Alcohol withdrawal

Alcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking alcohol.

Causes

Alcohol withdrawal occurs most often in adults. But it may also occur in teenagers or children.

The more often you drink, the more likely you are to have alcohol withdrawal symptoms when you stop drinking.

You may have more severe withdrawal symptoms if you have certain other medical problems.

Symptoms

Alcohol withdrawal symptoms tend to occur within 8 hours after the last drink, but can occur days later. Symptoms tend to peak by 24 to 72 hours, but may go on for weeks.

Common symptoms include:

• Anxiety or nervousness

  Anxiety

  Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...

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• Depression

  Depression

  Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...

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• Fatigue

  Fatigue

  Fatigue is a feeling of weariness, tiredness, or lack of energy.

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• Irritability
• Jumpiness or shakiness
• Mood swings
• Nightmares
• Not thinking clearly

Other symptoms may include:

• Sweating, clammy skin

  Sweating

  Sweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...

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  Clammy skin

  Clammy skin is cool, moist, and usually pale.

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• Enlarged (dilated) pupils
• Headache

  Headache

  A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...

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• Insomnia (sleeping difficulty)
• Loss of appetite

  Loss of appetite

  A decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.

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• Nausea and vomiting
• Pallor

  Pallor

  Paleness is an abnormal loss of color from normal skin or mucous membranes.

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• Rapid heart rate

  Rapid heart rate

  A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.

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• Sweating, clammy skin
• Tremor of the hands or other body parts

Delirium tremens is a severe form of alcohol withdrawal. It can cause:

• Agitation, irritability

  Agitation

  Agitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.

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• Sudden, severe confusion (delirium)
• Fever

  Fever

  Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...

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• Seeing or feeling things that aren't there (hallucinations)
• Seizures

  Seizures

  A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...

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Exams and Tests

Your health care provider will perform a physical exam. This may reveal:

• Abnormal eye movements
• Abnormal heart rhythms
• Dehydration (not enough fluids in the body)
• Fever
• Rapid breathing
• Rapid heart rate
• Shaky hands

Blood and urine tests, including testing for toxins and drugs, may be done. An electrocardiogram (ECG) may also be done.

Treatment

The goals of treatment are to:

• Reduce withdrawal symptoms
• Prevent complications of alcohol use
• Help you to reduce or stop drinking alcohol

INPATIENT TREATMENT

People with moderate-to-severe alcohol withdrawal symptoms may need to be treated at a hospital or other facility that treats alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens.

Treatment may include:

• Monitoring blood pressure, body temperature, heart rate, and blood levels of different chemicals in the body
• Giving fluids or medicines through a vein (by IV)
• Giving sedatives until withdrawal is complete

OUTPATIENT TREATMENT

If you have mild-to-moderate alcohol withdrawal symptoms, you can often be treated in an outpatient setting. During this process, you will need someone to stay with you and keep an eye on you. You will likely need to make daily visits to your provider until you are stable.

Treatment usually includes:

• Sedatives to help ease withdrawal symptoms
• Blood tests
• Patient and family counseling for alcohol use issues
• Testing and treatment for other medical problems linked to alcohol use

It is important to go to a living situation that supports you in avoiding unhealthy alcohol use. Some areas have housing options that provide a supportive environment for those trying to stay sober.

Total and lifelong avoidance of alcohol (abstinence) is the best treatment for those who have gone through alcohol withdrawal.

Support Groups

More information and support for people with alcohol use disorder and their families can be found at:

• Alcoholics Anonymous -- www.aa.org
• Al-Anon Family Groups/Al-Anon/Alateen -- al-anon.org
• National Institute on Alcohol Abuse and Alcoholism -- www.niaaa.nih.gov
• SMART Recovery - www.smartrecovery.org/
• Substance Abuse and Mental Health Services Administration -- www.samhsa.gov/atod/alcohol

Outlook (Prognosis)

How well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.

Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver, heart, and nervous system disease.

Most people who go through alcohol withdrawal make a full recovery. But, death is possible, especially if delirium tremens occurs.

When to Contact a Medical Professional

Alcohol withdrawal is a serious condition that may quickly become life-threatening.

Call your provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Call for an appointment with your provider if symptoms persist after treatment.

Go to the emergency room or call 911 or the local emergency number if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur.

If you go to the hospital for another reason, tell the providers if you've been drinking heavily so they can monitor you for symptoms of alcohol withdrawal.

Prevention

Reduce or avoid alcohol. If you have a drinking problem, it is best to stop drinking alcohol completely. Total and lifelong avoidance of alcohol (abstinence) is the safest approach.