Because alcohol is a legal drug, there is a common misconception that using and withdrawing from alcohol is safer than using and withdrawing from other drugs.
For many individuals, quitting drinking has some unpleasant, but tolerable side effects. For others, the side effects can be so severe as to become life threatening.
Detoxing as Part of a Process
More than just discontinuing the consumption of their drug of choice, a person in recovery goes through a series of changes to their mind, their bodies, their social lives, and their overall lifestyles. While getting a drug out of their system is one stop in that process, there is much more involved for a person who wants to make and maintain such a profound change.
Common Alcohol Withdrawal Symptoms
According to a WebMD article on alcohol withdrawal, it is not uncommon for people who stop using alcohol to experience non-life threatening withdrawal symptoms in the first six hours to three days after they stop drinking, especially if they previously drank large volumes and/or have drank consistently for a prolonged period of time. Withdrawal symptoms often include:
- Anxiety
- Shaky hands
- Headache
- Nausea
- Vomiting
- Insomnia
- Sweating
- Hyperventilation
- Hallucinations (visual, auditory and tactile)
Delirium Tremens
Delirium Tremens (sometimes called DTs) is only estimated to occur in about 5 percent of people withdrawing from alcohol, but the New England Journal of Medicine reports that this number could be somewhat higher, as criteria for recording incidents has not been consistent. While it is still generally agreed that the percentage of people who suffer from DTs is quite low, the fatality rate among those individuals is 15 to 40 percent, if left untreated. In cases where an individual has died from DTs, the cause of death has most often been related to hyperthermia, cardiac arrhythmia, complications of withdrawal seizures, or concomitant medical disorders.
For those who experience DTs, symptoms will normally appear in 48 to 72 hours and last for about two to three days after onset. One rare occasion, DT symptoms can last for up to eight days after onset. Symptoms can include:
- Nightmares
- Chest pain
- Fatigue
- Nausea or vomiting
- Severe anxiety, similar to a panic attack
- Uncontrollable tremors
- Hallucinations
- Delusions
- Confusion
- Racing heart/palpitations
- High blood pressure
- Fever
- Heavy sweating
- Seizures (see this article from LiveScience to learn more about the risks of DT related seizures)
How to Cope with Alcohol Withdrawal
Because most people are not in danger from alcohol withdrawal, it is generally recommended that it be treated like the flu or a migraine:
- A quiet, supportive environment
- Soft lighting
- Limited contact with people
- Healthy diet with lots of fluids
When Detox Becomes Dangerous
In their blog, Alcohol, Benzos, and Opiates—Withdrawal That Might Kill You, Psychology Today recommends, “If while withdrawing from alcohol a person develops a fever, extreme nausea, diarrhea, or DT (delirium tremens), they need to be rushed to see a doctor as soon as possible.” This could also include if a person’s blood pressure, pulse, or body temperature rises or if seizures or hallucinations become an issue.
Inpatient treatment provides a safe and effective way to get through the withdrawal stage. Patients receive 24/7 monitoring and support from a team of skilled professionals. Medications may be used to help a patient get through detox, in the most severe cases.
Who Is at Risk for Delirium Tremens in Alcohol Withdrawal ?
Delirium Tremens in alcohol withdrawal are more likely for anyone with:
- Heavy alcohol consumption, defined as 4 to 5 pints of wine, 1 pint of hard alcohol, or 7 to 8 pints of beer daily
- Extended history of regular heavy drinking, typically for 10 years or more
- Other medical conditions or poor overall health
- Older age
- Presence of structural brain lesions
- Experience of intense alcohol cravings
- A prior withdrawal experience that included DT
Overcoming Fear of Detox
For some people struggling with problem drinking, fear of severe withdrawal symptoms is a barrier to their recovery. It is important, however, to realize that 95 percent of the population does not experience severe, life threatening withdrawal symptoms.
For those individuals who do have such symptoms, there are a variety of interventions that doctors can utilize to help them get through the worst of the process. For example:
- Sedation to suppress the excitability of the nervous system, thus reducing the severity of symptoms
- Thiamine and other vitamins to promote proper nutrition
- IV fluids to prevent dehydration
- Dextrose to prevent hypoglycemia
- Monitoring and replacement of electrolytes as necessary, since people suffering from alcoholism often have low calcium, magnesium, phosphorous, or potassium levels
- Treatment of any co-occurring health conditions
Ultimately, getting is safer than allowing problem drinking to continue unchecked, especially when medical professionals are available to assist those who experience complications from detoxing.
The Alcohol Use and Your Health Fact Sheet from the Centers for Disease Control outlines the short and long-term consequences of problem drinking. These include social problems, health issues, and even death. Therefore, it is critical for a person who has suffered from alcoholism to conquer the fears that come along with getting sober and enter into recovery as soon as possible.