Alcohol Withdrawal Syndrome

Alcohol withdrawal syndrome (AWS) is the name for the symptoms that occur when a heavy drinker suddenly stops or significantly reduces their alcohol intake.

With AWS, you may experience a combination of physical and emotional symptoms, from mild anxiety and fatigue to nausea. Some symptoms of AWS are as severe as hallucinations and seizures. At its most extreme, AWS can be life-threatening.

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Excessive drinking excites and irritates the nervous system. If you drink daily, your body becomes dependent on alcohol over time. When this happens, your central nervous system can no longer adapt easily to the lack of alcohol. If you suddenly stop drinking or significantly reduce the amount of alcohol you drink, it can cause AWS.

People who have an addiction to alcohol or who drink heavily on a regular basis and can’t gradually cut down are at high risk of AWS.

AWS is more common in adults, but children and teenagers who drink excessively may also experience the symptoms. You’re also at risk for AWS if you’ve previously had withdrawal symptoms or needed medical detox for a drinking problem.

The Centers for Disease Control and Prevention define heavy drinking as more than eight drinks per week for women and more than 15 drinks per week for men. The following are the equivalent of one drink:

  • 1.5 ounces of distilled spirits or liquor, including gin, rum, vodka, and whiskey
  • 5 ounces of wine
  • 8 ounces of malt liquor
  • 12 ounces of beer

Binge drinking is the most common form of heavy drinking. For women, it’s defined as four or more drinks in one sitting. For men, it’s defined as five or more drinks in one sitting.

Alcohol withdrawal symptoms are known to come in three different stages: minor, moderate and severe. Minor withdrawal symptoms — such as headaches, slight tremors and nausea — are subject to start anywhere from six to 12 hours after a person’s last drink. More moderate side effects of withdrawal — such as vomiting, sweating, confusion and fever — may follow within 12 to 24 hours. Those who experience severe withdrawal may begin to feel these symptoms — called delirium tremens — between 48 and 72 hours after discontinuing alcohol use.

Delirium tremens are a potentially fatal medical emergency, although awareness of this serious complication of alcohol withdrawal has helped to lower the rate of fatalities. Research shows 5 percent of the roughly 2 million Americans who seek alcohol addiction treatment each year experience delirium tremens, also known as alcohol withdrawal delirium. The mortality rate for delirium tremens can range from 3 to 15 percent each year.

If your doctor suspects a patient to have symptoms of alcohol withdrawal symptoms, he will run some medical tests, take the medical history, how long has the patient been drinking for, whether there is a history of alcoholism in the family, and whether there is history of abuse of any other substances.

Based on this initial assessment, your doctor will run a physical exam to see the extent of damage that the alcohol consumption has had on the vital organs, and to check on any potential complications such as congestive heart failure, coronary artery disease, gastrointestinal bleeding, nervous system impairment, or infections.

Delirium tremens is a severe form of alcohol withdrawal with very sudden dramatic severe mental or nervous system changes. Delirium tremens can occur when you stop drinking alcohol after a period of heavy drinking. This is a medical emergency.

The treatment for alcohol withdrawal syndrome depends on the severity of the condition. For mild to moderate cases, your doctor may suggest an outpatient procedure.

For more severe cases, the following are the usual methods of treatment:

  • Reducing immediate symptoms
  • Preventing complications
  • Long term therapy
  • Promoting alcohol abstinence

Due to the potential occurrence of seizures as a result of alcohol withdrawal, it is strongly recommended that any individual who is attempting to become abstinent from their use of alcohol and diagnosed with an alcohol use disorder consult with a physician before stopping their use of alcohol. Most individuals will not develop seizures as a result of alcohol withdrawal; however, as the onset of seizures can result in a potentially fatal situation, it is far better to be safe in this situation. Individuals who have been using or abusing alcohol for several years, have experienced issues with nausea, shakiness, sweating, etc., when they stop using alcohol, and continue to use alcohol regularly to avoid these symptoms are at particular risk; however, there is no surefire manner to predict who will develop significant medical issues associated with alcohol withdrawal. Thus, anyone who has used alcohol on a regular basis and is planning to quit using alcohol should consult with their physician.

While medications alone are not sufficient to treat potential relapse and the symptoms of alcohol use disorder, medications can help an individual negotiate the withdrawal process and avoid relapse early in recovery. There are some medications that are commonly used in the treatment of alcohol use disorder.

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