Following are the three stages of alcohol withdrawal:
- Anxiety, insomnia, nausea and abdominal pain are characteristics of the first stage of withdrawal. These symptoms typically begin 8 hours after the last drink.
- High blood pressure, unusual heart rate, increase in body temperature, and confusion begin during stage 2 of withdrawal, typically 24-72 hours after the last drink.
- Stage 3 of withdrawals usually include hallucinations, fever, seizures and agitation. These symptoms typically present 72 or more hours after the last drink.
Within 5-7 days, symptoms typically decrease.
The average American, over the age of 18, has probably consumed alcohol at some point in their lifetime. In a study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) it was estimated that approximately 87% of the adult population has consumed at least one alcoholic beverage during their lifetime. Alcohol is legal for consumption for people over 21 year of age, whereas other addictive substances are not legal.
Studies published by the Mayo Clinic show that drinking in moderation is likely not harmful, and in fact can have some health benefits. These publications indicate that moderate drinking is the equivalent of one drink a day for women and two for a man. However, heavy drinking, or “binge drinking” can indicate a problem with alcohol abuse. Binge drinking would be defined as an average of 4 or more drinks for a woman, or 5 or more for a man, within the span of 3 or 4 hours. A problem with alcohol could also be defined by consuming more than 7 drinks a week for a woman, or more than 14 for a man. These stats are all according to the NIAAA. Statistics for the effects of alcohol abuse are as follows:
- It is estimated that in the year 2013, 16.6 million adults in America had AUD (alcohol use disorder), NIAAA.
- 1 out of every 10 deaths, occurring between 2006 and 2010, of working age adults were caused by excessive consumption of alcohol. These findings are based on a publication by the CDC (Centers for Disease Control and Prevention).
- According to the NIAAA, 88,000 people die every year from an alcohol related cause. Alcohol is the third leading, preventable cause of death in America.
Alcohol affects a person’s mood, increases self-confidence, and lowers inhibitions because as a person drinks, the levels of dopamine are elevated in their brain. As the effects of alcohol wear off, the good feelings and higher levels of dopamine dissipate. Over time, the repetition of drinking alcohol alters the normal dopamine levels in the brain, resulting in the expectancy of the presence of alcohol and higher dopamine levels. As a result, the brain will discontinue its production of the levels of dopamine that were previously present without alcohol.
The more alcohol a person drinks, the more the body becomes tolerant to the increased intake and the more dependent the brain becomes on its interference. When the effects of the alcohol wear off and the brain has become dependent, someone may suffer from withdrawal. These symptoms can range from mild to life-threatening.
Effects of Withdrawal from Alcohol:
The effects of withdrawal from alcohol typically begins within 6 – 12 hours after the last drink, as reported by American Family Physician. Withdrawal typically occurs in these three stages, in order of severity:
- Mild: insomnia, abdominal pain and/or vomiting, heart palpitations, nausea, anxiety, fatigue, depression, loss of appetite, tremors, foggy brain and mood swings.
- Moderate: irregular heart rate, increased blood pressure, body temperature and respiration, sweating, irritability, mental confusion and increased mood disturbances.
- Severe: DTs (delirium tremens) which includes shaking, confusion and hallucinations. Also may experience fever, seizures and agitation.
Alcohol detox and withdrawal can be influenced by several factors, such as, the amount consumed each time, length of time drinking, presence of co-occurring mental health disorders, medical history, childhood trauma, family history of alcohol abuse or addiction, and stress levels. Each case is highly individual based on many of these factors and how dependent on alcohol the person has become. Abuse of additional drugs with the use of alcohol may also influence alcohol detox and withdrawal symptoms and can increase the danger of these side effects.
DTs, or delirium tremens, is the most serious form of alcohol detox and withdrawal and according to the New England Journal of Medicine, it can be fatal without proper treatment. DTs occurs in 3-5% of individuals experiencing severe alcohol withdrawal. This may not occur for a day or two after the alcohol has left the bloodstream and can occur without warning. This is the primary reason that it is very important that an individual be monitored closely by a medical professional who can monitor vital signs and ensure safety during detox.
The associated withdrawal from an alcohol detox can be fatal. The brain and central nervous system experience a rebound after being suppressed by alcohol for an extended period of time. For this reason, to stop drinking by going “cold turkey” is never recommended without medical supervision as it can be life-threatening.
Alcohol Detox Timeline
Following is a general timeline, as detailed by the National Library of Medicine:
- First stage: roughly 8 hours after the last drink, withdrawal symptoms may begin.
- Second stage: symptoms generally peak within 24 – 72 hours, and stage 2 and 3 withdrawal symptoms can rapidly manifest.
- Third stage: symptoms generally start to taper off and decrease in intensity within 5 – 7 days.
- Fourth stage: side effects, particularly psychological ones, may continue for several weeks without proper treatment.
The first step during an alcohol detox is to monitor and control the physical symptoms and get to a stable point. Medical detox, which may include using medications, may be used to treat symptoms like dehydration, seizures, nausea and insomnia. Benzodiazepines are a common medication used to reduce some of the potential over-activity that the central nervous system may experience while it attempts to restore its natural order. All vital signs, including heart rate, respiration, blood pressure and body temperature need to be closely monitored and kept at safe levels in a skilled alcohol detox center like Milestone Detox.
Many times, a person who has been dependent on alcohol for some time, may suffer from malnutrition. It can also help improve withdrawal symptoms if there is a healthy diet put in place, along with supplements. A regular sleep schedule will also help with withdrawal effects and help the body heal more quickly.
Managing Symptoms in an Alcohol Detox Center
Once there has been some control of the physical symptoms of withdrawal, there are many ways that mental health professionals can help with the more powerful emotional effects of withdrawal from alcohol.
Therapy and counseling sessions, combined with certain medications can help alleviate the depression, anxiety and potential suicidal ideations that can follow detox. An important part of any alcohol detox center is the prevention of relapse. Individual therapy and 12 step groups can offer important support that continues through and beyond detox.
To assist with alcohol related cravings during the treatment of withdrawal and dependency, alcohol detox centers use three medications which are approved by the U.S. Food and Drug Administration (FDA). These medications are: Naltrexone, Disulfiram and Acamprosate. These medications manage withdrawal symptoms and discourage further drinking. Naltrexone blocks opioid receptors in the brain. This reduces cravings and the potential rewards that come from alcohol. Disulfiram will make people feel sick if they do drink, thereby making it undesirable to do so. Acamprosate is believed to work on long term withdrawal symptoms by stabilizing the chemical balance of the brain. Topiramate is another medication that has shown promise in disrupting the way alcohol makes a person feel. This comes from a report by Addiction Science and Clinical Practice.
Alcohol detox should never be attempted without the professional help of a detox center. Symptoms can appear and intensify very quickly. At times, even though the physical symptoms of withdrawal are under control, the continuation of emotional symptoms, cravings or even protracted withdrawal can continue without the proper emotional support and medical treatment.
During alcohol detox and withdrawal, Milestone Detox can provide the most supportive and comprehensive medical environment needed during all stages of detox to ensure successful recovery. If you or a loved one need help, call one of our professional admissions team members for a free and confidential assessment.