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Alcohol Addiction

Alcohol Withdrawal – What Is Delirium Tremens and Is It Dangerous?



Alcohol withdrawal occurs when someone who’s dependent on alcohol stops and experiences side effects. There are a variety of symptoms and side effects that range in severity. The most dangerous of these side effects are delirium tremens. This symptom of alcoholism is a result of heavy drinking for a long period of time. It is why someone should get professional detox when they abstain from alcohol. Recovering from alcohol addiction should always be managed properly to avoid the risk factors.

While there are addictions that come with their challenges, recovery from drinking is a concern. You may suffer from normal symptoms such as insomnia, irritability, and loss of mental functioning. They might be uncomfortable, but not life threatening. If there is a risk of alcohol tremens, you would need to be put on some type of benzodiazepine tapering in order to avoid the potential of it.

“When you are young, your body cannot handle alcohol, and when you get old, your mind cannot handle it. Either way, alcohol has its way.”

~Robert Black

Alcohol is the most widely-used intoxicating substance throughout the world, including here in America. Four out of five people in this country over the age of 12 have tried drinking.

In 2014, an estimated 16.3 million adults in the U.S. were diagnosed with an Alcohol Use Disorder (AUD) – equating to 9.2%of men and 4.6% of women.

Alcohol abuse kills almost 88,000 Americans every year, making it fourth on the list of preventable deaths. Almost 10,000 of those deaths are due to driving fatalities involving alcohol impairment –31% of all vehicular deaths.

For someone who has been drinking excessively, it can become abusive. This can become a life-or-death situation for alcoholics. So can quitting.

Alcohol Withdrawal is Serious Business

When a person has been abusing it for a long enough period of time, they can develop a tolerance and a physical dependence on alcohol.

When a person has developed a physical dependence on alcohol, it is because their brain has adapted to the presence of alcohol. This obviously occurs from long-term abuse, long enough for the functions of the body to become so dependent. When the person dependent on alcohol STOPS drinking, there is a hyper-excitable “rebound” response from the person’s autonomic and central nervous systems. This is known as delirium tremens. It will primarily occur in those who have been drinking heavily for a period and haven’t eaten enough food. These life-threatening side effects can be caused by head injuries, illness, benzodiazepine withdrawal or alcohol withdrawal. It happens in people with a history of heavy drinking who attempt to stop cold turkey.

Because of the bodily systems affected, alcohol withdrawal symptoms can vary widely – from mildly uncomfortable to severely disturbing –

  • Tremors
  • Agitation
  • Anxiety
  • Irritability
  • Insomnia
  • Nausea/Vomiting
  • Severe alcohol craving

But as unpleasant as these symptoms are, there are severe symptoms that can progress so far as to be life-threatening –

  • Hallucinations – visual, auditory, and tactile
  • Autonomic instability
  • Tonic-clonic seizures

But the most serious form of alcohol withdrawal is delirium tremens, also known as “the DTs” or “the shakes”.

What Need to Know about the Dangers of Delirium Tremens

Alcohol tremens has been known as a condition that can occur to long-term heavy drinkers. Since the 1700s, it was colloquially called the “drunken horrors”. It is a form of mental or nervous system changes that come from abstaining from drinking. There is debate on what causes DTs. The most common reason tends to be that drinking a lot of alcohol influences how the body regulates the GABA neurotransmitter.

The body mistakes alcohol for GABA so it decreases the production of it. When a heavy drinker stops and levels of alcohol drop in the body, the body thinks there isn’t enough GABA to function. Every person will experience DTs differently. The amount of time it will last depends on any given patient. The brain needs time to readjust the balance of excitation and inhibition. This process takes at least a few weeks and may take up to a few months.

Delirium tremens are characterized by:

A rapid onset of symptoms, usually developing 2 to 3 days after the cessation of heavy drinking, with the worst manifestations occurring on the fourth or fifth day. These symptoms include:

  • Shivering
  • Shaking
  • Irregular heartbeat
  • Autonomic hyperactivity – tachycardia and hypertension
  • Profuse sweating
  • Extremely high body temperature
  • Seizures
  • Panic attacks
  • Paranoia
  • Horrific nightmares
  • Global confusion
  • Acute disorientation
  • Hallucinations with no recognition of the real world
  • Perceptual disturbances
  • Formication – a sensation that small insects are crawling on or under the skin
  • An intense feeling of impending doom or death

Who Is Most at Risk for Delirium Tremens?

Delirium tremens occurs in up to 20% of patients undergoing alcohol detoxification and up to 33% of those patients already experiencing withdrawal seizures. So who exactly is most at jeopardy when withdrawing from drinking?

