alcohol withdrawal

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How Long Do Withdrawal Symptoms Last?

To stage an intervention, set an appropriate time and place, prepare the r

Expect alcohol withdrawal symptoms to last an average of 5 days. [1]

Heavy consumption of alcohol and long-term alcohol use are both linked to longer withdrawal times.

 

Generally speaking, withdrawal symptoms do not feel good.

But with proper information and support, unpleasant alcohol withdrawal symptoms can be overcome.

Common withdrawal symptoms from alcohol are:

  • Shaking/ tremors
  • Nausea/ vomiting
  • Insomnia
  • Anxiety
  • Headaches
  • Excessive sweating

 

 

More serious withdrawal symptoms include those that point towards:

  • Delirium Tremens (“the DTs”)
  • Epilepsy (including tonic-clonic seizures that are described as similar to epilepsy)
  • Hallucinations (seeing, hearing, and otherwise sensing things that are not really present)
  • “Wet Brain” or Wernicke-Korsakoff Syndrome

 

 

Formally, the condition associated with alcohol withdrawal is called Alcohol Withdrawal Syndrome (AWS). [2]

The AWS condition ranges from Mild, Moderate, or Severe.

Health care professionals diagnose Alcohol Withdrawal Syndrome (AWS) using a scale called CIWA-Ar, blood tests, and sometimes a toxicology procedure.

 

A mild case of AWS usually determined when the person has a low collective score in the categories defined by diagnostic tests.

A moderate case of AWS means the person is at risk of developing serious symptoms, and it would be best if they seek professional care.

 

A severe case of AWS is where a person experiences Delirium Tremens. DT is suspected when there is:  [3]

  • Mental Confusion
  • Hallucinations
  • Feeling disoriented/lost even in familiar everyday surroundings
  • Difficulty thinking and reason clearly
  • Long-term problems with memory about present events and past events

 

 

With severe cases of AWS, detoxing without professional support is not recommended as the risks are grave.

Individuals who have a serious case of AWS have a 4 to 6.6% fatality rate compared to persons who have milder cases. [4]

In addition, it is well recognized that professionally supervised detox contributes to a better outcome than detoxing alone [4].

However mild the case, withdrawal from alcohol use poses some risks, especially if there are signs that Delirium Tremens can happen.

 

Delirium Tremens is usually associated with heavy drinking that has gone on for many years [3].

Delirium Tremens can develop 1 to 4 days in the most vulnerable individuals.

Because alcohol withdrawal can be stressful, some individuals even if they do not have AWS, opt to go to a rehab clinic such as Abbeycare Scotland to detox from alcohol.

How Long Does Withdrawal Last?

An average of 5 days is the usual amount of time some alcohol withdrawal symptoms last. [1]

A typical time-line for alcohol withdrawal symptoms is presented below. [2]

Days 0 to 1

  • Anxious feelings
  • Irritability
  • Sleeplessness
  • Headaches/Migraines
  • Stomach upsets
  • Excessive sweating
  • Loss of appetite
  • Insomnia

Days 1 to 2

  • Shakes/ Tremors/ Muscle spasms
  • High temperature/ Fever
  • Nausea/Vomiting
  • Difficulty sleeping and staying asleep

 

Days 2 to 3

  • Shakes/ Tremors/ Muscle spasms
  • Excessive sweating
  • With some individuals signs of Delirium Tremens
  • High blood pressure
  • Heart is beating too fast
  • Difficulty sleeping and staying asleep

 

Days 4 to 5

  • By this time, the person may be feeling fewer headaches/stomach upsets/ flu-like symptoms.
  • But for some individuals, signs of Delirium Tremens may happen
  • With persons who have signs of the DTs, it is recommended to seek expert care

 

Delirium Tremens can cause health complications and even pose a risk to life.

 

In addition, alcohol addiction can co-occur with the following health conditions. These are: [5]

  • Anxiety and mood problems (particularly for women)
  • Other substance use problems like smoking and illegal drug use (particularly for men)
  • Liver damage
  • Neurologic (brain-related) impairment that shows up as blurred vision, slowed speech, and unbalanced stance when walking
  • Various cancers

 

 

Diseases that happen along with alcohol use and abuse can make recovery a long-time endeavour necessitating support from experienced care providers.

