Yolanda has taught college Psychology and Ethics, and has a doctorate of philosophy in counselor education and supervision.
Introduction and Definition
Tommy is an alcoholic. Every day he drinks at least a fifth of bourbon after work. After getting into a car accident and losing his license, Tommy decides that it is time to stop drinking. He gets rid of all the liquor in his house and quits cold turkey. About five hours after his last drink, Tommy notices that he cannot keep any food down and feels queasy. His hands are shaky, and he is sweaty. Seven hours later, Tommy starts seeing pictures float across the walls. He knows that these are hallucinations and are not real, but they still disturb him. One day after his last drink, Tommy has a seizure. Worried about his health, Tommy goes to the ER. The doctor tells Tommy that he is suffering from alcohol withdrawal syndrome. Tommy is immediately placed in an inpatient treatment center where he can be monitored.
_Alcohol withdrawal syndrome is a condition that occurs in individuals who either discontinue or significantly lower the amount of alcohol that they drink after being heavy drinkers for a long period of time (i.e. weeks, months, or years). When a person who is a heavy drinker suddenly stops drinking, it causes a sudden decrease in blood alcohol levels. This causes the central nervous system to become hyper-excitable, which results in the symptoms associated with alcohol withdrawal. The higher amount of alcohol you drink on a regular basis, the higher your chances are of developing alcohol withdrawal syndrome once you decide to quit drinking.
Symptoms and Timeline
The symptoms of alcohol withdrawal can start two hours after a person has his/her last drink, and can continue for weeks. Symptoms can range from mild (i.e. shaky hands and sweating) to severe (i.e. seizures and delirium). To better understand the symptoms of alcohol withdrawal syndrome, we will look at them as they occur in a timeline.
Five to Twelve Hours
Mild symptoms of alcohol withdrawal usually start about five to twelve hours after the person has the last drink. In Tommy's case, symptoms started five hours after he stopped drinking and included tremors in the hand, sweating, and stomach problems, such as nausea and vomiting. Other symptoms include rapid heartbeat, high blood pressure, mild anxiety, nightmares, night terrors, headaches, confusion, trouble sleeping, and rapid breathing.
Twelve to Twenty-Four Hours
Twelve hours after he stopped drinking, Tommy began to have visual hallucinations. Not all individuals in alcohol withdrawal will experience hallucinations. For those who do have them, hallucinations begin about twelve to twenty-four hours after the last drink. Hallucinations can be visual (seeing pictures float on the wall), auditory (hearing voices) or tactile (feeling that there are spiders crawling on your body). This condition is referred to as alcoholic hallucinosis. Most people who experience alcoholic hallucinosis know that the hallucinations are not real.
One to Two Days
Withdrawal seizures kick in after about one to two days after taking the last drink, though some people experience them as soon as two hours after they stop drinking. Those who have previously experienced detoxification are more likely to experience withdrawal seizures.
Two to Three Days
Delirium tremens occur in about one out of twenty people who experience alcohol withdrawal syndrome. It starts about forty-eight to seventy-two hours after the last drink and usually reaches its peak about four to five days after a person has quit drinking. Symptoms of delirium tremens include confusion, severe anxiety, agitation, seizures, irregular heartbeat, excessive shaking, fever, elevated blood pressure, and hallucinations. The hallucinations associated with delirium tremens are primarily visual and unlike alcoholic hallucinosis, delirium tremens hallucinations are not easily separated from reality. Individuals who have previously had withdrawal seizures or delirium tremens, acute mental illness, liver problems, and advanced age are at an increased risk for delirium tremens. Other symptoms that occur during this time include vivid night terrors, panic attacks, and excessive sweating.
The goals of alcohol withdrawal syndrome treatment are to decrease the symptoms of alcohol withdrawal, prevent complications that may arise as a result of alcohol withdrawal, and help maintain alcohol abstinence.
When the symptoms of alcohol withdrawal syndrome are mild, an outpatient setting (i.e. an outpatient alcohol treatment center) may be preferred. Outpatient settings generally require you to have someone who will support you and stay with you throughout the withdrawal process. You will also be required to visit your health care provider on a daily basis.
When symptoms of alcohol withdrawal syndrome are moderate to severe, inpatient treatment (i.e. hospital stay or inpatient alcohol treatment center) may be required. Impatient treatment is also preferred if you do not have someone to watch over you through the withdrawal process or you have previously experienced severe withdrawal symptoms, withdrawal seizures, delirium tremens, detoxification, or certain mental or physical illnesses.
Medications are also used in treating alcohol withdrawal syndrome. Benzodiazepines, such as Valium or Ativan, are used to reduce certain symptoms of alcohol withdrawal (i.e. anxiety, tremors, and confusion). They also reduce the chance of having withdrawal seizures and delirium tremens. Because benzodiazepines are addictive and make you sleepy, Tegretol is an anticonvulsant medication that is used as an alternative.
Other drugs may be taken in addition to benzodiazepines in order to reduce symptoms. For example, antipsychotics may be taken to reduce agitation and hallucinations. Beta-blockers can be taken to reduce heart rate and blood pressure. Clonidine, better known as Catapres, can be taken to reduce blood pressure.
In order to help maintain alcohol abstinence, it is important for the person to be treated for alcohol abuse or dependence following alcohol withdrawal. Psychotherapy, like cognitive behavioral therapy and family therapy, staying at an alcohol treatment facility, or joining programs, such as Alcoholics Anonymous, are effective ways to help a person successfully remain abstinent.
_Alcohol withdrawal syndrome is a condition that occurs in individuals who either discontinue or significantly lower the amount of alcohol that they drink after being heavy drinkers for a long period of time. Symptoms can range from mild to severe. These can include shaking, nausea, hallucinations, seizures and delirium tremens. Treatment programs are usually in an outpatient or inpatient setting, and medications to help with symptoms are available. Now that you know the dangers of heavy drinking, hopefully you can avoid being a victim of alcohol withdrawal syndrome in the future.
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