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By Boris M | 17 April, 2020 Published in Alcohol Withdrawal Symptoms
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Alcoholism is known by several names, including alcohol dependency, alcohol use disorder, and alcohol addiction. It is a chronic disease; the biggest symptom of this disease is uncontrollable drinking due to both a physical and emotional dependency.

Those who struggle with alcohol abuse will generally find themselves unable to stop even if it causes problems with their physical, emotional, financial, or relational health.

If someone with alcohol dependence stops drinking, they generally begin to feel withdrawal symptoms within eight hours of their last drink, and they do not reach their peak for two to three days. [1]

Alcohol changes the way the body’s neurotransmitters transmit, move, and absorb within the brain. When someone drinks large amounts of alcohol on a regular basis, the brain begins to adapt to the changes until it cannot function normally without regular alcohol intake.

Because of this, when the brain stops receiving the alcohol, a number of uncomfortable and even dangerous symptoms manifest.

Dangers of alcohol withdrawal

There are a few symptoms of alcohol withdrawal that are significantly more dangerous than others. The most severe include hypothermia, delirium tremens seizures, and cardiac arrhythmias.

According to a recent study, [2] around 12.8% of people who have alcohol use disorder and go through withdrawal have at least one episode of either convulsions or delirium tremens. Withdrawal symptoms are an unpleasant part of recovery – but this should not put you off making that decision to improve your life forever.

Delirium tremens (DT) is one of the most severe forms of alcohol withdrawal that is categorized by confusion, hallucinations, tremors, agitation, and high fevers. Delirium tremens becomes significantly more fatal if paired with any of the other symptoms listed.

Additionally, sometimes DT symptoms do not show up for up to three days after someone stops drinking, which means they may believe they are safe and not seek proper medical attention.

If you or someone you love is experiencing the symptoms listed above and has recently stopped drinking alcohol after prolonged use, you should seek medical help immediately.

Is it possible to quit drinking alcohol ‘cold turkey?’

Going ‘cold turkey’ means to stop drinking completely, all at once, and without the aid of any professionals. Many people are tempted to go cold turkey once they decide they want to get sober because it sounds easiest and fastest. But the truth is treating alcohol use disorder this way is dangerous.

Alcohol changes the way the brain develops and regenerates. The brain needs receptors (which can be called happy brain structures) to process happy/positive thoughts and unhappy brain structures to process negative thoughts.

Alcohol can throw off the balance of healthy and unhealthy brain structures, which can lead to various mental health problems. When someone quits alcohol suddenly, they are left with an imbalance that can lead to extremely dangerous (not just uncomfortable) mental and physical symptoms.

In order for someone to avoid dangerous symptoms during alcohol detox and then learn how to cope without alcohol, they need the support of doctors and therapists. For this reason, most professionals highly recommend not quitting cold turkey.

The dangers of going ‘cold turkey’

When someone goes cold turkey, they are significantly more likely to experience the dangerous and even fatal symptoms of delirium tremens and withdrawal.

Furthermore, when you experience these withdrawals in a rehab or treatment centre, you are under the supervision of a team of medical professionals. They will be able to prescribe medications and treatments to ensure that you do not undergo any significant damage or die. Furthermore, they will be able to make you overall more comfortable throughout the process.

The difference between acute & post-acute withdrawal symptoms

Acute symptoms are the original withdrawal symptoms a person experiences. These symptoms can be both physical and psychological and are generally the most intense withdrawal symptoms.

After the original detox and withdrawal are over, a person may suffer from what is known as PAWS or post-acute-withdrawal syndrome.

Symptoms of PAWS are usually only psychological and can persist for months or even years after someone stops drinking. PAWS symptoms usually come and go, and they can be triggered by certain situations, circumstances, or people.

Mild alcohol withdrawal symptoms

Below we have listed what is known as mild and severe alcohol withdrawal symptoms. Most sensations are common and are to be expected during the detox phase. These include: [3]

  • Nausea
  • Headaches
  • Anxiety
  • Fatigue
  • Insomnia
  • Loss of appetite
  • Minor shaking
  • Mood swings
  • Clammy hands
  • Sweating

Severe alcohol withdrawal symptoms

Below we have listed the most common and serious complications that can arise from alcohol withdrawal. If you experience any of the following during a cold turkey detox, seek immediate medical help.

