Home » Blogs » Alcohol abuse or alcohol dependency is one of the most significant issues still plaguing our modern society. The excessive consumption of or dependency on alcohol can give rise to many social and personal problems. Over the long term, it can have significant detrimental effects on the mind and body. Individuals addicted to alcohol or those who abuse alcohol face several issues due to their addiction, and yet the biggest challenge they face is when it comes to quitting alcohol. This is because quitting alcohol is not just about kicking a bad habit, it involves putting your entire system through what is known as alcohol withdrawal.
If you or somebody you know is planning on quitting alcohol, you should be aware that you’re in for a bit of a challenge. Before you opt for alcohol detox or rehab of any sort, you should be aware of alcohol withdrawal symptoms and how to seek appropriate medical help so that you do not experience seizures or stroke caused by withdrawal.
Understanding alcohol withdrawal
Let’s first start with the basics and then dive deeper into the concept of withdrawal. In simple terms, alcohol withdrawal can be defined as the changes your entire system goes through when you quit drinking. The most important thing to understand here is that even though alcohol consumption appears to have a temporary effect on your body, its impact can last for years and can potentially modify the way your system functions and behaves.
This is because alcohol affects your central nervous system. It primarily acts as a depressant and suppresses some significant neurotransmitters in your brain. The result is that you end up feeling relaxed and more at ease. However, excessive alcohol consumption gets your used to the depressant effect. You develop a dependency for it over time and this is the most damaging aspect of alcohol abuse, that can happen with any narcotic substance abuse. However, if you suddenly stop consuming alcohol, your neurotransmitters are kicked into overdrive. Your body struggles to adjust to the change and you will end up experiencing numerous physical and mental effects. It is this readjustment phase that is referred to as alcohol withdrawal. This can be very uncomfortable physically and carries the risk of seizures or even stroke.
Here, it’s also important to understand that withdrawal could work differently for different people. One size does not fit all and there are no simple answers to questions like what are the exact withdrawal symptoms, how long will they last and so on. It all depends on several factors like level of addiction, frequency of consumption, age, sex, lifestyle, etc. For many people, the sheer thought of undergoing withdrawal scares them away from quitting. In general, there is a fairly low level of awareness about the issue and, as a result, people either don’t quit at all or randomly go cold turkey and then face the adverse effects of withdrawal. A bad withdrawal experience often prompts people to start drinking again so it is important for you to educate yourself well before embarking on this journey.
Symptoms of withdrawal –
While withdrawal symptoms might manifest themselves very differently for different people, here are a few pointers that should act as guidelines for you and give you an idea of what to expect in the days to come. Withdrawal symptoms can range from something minor like hand tremors and palpitations to life-threatening conditions like delirium tremens. Seizures, or even stroke. The first 48 hours are the most crucial though it is important for you to keep monitoring yourself throughout the withdrawal process. Let’s break down some of the common symptoms for you –
First 24 hours –
● Feelings of anxiety
● Feelings of agitation
24 to 48 hours –
This is the most crucial phase of withdrawal since it’s also the time when the most severe symptoms might kick in. Alcohol cravings reach a crescendo and your body struggles to cope with the changes. This is also the time when many heavy drinkers might end up facing what is known as acute alcohol withdrawal. Here are some of the ways in which withdrawal will manifest itself at this stage –
● Spikes in blood pressure
● Raised body temperatures
● Delirium tremens
Delirium tremens is a serious condition which needs immediate medical attention. Besides these symptoms, it can also cause irregular blood flow in the brain leading to seizures or stroke.
In general, the worst manifestations of withdrawal usually resolve within five to six days. Again, it all depends on the level of addiction, age, and other such factors. In extreme cases, some people experience what is known as acute withdrawal symptoms.
Acute withdrawal symptoms
Acute withdrawal can occur even weeks after quitting alcohol and can be potentially life-threatening. Severe symptoms like delirium tremens and seizures are common and require immediate attention. It is not possible to deal with acute symptoms without medical treatment. This is also why heavy drinkers and those who mix drugs with alcohol are advised to opt for medically-supported withdrawal.
Let’s explore the treatment options for alcohol withdrawal and see how medication can play an important role in it.
