Alcohol Withdrawal

What is alcohol withdrawal?

Alcohol withdrawal is a physical or mental sickness that happens when you drink alcohol daily and suddenly stop drinking. It can begin within 10 hours of your last drink and gets worse over 2 to 3 days. Withdrawal may also happen if you suddenly reduce the amount of alcohol that you normally drink.

What are the signs and symptoms of alcohol withdrawal?

The signs and symptoms of alcohol withdrawal normally start 4 to 24 hours after you stop drinking. The symptoms may be mild at first, and get worse as your body goes through the detoxification process. Detoxification means your body is working to remove the alcohol. Severe symptoms of alcohol withdrawal are often called delirium tremens (DTs). DTs usually occur 3 to 4 days after you stop drinking. You may have any of the following signs and symptoms:

  • Seizures 24 hours to 1 week after your last drink

  • Confusion and trouble remembering

  • Fever, sweating, shakiness, and a fast heartbeat

  • Hallucinations (you see, hear, feel, or taste things that are not there)

  • Nausea and vomiting

  • Nervousness and agitation

  • Poor sleep, restlessness, or nightmares

How is alcohol withdrawal diagnosed?

  • Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works during alcohol withdrawal. Caregivers will check how your pupils react to light. They may check your memory, balance, and hand grasp.

  • Blood tests: You may need blood taken to test for the amount of alcohol in your body. The tests can also show if you have low levels of vitamins and electrolytes, or organ damage. The liver and pancreas are commonly damaged by alcohol.

  • Urine sample: A sample of your urine may be collected and sent to a lab to test for alcohol.

  • Chest x-ray: Caregivers use these pictures of your lungs and heart to look for signs of infection, such as pneumonia.

  • ECG: This is also called an EKG. An ECG is done to check for damage or problems in your heart. A short period of electrical activity in your heart is recorded.

  • CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your skull and brain. You may be given dye, also called contrast, before the test. Tell the caregiver if you are allergic to dye, iodine, or seafood.

How is alcohol withdrawal treated?

  • Medicines:

    • Sedative: This medicine is given to help you stay calm and relaxed.

    • Anticonvulsant medicine: This medicine is given to control seizures. Take this medicine exactly as directed.

    • Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.

    • Glucose: This medicine may be given to increase the amount of sugar in your blood.

    • Vitamin supplements: You may need to take supplements because alcohol kept your body from absorbing enough vitamins from food. Vitamins can also help prevent alcohol-related brain damage.

  • Breathing support:

    • You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.

    • Ventilator: This machine breathes for you. A tube is put into your airway through your mouth or nose, or through a small incision in your throat. The machine gives you oxygen through the tube.

What are the risks of alcohol withdrawal?

You may act out violently when you go through alcohol withdrawal. You may harm yourself and others. You can have high fevers, abnormal heartbeats, and hallucinations. Severe alcohol withdrawal can be life-threatening.

Where can I find support and more information?

  • Alcoholics Anonymous
    Web Address: http://www.alcoholics-anonymous.org.

When should I contact my caregiver?

Contact your caregiver if:

  • You keep drinking to avoid alcohol withdrawal symptoms.

  • You need help to stop drinking alcohol.

  • You have trouble with work or school because you drink too much alcohol.

  • You get into fights because of alcohol.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have sudden chest pains or trouble breathing.

  • Your heart is beating faster than normal.

  • You pass out or think you had a seizure.

  • You feel sad enough to harm yourself or others.

  • You hallucinate. This is when you see, hear, feel, or taste things that are not real.

  • You cannot stop vomiting, or you vomit blood.

  • You are shaking and it does not get better after you take your medicine.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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