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Learning About the Side Effects of Alcohol Withdrawal

Alcohol withdrawal is a collection of physical and psychological symptoms that may occur when someone with alcohol use disorder (AUD) stops drinking suddenly or when significantly reduces alcohol consumption. These signs and symptoms -moderate to severe- may manifest several hours following your last drink. Possible minor symptoms include trembling, nausea, and perspiration. Furthermore, seizures, hallucinations, and hazardous Delirium Tremens (DTs) might emerge from more severe symptoms. Irregular heartbeat, elevated core temperature, and disorientation are the hallmarks of DT. Death can result from DTs if it is not addressed. 

16 Minutes Read | Published Aug 14 2023 | Updated Jun 20 2024 Expert Verified
Amber Asher
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Amber Asher
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The severity and length of alcohol withdrawal symptoms are affected by a person's overall health, the quantity and duration of their AUD, and their history of withdrawal -whether it has happened before or not-. Medical supervision is typically required for quitting alcohol, especially when there is mid to severe consumption, since the management of alcohol withdrawal symptoms, especially in extreme cases, is mandatory to lessen the symptoms and observe for any life-threatening condition. Common prescriptions for drugs like benzodiazepines are meant to help with withdrawal symptoms and stop seizures. Along with medication, supportive care -including vital sign monitoring, hydration, and nutritional support- is critical. Counseling and support groups are essential for long-term recovery in preserving sobriety and avoiding relapse.

What are The Symptoms of Alcohol Withdrawal?

The degree of dependency of the person and general health will determine the degree of alcohol withdrawal symptoms. In its mildest form, symptoms could include headaches, nausea, an increase in anxiety, shaking hands or body trembles, and trouble sleeping. Usually, these first symptoms show from hours to several days of stopping drinking.

As withdrawal progresses, early symptoms such as tachycardia, hypertension, mood swings, confusion, fatigue, and digestive problems such as stomach cramps or appetite changes may appear, indicating a shift in alcohol consumption patterns rather than a general change in health status. These symptoms, while usually not serious, can have a major impact on daily activities and indicate a developing withdrawal syndrome that may require medical attention as well as supportive care.

The worst-case scenario is when individuals suffer severe cases of delirium tremens (DTs) since they may experience hallucinations (seeing or hearing things that are not there), seizures, profound confusion, fast breathing, fever, and dehydration as a result of heavy sweating, vomiting, or diarrhea, but, at the same time, they could be in high risk of death.

Numerous factors, including past experiences with withdrawal, duration and amount of alcohol usage, and individual health problems, might affect the timing and severity of alcohol withdrawal symptoms.

Symptom Category

Description

Mild Symptoms

- Anxiety.

- Trembling.

- Increased sweating.

- Nausea.

- Difficulty sleeping.

- Headaches.

Moderate Symptoms

- Tachycardia.

- High blood pressure.

- Mood swings.

- Confusion.

- Fatigue.

- Digestive issues.

Severe Symptoms (DTs)

- Hallucinations.

- Seizures.

- Profound confusion.

- Rapid breathing.

- Fever.

- Dehydration.

What Are the Side Effects of Alcohol Withdrawal?

When an individual goes through alcohol withdrawal, the cessation of excessive and consistent drinking can lead to various physiological reactions. Disturbances in the electrolyte balance can lead to various disorders, such as low magnesium levels (hypomagnesemia) or low potassium levels (hypokalemia). Metabolic changes due to alcohol consumption could impact glucose metabolism and energy consumption, causing hyperglycemia and also impacting insulin and glucagon secretion.

Several heart conditions, including arrhythmias and heart attacks, can be worsened by fluctuations in blood pressure and heart rate and imbalances in the electrolytes mentioned above. Hyperventilation can disrupt the body's acid-base balance and lead to respiratory alkalosis.

It is common for people to have gastrointestinal issues like nausea, vomiting, diarrhea, and dehydration while they are going through withdrawal. Abstinence from alcohol can lead to neurological symptoms such as tremors, convulsions, or cognitive impairment due to its effects on the nervous system.

Specific psychological symptoms associated with alcohol withdrawal include emotional instability, anxiety, depression, and disrupted sleep habits. These adverse effects highlight the importance of appropriate medical monitoring and support in treating symptoms and lowering the potential health hazards associated with acute withdrawal.

Here is a summary of symptoms and their associated side effects:

Category

Symptoms

Side Effects

Mild Symptoms

- Anxiety.

- Trembling.

- Increased sweating.

- Nausea.

- Difficulty sleeping.

- Headaches.

- Electrolyte imbalance.

- Metabolic changes.

- Gastrointestinal disturbances.

- Dehydration.

Moderate Symptoms

- Tachycardia.

- High blood pressure.

- Mood swings.

- Confusion.

- Fatigue.

- Digestive issues.

- Cardiovascular effects.

- Respiratory issues.

- Constipation or diarrhea.

- Mania or depression.

Severe Symptoms (DTs)

- Hallucinations.

- Seizures.

- Profound confusion.

- Rapid breathing.

- Fever.

- Dehydration.

- Neurological effects.

- Immune system suppression.

- Psychological effects.

- Hyperthermia

- Respiratory alkalosis.

- Dehydration.