The symptoms to look out for include:

Sudden alcohol cessation (SAC) is what happens right after the body is deprived of alcohol. It is more likely to occur when the body is shocked by the person going cold turkey and results in the most fatalities.

When someone is recovering from alcohol addiction, they may suffer from dehydration due to an imbalance of electrolytes, nausea, diarrhoea, and sweating.

Dehydration can lead to mental confusion and malfunction in the central nervous system. If you detox in a rehab center, they will know how to prevent you from becoming dehydrated.

Delirium Tremens is classified by agitation, disorientation, paranoia, hallucinations, sensitivity to light, sound, and touch, and the person may even go into a coma-like sleep.

Seizures in the body occur when there a variety of chemical disruptions in the brain. This relates to the physical effects of excessive drinking, as alcohol negatively adapts the way in which the brain absorbs neurotransmitters.

Alcohol clings to what we call the GABA receptors in our brains, which causes the neurons (and the body) to relax. If this is done excessively, the intoxicated person will then start to stumble, appear fatigues, slur their speech - or appear 'too drunk.'

One step further and the brain's neurons will overwork, causing increased tension, stress, anxiety, insomina - and ultimately, the risk of seizures.

 Too much GABA and a person will slur their speech, stumble, experience fatigue, or otherwise appear drunk; too little GABA, and neurons will fire rapidly, increasing anxiety, tension, the risk of insomnia, and the potential for seizures.

For those struggling with alcohol addiction who are going through detox, the most common type of seizure is tonic-clonic seizures.

Alcoholic cardiomyopathy is a type of cardiovascular condition caused by years of chronic alcohol abuse. This is caused by toxins in alcohol thinning and weakening the heart's muscle, which in turn disrupts its ability to sufficiently pump blood around the body.

This type of heart disease is the most commonly seen condition in men between the ages of 35 and 50, but it does affect women too. It is caused by 'prolonged' alcohol abuse which typically means excessive drinking for a period of five years or more.

This is a risky element of alcohol withdrawal as alcoholic cardiomyopathy does not always give rise to specific symptoms. If symptoms do occur, they often mimic general heart failure warning signs such as lethargy, fatigue, shortness of breath and swelling of the feet and hands.

Alcohol can cause a deficiency in thiamine or vitamin B1. Up to eighty percent of alcoholics do suffer from this deficiency. This deficiency can lead to Wernicke's encephalopathy and Korsakoff syndrome.

These disorders are categorized by a lack of motor coordination, mental confusion, issues forming new memories, and issues learning.

For those struggling with alcohol addiction, malnutrition is a serious risk due to the fact that alcoholic-dependent people often neglect their health, wellbeing, and eating routines.

Alcohol affects the appetite in a similar way it does the central nervous system, with immediate effect. The false sense of energy and happiness alcohol provides often supersedes the need or desire for food. Alcohol then also causes sleepiness and unconsciousness, resulting in skipped meals and therefore a lack of satiable nutrition.

Like the false sense of happiness, alcohol is also very dense in calories - but it lacks nutrients, so the calories 'do not count.' Thus, the higher the calorific intake of calories from alcohol, the less probable it is for someone to consume the right level of good food to receive adequate nutrition.

This also enhances the craving for similar 'empty calorie' like foods such as carbohydrates, sugars, and salts.

It is also well-known that alcohol disrupts the way the body metabolizes nutrients, which leads to liver and digestive damage. This can lead to gastritis, nausea, poor appetite, and diarrhoea.

Kindling is when someone struggling with alcohol abuse disorder repeatedly tries to quit cold turkey, which can result in more intense and dangerous withdrawal. After each attempt, the severity of withdrawal symptoms increases, causing a process of 'kindling.' 

In scientific terms, 'kindling' is when a dim stimulus (electrical or chemical) causes an acute effect after repeated application. If you think of alcohol withdrawal as a chemical rewiring of the brain (an effect on a stimulus), each attempt at withdrawal is another 'spark.'

