Understanding Alcohol Withdrawal Syndrome
Learn more about alcohol withdrawal syndrome at Highland Ridge Hospital in Salt Lake City, Utah
In 2012, it was estimated that about 18 million people in the United States have an alcohol use disorder, alcohol dependence, or alcoholism. People who are dependent upon alcohol often spend a great amount of their time drinking, ensuring they have access to alcohol, and recovering from alcohol’s effects – often at the expense of scholastic, occupational, or interpersonal activities and obligations. Alcoholism is considered a chronic, often progressive disease that requires medical intervention and behavioral therapies to successfully recover from. People who suffer from alcoholism, the most serious form of alcohol use disorders, are physically dependent upon alcohol, meaning that they rely upon alcohol to function and feel physically compelled to drink alcohol, despite the negative consequences in their lives. Men and women who are physically dependent upon alcohol will develop tolerance to alcohol; a tolerance means that they require more and greater amounts of alcohol to achieve similar feelings of intoxication. People who are physically dependent upon alcohol also develop a withdrawal syndrome if they dramatically cut down on their drinking or attempt to stop drinking.
Alcohol withdrawal syndrome is a potentially life-threatening condition that occurs in people who have been heavily drinking alcohol for weeks, months, years, or decades and abruptly discontinue or cut down on their alcohol intake. Alcohol withdrawal syndrome affects as many as 2 million people in the United States each year, with symptoms beginning as early as two hours after the last drink. As alcohol withdrawal syndrome can quickly go from minor annoyance to life-threatening emergency, it’s important that people who are experiencing alcohol withdrawal syndrome seek medical attention and begin withdrawal under the careful supervision of trained medical personal.
Causes of alcohol withdrawal syndrome
Alcohol withdrawal syndrome is caused by a number of mechanisms. The brain maintains neurotransmitter balance by using inhibitory and excitatory mechanisms. Initially, alcohol use enhances the effects of the neurotransmitter GABA, which produces the feelings of calm and relaxation. Chronic alcohol usage, however, eventually suppresses GABA activity so that more alcohol is needed to achieve the same effects. This is called tolerance. Chronic alcohol consumption suppresses the activity of glutamate, a neurotransmitter that produces feelings of excitability. To create equilibrium, glutamate in the brains of those who drink chronically responds by functioning at a far higher level than that of non-drinkers or moderate drinkers.
When people who are heavy, chronic drinkers significantly reduce their alcohol intake or stop it altogether, the previously-suppressed neurotransmitters are no longer suppressed. They rebound, causing a phenomenon called hyperexcitability, which is why the effects of alcohol withdrawal syndrome are the opposite of those associated with drinking alcohol.
Symptoms of alcohol withdrawal syndrome
Alcohol withdrawal symptoms generally occur on a spectrum and the symptoms are proportionate to the amount and duration of a person’s alcohol habit. Minor symptoms of alcohol withdrawal tend to appear within six to twelve hours of the person’s last drink, sometimes when a person still has a measurable blood alcohol level. Symptoms of alcohol withdrawal syndrome are broken down by the time they’re expected to appear.
Symptoms 6 to 12 Hours After Last Drink:
- Mild anxiety
- Gastrointestinal upset
- Cardiac palpitations
- Inability to eat
Symptoms 12 to 24 Hours After Last Drink:
- Alcoholic hallucinations – these symptoms are not the same as those experienced during the DT’s or delirium tremens. Most people know these hallucinations are not real.
- Visual hallucinations
- Auditory hallucinations
- Tactile hallucinations
Symptoms 24 to 48 Hours After Last Drink:
- Withdrawal seizures – especially common in those who have been through numerous alcoholic detoxifications
- Generalized tonic-clonic seizures
Symptoms 48 to 72 Hours After Last Drink:
- Delirium tremens – alcohol withdrawal delirium; usually peaks at five days after last drink
- Profuse sweating
- Cardiac arrhythmias
- Severe tremors
- Low-grade fever
- Hallucinations – primarily visual, cannot be distinguished from reality
Treatment for Alcohol Withdrawal
Treatment for alcohol withdrawal syndrome
Any successful treatment for alcohol withdrawal syndrome must include medically monitored detox as well as behavioral therapies to address the underlying cause for the addiction to alcohol. The three goals for detoxification from alcohol include the three following principles:
- A safe environment to withdraw from alcohol that allows and enables the person to become alcohol-free
- Provide a safe, humane way for a person to detox from alcohol while maintaining dignity and comfort
- Prepare a person to engage in the next steps of recovery of alcoholism
Successful detox from alcohol is often done in an inpatient rehab center to allow for the seamless transition from the detox state into the addiction recovery program.
What is Alcohol Poisoning?
What is alcohol overdose & alcohol poisoning?
