Alcohol Withdrawal

What is alcohol withdrawal?

Alcohol withdrawal is the physical problems and emotions you have if you are dependent on alcohol and then suddenly stop drinking. It can also happen if you drink much less than you are used to drinking. You are most likely to have withdrawal problems 1 to 7 days after your last drink.

How does it occur?

If you are an alcoholic, you may have withdrawal if:

• You decide to stop drinking.
• You are in a situation where you can't drink alcohol, such as at a hospital, treatment center, or jail.

What are the symptoms?

The effects of alcohol withdrawal vary greatly. Most people with mild to moderate alcohol dependence have one or more of these symptoms:

• headache
• dizziness
• nausea and vomiting
• shaking
• sweating
• restlessness
• seizures
• increased heart rate or blood pressure
• trouble sleeping or concentrating
• strong desire to drink to relieve the symptoms of withdrawal

A few alcoholics experience a life-threatening condition called delirium tremens (DTs). This is a medical emergency. The symptoms may include:

• confusion
• hallucinations
• agitation
• seizures
• memory problems
• fever
• very high heart rate and blood pressure.

How is it diagnosed?

Your health care provider will review your symptoms, examine you, and ask about your medical history and memory.

You may have one or more of these tests:

• urine and blood tests to check for the level of alcohol and other drugs in your body
• blood tests to measure blood count, the sugar level in your blood, and how your liver is working
• chest x-ray if your provider thinks you might have pneumonia
• other x-rays if your provider thinks you may have a broken bone, perhaps from a fall.

How are alcoholism and withdrawal treated?

If you are an alcoholic, you must acknowledge the problem and take responsibility for it before you can begin treatment. Some people know they have an alcohol problem but deny that they need help to stop drinking. When you can take responsibility for your problem and admit you need help, call your health care provider to get some help.

Many alcoholics cannot admit that they have a problem. Loved ones, employers, or others may then have the painful task of committing the alcoholic to treatment. This is very tough but necessary. To say the alcoholic can't be helped until he or she wants help is not true.

Detoxification:
Depending on how much and how long you have been drinking, you may need a hospital stay to "dry out" (detoxification). There are also many outpatient centers for detoxification. Treatment for withdrawal symptoms may include tranquilizers, vitamin supplements, and intravenous (IV) fluids. Medical supervision of your withdrawal from alcohol is especially important if you have other medical problems or are taking medicines.

Detoxification may take 3 to 4 days.

Long-Term Treatment:
After detoxification, you will need long-term treatment. This may include social, medical, and psychological therapy.

• Social treatment involves family members and focuses on problems in the home and at work.
• To discourage you from drinking again, your health care provider may prescribe the medicines disulfiram or naltrexone. These medicines work best as one part of a full treatment program.
  • Disulfiram (Antabuse) will make you feel sick if you drink alcohol after taking the medicine. Knowing you will have this reaction will discourage you from drinking.
  • Naltrexone (ReVia or Depade) can help stop drinking by reducing your craving for alcohol without the side effects of disulfiram.
• Psychological therapy usually involves group therapy sessions to understand the illness and why you drink.

Self-help support groups such as Alcoholics Anonymous (AA) can be very helpful. At local chapter meetings you can meet other alcoholics, share experiences, and receive encouragement. It does not cost anything to join AA. Meetings are open to anyone who has a drinking problem and wants to become and stay sober. Phone numbers for local chapters of AA are usually listed in the phone book.

Families of alcoholics can join a related organization called Al-Anon. For families of someone who does not recognize his or her drinking problem, Al-Anon meetings can help build understanding and strength before forcing the person into treatment. It's very hard to keep denying an alcohol problem if your family is attending Al-Anon.

How long will the effects last?

The symptoms of a hangover may last 24 hours. The shakes and hallucinations of delirium tremens (DTs) may last 1 to 5 days. Delirium tremens can be fatal if it is not treated.

How can I take care of myself?

If you are an alcoholic, the most important thing you can do for yourself is to admit the problem and ask for help. If you decide to stop drinking alcohol or find yourself in a situation in which you cannot drink (such as in a hospital), ask for medical help. You may not need hospital treatment for withdrawal symptoms, but you should be where someone can get help for you if you need it.

While you are having treatment for withdrawal:

• Take the full course of treatment your health care provider prescribes.
• Follow your provider's advice for treatment of any other medical problems.
• Have 3 meals a day.
• Take a multiple vitamin.
• If possible, avoid drinking coffee and smoking.
• Get enough sleep and stay as active as possible during the day.
• Attend AA meetings often.

For more information, contact:

• Alcoholics Anonymous (AA)
  P.O. Box 459
  New York, NY 10163
  212-870-3400
  http://www.alcoholics-anonymous.org/
• Al-Anon Family Groups, Inc.
  1600 Corporate Landing Parkway
  Virginia Beach, VA 23454-5617
  Phone: 800-356-9996
  Web site: http://www.al-anon.alateen.org.

What can be done to help prevent alcohol withdrawal?

If you are physically dependent on alcohol, you will experience withdrawal symptoms when you quit drinking. But alcoholism can be treated so that you can withdraw safely and with much less discomfort.