Alcohol tremens are most common in those individuals who:

  • Have a history of alcohol withdrawal
  • Drank heavily every day for several months which is considered to be4-5 pints of wine, 7-8 pints of beer, or one pint  of hard alcohol daily for a period of many months.
  • Have a personal history of alcoholism or chronic alcohol abuse of more than 10 years

Can Withdrawal from Alcohol Cause Seizures?

So what kind of seizure is it that comes when one abstains from heavy drinking? It’s known as a grand mal seizure. It can cause you to lose consciousness and have muscle contractions that are uncontrollable. It’s also known as a generalized tonic-clonic seizure and is happens due to abnormal electrical activity occurring in the brain.

The worst day of withdrawal may include seizures for heavy drinkers. This will usually occur between seven to 72 hours after one stops drinking. There are other reasons that tonic-clonic seizures may occur as well. Triggers for grand mal seizure can come from low levels of sugar, salt, magnesium, and calcium in the body. Certain drugs can also cause seizures. Toxic effects of alcohol, too much fluid, and changes in the body can cause seizures. Binge drinking has the potential to cause seizures for people who don’t suffer from deficiencies or who don’t have epilepsy.

These seizures are what makes quitting drugs and alcohol even more challenging than with other substances. If you don’t withdraw properly, you put yourself at risk of death. This is why it’s important to go through a professional detox. While there are home remedies for withdrawal, this puts you at risk of out of control alcohol tremens that could lead to serious problems.

How Long Does Alcohol Take to Detox From?

Perhaps an intervention took place to help the alcoholic see that they have a problem. The first step in recovery is the detoxification phase. This is a dedication to getting alcohol and toxins out of the body so treatment can begin. The goal in detox is to abstain from drinking in the safest and most comfortable way so you succeed. This period of abstinence is the start of the road to recovery. Getting ‘clean” will allow you to start recovering.

When alcohol is no longer in the system, the brain will struggle to adjust itself. The level of stimulation will bounce radically, to the point the brain can’t keep up. The neuronal activity can then cause seizures known as DTs. The risk for seizures can last for many days. This is why it’s necessary to remove all toxins from the body first before trying to move forward with the next steps of recovery. Once the initial discomfort is over, it’s much easier to just focus on recovering.

Detox can last for quite a few days once the alcohol withdrawal symptoms start. The cravings will get greater and the body will become more uncomfortable. If there is the potential for seizures and it’s not supervised closely, they can continue and even worsen. After 48 hours, the potential for seizures will lessen. However, it’s still important to be monitored due to confusion and cardiovascular risks. This includes hearts attacks or strokes. After the last drink, these dangerous symptoms can happen for 48-96 hours after the last drink was consumed. There is potential of a delayed reaction to withdrawal that can start from 7-10 days after the last drink.

Can Withdrawal from Alcohol Cause Hallucinations?

The answer is yes. Withdrawal can include hallucinations that occur with other dangerous side effects. This includes high fever and seizures. Tactile hallucinations can include itching, burning or numbness. It feels real but isn’t actually happening. There are auditory hallucinations that may occur which includes hearing sounds that aren’t there. Visual hallucinations will include seeing things that aren’t there.

Withdrawal Timeline

You know what the alcohol withdrawal signs are but you may not know when they will arise. Here is what you can expect timewise.

The first few hours of detox may include cravings as the initial symptom. Cravings can begin within just a few hours after drinking has stopped. They will likely continue for most of the detox process. Other symptoms include:

  • Feeling physically ill.
  • Feeling moody such as anxiety, depression, and irritation.
  • The heart and blood pressure may spike.
  • Nightmares.
  • Insomnia.
  • Tremors may occur.

When someone has extensive addictions, the symptoms may be much worse through the detox period and DTs are a higher risk.

The first 48 hours can come with severe symptoms that include hallucinations to delirium tremens. This is the brain reacting to alcohol leaving the system. Seizures can occur in the first 12 hours of detox and can continue to be a risk for days after. The heart may become more rapid and one might even experience chest pain. Blood pressure may also rise.

Most people will experience the symptoms of withdrawal for more than 48 hours.

What Helps Ease Withdrawal Symptoms?

Easing withdrawal symptoms doesn’t necessarily mean you’ll be safe from the dangerous side effects. However, there are ways to ease the discomfort. When you attend an addiction treatment facility, they will ensure that you’re as comfortable as possible. Guidelines for withdrawal are constantly being paid attention to and updated. These are some of the things that can help ease the symptoms:

  • Drink plenty of fluids that have electrolytes. You are suffering from dehydration and will likely feel nauseous as a result. It will help to combat those effects.
  • A quiet place with soft lighting.
  • Very little contact with people.
  • An atmosphere that is positive and supportive.
  • Health, nutritious foods that replenish the body so it can fight the effects of withdrawal more efficiently.

Your blood pressure, pulse, heart rate, and body temperature may rise. Medications that can help treat symptoms like seizures include benzodiazepines. They also help with anxiety and insomnia. Anti-seizure medication and antipsychotics may also be utilized within the detox setting. Keep in mind that there is a difference between holistic and medical detox. You’ll want to determine what will be the right route for you as there are pros and cons for each.

