Alcohol Detox and Withdrawal

Alcohol addiction can ruin a person’s life, and yet many continue to abuse the drug knowingly in order to avoid withdrawal. Detox and withdrawal are infamous in the addiction community for being physically and psychologically uncomfortable experiences. If done at home without medical attention, alcohol withdrawal can even turn deadly. However, this time of bodily cleansing is the first step to getting off of alcohol and putting your life back on track. Following detox, an alcoholic is ready to enter rehab and learn the sober living skills that will help them maintain a booze-free life.

A person has reached a state of alcohol dependence — the physical half of addiction — when their body experiences withdrawal symptoms once there is no more alcohol in their system. Withdrawal symptoms occur during detox, a natural bodily process that removes toxins from the system.Withdrawal is a physically and psychologically uncomfortable experience — so much so that many heavy drinkers will continue drinking, despite the negative consequences, because it helps them avoid experiencing withdrawal. Withdrawal occurs because continued and excessive alcohol use eventually interferes with the brain’s natural functions, disrupting neurotransmitters that send messages to your central nervous system.The primary neurotransmitter tied to the production of feelings like relaxation is gamma aminobutyric acid. GABA also helps produce endorphins in the brain, which present a sense of well-being. Excessive alcohol use causes a GABA imbalance, resulting in negative physical and mental symptoms of alcohol withdrawal:

  • Headaches
  • Heart palpitations
  • Seizures
  • Anxiety
  • Restlessness
  • Confusion

Alcohol abuse also affects dopamine, the neurotransmitter linked to the body’s reward system. This pleasure center regulates your energy, enjoyment and motivation. Dopamine also assists with the body’s sense of attention, motor coordination, cognition and mood. Alcohol releases dopamine, triggering some of these happy feelings addicts crave. And as your body begins to build higher alcohol tolerances, the brain becomes more dependent on the substance to release these neurotransmitters. So, when a long-term heavy drinker suddenly stops drinking, dopamine production stops also, causing withdrawal symptoms.

Other symptoms of alcohol withdrawal syndrome include:

  • Tremors
  • Nausea
  • Vomiting
  • Loss of appetite
  • Confusion
  • Irritability
  • Mood swings
  • Sweating
  • Fever

Some alcoholics going through withdrawal may experience a very severe set of symptoms, called delirium tremens. Delirium tremens most commonly occur in those who drink in excess every day for various months and those who have abused alcohol for more than 10 years.

DT symptoms include:

  • Altered mental functions
  • Deep sleep
  • Fear
  • Seizures
  • Sudden mood changes
  • Excitement

The severity of withdrawal symptoms can depend on many variables, and therefore is different from addict to addict. Such factors include how long the addict was abusing alcohol, the quantity of alcohol they consume, how frequently they drink, the patient’s history with addiction to other substances, polydrug use, family addiction history, and the person’s physiological makeup, such as gender, weight and age.

It is important to contact a medical physician if you begin to feel any withdrawal symptoms after you stop using alcohol, as withdrawal symptoms can become life-threatening if not treated appropriately.

Although alcohol detox takes a fairly standard amount of time — about a week — alcohol withdrawal is different for every person who goes through it. For some, the process lasts days. For others, it lasts months.The process is triggered when an addict stops drinking alcohol. As the liver metabolizes ethanol and moves the drug through a person’s system, withdrawal symptoms will begin. It takes 30 minutes – two hours for the body to absorb one serving of alcohol into the bloodstream. Alcohol can be detected in the urine 12 – 24 hours after consumption, however, because the liver can only metabolize about .25 ounces per hour.

Most alcohol detox programs last anywhere from a few days to more than a week, with withdrawal symptoms usually subsiding within seven or more days of the program. However, alcohol cravings and other minor side effects may continue for some time after detox.

Alcohol Withdrawal Timeline

Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms are known to come in three different stages: minor, moderate and severe. Minor withdrawal symptoms — such as headaches, slight tremors and nausea — are subject to start anywhere from six to 12 hours after a person’s last drink. More moderate side effects of withdrawal — such as vomiting, sweating, confusion and fever — may follow within 12 to 24 hours. Those who experience severe withdrawal may begin to feel these symptoms — called delirium tremens — within 48 – 72 hours after discontinued alcohol use.

Delirium tremens are a potentially fatal medical emergency, although awareness of this serious complication of alcohol withdrawal has helped to lower the rate of fatalities. Research shows 5 percent of the roughly 2 million Americans who seek alcohol addiction treatment each year experience DTs, also known as alcohol withdrawal delirium. The mortality rate for DTs can range from 3 – 15 percent each year.

