Alcohol Withdrawal Syndrome: What it is, How to deal with it

Going cold turkey might not be the best way to overcome alcohol addiction. When an alcoholic suddenly quits alcohol, his or her body can react to this instant transition in a number of ways. Anxiety, fatigue and even hallucinations can be a result of sudden alcohol withdrawal, also known as Alcohol Withdrawal Syndrome.

The symptoms of alcohol withdrawal syndrome can get severe if not dealt with effectively. This is because your body is dependent on the alcohol intake that it is used to and needs to be tapered of gradually. Health Shots got in touch with general physician Dr Priyam Agarwal, who tells us all about the symptoms and causes of alcohol withdrawal symptom and how to prevent it.

What is alcohol withdrawal?

Alcohol withdrawal refers to the symptoms that occur when a person who is dependent on alcohol suddenly stops or reduces their alcohol intake. It typically occurs in individuals with a history of heavy or prolonged alcohol use, explains Dr Agarwal.

Causes of alcohol withdrawal syndrome

Drinking excessive amounts of alcohol can have a serious impact on your nervous system. After a while, your nervous system needs the alcohol to function. If alcohol is taken away suddenly, it results in alcohol withdrawal syndrome. A study published in Alcohol Health and Research World states that when alcohol is consumed in excess, there are many imbalances introduced in the brain chemistry. And when more alcohol is not provided, it results in excessive neuronal activity, the electric currents and transmissions in the brain.

Symptoms of alcohol withdrawal syndrome

Alcohol withdrawal syndrome is a serious condition that requires medical attention and support to manage safely. The symptoms can range from mild to severe. These are as follows:

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• Anxiety
• Tremors of hand (shakes)
• Sweating
• Nausea
• Vomiting
• Insomnia
• Hallucinations
• Seizures and delirium tremens

Timeline of symptoms of alcohol withdrawal

The symptoms typically begin with tremors, anxiety, and vomiting within 5 to 10 hours of decreasing alcohol intake, followed by hallucinations and psychotic symptoms at 8-12 hours. “The symptoms go up day 2 or 3 with seizures and delirium tremens. If treated they improve by day 4 or 5, although mild levels of these problems may persist for 4 to 6 months as a protracted abstinence syndrome,” says Dr Agarwal.

How do you diagnose alcohol withdrawal syndrome?

Alcohol withdrawal syndrome can be diagnosed based on a combination of clinical assessment, patient history and evaluation of symptoms. “Additionally, laboratory tests may be performed to assess alcohol levels in the blood, screen for other substances like gamma glutamyl transferase (GGT) and carbohydrate deficient transferrin (CDT), and evaluate organ function,” says Dr Agarwal.

Treatment of alcohol withdrawal syndrome

The first step is thorough physical examination in all alcoholics considering abstinence. “Adequate nutrition and oral multiple B vitamins are integral here because most alcoholics who enter withdrawal are either normally hydrated or mildly over hydrated,” says Dr Agarwal.

The next step is to recognise that withdrawal symptoms are due to rapid removal of a CNS depressant (alcohol). “The symptoms can be controlled by administering any depressant in doses that decrease symptoms and then tapering the dose over 3 to 5 days, benzodiazepines have the highest margin of safety and lowest cost and therefore the preferred class of drugs,” says Dr Agarwal. Although alcohol withdrawal can be treated in a hospital patients in good physical conditions can be considered for outpatient detoxification.

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Treatment of a patient with Delirium Tremens (DTs) can be challenging. “The condition is likely to run a course of 3 to 5 days regardless of the therapy used,” says Dr Agarwal. The focus of care is to identify and correct medical problems and to control behaviour and prevent injuries.

How to prevent alcohol withdrawal syndrome?

Preventing alcohol withdrawal syndrome primarily involves avoiding or minimizing alcohol dependence through responsible drinking habits and seeking appropriate support if needed.

1. Avoid binge drinking

If you are drinking large amounts of alcohol over a period of time, it might get tough for you to cut down your consumption. It’s important to check your alcohol consumption right from the start.

2. Gradual reduction in drinking

If you are on the path to recovery, it is important to be slow but steady. Start by reducing 10 per cent of your consumption per day, and take it from there.

3. Seek support

Even before you get on the path of recovery, it is very important to talk to your doctor about your plans. Understand from him how this journey is going to be, the challenges that you will have to combat.

4. Medication-assisted treatment

Understand from your doctor about the various medications that he can put you on to help you on the path of recovery. These will help you sustain yourself.

5. Healthy lifestyle

Maintaining a healthy lifestyle will help keep your over all health in check and will make it easier for you to quit alcohol completely, over a course of time, with minimum side effects.

6. Mindfulness and coping skills

Being mindful can help you in increasing your concentration as strengthen your memory. This can help you deal with addiction.

7. Regular check-ups

Regularly going for check ups is very important as you inch towards your goal. Not only will this help you keep a check on your health, but will also help you stay on the path of recovery.