After repeated attempts, the brain has been 'kindled' that many times that it causes a severe reaction (such as seizures.) That is, every attempted detox or 'spark' has contributed to the accumulative collection as a whole.

It has been said that kindling also contributes to a patient's probability of relapse, due to the increasingly unpleasant 'kindling' or withdrawal symptoms experienced each time.

How long will alcohol withdrawal symptoms last?

The first six to twelve hours of alcohol detox can be unpleasant. But being aware of what to expect provides you with more opportunity to prepare for the process.

Symptoms you are expected to experience include:

  • Headaches
  • Shaking
  • Nausea
  • Vomiting
  • Agitation
  • Anxiety

From hour twelve to twenty-four, the following symptoms may manifest:

  • Disorientation
  • Hand tremors
  • Seizures

After 48 hours, the person may experience the following:

  • Continuing or new seizures
  • Insomnia
  • High blood pressure
  • Hallucinations
  • High fever
  • Excessive sweating
  • Delirium tremens (it may take up to another 24 hours for these symptoms to appear)

Medications to help with going ‘cold turkey’

  • Librium is used to relieve severe anxiety short-term
  • Lorazepam is usually given intravenously, which means you will most likely need medical help. It can treat insomnia, nausea, seizures, and agitation
  • Antihypertensives can be used to treat withdrawal symptoms, including sweating, arrhythmia, elevated heart rate, and tremors
  • Alpha-2 Adrenergic Agonists are used to minimize alcohol withdrawal symptoms

Other Detox Options

Taking a cold turkey approach to an alcohol use disorder is highly dangerous, and is often not recommended by medical professionals. There are however other options to detox from alcohol which include:

1. Tapering Off

Tapering off is a longer process than going cold turkey, but it is safer if you do not want to do a medically assisted detox. It is the process of slowly decreasing the amount of alcohol you consume.

It is safer than cold turkey, but it still has a much lower success rate than medical detox and is not as safe.

2. Medical Detox

This is the safest kind of detox and generally the most successful. During medical detox, an alcoholic goes and stays at a rehab centre so they can be monitored and cared for by a team of medical professionals.

Beyond monitoring, they also can prescribe medicine to minimize withdrawal symptoms to make you as comfortable as possible during the process.

A medically assisted detox is both more comfortable and safer. When there is a medical support team on hand, they will be able to monitor and immediately treat any symptoms that could be harmful or life-threatening.

FAQ’s on quitting alcohol cold turkey

Quitting alcohol cold turkey is dangerous, but people still attempt this form of detox for a variety of reasons. Below we have listed some of the most common questions people consider when contemplating their alcohol detox method.

These questions include:

Relapse is common when people have addictions, but the goal of most people is to avoid doing so. When someone quits drinking cold turkey, the chance or relapse is significantly higher.

An inpatient rehab program is usually a person's best bet at avoiding relapse.

Detox is not the end of recovery, rather the beginning. It is important that after a person finishes detox, they get support and therapy to learn coping skills for life while sober. Rehab programs are a great way to receive this help and stay sober after detox.

There are various kind of therapies that a rehab program may offer such as CBT, DBT, EMDR, group therapy, family therapy, and alternative therapy (art therapy, music therapy, animal therapy, yoga, aromatherapy, etc.)

Yes, alcohol withdrawal can be fatal. This does not mean that you actually need alcohol to survive, but your body may be so dependent on it that it thinks it does.

That means that while simply not drinking alcohol is not fatal, the reaction your body has when you stop maybe if not done right. That is why it is so important to detox properly, with medical assistance and supervision.

Different people count success as different things, but most people consider consistent or permanent sobriety to be a success. When someone detoxes cold turkey, they generally only have about a twenty percent chance at staying sober.

The chance of success is significantly higher for people who go through a rehab program and then continue therapy or support groups afterward. As far as support groups, the longer someone is in a program, generally the higher the success rate they have.

This is probably due to the community of support and encouragement that they build.

Ready to get help?

We offer high-quality rehabilitation & detoxification services tailored to your individual needs.

To discover your road to recovery, call us today on 0800 140 4690.

References

[1] https://medlineplus.gov/ency/article/000764.htm

[2] https://www.ncbi.nlm.nih.gov/pubmed/8616462

[3] https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm

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