Are you struggling with alcohol addiction and determined to quit completely without having another drink? Avoid being overly willful; the cravings for alcohol can make you suffer tremendously, and it’s easy to “give in” and start drinking again. It’s best to reduce your intake gradually.
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When a person suddenly stops drinking alcohol, they may experience withdrawal syndrome with symptoms such as tremors, insomnia, and anxiety.
Alcohol has slow effects on the brain, acting as a sedative or causing depression. In long-term alcoholics, the brain is continuously affected by the depressant effects of alcohol. Over time, the brain self-regulates the chemicals to compensate for the effects of alcohol, producing stimulating chemicals like serotonin or norepinephrine (related to adrenaline) in greater than normal amounts.
If you suddenly quit drinking (due to withdrawal), the brain is like a car speeding down a hill without brakes. Most of the withdrawal symptoms occur due to excessive stimulation of the brain. The most dangerous clinical manifestation occurs in 1 out of 20 people undergoing withdrawal, known as delirium tremens, where the brain can no longer regulate the chemicals after stopping alcohol. Delirium tremens is a temporary state of confusion where the brain loses control over many functions such as circulation and respiration. Vital signs like heart rate and blood pressure can change abruptly and unpredictably, leading to heart failure, stroke, and death. Therefore, to allow the brain to adjust back to its normal drinking habits, a lengthy period is needed for the brain to regain its balance.
Withdrawal symptoms can vary widely, are unpredictable after the last drink, and not all patients will experience them all:
Tremors: These typically start about 5-10 hours after the last drink and peak after 24-48 hours. Following the tremors, symptoms include rapid heartbeat, increased blood pressure, rapid breathing, sweating, nausea, anxiety, restlessness, vivid dreams, and insomnia.
Alcohol hallucinations: This symptom starts 12-24 hours after the last drink and can last for 2 days. People undergoing withdrawal often see numerous small, similar, moving objects. Sometimes they perceive many insects crawling or hear the sound of coins dropping.
Withdrawal seizures: Seizures can occur 6-48 hours after the last drink, often occurring in clusters over several hours. The greatest risk for seizures occurs after 24 hours, particularly for grand mal seizures.
Delirium tremens: This typically occurs 2-3 days after the last drink and can be delayed for up to a week. The peak often occurs 4-5 days after the last drink. This condition poses risks to breathing, circulation, and the patient’s temperature; it can result in a rapid heart rate, excessively high blood pressure, or dangerously low hydration levels. Delirium tremens can also reduce blood flow to the brain, leading to vomiting, delirium, disorientation, stupor, unusual angry outbursts, irrational beliefs, sweating, sleep disturbances, and numerous hallucinations.
Alcohol withdrawal syndrome usually improves after 5 days, although a small number of patients may experience symptoms for several weeks. If a patient is experiencing severe vomiting, seizures, or delirium tremens, hospitalization is the safest option. For delirium tremens, treatment should occur in an intensive care unit where the patient’s heart rate, breathing, and blood pressure can be closely monitored, and sometimes mechanical ventilation may be necessary.
Benzodiazepine medications can help alleviate alcohol withdrawal symptoms; commonly used drugs include Valium, Librium, and Ativan. Patients undergoing alcohol withdrawal often have deficiencies in several vitamins and minerals simultaneously, which need to be supplemented. The most commonly deficient nutrients are folate, thiamine, B12, magnesium, zinc, and phosphate. Patients may also experience decreased blood sugar levels.