Most people enjoy a drink with friends, but what happens when the line is crossed from having a good time to overdosing on alcohol? The results can be deadly. An alcohol overdose occurs when a person has a blood alcohol content (BAC) significant enough to produce impairments that increase the risk for harm. An overdose on alcohol can range in severity from problems balancing and slurring speech to coma and death. Alcohol overdose is affected by age, drinking experience, sex, the amount of food in the stomach, and ethnicity. As younger people often engage in binge drinking of five or more drinks at one time, this age group is at higher risk for alcohol overdose. Binge drinking can overwhelm the body’s ability to breakdown and clear alcohol from the bloodstream, causing rapid increases in blood alcohol content and significantly altering brain function.
As the blood alcohol content rises, so do the effects of alcohol. Even smaller increases in BAC can impair coordination, cause vomiting, and cloud judgment. This can lead to injuries, car crashes, and leave a person vulnerable to sexual assault and violence. When BAC increases even more, blackouts, or amnesia can occur.
Continuing to drink despite clear signs of impairment can lead to an even more deadly type of overdose on alcohol called alcohol poisoning. Alcohol poisoning occurs when there is so much alcohol in the bloodstream that the areas of the brain controlling basic life-support functions – breathing, heart rate – begin to shut down. BAC can continue to rise even after a person becomes unconscious; alcohol in the stomach and intestine continues to enter the bloodstream and circulate throughout the body. This is why it is dangerous to assume an unconscious person can be okay simply “sleeping it off.”
If you suspect that a person has an alcohol overdose or alcohol poisoning, this is a medical emergency. Call 911 immediately.
Alcohol effect on a person
As blood alcohol rises, so do the symptoms of impairment and the chance for overdose and alcohol poisoning. The most common symptoms related to blood alcohol content include:
Mild Impairment: BAC 0.0 to 0.05%:
- Mild sleepiness begins
- Mild balance and coordination impairments
- Mild speech impairments
- Mild memory changes
- Mild attention impairments
- Perceived beneficial results – calmness, relaxation
Increased Impairment: BAC 0.06 to 0.15%:
- Moderate memory impairment
- Increased risk of aggression in some
- Significant impairments in all driving abilities
- Further impairment of speech, memory, attention, coordination, and balance
- Perceived beneficial results becoming intoxication
Severe Impairment: BAC 0.16 to 0.30%
- Loss of consciousness
- Speech, memory, coordination, attention, reaction time, balance significantly impaired
- All driving abilities dangerously impaired
- Significant impairment of judgment and decision-making abilities
- Vomiting and other signs of alcohol poisoning
Life-threatening: BAC 0.31 to 0.45%
- Loss of consciousness
- Significant risk of death due to suppression of vital functioning
- Danger of life-threatening alcohol poisoning
Symptoms of alcohol poisoning
Alcohol poisoning is a serious, sometimes deadly, consequence of drinking large amounts of alcohol in a short period of time. This can also occur when children or adults intentionally or unintentionally drink household products that contain alcohol. Alcohol poisoning is an incredible dangerous, life-threatening situation that requires immediate medical intervention. Call 911 immediately if you suspect someone of having alcohol poisoning.
Symptoms of Alcohol Poisoning include:
- Marked confusion
- Dulled responses
- Diminished gag reflex
- Slowed breathing – less than 8 breaths a minutes
- Irregular breathing – a gap of 10 or more seconds between breaths
- Cyanosis and pale, clammy skin
- Unconsciousness so severe that the person cannot be awakened
Without proper treatment, alcohol poisoning can lead to some serious complications. These include:
- Choking – alcohol may lead to vomiting and because alcohol depresses the gag reflex, the risk for choking on vomit while passed out increases
- Respiratory arrest – accidentally inhaling vomit into the lungs can lead to a fatal interruption of breathing
- Severe dehydration – vomiting can lead to severe dehydration, causing dangerously low blood temperature and rapid heart rate
- Seizures – blood sugar may drop low enough to cause seizures
- Hypothermia – body temperature may drop so low that it leads to cardiac arrest
- Brain damage – heavy drinking can lead to irreversible brain damage
- Death – all of the above complications can quickly lead to death
Treatment for Alcohol Poisoning
Treatment for alcohol poisoning
Alcohol poisoning is a medical emergency that requires serious medical care. When a person who has alcohol poisoning receives treatment, he or she will be placed in a safe environment while his or her body rids itself of the alcohol. Treatment for alcohol poisoning tends to involve:
- Careful monitoring
- Prevention of choking
- Maintaining airway patency
- Oxygen therapy
- IV fluids to prevent dehydration
- Vitamins and glucose to prevent serious complications
Our location in Midvale, Utah, allows residents of the greater SLC area to get help with alcohol related health issues.