Alcohol Withdrawal Symptoms

  • Disorientation
  • Confusion
  • Vivid Hallucinations
  • Extreme Tremors
  • Autonomic hyperactivity including shortness of breath, sweating, dry mouth , and palpitations
  • Rapid heart rate or tachycardia
  • Agitation
Scientists are still determining what causes DTs. Although former research pointed to vitamin deficiencies, more recent studies show the brain releases glutamate during alcohol withdrawal to compensate for the alcohol’s enhancement of gamma aminobutyric acid in the brain. Glutamate is a type of excitatory neuron, which may explain the autonomic hyperactivity and other DT symptoms.Fatal complications from delirium tremens include oversedation, respiratory arrest, cardiac arrhythmias and aspiration pneumonitis, which occurs when a person inhales toxic substances into the lungs, resulting in infection.

You may be at risk for delirium tremens if you:

  • Are middle aged or a senior citizen
  • Experienced seizures during previous alcohol withdrawal
  • Have a co-occurring mental illness
  • Have abnormal liver function
  • Experience intense alcohol cravings
  • Have abused alcohol for a longer period of time
  • Have experienced DTs before

Delirium tremens can be difficult to diagnose, as some of the DT symptoms are similar to those of acute alcohol withdrawal, such as hallucinations. However, acute alcohol withdrawal is rarely deadly, while alcohol withdrawal delirium can be lethal in up to 15 percent of cases. If you undergo detox at an accredited detox facility with experienced addiction professionals, such as those at The Recovery Village, you have a greater chance of experiencing a safe alcohol withdrawal. Delirium tremens often require advanced pharmacotherapy, and in extreme cases may even require a stay in a hospital’s intensive care unit.

Alcohol withdrawal and detox can be deadly in certain circumstances, so it’s incredibly important for those detoxing from alcohol to do so in a medical facility.Alcohol withdrawal can cause many deadly symptoms, including:

  • Heart palpitations
  • Heart arrhythmia
  • Kidney dysfunction
  • Liver dysfunction
  • Seizure
  • Seizure-related head injury
  • Delirium
  • Hallucinations
  • Increased heart rate
  • High blood pressure
  • Hyperventilation

Detox can be dehydrating to the body as it uses any means — most notably vomiting, diarrhea and sweating — to expel alcohol and its toxins. Alcohol in and of itself is also a dehydrating substance. Combining an alcohol user’s pre-existing dehydration with withdrawal-related dehydration can easily induce seize and prove lethal.

If an alcoholic experiences a seizure during withdrawal, they could die from hitting their head during the seizure. Also, it’s possible for a person to vomit while seizing and aspirate, or breath in the vomit, effectively choking themselves to death.

Detoxification is the natural bodily process of removing toxins from the system. Any time you consume alcohol, the body naturally begins to detoxify, using the liver to metabolize ethanol from your system. Alcoholics and those who constantly drink never truly detoxify from the substance because they are always adding more into their system. When an addict chooses to get clean, however, the first thing they must do is stop drinking alcohol and let the body detoxify.Detox can occur in many settings, including:

  • At home
  • At a hospital
  • In prison
  • At a free medical clinic
  • At a detox center
  • In alcohol addiction rehab

There are two ways to detox — cold turkey, or all at once, or from lowering dosage over time, called tapering. Most people who choose to detox on their own at home resort to cold turkey, because they liken it to ripping the bandaid off. However, cold turkey detox can be dangerous, as the onset of withdrawal symptoms is more severe. In the face of the symptoms, the addict may end up relapsing and putting themselves in danger of alcohol poisoning.

Professional medical detox is the safest option when it comes to stopping drinking. At The Recovery Village, we monitor patients 24/7 to ensure their pain during withdrawal is managed, their vitals are at healthy levels and they are not experiencing any life-threatening symptoms. You may have many questions during this time, which our staff of highly-experienced addiction professionals are always happy to answer.

The risks during detox include dehydration and delirium tremens. As the body uses vomiting, diarrhea and sweating to expel the toxins of alcohol, it’s easy for patients become unknowingly dehydrated. Severe dehydration can lead to seizures, which can easily become lethal, especially if they occur in a home environment. Delirium tremens can lead to cardiac arrhythmia and respiratory failure, which can also be fatal if uncaught and left untreated.

When detoxing at a medical facility, doctors can also administer medications that will make your withdrawal experience more pleasant. The U.S. Food and Drug Administration has approved three medications to help treat alcohol dependence:

  • Naltrexone
  • Disulfiram (Antabuse or Antabus)
  • Acamprosate (Campral)

Naltrexone helps block opioid receptors located within the rewards center of the brain that alcohol actives. As a result, the medication can help reduce alcohol cravings and, therefore, relapse.

Disulfiram causes a sensitivity to ethanol, spurring typical hangover symptoms immediately after a person consumes alcohol. This motivates the abuser to avoid alcohol.

Acamprosate helps aid long-term withdrawal symptoms, such as anxiety, insomnia and restlessness. This medication is recommended for patients suffering from a more severe addiction to alcohol.

Following detox, you will be ready to begin treatment for alcohol addiction. The Recovery Villageoffers many different treatment options including inpatient and outpatient rehab. Rehab is a proven-successful treatment method for alcohol addiction because it addresses both the physical side of the disease (detox) as well as the psychological side (using therapy and counseling to understand why a person first began abusing alcohol, and what their triggers for abuse are).