Withdrawal from Alcohol
Alcohol withdrawal refers to the physiological changes that occur when a person abruptly quits consuming alcohol after a period of continuous and excessive use. Trembling (shaking), sleeplessness, anxiety, and other physical and mental symptoms are common.
Alcohol has a sedative or depressing effect on the brain. The brain of a heavy, long-term drinker is nearly always exposed to alcohol's repressive influence. Over time, the brain's chemistry changes to compensate for alcohol's influence. It accomplishes this by releasing naturally stimulating substances in greater quantities than normal (such as serotonin or norepinephrine, a relative of adrenaline).
When alcohol is abruptly discontinued, the brain behaves similarly to an accelerating vehicle that has lost its brakes. Not surprisingly, the majority of withdrawal symptoms occur as a result of the brain being overstimulated.
The most deadly type of alcohol withdrawal happens in around one out of every twenty people experiencing withdrawal symptoms. This is referred to as delirium tremens (also called DTs).
In delirium tremens, the brain is unable to smoothly rebalance its chemistry following the cessation of alcohol. This induces a temporary state of bewilderment and results in potentially harmful alterations in the way your brain regulates your blood circulation and breathing. Vital indicators such as heart rate or blood pressure can fluctuate significantly or unexpectedly, increasing the risk of heart attack, stroke, or death.
Symptoms
If your brain has been accustomed to your heavy drinking habits, it will take time for it to re-adjust. Alcohol withdrawal symptoms manifest themselves in a predictable sequence following your final alcoholic beverage. Not all symptoms manifest in every patient:Tremors (shakes) – These often begin within five to ten hours of the last alcoholic beverage and peak between 24 and 48 hours. Along with tremors (trembling), you may experience a racing pulse, a rise in blood pressure, fast breathing, sweating, nausea and vomiting, anxiety or hypervigilance, irritability, nightmares or vivid dreams, and insomnia.
Alcohol hallucinosis – This symptom often occurs between 12 and 24 hours after your last drink and may linger for up to two days. If this occurs, you will have hallucinations (see or feel things that are not real). Individuals who are abstaining from alcohol frequently perceive many little, similar, moving things. Occasionally, the image is interpreted as crawling insects or falling money. Alcohol withdrawal hallucinations can be extremely detailed and imaginative visions.
Seizures associated with alcohol withdrawal can occur between 6 and 48 hours after the last drink, and it is normal for numerous seizures to occur over several hours. At 24 hours, the risk is greatest.
Delirium tremens — Delirium tremens often occur two to three days after the last alcoholic beverage, but it can occur up to a week afterward. It reaches its peak severity four to five days after the previous drink. This disorder results in dangerous changes in your breathing, circulation, and temperature regulation. It can cause your heart to race dangerously fast, your blood pressure to skyrocket, and you may have serious dehydration. Delirium tremens can also cause a temporary decrease in blood flow to the brain. Confusion, disorientation, stupor, or loss of consciousness, anxious or aggressive behavior, irrational beliefs, drenching perspiration, sleep difficulties, and hallucinations are all possible symptoms.
Diagnosis
Alcohol withdrawal is simple to detect if you exhibit typical withdrawal symptoms following a period of excessive, persistent drinking. If you have already had withdrawal symptoms, they are likely to recur if you begin and stop drinking heavily again. There are no specialized diagnostics for alcohol withdrawal.
If you are experiencing withdrawal symptoms as a result of drinking, you have taken enough alcohol to cause damage to other organs. Your doctor should conduct a thorough examination and blood tests to look for alcohol-related damage to your liver, heart, nerves in your foot, blood cell count, and gastrointestinal tract. Your doctor will assess your regular diet and check for vitamin deficiencies, as malnutrition is frequent in people who are alcohol dependent.
Generally, it's difficult for people who drink to be entirely candid about how much they've consumed. You should be candid with your doctor about your drinking past so that withdrawal symptoms may be managed properly.
Duration Estimated
Alcohol withdrawal symptoms normally subside after five days, while a tiny percentage of patients may experience persistent effects lasting weeks.
Prevention
Numerous variables contribute to the development of alcoholism. If you have an alcoholic brother or parent, you are three or four times more likely to acquire alcoholism than the ordinary person. Some individuals with a family history of alcoholism prefer to abstain from alcohol in order to avoid developing alcohol dependence. Many persons who do not have a family history of alcoholism also get the disease. Consult your physician if you are concerned about your drinking.
Treatment
If you are experiencing severe vomiting, seizures, or delirium tremens, you should seek treatment in a hospital. Treatment for delirium tremens is frequently required in an intensive care unit (ICU). In an intensive care unit, your heart rate, blood pressure, and respiration can be constantly monitored in case emergency life support (such as machine-assisted breathing) is required.
Benzodiazepines are a class of medications that can help alleviate the symptoms of alcohol withdrawal. Chlordiazepoxide (Librium) and lorazepam are two frequently used medications in this class (Ativan).
The majority of alcoholics experiencing withdrawal symptoms are deficient in various vitamins and minerals and could benefit from nutritional supplements. Alcohol misuse, in particular, can result in a deficiency of folate, thiamine, magnesium, zinc, and phosphate. Additionally, it can result in hypoglycemia.
When Should You Consult a Doctor
Seek help if you or someone you care about is struggling with an alcohol-related problem. Alcoholism is a treatable disease.
If you have an alcoholism issue and have decided to abstain from drinking, contact your doctor for assistance. Your doctor can counsel you and may prescribe medications to help you cope with withdrawal symptoms if they arise. Additionally, your doctor can connect you with local organizations that can assist you in remaining alcohol-free.
Prognosis
While alcohol withdrawal is prevalent, delirium tremens occur in less than 5% of persons who experience it. Delirium tremens is a deadly condition that kills up to 1 in every 20 people who develop symptoms.
After withdrawal is complete, it is critical that you do not reintroduce alcohol. Alcohol treatment programs are critical because they increase your chances of remaining sober for an extended period of time. Only around 20% of alcoholics are able to maintain permanent abstinence from alcohol without the assistance of formal therapy or self-help groups such as Alcoholics Anonymous (AA). 44 percent of those who join AA and remain alcohol-free for one year are likely to continue abstinence for another year. This percentage jumps to 91% for individuals who have been abstinent and attended AA for at least five years.
On average, an alcoholic who does not abstain from drinking should expect to lose at least 15 years of life.
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