What Is Alcohol Withdrawal?

Alcohol withdrawal is the medical term used to describe a collection of symptoms individuals experience after they have stopped drinking.

Typically, people who experience alcohol withdrawal are those who have an alcohol use disorder (AUD), as their body has developed an increased tolerance and has become psychologically dependent on alcohol.

For these individuals, the sudden reduction of alcohol in the system creates bodily system failures that are observed as a cluster of different symptoms ranging in levels of discomfort. This experience is considered a serious medical event and, depending on the severity of the alcohol use, can be life-threatening.

Alcohol is the fourth leading cause of preventable death in the United States, which highlights the seriousness of misuse. When an individual misuses alcohol to the degree that they develop an addiction, a variety of changes occur within the body that results in dependence developing.

When an individual who has an alcohol addiction attempts to stop using alcohol, a series of events begins to occur within the body. Understanding how this process unfolds can be essential in ensuring proper care is taken to prevent further harm from occurring.

How Does Alcohol Withdrawal Occur?

To function properly, our brains require a special balance of chemicals called neurotransmitters. Alcohol has a strong impact on a few key neurotransmitters responsible for a wide range of bodily functions, particularly dopamine, serotonin, and gamma-aminobutyric acid (GABA).

  • Dopamine – The “feel-good” chemical that tells you what feels good and will motivate you to repeat behaviors that feel good.
  • Serotonin – This is the regulatory chemical that helps to maintain balance in mood among other bodily functions. It is a key neurotransmitter treated for conditions like depression or anxiety.
  • GABA – This is the “relax” chemical, or more specifically, it reduces the speed at which the brain sends signals out, which results in feeling calm or sedated.

These neurotransmitters also play a very large role in regulating our mood and managing emotions. Even minor shifts in the balance of these chemicals can lead to a variety of symptoms like drowsiness, loss of motor skills, euphoria, and dysphoria. Alcohol, being a neurotoxin, disrupts this balance of neurotransmitters in the brain, and its effects are what we refer to as intoxication.

Alcohol use directly changes the balance of neurochemicals in the brain, most notably by increasing the production of dopamine and serotonin. This results in the familiar “happy feeling” associated with alcohol use, which, over time, is believed to evolve into addiction-based thinking.

Fortunately, the body is very good at rebalancing itself when something disrupts its natural balance. When alcohol is not misused, the brain can rebalance the flow of neurotransmitters to ensure it is functioning properly. However, when alcohol is misused frequently, the brain must adapt and adjust to the influx of neurotransmitters created by chronic alcohol use.

How Chronic Alcohol Abuse Leads To Withdrawal

When someone abuses alcohol frequently, the brain reduces its production of neurotransmitters due to the increased production of chemicals like dopamine caused by alcohol use. This process eventually leads to the brain becoming physically dependent on alcohol to provide these extremely important chemicals and even manipulates the required balance of them to “function.”

The problem with this is that the “new functioning” is often a reduced capacity of its original ability to function, including cognition issues, sleeping issues, mood regulation issues, and overall difficulty in daily life activities.

Eventually, the brain adapts to chronic alcohol use to the degree that alcohol no longer provides it the same effect without more and more alcohol being used. When someone develops a high tolerance for alcohol, they must drink increasingly more for the same effect. However, this eventually becomes impossible to maintain as dopamine, serotonin, and GABA all begin to deplete from constant overstimulation. This is a very uncomfortable feeling and is the process that drives severe alcoholism and alcohol addiction.

The reduction or absence of alcohol In someone who has become severely dependent on alcohol results in withdrawal symptoms. Simply put, the brain no longer has the balance of neurotransmitters it once had to maintain proper regulation of the body without alcohol, and now it no longer has alcohol to help.

The brain has long stopped producing its own resources and begins to struggle with its limited resources. This results in many bodily functions going awry and, in some instances, can be potentially life-threatening.

