Alcohol withdrawal symptoms and treatment
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What does "alcohol withdrawal" really mean?
Alcohol withdrawal is a catchall term that refers to the group of symptoms that occur when someone suddenly stops or reduces their drinking—commonly called detox. Withdrawal symptoms include psychological effects (like cravings and anxiety) and physical effects (like sweating and high blood pressure). Alcohol withdrawal, in particular, brings serious medical risks.
The good news is that alcohol withdrawal is temporary. For most people, the worst is over in under a week.
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The risks of alcohol detox
Since alcohol is easy to get all across the country, it’s common to think of it as safe. Even when problems with alcohol use disorder (often called alcoholism or alcohol abuse) arise, many people think that they’ll be fine once they just stop drinking. And quitting or moderating your alcohol intake is an excellent goal. But it’s important to be aware of the risks of alcohol detox so you can be prepared if they crop up after you stop or reduce your drinking.
It is important to have trusted people check in regularly if you choose to detox at home. People with a history of experiencing delirium tremens or withdrawal-induced seizures should seek medical supervision.
Alcohol withdrawal symptoms
Alcohol withdrawal symptoms can begin sooner than many people realize—usually less than 8 hours after the last drink. They can also occur days after stopping drinking.
The most severe symptoms of alcohol withdrawal include seizures and hallucinations, which manifest 1 to 2 days after withdrawal symptoms begin, and delirium tremens (DTs). DTs can develop between 1 and 4 days after withdrawal starts. They are characterized by disorientation and often include severe agitation, rapid heartbeat, high blood pressure, and fever. They can cause heart attack and stroke. About five percent of the patients who experience DTs die.
Common alcohol withdrawal symptoms
- Anxiety
- Headache
- Fatigue
- Irritability
- Shakiness or tremors
- Nausea
- Sweating
- Insomnia
- Rapid heart rate
Symptoms of delirium tremens
Delirium tremens (DTs) is very serious and dangerous, and can occur during alcohol withdrawal. DTs usually arise between 1 and 3 days after stopping drinking. Seek emergency medical care if these symptoms occur.
- Confusion/disorientation
- Agitation
- Fever
- Hallucinations (seeing, hearing, or feeling things that aren’t there)
- Seizures
- High blood pressure
- Loss of consciousness
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Coping with withdrawal symptoms
If you’re detoxing at home (without medical supervision), consider a slow taper instead of cold turkey. It takes longer, but is safer.
If you do choose to stop all at once, plan ahead for the kinds of comfort that usually help when you’re sick. If possible, stay in a quiet, calm environment away from disruptions. Keep hydrated with water and electrolyte drinks. Wear comfortable clothing (and have changes of clothes ready if you get sweaty and chilled). You may not feel hungry, but try to have small, frequent meals, like yogurt or soup. Music, TV, books, or other entertainment can help your thoughts from spiraling into negativity.
If you have medical supervision for your detox, your provider may prescribe medications to help ease the discomfort of withdrawal. Even if a home detox was the plan, anyone who begins to experience hallucinations or seizures should seek emergency medical assistance immediately.
Post-acute withdrawal syndrome
Some people experience withdrawal symptoms for a prolonged period of time, beyond the typical 1-2 week window (that is, after you’re done detoxing). This extended process of withdrawal is called post-acute withdrawal syndrome (PAWS). PAWS can recur periodically in episodes of a few days. These episodes can persist for up to two years and can fluctuate in severity. It is estimated that up to 75% of heavy drinkers who quit alcohol may experience PAWS to some extent.
PAWS symptoms can be triggered or made more severe by stressful situations, but they can also recur without any obvious triggers. If PAWS causes you distress, speak with your healthcare provider.
All the benefits of medication-assisted treatment, from the comfort of home
Common symptoms of PAWS:
- Irritability
- Cravings
- Apathy
- Anxiety or panic
- Depression
- Insomnia
- Mood swings
- Low energy/fatigue
- Chronic pain
- Difficulty with cognitive tasks (remembering things, learning, problem-solving)
Medication-assisted treatment for alcohol use disorder
There are FDA-approved medications that help to control alcohol cravings and stabilize long-term recovery:
Naltrexone
Naltrexone (ReVia) reduces the motivation to drink by blocking the euphoric effects of alcohol and relieving cravings. Basically, it makes drinking feel less good. Over time, this can change the brain’s reaction to alcohol, and help you lose interest in drinking. Naltrexone can be taken to help you quit drinking or to help you moderate your drinking. It should not be taken by those who are using opioids, as it can precipitate opioid withdrawal. Naltrexone is usually well tolerated. The main side effects may be digestive upset, tiredness, headache, and dizziness, which usually pass.