Alcohol withdrawal treatment
Alcohol withdrawal is a serious and complicated issue, one that is regularly discussed in medical circles. During this phase of withdrawal, one needs to not only deal with the symptoms which can be potentially life-threatening but also ensure that the patient doesn’t slide back into drinking as a result of those symptoms. There is always a fear of acute withdrawal symptoms kicking in as well. Which is why WHO and the NHS have put in place specific guidelines when it comes to dealing with something like this.
First, let’s begin by diving deeper and understanding the concept of supported or medically supported withdrawal. It is a well-known fact that alcohol withdrawal will cause drastic changes in your body and will affect your day-to-day life. Besides changing the way your brain reacts and functions, it also results in a number of deficiencies that have to be addressed to avoid further complications. To this end, doctors recommend a course of medication to go along with your withdrawal process. Why is this necessary? Let’s explore.
Alcohol withdrawal completely throws your body out of balance. This includes pulse rate, base temperature, blood pressure, and more. A doctor treating alcohol withdrawal will first seek to stabilize all these fluctuating physical aspects. The aim is to keep your system running as normally as possible. Maintaining water balance in the body is also a very important factor. Withdrawal can cause a number of issues like vomiting and diarrhea which further lead to acute dehydration.
In such cases, intravenous fluids might be required to maintain the smooth functioning of the liver and kidneys. Electrolyte imbalances can also occur from the dehydration: reports indicate that low levels of magnesium can, in fact, give rise to seizures and delirium. IV fluids can, once again, help address this problem. Alcoholics are also at risk of developing something known as Wernicke’s Syndrome. This is a condition that manifests in the form of extreme confusion, weakening of muscles, and ocular abnormalities. This mainly happens due to the depletion of thiamine in the body. Most doctors recommend starting the withdrawal period with a dose of thiamine with subsequent lower doses at regular intervals.
However, don’t let all this medical jargon scare you. The aim of detox or assisted withdrawal is to provide the patient with comfort and care. All you need to do is follow medical instructions, take your medication and focus on the healing process. What’s more, you can also choose your method of treatment and opt between outpatient treatment or inpatient care. Let’s explore both alternatives.
Outpatient care for alcohol withdrawal is a more recent trend, based on the belief that addiction is a disease and not a behavioral issue. In the past, people had no other option but to book themselves or their family members into rehab, as addiction was viewed as a behavioral problem. Now, more and more people are opting for outpatient care and it has proved to be remarkably effective. Some reports indicate that almost 70% of people receiving withdrawal treatment are doing so in an outpatient capacity. In general, no specific statistics exist to indicate whether this form of treatment is better or worse than getting admitted to a treatment facility; and, in general, outpatient care is easier and more convenient. Besides, it also helps patients stay committed since they don’t need to isolate themselves from their friends or family.
There are no specific criteria used to determine whether or not somebody qualifies for outpatient care. More recently, only people who do not have a modicum of family support are recommended for inpatient detox. Even individuals with a history of seizures or delirium tremens can choose to receive outpatient treatment. Outpatient treatment works better when the patient has some support at home. The family can also monitor their physical symptoms and ensure they are safe.
Inpatient care is the traditional option when it comes to alcohol withdrawal, though it is not necessary for most people. Only those people who do not have any familial support need inpatient treatment. Also, people experiencing active delirium tremens or seizures may be good candidates for inpatient treatment. In an inpatient treatment facility, patients are given the same medical detox protocols as in an outpatient setting. Support at home is not needed as the patient is isolated from his living environment and monitored 24 hours a day. The withdrawal phase is not easy and monitoring helps. Inpatient treatment isolates the patient from external influences. Although for a temporary period of time.
Coping and living with alcohol withdrawal
While medical intervention is absolutely necessary, dealing with alcohol withdrawal calls for several significant lifestyle changes. While your first step should be to seek medical advice, these pointers could help you deal with your alcohol cravings and withdrawal symptoms.
The importance of staying hydrated cannot be overstated when it comes to dealing with alcohol withdrawal. During the withdrawal period, your body constantly loses fluids and essential minerals along with it. So make sure you are not only drinking plenty of water but also loading up on electrolytes. Instead of opting for electrolyte-rich juices or drinks, you can always consume fruits by including them in your daily diet.