To sum up this vicious cycle, if we think of the brain as producing regular gas to run itself normally, alcohol is like jet fuel that quickly outpaces the brain’s fuel production abilities. Eventually, the brain decides to stop making its own gas and becomes dependent on the jet fuel being provided. However, the brain was not designed to run on jet fuel, and eventually, the “engine” of the brain begins to burn out because of it. This leads to malfunctions in the engine, which we refer to as symptoms.

Symptoms Of Alcohol Withdrawal

Everyone who undergoes alcohol withdrawal will have a different experience, but the most common symptoms of alcohol withdrawal are:

  • Anxiety/depression
  • Tremors
  • Hyper vigilance
  • Restlessness
  • High blood pressure
  • Rapid heart rate
  • Insomnia
  • Fatigue
  • Nasuea
  • Vomiting
  • Irritability/anger
  • Fever
  • Alcohol cravings
  • Sweating
  • Loss of appetite
  • Chills

Serious Symptoms Of Alcohol Withdrawal:

  • Seizures
  • Hallucinations
  • Delirium tremens

Delirium tremens (DT) is a serious medical condition in which an individual experiences disorientation, agitation, hallucinations, fever, increased sweating, rapid pulse, and seizures after stopping alcohol use. This condition is uncommon for most people experiencing alcohol withdrawal; however, it is a life-threatening emergency when it does occur.

With alcohol withdrawal, seizures are among the most concerning symptoms, as they can result in fatality. It is strongly recommended to seek medical care and guidance when planning to stop alcohol use, especially if withdrawal symptoms are expected. Working with a medical provider can be helpful, as they can assist in preparing you for medical alcohol detoxification procedure.

Understanding Alcohol Detox

Due to the very serious nature of alcohol withdrawal, medication management is extremely warranted.

Around 20% of emergency room visits involve alcohol use conditions, which continues to increase year after year. Unfortunately, deaths from alcohol have also increased in the last few years, with almost 100,000 people losing their lives in 2020 from alcohol use. Although people can potentially survive alcohol withdrawal without medical supervision, they often describe the experience as unbearable and traumatic.

The safest and clinically recommended strategy for managing active or potential alcohol withdrawal symptoms is by working with a medical practitioner who is trained in treating substance use conditions.

Medically supervised alcohol detoxification includes a full physical, medication planning, and proper lab work to ensure no other medical conditions have developed due to prolonged alcohol use, which could potentially complicate the detox process.

Many individuals choose to complete their alcohol detox within an inpatient setting, such as a hospital or a freestanding treatment center designed for detoxification from substances. Others may have the option to complete their detox through an outpatient setting depending on the severity of their symptoms and the medical provider’s judgment. Either way, having medical guidance and support is essential to navigating to a healthier future in alcohol addiction recovery.

Medications For Alcohol Withdrawal

Addiction medicine has come a long way in its ability to treat individuals with alcohol use disorder and withdrawal symptoms related to it. To help with the neurotransmitter disruption, detox programs will often provide medications directed at reducing the discomfort of the detoxification process as well as reducing the risk of other serious medical conditions happening.

Common medications used to help with alcohol withdrawal include long-acting Benzodiazepines (Librium, Valium, etc.), which function similarly to how alcohol impacts the brain. These medications soothe GABA receptors so the individual can relax more and prevent seizures from developing.

Depending on other symptoms, Antidepressants may be started to help improve serotonin and dopamine levels quicker so one can feel more “normal,” though they will not cure mental health conditions, they are invaluable in helping the recovery process become easier to accomplish.

Other medications might include Naltrexone or other non-addictive medications that are provided after the detox process has been completed to help maintain abstinence from alcohol long-term.

Find Help Today

Alcohol withdrawal is a very serious medical condition. It requires professional medical care to prevent potential long-term health consequences. This can be a scary situation to experience and try to manage on your own, which is why it is strongly encouraged that you make the call to find help for yourself or the person you care for today.

Treatment providers can discuss options for free to help individuals struggling with alcohol use disorder. Contact a treatment provider today to determine what is the safest next step to take in the journey to recovery from alcohol use disorder.