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Alcohol addiction, formally called alcohol use disorder (AUD), is a chronic, relapsing brain disorder. It occurs in at least 14.4 million adults aged 18 and older in the United States. 

People who suffer from AUD have an impaired ability to stop or reduce alcohol consumption. Even when some attempt to quit drinking, withdrawal symptoms can be overwhelming (both mentally and physically). This results in relapse and potential overdose. 

Alcohol addiction is a recurring cycle of drinking and withdrawal. When someone decides to stop drinking, withdrawal symptoms and strong alcohol cravings can arise. In an attempt to avoid this, they begin drinking again, but more heavily than before.

Alcohol addiction is a challenging medical condition to overcome. However, advancements in therapies and medications have made it easier for people to recover.

What is Alcohol Withdrawal?

Long-term, heavy alcohol consumption affects brain chemistry and leads to dependence.

If you are addicted to the substance and suddenly stop drinking, the brain is unable to function correctly. As a result, withdrawal symptoms will arise. These symptoms can range from mild to life-threatening.

Alcohol withdrawal occurs within hours to days after someone who is addicted to alcohol stops drinking. As the body adjusts to no alcohol, you can experience a wide range of symptoms. Common symptoms include nausea, shaking, sweating, anxiety, and insomnia.

What is Alcohol Withdrawal Syndrome (AWS)?

Alcohol withdrawal syndrome (AWS) is a clinical condition that occurs primarily in individuals who are alcohol-dependent. It develops within 6 to 24 hours after sudden discontinuation or decreased alcohol consumption. 

AWS has a wide range of symptoms, including agitation, tremors, anxiety, disorientation, fast heartbeat, high blood pressure, and many more. In more severe cases of AWS, individuals require medical attention to treat more life-threatening symptoms like seizures and coma. 

Alcohol withdrawal syndrome is one of the causes of preventable mortality.

You should always detox under the supervision of professionals at a licensed treatment center. This is because withdrawal symptoms can be severe and dangerous. It doesn't matter if you have been drinking heavily for months or years; anyone can experience AWS

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What Causes Alcohol Withdrawal?

Long-term alcohol users expose their brains to alcohol so often that the brain adjusts to compensate for the sedating effect of the chemicals.

An alcoholic’s brain produces serotonin and norepinephrine in higher quantities than a non-alcoholic’s brain. If that person stops drinking suddenly, their brain is overstimulated with too much of these naturally occurring chemicals.

Alcohol Detox Timeline 

Stopping alcohol consumption can cause the body to experience different stages of detoxification and withdrawal.

It is important to understand that while these are general guidelines, people may experience symptoms up to 10 days after the last drink

Stage 1 — 6 Hours

Withdrawal symptoms begin to appear within 6 hours of the last drink. These symptoms tend to be mild. 

Mild alcohol withdrawal symptoms may include:

  • Some nausea
  • Mild sensitivity to light and sounds
  • Anxiety
  • Minor headache
  • Clammy feeling
  • Mild itching
  • Irritability
  • Minor tremors (alcohol ‘shakes’)

Stage 2 — 6 to 12 Hours

Symptoms will gradually intensify.

You may experience symptoms like tremors or tachycardia. This is a condition where the heart beats over 100 beats per minute. Other symptoms can include nausea and vomiting.

Stage 3 — 24 to 48 Hours

At this point of withdrawal, depending on the severity of alcohol addiction, individuals may transition to a period known as alcoholic hallucinosis. This stage is characterized by auditory, visual, and tactile disturbances. The last two types of symptoms are not as frequent as the first. 

Examples of withdrawal-related hallucinations could include:

  • Sensitivity to light or hallucinations
  • Intensified harshness or fear of sounds
  • A feeling of pins and needles or numbness

In more severe cases, these symptoms can lead to paranoia and agitation. 

Seizures can also occur in some individuals. 

For those suffering from minor withdrawal, symptoms may peak at 18 to 24 hours after the last drink and begin decreasing 4 to 5 days later. 

Stage 4 — 48 to 72 Hours

During this time frame, some people experience delirium tremens (DTs), a short-term condition that causes severe physical and psychological symptoms.

Similar to alcohol hallucinosis (AH), people with DTs will show agitation and hallucinations.

The main difference between DTs and AH is disorientation. Those with DTs become disoriented and run the risk of injuring themselves or healthcare staff unintentionally. 

DTs is the severest of all the symptoms that manifest during the detox process. It has been reported that DTs can occur 7 to 10 days after the last drink. 