Acamprosate (Campral)
Acamprosate (Campral) is believed to act by correcting some of the brain changes caused by chronic alcohol consumption. Acamprosate decreases the mental and emotional discomfort of quitting drinking by affecting neurotransmitters in the brain that cause excitability. Acamprosate is usually well tolerated. The main side effect may be diarrhea, which should be mild and usually passes quickly.
Medications for withdrawal
Some doctors prescribe medications to relieve the discomfort of alcohol withdrawal. These can include gabapentin and topiramate, which are intended for other purposes but have been discovered to be helpful for some people with alcohol use disorder. Your healthcare provider can also suggest over-the-counter medications to relieve discomfort from alcohol withdrawal symptoms.
Some providers may also prescribe benzodiazepines like chlordiazepoxide (Librium) to those in withdrawal from alcohol use.
The benefits of quitting or moderating alcohol use
There are so many benefits to changing your relationship with alcohol:
Physical health benefits
- No more hangovers to make your body suffer from aches, nausea, and dehydration.
- Support your natural, healthy immune system, which can be impeded by alcohol.
- Your cancer risk factors will go down.
- Digestive health can recover from the recurring nausea, diarrhea, acid reflux, and reduced ability to absorb nutrients that often result from heavy drinking.
- Your cardiovascular system can heal from the strain alcohol placed on it.
- Your sleep patterns have a chance to recover, with alcohol no longer disrupting your REM cycles.
Mental health benefits
- Your memory can improve, with alcohol no longer causing blackouts and mental fog.
- Your brain can recover from the damaging effects of alcohol.
- You will be able to feel a full range of emotions again.
Social health benefits
- Save money that you’re no longer spending on drinks, getting rides when you’ve been drinking, and impulsive purchases made while under the influence.
- Have more free time, once your day is no longer filled (or is less filled) with planning when you’ll be able to drink, getting alcohol, and consuming alcohol.
- Gain more control over your actions and choices, without the impairment of drinking to excess.
Freedom from alcohol in 90 day
FDA-approved medication can relieve alcohol cravings and decrease heavy drinking days. With Workit 90, you can access this support as part of a 100% online recovery program that fits your life, giving you the tools you need to quit drinking or cut back.
Medication alone may be enough to help you achieve your goals, but people are most likely to succeed when they combine medication with a combination of community and behavioral health support—the kind you can expect from Workit 90.
The Workit 90 Day Plan
Recovery designed to fit into your life
Month 1
Stabilize
Focus on key elements of your recovery journey, including understanding your motivation, building a network of support, and receiving expert care to manage cravings.
- A treatment plan created with a licensed medical provider
- Weekly video visits (either 1:1 with a medical provider or in group follow-up appointments)
- Medication e-prescribed to relieve cravings, as appropriate
- Alcohol withdrawal care with monitoring support by medical assistants
- Manage co-occurring disorders like anxiety and depression
- Enroll in at least 1 online recovery group
- Activities, tools, and affirmations in your inbox
- In-app care team chat support
Month 2
Strengthen
Add tools to your recovery toolbox and develop new coping skills while you continue to receive expert clinical care. We'll also focus on peer support in groups and our Forum chatrooms.
- All Month 1 features
- Switch from weekly appointments to bi-weekly appointments
- Participate in Forum
- Learn coping strategies
- Recovery stories in your inbox
- Attend at least 1 online recovery group, with no upper limit
Month 3
Thrive
Build on your recovery foundation with once a month, 60-minute group visits for support, optional medication management, and staying connected through in-app chats and peer chatrooms.
- All Month 1 + Month 2 features
- Switch from bi-weekly appointments to once a month group follow-ups
Connect with people who understand
- Non-judgmental support
Changing your relationship to alcohol is easier with a community that understands because they're in recovery, too.
- Group follow-ups
Join a provider, a behavioral health team member, and other Workit Health members like you for a group follow-up that combines clinical care, coping tools, and peer support.
- Unlimited recovery groups
Therapist- and peer-led recovery groups are safe, guided sessions that help you develop the tools to thrive without alcohol.
- 24/7 Forum
A members-only space to chat, day or night. Share experiences, receive guidance and support, and offer your own insights.
Reclaim your life from alcohol
Changing your relationship with alcohol is easier with support. Whether you want to stop drinking altogether or to moderate your drinking, we can help.
We get it.
Workit Health was founded by two women in recovery, and many of our team are in recovery, as well. That’s why our program is grounded in harm reduction, supporting all recovery goals.
You can take your life back.
- Our judgment-free clinicians don't punish members for going off course
- We have whole-person care, treating co-occurring conditions like anxiety, depression, insomnia, and more
- We have a community built in group follow-ups, online recovery groups, and members-only forums
- We understand the FDA-approved medications that can relieve cravings