Is There a Timeline?

Yes, without a doubt. However, the severity and duration of alcohol withdrawal symptoms may vary from person to person depending on factors such as health and level of dependence. However, the symptoms of alcohol withdrawal typically appear at regular intervals.

The first symptoms of withdrawal usually appear six to twelve hours after the last drink. At this point, symptoms include headaches, nausea, trembling, sweating, mild anxiety, and insomnia.

The peak phase of withdrawal occurs 24 to 72 hours after the last drink, during which the worst withdrawal symptoms typically appear. This stage is defined by increased heart rate, high blood pressure, anxiety, irritability, confusion, perspiration, tremors, and gastrointestinal discomfort, including nausea, vomiting, or diarrhea.

Late withdrawal symptoms, in severe situations, can show up after 72 hours and might include delirium tremens (DTs), hallucinations—visual or auditory, and seizures. Severe confusion, a fast pulse, fever, and, occasionally, death can all be brought on by DTs.

The development and degree of alcohol withdrawal symptoms can all be influenced by a person's physiology, alcohol consumption level, and any underlying medical condition as well as their Seeking medical help and support during your withdrawal will help you to correctly control symptoms and lower the likelihood of major issues.

 Does Alcohol Withdrawal Stop or Exacerbate Anxiety?

Anxiety can have a complicated relationship with alcohol withdrawal; often, it aggravates symptoms during the process of stopping. At first, alcohol functions as a depressant on the central nervous system, therefore momentarily relieving anxiety and encouraging rest. On the other hand, long-term and excessive alcohol consumption can cause tolerance and dependency, therefore changing the chemistry of the brain over time.

Particularly in cases of chronic usage, sudden stopping of alcohol causes major alterations in the brain as it adapts to the lack of it. This change period can cause a rebound effect whereby the brain becomes hyperexcitable and increases anxiety symptoms. These could be restless, nervous, irritable, or otherwise unpleasant emotions.

For people with a history of heavy drinking, alcohol withdrawal may uncover or exacerbate underlying anxiety issues that alcohol may have obscured or temporarily alleviated. This may make it challenging to manage both the emotional consequences of increased anxiety and the physical symptoms of withdrawal.

Managing anxiety during alcohol withdrawal often necessitates medical supervision to monitor symptoms and offer necessary remedies. Along with therapy and counseling to address underlying psychological issues and develop coping methods for anxiety control without alcohol, treatment may include medications to alleviate symptoms and stabilize mood. 

Is It Important to Have Medical Supervision When Stopping Drinking?

While stopping alcohol, it is imperative to seek medical advice since the likely severity and erratic character of alcohol withdrawal symptoms demand it. People who have used alcohol excessively or for a long length of time especially run great risk without medical monitoring.

First, medical experts can track the development and evolution of withdrawal symptoms, which can range from moderate anxiety and tremors to more severe manifestations such as seizures or delirium tremens (DTs). These symptoms can appear fast and worsen, necessitating immediate attention to manage and prevent consequences successfully.

Furthermore, physician monitoring ensures that medications are properly administered. To treat withdrawal symptoms and avoid seizures, medications like benzodiazepines may be administered. Medical supervision ensures that these medications are provided safely, taking into account individual health conditions and any interactions.

Monitoring vital signs is an important element of medical monitoring during alcohol withdrawal. Heart rate, blood pressure, and body temperature changes can occur, necessitating comprehensive monitoring to detect any anomalies early and intervene swiftly.

Medical monitoring also offers an environment fit for psychological and emotional needs. Professionals can provide counseling, support, and advice during the withdrawal process, smoothing the transition and minimizing the danger of relapse.

Medical supervision offers fast access to medical care and interventions in acute withdrawal symptoms or medical emergencies, protecting the individual's health and well-being during a difficult and vulnerable moment.

What to Do in Case of an Emergency?

In short words, call 911 immediately. Stay with the victim, keep them calm, and, if possible, monitor their vital signs. Give emergency personnel accurate information about the issue, including the person's medical history and recent alcohol consumption. Follow their instructions attentively when they arrive, as they will examine the situation and offer any necessary medical care, which may involve transport to a hospital for additional treatment.

Resources

bullet National Library of Medicine
"Introduction to Alcohol Withdrawal"
Retrieved on June 20, 2024
bullet National Library of Medicine
"Electrolyte abnormalities in the alcoholic patient"
Retrieved on June 20, 2024
bullet National Library of Medicine
"Multiple Dyselectrolytemia in a Chronic Alcohol Abuser: A Case Report"
Retrieved on June 20, 2024
bullet National Library of Medicine
"Hyperventilation, anxiety, craving for alcohol: a subacute alcohol withdrawal syndrome"
Retrieved on June 20, 2024
bullet Cleveland Clinic
"Alcohol Withdrawal"
Retrieved on June 20, 2024
bullet National Library of Medicine
"Delirium Tremens"
Retrieved on June 20, 2024
bullet National Library of Medicine
"Panic Disorder After the End of Chronic Alcohol Abuse: A Report of 2 Cases"
Retrieved on June 20, 2024
bullet National Library of Medicine
"Clinical management of alcohol withdrawal: A systematic review"
Retrieved on June 20, 2024
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