Is it alcohol withdrawal?

Source: U.S. Office of Women's Health

As seen in the diagram above, alcohol abuse can cause damage to the human body. But sometimes ending this abuse is even more difficult.

The range of symptoms of alcohol withdrawal is referred to as alcohol withdrawal syndrome. The symptoms are both psychological and physical and can vary broadly among alcoholics. Some of the symptoms can even be life-threatening.

 Previous attempts at withdrawing from use (i.e. detox) can make the symptoms worse during subsequent attempts. But there are treatments and help available!

Alcohol withdrawal syndrome

According to American Family Physician, less than a quarter of all who suffer from alcohol withdrawal receive treatment in a medical setting. As of 2004, an estimated 2 million Americans likely experience symptoms of withdrawing from chronic alcohol use or abuse, a small portion of those who actually suffer from alcohol dependence. The symptoms are both psychological and physical and can vary broadly among alcoholics. Some of the symptoms can even be life threatening and care from a medical professional should be sought for those who exhibit 2 or more symptoms after discontinuing prolonged alcohol use.

Causes of withdrawal symptoms

Alcohol affects the brain, primarily the GABA (gamma-amino-butyric acid) neurotransmitter pathway. Alcohol use alters the responsiveness of the GABA pathway, resulting in a decreased response once alcohol’s effects are withdrawn. This is also the pathway involved in the development of alcohol tolerance. On the other hand, alcohol also increases the number of NMDA receptors in the brain, leading to hyperexcitability in its absence.

Hyperexcitability

A feature of alcohol withdrawal is hyperexcitability, which manifests as tremors, anxiety, irritability, insomnia and agitation. In severe cases, it may result in seizures and a condition known as delirium tremens – also known as alcohol withdrawal delirium. Autonomic hyperactivity – increased heart rate, hypertension, sweating – may also be present. Severe cases may include hallucinations, known as alcohol withdrawal hallucinosis. They can be auditory, visual or tactile.

Effects of previous detox

Previous detoxification attempts tend to increase the severity of withdrawal symptoms. This phenomenon is sometimes called “kindling”. This effect is attributed to amplification of brain signals in the brain, much like hyperexcitability, but leading to more overt, and permanent, behavioral effects. Kindling is thought to play a role in alcohol-related brain damage and cognitive impairment.

Other withdrawal symptoms

Other psychological symptoms include being disoriented or confused, nervousness, difficulty thinking clearly, jumpiness, nightmares and emotional disturbances. Physical symptoms include nausea and vomiting, clammy skin, dilated pupils, headache, loss of appetite and pale skin.

Potential complications from long-term alcohol use that may be seen upon examination for alcohol withdrawal include dehydration, liver failure, abnormal heart rhythms and fever.

Treatment of alcohol withdrawal symptoms

The goal of treatment is to alleviate symptoms and prevent long-term complications. Patients with severe symptoms will be monitored in an in-patient setting to ensure immediate care for potentially life threatening symptoms. Benzodiazepines are a common class of drug used to treat alcohol withdrawal symptoms. For mild symptoms, counseling and support are often the solution recommended to get past them. In all cases, after alleviating the symptoms, the underlying alcohol dependence must be treated.