Because recovery is not just about taking a pill or attending a group meeting, experts cite the full use of a system that tackles the problem holistically.

 

Dealing with alcohol problems in a whole-person approach means:

  • Promoting wellness of the mind, body, and spirit/psyche
  • Thinking of Sober Living as a lifestyle instead of a quick-fix solution
  • Addressing issues of alcohol misuse by restoring balance in a person’s different life aspects
  • Focusing on long-term recovery and/or abstinence

 

 

In a clinic that uses a holistic approach such as Abbeycare Gloucester, these goals are achieved by having the following Holistic Care services available:

  • Nutritionally balanced diet – as long-term alcohol use depletes the body of essential nutrients [1]
  • Exercise – wards of depressive and anxiety-causing thoughts during the withdrawal phase of treatment [6]
  • Massage therapy – to encourage body-focus and body-awareness
  • Acupuncture – can help ease sensitivity to pain as well as some anxiety symptoms when a person is going through alcohol detox [7]
  • Relaxation techniques – such as guided meditation can help a person manage moods and increase mental focus [6]

 

Alongside established therapeutic methods such as Cognitive Behavioural Techniques and 12 Step Facilitation, these alternative methods can boost a person’s chancer of fully recovering from alcohol addiction [6].

How Do You Stay Sober?

A person who wants to stay sober can benefit from learning behavioural techniques usually taught in 12 Step Facilitation and Cognitive Behavioural Therapy.

Learning techniques from these proven systems promote long-term abstinence from alcohol. [8]

Whereas, the cold turkey approach can be detrimental to a person’s chances of recovery because it sets the stage for the kindling phenomenon to occur. [9]

 

The kindling phenomenon is explained using an illustration here:

  • A person tries to do quit alcohol abruptly without other forms of support (like therapy or professionally supervised alcohol detox)
  • After a brief period of sobriety, the person relapses and goes back to drinking
  • The next time the person tries to quit alcohol again, withdrawal symptoms become worse.
  • The person is discouraged to quit from alcohol because the withdrawal symptoms are horrible.

 

Experts agree that if abstaining from alcohol is experienced negatively, especially if the withdrawal symptoms are severe, the less likely the person will stay sober [10].

Is Alcohol Use Disorder The Same As Alcoholism?

Yes. Alcoholism is the layman’s term for Alcohol Use Disorder (AUD).

The terms “alcoholism” and “alcoholics” are regarded as derogatory. [11]

Health care professionals diagnose a person with AUD depending on several tests.

 

Mostly, a person who has AUD tends to have:

  • Physical signs of withdrawal when alcohol use is stopped
  • Psychological dependence on alcohol
  • Co-occurring health problems such as liver disease

 

In Scotland, the increasing numbers of alcohol-related accidents and deaths have alarmed officials. [12]

A change in policy increased the price of non-branded value bottles with the intention to discourage AUD affected persons to buy large amounts of alcohol for cheap a price. [12]

So far, it is suggested that making alcohol less accessible can help AUD affected individuals make better choices about alcohol.

But experts still agree that a comprehensive plan involving alcohol rehabilitation is the best route to recovery from AUD [8].

 

What Happens To Your Liver When You Stop Drinking?

The liver of a person who stops drinking alcohol will likely recover from the first stage of liver disease. However, if the person has a moderate to serious case of liver disease, professional help is needed in order to fully recuperate [13].

The liver is partly responsible for removing toxins from the body.

Alcohol is considered a toxin, because of its active ingredient, ethanol.

 

When a person stops using alcohol, the liver does not need to remove ethanol from the body.

As a result, the liver can remove other toxins causing the body harm.

