Alcohol Withdrawal: Symptoms, Treatment & Timeline

Some people can be treated at home, but others may need supervised care in a hospital setting to avoid potentially dangerous complications such as seizures. If you have alcohol use disorder and want help, a healthcare provider can guide you to resources and rehabilitation programs to help you quit. Know that your provider will be there to support you, not to judge you. The main management for severe symptoms is long-acting benzodiazepines — typically IV diazepam or IV lorazepam. It’s difficult to predict who will and who won’t experience alcohol withdrawal — and how severe it will be. Go to the nearest emergency room or call 911 (or your local emergency service number) if you or a loved one has any concerning symptoms of alcohol withdrawal.

In the Next Few Weeks

• If you drink alcohol heavily for weeks, months, or years, you may have both mental and physical problems when you stop or seriously cut back on how much you drink.
• Alcohol withdrawal syndrome is the group of symptoms that can develop when someone with alcohol use disorder suddenly stops drinking.
• If you’re concerned about the safety of calling 911 for emergency help, consider the alternatives at Don’t Call the Police.
• If you are concerned you might be dependent on alcohol, you should seek medical advice to help you cut down and stop your drinking safely.
• Rehabilitation is a long-term treatment plan intended to help treat alcohol addiction.

Vitamins such as thiamine and folic acid will need to be supplemented. The person should also try to eat three well-balanced meals per day and drink enough water to remain hydrated. If you’re otherwise healthy and can stop drinking and get treatment, the outlook is usually good. However, sleep disturbances, irritability, and fatigue may continue for months.

Stage 3: 24 to 48 hours after last drink

If a patient begins experiencing signs and symptoms of severe withdrawal, including but not limited to seizure, altered mental status, or agitation, they should seek emergency care immediately. When alcohol withdrawal syndrome has resolved, patients ought to be evaluated for AUD and offered treatment, if appropriate, including pharmacotherapy and behavioral treatment. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol is the most commonly used substance in the United States, with over 75% of individuals aged 12 and older reporting lifetime consumption. Alcohol consumption spans a spectrum from low-risk to severe alcohol use disorder (AUD). Alcohol withdrawal syndrome poses a significant clinical challenge arising from the spectrum of AUD—a prevalent condition affecting a substantial portion of the United States population. Although most cases of alcohol withdrawal syndrome are mild and do not necessitate medical intervention, severe presentations can lead to life-threatening complications and require urgent intervention across multiple healthcare settings.

What Causes Alcohol Withdrawal Symptoms?

According to a 2021 study, PAWS is one of the major causes of relapse in people with alcohol use disorder. Although without a true withdrawal syndrome, complications of abstinence from stimulants include anxiety, anhedonia, and depression. A protracted withdrawal syndrome, sometimes termed the extinction phase, with the manifestation of behavior disturbances, including depression with suicidal thoughts, may also occur.

• North America was found to have the highest rates of opioid and cocaine dependence.
• Treatment typically involves reintroducing the substance in controlled amounts or using a similar drug to alleviate symptoms, allowing for a gradual taper.
• If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or if your family is concerned about your drinking, talk with your health care provider.

Alcohol use disorder

Approximately one-half of patients with alcohol use disorder who abruptly stop or reduce their alcohol use will develop signs or symptoms of alcohol withdrawal syndrome. The syndrome is due to overactivity of the central and autonomic nervous systems, leading to tremors, insomnia, nausea and vomiting, hallucinations, anxiety, and agitation. If untreated or inadequately treated, withdrawal can progress to generalized tonic-clonic seizures, delirium tremens, and death. The three-question Alcohol Use Disorders Identification Test–Consumption and the Single Alcohol Screening Question instrument have the best accuracy for assessing unhealthy alcohol use in adults 18 years and older. Two commonly used tools to assess withdrawal symptoms are the Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised, and the Short Alcohol Withdrawal Scale.

• For most people, alcohol withdrawal symptoms will begin sometime in the first eight hours after their final drink.
• In some cases, these sleep disturbances — which may include strange, vivid dreams — persist for weeks or even months.
• When the substance is removed, the residual counter-regulatory mechanisms produce unopposed effects and withdrawal symptoms.
• Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help.
• Treatment can occur in various settings, such as the emergency room, outpatient clinic, intensive care unit, or detoxification facility.

It’s important to get medical help even if you have mild symptoms of withdrawal, as it’s difficult to predict in the beginning how much worse the symptoms could get. It affects about 50% of people with alcohol use disorder who stop or significantly decrease their alcohol intake. AUD is the most common substance use disorder in the U.S., affecting 28.8 million adults. The more you drink on a regular basis, the more you’re likely to be affected by withdrawal symptoms. To keep health risks from alcohol to a low level, the UK Chief Medical Officers (CMOs) advise it is safest not to drink more than 14 units a week on a regular basis. Withdrawal symptoms are part of a condition called ‘alcohol withdrawal syndrome’, which is a reaction caused when someone who has https://ecosoberhouse.com/ become dependent on alcohol is deprived of it.

• The symptoms tend to develop 2 to 10 days after discontinuation of the agent and can last for weeks.
• Although it doesn’t occur in everyone, some people experience PSSD months after stopping long-term SSRI use.
• The person should also try to eat three well-balanced meals per day and drink enough water to remain hydrated.
• If your home environment is not supportive for staying sober, talk with your doctor.
• Withdrawal is a natural part of recovering from alcohol use disorder.
• Whether you’ve experienced addiction or are withdrawing after using prescription medication, it can be helpful to find a support group.

Dehydration and electrolyte disturbances can develop in the setting of vomiting and diarrhea. The physical examination of a patient with the signs and symptoms of alcohol withdrawal may reveal hyperventilation, tachycardia, tremor, hypertension, and diaphoresis. Other features of chronic alcohol use disorder include ascites, hepatosplenomegaly, and melena. Thinning of hair and gynecomastia are also seen in patients with chronic alcohol use disorder. Still, if you’re experiencing withdrawal symptoms, it’s essential to get evaluated by a healthcare professional.

It also provides an overview of the alcohol withdrawal timeline process and when to discuss your drinking with your healthcare provider. Patients presenting with alcohol withdrawal syndrome should receive thiamine and folate supplementation as they are often nutritionally deficient. For example, benzodiazepines might be effective for alcohol withdrawal syndrome symptoms helping people with alcohol withdrawal syndrome, but they won’t be appropriate for someone who has misused benzodiazepines in the past. PAWS can also be called protracted withdrawal syndrome or prolonged withdrawal syndrome. The symptoms of PAWS can differ from the symptoms of acute withdrawal, and are often milder and more sporadic.