What is Alcohol Withdrawal?
Withdrawals happen because alcohol depresses the human body (as opposed to stimulating it). Alcohol decreases brain function and shifts nerve function so messages aren’t sent as clearly. When alcoholism occurs over time, the central nervous system gets used to having alcohol in the body—it also becomes dependent on it.
Simultaneously, the brain is working overtime to help a person stay awake and nerves communicating as best they can. This is tough when a person is an alcoholic, as the brain is battling a strong drug. When alcohol is suddenly no longer in the body, the brain activity goes a little haywire. It remains in a hyper-aware state, not able to process the sudden loss of the drug, and withdrawal symptoms kick in.
Withdrawal symptoms are the body’s response to having an addiction pulled out from under it. Some alcoholics are surprised at how intense their symptoms are. They may have thought they “weren’t that serious of an alcoholic.” However, some bodies adapt very quickly to a regular drug, and will fight against itself when it’s taken away. You can never really know how a body will respond to withdrawal until it occurs.
Alcohol Withdrawal Symptoms
Some of the milder symptoms of alcohol withdrawal include shaking hands, nausea and vomiting, anxiety, headaches, insomnia, and sweating. These symptoms are rarely dangerous, but they can be uncomfortable enough to force an alcoholic to reach for another drink. This is a main reason why at-home detoxes are rarely successful.
For more severe alcoholics, withdrawal symptoms can include hallucinations. These often occur about 12 hours after the last drink. Seizures can happen starting around two days after the last drink. Both of these withdrawal symptoms are serious and potentially life-threatening.
However, delirium tremens or “DTs” are even more dangerous. DTs start about two – three days after the last drink. Symptoms are severe and often combine delusions with hallucinations. DT delusions are different than the somewhat less serious hallucinations. Around five percent of alcoholics get DTs, and although it usually happens in only the most severe cases, any alcoholic might suffer from them during withdrawals.
If a person has DTs, they are also more likely to experience high blood pressure, a fever, intense sweating, confusion, and increased heart rate. All of these are symptoms of serious alcohol withdrawal, and all may become deadly. Only medically trained professionals are capable of caring for alcohol withdrawal symptoms of this degree. Due to delirium and hallucinations, there is also a danger for anyone trying to help the alcoholic—which is another reason you should always leave withdrawal management to a professional clinic.
There isn’t a standardized timeframe that will work for every alcoholic. How long withdrawals last will depend on the person, the severity of their alcoholism, and their tolerance level. However, there are stages of alcohol withdrawal. It can start as soon as two hours after the last drink or up to a full day. However, on average an alcoholic starts showing withdrawal symptoms about eight hours after their last drink. The first stage of withdrawal is always the mildest, and symptoms may vary. Common symptoms are anxiety and frustration, fatigue, nausea and vomiting, insomnia, tremors, stomach pain, loss of appetite, confusion, and moodiness. Most alcoholics will relate to at least a few of these first-stage symptoms.
Since alcohol is a depressant, every alcoholic will experience some type of sadness during withdrawals. Tremors are less common at this stage, but long-term alcoholics seem to suffer from them more. Vomiting is common for everyone, and that can kick-start dehydration—yet another reason medical intervention is a must. In a clinic, the patient can be kept hydrated through an IV. Dehydration can lead quickly to organ failure. The first stage lasts about 24 hours.
In stage two, there might be a brief moment of relief while stage one ends. However, stage two soon begins and is much more painful. It usually starts 24 hours after the last drink and can include breathing issues, fevers, strange heart rates, high blood pressure, confusion, and sweating. On average, stage two lasts two or three days. Sweating and vomiting is more intense, which increases dehydration.
The final stage, or stage three, is the most dangerous. The symptoms are most severe and it’s when death is most likely to occur. Stage three begins, on average, three days after the last drink. This stage can last for several weeks. Symptoms are a high fever, seizures, and hallucinations. Each of these symptoms demand medical help. Seizures are the most dangerous of the three symptoms, but all can be deadly—especially when combined.
Not every alcoholic will experience all three symptoms. Less serious alcoholics often don’t advance beyond stage one or two. However, medical intervention is still a good idea.
Alcohol Withdrawal Timeline
There is no way to gauge how long withdrawal symptoms will last. Sometimes it’s just a few days, and other times it takes several weeks. A better measurement is the stages of alcohol withdrawal. Only a medical doctor can diagnose whether a patient is in withdrawals and at what stage. Plus, only doctors can tell whether an alcoholic is going through all three stages or not.
As previously mentioned, the third stage is the most dangerous. It can also last the longest. If an alcoholic has been drinking heavily and steadily for many years, they can take several weeks to complete withdrawal symptoms.
In many cases, withdrawals (when medically supervised) are also part of detox. Detox is the process in which the body completely rids itself of alcohol and the metabolism has processed all of the remaining drug. This can be the first step in treatment, but for adults that’s only possible if the patient actually wants to recover.
Recovering from alcoholism is a lifelong endeavor. Although withdrawals and detox are often the most severe part of recovery, it’s not necessarily the “hardest.” It is very challenging to go without your addiction for the rest of your life. Some people hope that withdrawals and detox are a wakeup call for the alcoholic, and sometimes that happens. Other times, the patient may return to drinking—sometimes very shortly after withdrawals occur.
However, going through withdrawals at home or in a non-medically-supervised space is not only dangerous. It also sets up the alcoholic for failure. Few people would willingly go through high fevers, hallucinations, and extreme pain when the antidote to their pain is within reach. An alcoholic without restraint, particularly in stages two or three, will almost certainly have a drink. In many cases, they will do anything possible to get that drink.
Medically-supervised detox centers that work with withdrawal patients have the tools and training necessary to help even the most severe alcoholics survive withdrawal symptoms safely. This sometimes requires administering medications that ease withdrawal symptoms. Hydration is a key component of detox and withdrawal. Many times, the withdrawals and detox can give way to a longer-term treatment plan if the patient is ready for it.
Alcohol Withdrawal Treatment
The exact treatments for alcohol withdrawal are as unique as the patient. Many patients require hydration, particularly to treat the side effects of sweating and vomiting. Some require special medications to make them more comfortable or to keep them out of dangerous territory. All treatments should include around the clock care by professionals. Leaving someone with their withdrawal symptoms, and no help, is painful, cruel, and unhelpful.
Although it can be difficult to watch, the proper care is a must for withdrawal patients and it can only be provided by professionals. Family and friends who try to help in home environments often find themselves giving in to the wishes of the alcoholic because the pain is too much to watch. Nobody wants to see their loved ones suffering. That’s the reason why family and friends are never the right person to help someone through withdrawal symptoms.
Treatment for Alcohol Addiction
Treatment for alcohol addiction often begins with withdrawals. If the addict completely withdrawals and goes through detox, they’ve already achieved great success—however, it’s only the first step in a lifetime of recovery. It’s very common for alcoholics to slip up and return to their addiction, particularly if they were addicted enough to go through stage three of withdrawals.
An addict is an addict for life. Full “recovery” is not technically possible, but a lifetime of management is. It’s a challenge that must be tackled on a daily basis, and one which often requires support networks for life. Fortunately, there are a number of treatment centers that offer a variety of strategies and approaches. It’s important for alcoholics to re-learn how to function in the real world. Unlike illegal drugs like heroin, alcohol will likely always be present. It’s at many social gatherings and professional functions. Alcoholics may be able to avoid these situations in the tender, early stages of their recovery, but probably not forever. Learning to adapt and having the tools they need to live parallel to alcohol is a must for a full, fruitful life. There are a number of strategies available, and learning them while practicing them in a safe, controlled environment is key to success.