Drinking too much alcohol for a long period of time can cause liver disease, which comes in four stages. [13]

  • Alcoholic fatty liver disease – usually, there are no obvious signs, but a person might feel pain in the upper right side of the abdomen
  • Alcoholic hepatitis – the most obvious sign is the yellowing of the skin (jaundice)
  • Fibrosis – this stage is when the liver repeatedly forms scars which hinder its normal activity
  • Cirrhosis – usually, this stage requires professional intervention as the person is at great risk of liver failure

 

 

Factors that make a person more vulnerable to permanent liver damage (cirrhosis) are: [10]

  • Being female
  • Being under-nourished or malnourished
  • Has a relative who has liver disease

 

A person who quits alcohol because of liver concerns will be fully evaluated for the extent of liver damage. [10]

To prolong the life of the individual who suffers from alcohol-related liver disease, professionals recommend life-long abstinence from alcohol. [10]

Aside from easing stress from the liver, abstinence from alcohol also benefits other parts of the digestive system.  Specifically: [14]

  • The lining of the oesophagus
  • The small intestines
  • The stomach

 

Excessive alcohol consumption even by individuals not affected by Alcohol Use Disorder tends to cause problems in the digestive process.

These symptoms can include: [14]

  • Diarrhoea – as alcohol is processed first, other things are not digested properly
  • Constipation – alcohol triggers the kidneys to remove more water from the body, causing hard, dry stools
  • Allergic reaction – particularly if the person is allergic to alcohol or ingredients with gluten/wheat in the drink

 

Abstaining from alcohol also lessens the risk of ulcers in the forming in the gastrointestinal tract, also called peptic ulcers. [3]

For professionally supervised detox and withdrawal from alcohol, Abbeycare Clinic can help.

After the duration of the rehab stay, clients are encouraged to keep in touch with therapists and to seek further help if needed.

References

  1.   Harvard Health Publishing. (2019). Alcohol Withdrawal. Available at: https://www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z
  2.   Muncie, H. Jr., Yasinian, Y. & Oge’ L. (2013). Outpatient Management of Alcohol Withdrawal Syndrome. Available at: https://www.aafp.org/afp/2013/1101/p589.html
  3.   Trevisan, L., Boutros, N., Petrakis, I. & Krystal, J. (1998). Complications of Alcohol Withdrawal Pathophysiological Insights. Available at: https://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf
  4.   O’Donnell, J. (DATE). Quitting alcohol can be deadly: Hundreds in the US die each year. USA TODAY. Available at:https://www.usatoday.com/story/news/health/2018/11/27/alcohol-withdrawal-syndrome-detox-delirium-tremens-hallucinations-substance-abuse-disorder/2082020002/
  5.   Enoch, M.A. & Goldman, D. (2002). Problem Drinking and Alcoholism: Diagnosis and Treatment. Available at: https://www.aafp.org/afp/2002/0201/p441.html
  6.   Mayo Clinic. (2018). Alcohol Use Disorder. Avialbale at: https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250
  7.    Chen, P. et. al. (2018). Acupuncture for alcohol use disorder. Int J Physiol Pathophysiol Pharmacol. 10(1), 60–69. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871630/(2018).
  8.   NHS. (2018). Alcohol Misuse Treatment. Available at: https://www.nhs.uk/conditions/alcohol-misuse/treatment/
  9. Modesto-Lowe, V., Huard, J. & Conrad, C. (2005). Alcohol Withdrawal Kindling: Is There a Role for Anticonvulsants? Psychiatry, 2(5), 25–31. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000183/
  10. Worman, H. (2005). Approach to the Patient with Alcoholic Liver Disease. Available at: https://journalofethics.ama-assn.org/article/approach-patient-alcoholic-liver-disease/2005-09
  11. Morris, J. (2017). The media has a problem with alcoholism – and it’s stopping people getting help. Available at: https://www.theguardian.com/science/sifting-the-evidence/2017/nov/22/the-media-has-a-problem-with-alcoholism
  12. Jamieson, A. (2018). Scotland tackles alcohol crisis with minimum price law. NBC News. Available at: https://www.nbcnews.com/news/world/scotland-tackles-alcohol-crisis-minimum-price-law-n844696
  13. Felman, A. (2018). What’s to know about alcoholic liver disease? Medical News Today. Available at: https://www.medicalnewstoday.com/articles/215638.php
  14. Medline Plus. (2017). Digestive diseases. Available at: https://medlineplus.gov/ency/article/007447.htm

About the author

Melany Heger

Registered Psychologist and Freelance Writer, Jinjin Melany passionately writes about mental health issues, addiction, eating disorders and parenting since 2015. Read more about Melany on LinkedIn. Content reviewed by Dr Khan.


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