Adult and Adolescent Mental Health Blog

The team at Fifth Avenue Psychiatry aims to help both adults and adolescents with substance abuse and mental health issues.

Better Recovery With Medically Supervised Detox

The effects of alcohol account for one in three emergency room visits every year. This is due in part to the effects of alcohol detox and withdrawal. Alcohol withdrawal is the body and brain chemistry readjusting to a permanent sober state, once the individual is no longer consuming alcohol. Chronic alcohol use changes brain chemistry by inhibiting neurotransmitters that induce feelings of relaxation and excitability. Without alcohol these neurotransmitters work in overdrive, similar to a rebound effect.

Few individuals realize alcohol withdrawal must be medically managed, or it can be fatal. Symptoms like the shakes and anxiety may wear off, but seizures and delirium tremens can become permanent and be life threatening. If an individual is interested in quitting alcohol, it is important to understand all the possible side effects and how to manage them. The best strategy is to get assistance through a medical detox program.

Symptoms Of Detoxing From Alcohol

What are the symptoms of detoxing from alcohol? Drug and alcohol detox symptoms can range from mild to severe. While some alcohol detox symptoms subside, more severe symptoms can be permanent and require medical attention. Mild alcohol detox symptoms may include:

  • Shaking
  • Mild sweating
  • Mild anxiety
  • Fatigue
  • Headaches
  • Insomnia
  • Nausea
  • Vomiting
  • Irritability

More severe alcohol detox symptoms may include:

  • High blood pressure
  • Elevated body temperature
  • Elevated heart rate
  • Irregular heartbeat
  • Seizures
  • Tremors
  • Alcohol withdrawal depression
  • Altered consciousness
  • Hallucinations
  • Delirium tremens (DTs)
The severe symptoms of alcohol detox require medical attention. Common side effects like high blood pressure, elevated heart rate and irregular heartbeat can cause a life-threatening stroke or cardiac arrest if not treated promptly. The most severe symptom of alcohol detox is delirium tremens. Delirium tremens affects three to five percent of individuals during alcohol detox and can be fatal without treatment. Delirium tremens describes the sudden and severe mental health changes after the removal of alcohol as a central nervous system depressant. It can begin without warning a day or two after alcohol leaves the bloodstream. This is why seeking medical supervision for alcohol detox and withdrawal is crucial.

General Timeline For Alcohol Withdrawal

The alcohol detox symptoms timeline occurs in three stages. Characterized by unique symptoms, each stage begins a certain amount of time after alcohol consumption ceases. All symptoms tend to decrease after five to seven days. The three alcohol withdrawal stages are:

  • Stage 1: The first stage occurs approximately eight hours after the last drink. The symptoms are the mildest and include anxiety, insomnia, nausea, abdominal pain and/or vomiting, loss of appetite, fatigue, tremors, depression, foggy thinking, mood swings, and heart palpitations.
  • Stage 2: Symptoms are more serious, but still fairly moderate during Stage 2. This stage begins anywhere from 24 to 72 hours after the last drink. Common symptoms during Stage 2 are increased blood pressure, body temperature and respiration, irregular heart rate, mental confusion, sweating, irritability, and heightened mood disturbances.
  • Stage 3: This stage occurs anywhere from two to four days after the last drink. Medical attention is highly recommended because of the possibility of an alcohol related death. Without medical supervision delirium tremens may occur and alcohol withdrawal deaths take place in 3-15% of people going through it. Other symptoms during this stage are vivid hallucinations, fever, seizures, severe confusion, and agitation.

Alcohol detox and withdrawal is highly variable. For this reason, this is a general timeline and each individual may not go through every stage. Some factors that may affect the withdrawal timeline are length of time drinking, the amount consumed each time, medical history, the presence of a co-occurring mental health disorder, family history of addiction, childhood trauma, and stress levels. Because of all the factors involved, medical supervision is vital.

Protracted Withdrawal And Post-Acute Withdrawal Syndrome

The process of acute withdrawal typically lasts no more than two weeks, especially with medical supervision in place. However, alcohol and some drug addictions withdrawal can lead to a protracted withdrawal. Protracted withdrawal is a prolonged, ongoing, withdrawal process, which can last for weeks, months and up to a year. Specifically, protracted withdrawal is known as Post-Acute Withdrawal Syndrome, PAWS. Individuals who consume large amounts of intoxicating substances over a long period of time are likely to develop PAWS.

PAWS may include any symptoms that continue after acute withdrawal, often described as a rollercoaster of symptoms for individuals.