Prepare for the cravings
Alcohol is a highly addictive substance. If you are at the point where you are facing withdrawal symptoms, you should know that you will constantly crave alcohol. It goes beyond a simple mental craving and becomes an overarching physiological need akin to thirst, hunger or the need to sleep. Be prepared for the cravings and have your strategy in place beforehand. Many people take up hobbies to keep them distracted, while others prefer to surround themselves with friends or family. If you feel you cannot do it by yourself, seek out the help of counselors. These counselors will handhold you through your withdrawal process and you will always have somebody to call in times of intense cravings. Whatever method you feel will work for you, make sure you have a plan in place well in advance.
Identify somebody you can count on
Dealing with alcohol withdrawal should never be a solo effort. Find a close friend or family member who you can rely on and let them handhold you through this journey. Confide in them and don’t be ashamed to share everything you are going through. They can not only help you through the journey but also act as an emergency contact in case you feel you might start drinking again. Very often, isolation and loneliness are the main causes of people giving up on their detox process.
Seek group therapy
AA meetings are an essential part of the recovery process. Surround yourself with people who are undergoing the same ordeal. Hear their stories and share your own. This will make you feel less lonely. On the other hand, this also helps instill a sense of community and common purpose. Alcoholics and people suffering from withdrawal often feel alienated and misunderstood. Group therapy sessions help them to form a bond with other such people – and an individual struggle turns into a group effort. Many community centers offer self-help groups for people suffering from a dependence on alcohol. Go to a meeting and try to participate. Be vocal about your struggle and don’t be afraid to talk about the problems you face on a day-to-day basis. This will also help you deal with your cravings through positive reinforcement within the support group.
Every recovering alcoholic or person suffering through withdrawal will have certain significant triggers that might push them to consume alcohol. For some people, it could be something as simple as hanging out with a particular group of friends on weekends, while for others, stress could be an important trigger. You need to ask yourself one simple question – when do you feel like drinking the most? Then, make a list of all the things that might push you to have a drink and avoid them completely. If you have a social group that insists on drinking regularly, politely decline to spend time with them. If you know that work or personal stress might push you towards drinking, you need to find new ways of dealing with those stressors. Again, having a friend or family member who you can rely on can be of great value.
Meditate and exercise
While this might sound like very generic advice, meditation can help calm your body’s agitation during the withdrawal process. Through guided meditation, you will be able to ease your breathing, calm your heart rate, and become more mindful of your system. Exercise, too, can positively impact your body during withdrawal. The release of endorphins after a workout can help negate a lot of the cravings. This is why many people choose to take long walks to calm their restless systems. Simple exercises will also help your body heal from alcohol abuse. Setting a regular exercise routine is always recommended by doctors and is of special importance when it comes to coping with withdrawal.
Helping someone deal with alcohol withdrawal
If somebody you know is dealing with alcohol withdrawal or seeking to quit drinking, there are many ways in which you can be of assistance. First and foremost, urge them to seek professional help. The detox process will be more successful if guided by a medical professional and less dangerous. You can offer to act as a companion through the withdrawal process and be their point of contact. This might mean giving them a lot of your time and being available whenever they need you. You will have to understand that most individuals suffering from addiction cannot face withdrawal alone so it’s always a good idea to learn as much about the process as you can so you can give them the best possible support.
Alcohol withdrawal might be a painful and sometimes long process. But it is a step in the direction of a stronger and healthier life. If you are thinking about quitting alcohol, you should know that you are not alone. Don’t be afraid to seek help and always prepare for the worst.
Dr. Cidambi is a leader in addiction treatment and innovator of safe and effective ambulatory (outpatient) detoxification level of care for alcohol, benzodiazepines, opiates, and suboxone. Prior to founding the Center for Network Therapy, she completed her residency in Psychiatry at Maimonides Medical Center in Brooklyn and an Addiction Medicine Fellowship at NYU/Bellevue Hospital in New York. Due to the successful detoxification program, Dr. Cidambi was featured frequently by media outlets, including NPR, CBS, NY Times, and Wall Street Journal.