day 4 or Day 5. Some patients may have delayed onset of symptoms and experience DTs more than a week after their last drink. The symptoms of DTs include:

•       Confusion, disorientation, and severe anxiety caused by a lack of blood flow to the brain
•       Dehydration
•       Fever
•       Hallucinations that cannot be distinguished from reality
•       High blood pressure
•       Profuse sweating
•       Racing and irregular heartbeat
•       Seizures
•       Severe tremors

Alcohol withdrawal symptoms can worsen quickly, so it’s important to seek medical attention even for mild symptoms. Receiving appropriate treatment early in the detox process can reduce the risk of developing more severe symptoms like withdrawal seizures and DTs.

It’s also important to consult with a doctor if you’ve previously experienced alcohol withdrawal symptoms or if you have certain health conditions such as heart disease, infections, lung disease, or a medical history of seizures.

Treatment Time Frame for Alcohol Use Disorder – It Takes Time

Each person is different, but both the Centers for Disease Control (CDC) and the National Institute on Drug Abuse (NIDA) state that patients who enroll in a detox and treatment program that’s at least 90 days in length have greater success rates than patients who participate in programs of shorter durations.

While three months might seem like a long time, this time is necessary to manage withdrawal symptoms and address the changes that an AUD causes in your brain and body. Patients did not acquire an AUD overnight, so alcohol addiction cannot be properly treated in just a few days. Each person needs time to recover from the mental and physical effects of alcohol addiction.

Recovering from any type of addiction, whether it is to drugs or alcohol, is a long process, and it is one that requires counseling, medication, and support. For the best results, you should take time to discuss your treatment goals with your doctor. This simple step can help the doctor create the right treatment and care plan for your situation. Finding the right treatment is the first step on the road to recovery and long-term sobriety.

Treatment Settings for Alcohol Withdrawal – Several Options

There are multiple locations where you can detox from alcohol. The best location will depend on the severity of your withdrawal symptoms. If you have more minor symptoms, it may be possible to manage withdrawal symptoms and complete the detox process at home. However, if you have more severe symptoms you should only attempt detox under direct medical supervision in a hospital or alcohol rehab and drug treatment center.

You should talk to your doctor about your health history, home situation, and symptoms to find the best treatment setting.

•       Home – If you are dealing with milder symptoms of alcohol withdrawals, the detox process can occur at home. However, patients who select in-home detox need to find the right medications and support in order to find success with in-home detox. We do not recommend this method as it can be dangerous to your health and increase the risk of relapse.

•       Alcohol and Drug Treatment Centers – A great place for you to undergo detox is a treatment facility like The River Source. Our team of medical professionals follows an approach that utilizes behavioral and pharmacological therapies to help patients get through the symptoms of withdrawal and find long-term sobriety.

•       Hospitals – With more intense alcohol withdrawal symptoms like DTs, severe vomiting, and withdrawal seizures, you should go to a hospital’s intensive care unit (ICU). In this location, doctors can monitor your blood pressure, breathing, and heart rate. They can also provide emergency life-support if your condition deteriorates.

Counseling, Medication, and Support – A Mix of Treatments

The best way to ensure treatment success is to utilize a holistic alcohol treatment approach that incorporates a mix of counseling, medication, and support. This combination has been proven to help patients manage the symptoms of alcohol withdrawal and recover from alcohol addiction.

Most alcohol treatment programs will include several steps including detox, medication, counseling, and support.

You stop drinking alcohol during the detox process. During this time, you may experience alcohol withdrawal symptoms as all traces of the substance leave the body. To help deal with the symptoms of withdrawal doctors may prescribe medication or supplements.

•       Librium and Ativan are sometimes prescribed to patients to help reduce the symptoms of alcohol withdrawal, as both medications can be helpful for anxiety.

•       Supplements, especially those that contain folate, magnesium, phosphate, thiamine, and zinc, can replenish the minerals and vitamins that alcohol withdrawal symptoms deplete.

After undergoing the detox process, it is the ideal time to start focusing on the long-term treatment of alcohol addiction. This time should be filled with a combination of counseling, treatment of other mental disorders, and support.

•       Counseling is a necessary component of treatment for an alcohol addiction. It can be performed on an inpatient or outpatient basis, and it can be completed alone, with your family members, or in a group setting. Counseling is designed to identify and modify the behaviors, relationships, and thought patterns that contributed to your alcohol addiction.

•       Treatment of other mental disorders may also be performed during the recovery process. It’s common for patients with a substance abuse disorder to have another untreated mental disorder like anxiety or depression. Diagnosing and treating these disorders reduces the risk of a relapse and improves your quality of life.

•       Support from loved ones, medical professionals, and support groups can do wonders for your recovery. A strong support system can help you stay on track, while support groups can show you that you aren’t alone in the recovery process.

The symptoms of withdrawal can make the process of recovering from alcohol addiction feel like an insurmountable task. However, sobriety is possible and worth the time and effort. It’s important to remember that alcoholism is a disease and should be treated as such.

The River Source offers a holistic approach to addiction recovery. By providing behavioral and pharmacological therapies in a supportive and professional environment, we help patients detox from alcohol and explore the reasons for their addiction. After inpatient treatment, patients leave with a long-term care plan to help them stay sober.

If you or someone you love is suffering from an addiction to alcohol, the River Source can help. Please contact us to learn more about our approach to treating alcohol addiction and how our team of trained professionals helps patients overcome the symptoms of alcohol withdrawal.