However, the most common symptoms of PAWS include:

  • Irritability and emotional outbursts
  • Anxiety
  • Low energy
  • Trouble sleeping
  • Memory problems
  • Dizziness
  • Increased accident proneness
  • Delayed reflexes
PAWS is the most prevalent with alcohol withdrawal, but can also occur with antidepressants, antipsychotics, marijuana, and other intoxicating substances. It is possible to feel the lingering effects for up to one year after acute withdrawal. PAWS is the reason it is important to have a rehabilitation program following the initial detox, otherwise it increases the possibility of relapse. Whether the withdrawal symptoms occur after being sober for three weeks or three months, it can be scary for individuals in recovery. Many return to alcohol to get rid of the symptoms of PAWS, which they often think will last forever especially if they do not have help in the form of a mentor, sponsor or therapist, and education to help them understand why they feel this way and why it is happening.

Alcohol Withdrawal Treatment

Alcohol detox and withdrawal can occur with or without medical supervision. However, Delirium tremens and other serious side effects can be life threatening. It is highly recommended to seek medical supervision if an individual is considering quitting alcohol. An individual’s withdrawal experiences will differ depending on whether they went through it with professional assistance or without.

How To Prepare For Alcohol Withdrawal Without Medical Help

  • Get rid of all alcohol in the home. Individuals who drink alcohol habitually, usually develop a routine. Ensure that there is no access to alcohol when daily stressors make you long for a drink.
  • Do not allow drinking partners to visit. Similarly, do not allow others who reinforce your drinking habits to visit during the detox and withdrawal.
  • Supply the home with plenty of other liquids. Individuals will likely experience nausea and vomiting, which leads to dehydration. Store plenty of fluids to replenish electrolytes.
  • Inform friends and family members of your plans. Support from others is the best way to combat the urge to drink.
  • Write down reasons to stop drinking. The individual should put this list up where he or she can always see it. This keeps the individual focused and grounded when cravings strike.
  • Try deep breathing and meditation. This is yet another strategy to combat the cravings that will inevitably strike. The body needs to remain calm, focused, and relaxed.

Even with all these safeguards in place, an individual attempting to quit drinking on their own or ‘cold turkey’ should be prepared to call for medical help or check into a detox facility, particularly if they did more than casual drinking. Willpower is one thing, but experienced, professional help can mean the difference between a successful detox and a fatal one. By the time individuals who attempt alcohol detox on their own arrive at hospitals with alcohol withdrawal syndrome, it is often too late.

Types Of Alcohol Withdrawal Treatment With Medical Supervision

The problem is that alcohol withdrawal symptoms can shift violently and unexpectedly. Professional rehab facilities can be beneficial to, and potentially save the life of a person going through alcohol detox and withdrawal. The type of professional treatment an individual receives depends on their history of alcohol abuse, such as frequency and the amount consumed. Various treatments may be as follows:

  • Inpatient treatment. Here, individuals get 24/7 monitoring. Programs are available for 30, 60, or 90-days and offer a safe environment for individuals struggling with alcohol addiction.
  • Outpatient treatment. Outpatient facilities allow individuals to complete their daily routines, such as work, while still receiving treatment – typically recommended for individuals with less severe forms of alcohol abuse.
  • Medication-assisted therapy. Certain prescribed medications can treat alcohol withdrawal, allowing patients to focus on other aspects of recovery in any setting.
  • Individual counseling. Counselors can provide support during individuals’ highs and lows before, during, and after alcohol withdrawal. They can help individuals work through the more challenging matters that occur during detox.

Successful Alcohol Withdrawal Treatment

Alcohol is one of the most difficult substances from which to withdraw. For individuals interested in quitting alcohol consumption on their own and without medical supervision, the consequences can be deadly. The shaking and cold sweats might wear off, but symptoms such as high-blood pressure, heart palpitations, and especially delirium tremens result in approximately one in twenty-five deaths. In 2016, the Center for Disease Control and Prevention reported 831 deaths due to alcohol withdrawal syndrome.

If you are considering withdrawing from alcohol, getting professional help for the detox is very important, crucial, even. Then have a plan for rehabilitation in place after alcohol detox, for the highest chance of a successful recovery without the risk of relapse. Being aware of PAWS is vital to that success. A bright future from alcohol withdrawal and a good life in sobriety includes having a good support system, maybe a 12 step program and meditation to help deal with stress.

Contact us today to schedule your first appointment towards addiction freedom: 212-734-0506

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