Symptoms of DTs include:

  • Elevated body temperature
  • Paranoia
  • Seizures
  • Hallucinations (auditory/visual)
  • Constant nausea and/or vomiting
  • Irritability and anger
  • Panic attacks
  • Drenching sweats

You are more likely to experience DTs if you:

  • Have liver function issues
  • Have low potassium or sodium levels
  • Have a low platelet count
  • Are older
  • Are using other drugs or substances
  • Are severely dehydrated
  • Have a history of delirium tremens
  • Have brain lesions
  • Have a history of seizures

Stage 5 — 72 Hours

This stage is when the severity of alcohol withdrawal symptoms are highest.

Common Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms can range from one individual to the next. Some of the many symptoms that comprise withdrawal include:

  • Tremors (delirium tremens in severe cases)
  • Nausea/vomiting
  • Tachycardia (rapid heart rate) 
  • Hyperthermia (irregularly high body temperature can cause heat-related conditions)
  • High blood pressure 
  • Irritability 
  • Mood swings
  • Jumpiness or shakiness 
  • Headaches 
  • Hallucinations

Many people choose to continue drinking alcohol to combat any negative feelings that come with withdrawal. However, alcohol only relieves negative feelings temporarily. Symptoms of withdrawal will worsen during the next period of abstinence.  

Are Night Sweats a Sign of Alcohol Withdrawal?

Another potential indicator of alcohol withdrawal is night sweats. Excessive alcohol consumption can cause sweating because it increases your heart rate.

As the heart rhythm becomes fast and irregular, the blood vessels in the skin widen. This process is medically known as vasodilation. The skin becomes flushed due to dilated blood vessels, and intense sweating occurs.

Medications for Managing Withdrawal Symptoms

As it stands, the FDA has approved three medications to treat alcohol addiction. These medications include:

  • Naltrexone —this drug helps to block opioid receptors that influence both cravings and the rewarding effects of alcohol consumption. It decreases the risk of relapse to heavy drinking. However, genetic differences may affect the efficacy of the drug. 
  • Acamprosate (Campral®) — for those who suffer from more severe addictions, this drug may prove rather effective in minimizing symptoms like insomnia, anxiety, and dysphoria (sensations of unhappiness or unease).
  • Disulfiram (Antabuse®) — this medication can fight chronic alcoholism by causing unpleasant effects whenever alcohol is consumed. Flushing of the face, headaches, nausea, and irregular heartbeat are just some of the many effects to discourage drinking. 

Currently, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is exploring other breakthrough medications to treat alcohol dependence.

One particular drug, Topiramate, has shown promising results thus far in large clinical trials. The anti-epileptic drug has helped some individuals reduce drinking, especially in those with certain genetic makeups. 

If you believe that you or a loved one are suffering from an addiction, it is important to seek professional medical care to receive proper addiction treatment and guidance.

Sudden discontinuation of alcohol consumption can lead to relapse and make future attempts to quit much more difficult. 

While overcoming addiction is never easy, there are many resources, specialists, therapies, and support groups to lead you on a path to recovery. 

How to Safely Detox From Alcohol

Anyone undergoing alcohol detox should do so under the supervision of medical professionals at an inpatient treatment center. Alcohol addiction treatment is the most effective way to overcome and abstain from alcohol long-term.  

At an inpatient facility, patients live there throughout the duration of treatment. They receive 24/7 supervised care from professionals, doctors, and therapists. These programs last between 30 and 90 days.

Detox is the first step in recovery. For many, it’s the most difficult phase, but also one of the most important. 

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Resources

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“Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 18 Feb. 2020, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics.

“Are Night Sweats a Normal Part of Drinking Alcohol?” Alcoholics Anonymous, 25 Aug. 2016, alcoholicsanonymous.com/are-night-sweats-a-normal-part-of-drinking-alcohol/.

National Institute on Drug Abuse. “Treatment Approaches for Drug Addiction DrugFacts.” National Institute on Drug Abuse, 19 June 2020, www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction.

“Treatment for Alcohol Problems: Finding and Getting Help.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 5 Mar. 2020, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help.

“Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health - Full Report.” Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health - Full Report | Publications and Digital Products, Nov. 2016, https://addiction.surgeongeneral.gov/sites/default/files/surgeon-generals-report.pdf.

Harvard Health Publishing. “Alcohol Withdrawal.” Harvard Health, https://www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z.

“Delirium Tremens: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, 2 June 2020, medlineplus.gov/ency/article/000766.htm.

Mirijello, Antonio, et al. “Identification and Management of Alcohol Withdrawal Syndrome.” Drugs, U.S. National Library of Medicine, Mar. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4978420/.

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