Medications for Detox

The most common drugs used to reduce alcohol withdrawal symptoms are benzodiazepines. Dosing will be guided by the CIWA scale.They include:

  • Librium (chlordiazepoxide)
  • Valium (diazepam)
  • Ativan (lorazepam)
  • Serax (oroxazepam)

The medication will be used within various treatment patterns. Detox from alcohol is an abrupt cessation of consumption. These drugs are a substitute because they have similar effects to alcohol on the brain. A standard dose of benzodiazepine will be given every 30 minutes until the patient is lightly sedated. This will determine the baseline. Medication is then tapered over a period of 3-10 days.

Another method is to give a dose of benzodiazepine based on the history of the patient. It can then be adjusted based on the results of withdrawal.

The third option would be to not use medical detox until the symptoms begin. This would be an initial holistic approach. If a patient has had alcohol-related seizures, this method isn’t an option.

There are a few different types of benzodiazepine medication that can be utilized.

Librium is used for uncomplicated alcohol withdrawal because of it’s long half-life.

There is an injection available for those who likely can’t safely take medications. It may be that they will look to abuse them or perhaps not take them at all. These injections will be lorazepam or diazepam.

Lorazepam and oxazepam will be used for patient who have damaged their liver.

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Addiction in America

How Common Are Addiction and Alcoholism in the US?




The figures are even higher when it comes to the use of alcohol. The National Institute on Alcohol Abuse and Alcoholism reports that almost 87% of US adults admit to drinking alcohol at some point in their lifetime, while more than half reporting that they have done so within the past month. Over 16 million American adults and almost 700,000 adolescents meet the benchmark for an Alcohol Use Disorder (AUD).

In both human and financial terms, the impact of addiction is staggering. EVERY SINGLE YEAR in America:

  • Addiction costs American society $484 BILLION.
  • This is more than diabetes and cancer COMBINED.
  • approximately 570,000 people die because of drug use.
  • 440,000 people pass away because of tobacco-related illnesses.
  • Alcohol kills 85,000
  • 20,000 people die due to illegal drug use.
  • Prescription drug abuse kills more than 20,000
  • Approximately 100 US citizens die EVERY DAY because of fatal drug overdoses.

03 addiction

Alcoholism and Drug Addiction Affects EVERY US Citizen

At the top of this article, there is a quote saying that 1 out of every 10 US citizens over the age of 12 is addicted to alcohol or drugs. Although that may seem like a high number, when you do the math, the results are positively chilling.

According to an article printed in the New York Times, the average American knows around 600 people. This means every person in America knows 60 other people who have a drug or alcohol disorder.

04 signs of addiction

Let that sink in for a moment, and then let’s go further.

You’re a typical American, aren’t you? Think about everyone you know. Are you surprised that YOU PERSONALLY KNOW 60 addicts and alcoholics?

Wait a minute,” you might say. “Most of those are just acquaintances. That doesn’t REALLY count.”

Fair enough.

That same article estimates that most Americans know between 10 and 25 other people well enough to be counted as trusted “real friends”.

That means in your personal circle of friends – people you know, trust, and maybe even loveyou might be close to as many as three people who are addicted to illegal drugs, alcohol, or prescription medications.

That is what all of these statistics mean –ANYONE can suffer from the disease of addiction.

The addict or alcoholic in your life can be your husband or wife, one of your children, your brother or sister, your mother or father, someone you work with, or your best friend – ANYONE.

05 psychologcal signs addiction

It might even be YOU.

When you feel alienated and alone, it can be difficult to find the strength needed to deal with all of the difficulties caused by the disease of addiction.

But as you can see from all of the statistics – YOU ARE NOT ALONE.  Others are and have been where you are, and they have been able to regain their sobriety and return to a stable life. Take comfort and draw strength from that knowledge, because with help, you can do the same.

Northpoint Recovery is the premier drug and alcohol rehab program in the Inland Northwest, and proudly serves residents of Idaho, Washington State, Utah, Wyoming, and Montana.

06 drug alcohol detox

Northpoint’s experienced clinical staff understands the challenges you are facing, and they can help you create an individualized Evidence-Based Treatment plan that will allow you to take your first positive steps on your personal journey of recovery.

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Alcohol Addiction

I Got a DUI in Idaho – Now What?




“…we want to remind anyone who might think about getting behind the wheel after drinking that real lives are at stake, and that it is just not worth the risk of killing someone else or yourself.” ~Idaho State Police Sgt. Rich Adamson If you have been arrested and charged with a DUI in the […]

The post I Got a DUI in Idaho – Now What? appeared first on Northpoint Recovery Drug & Alcohol Rehab Blog.

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How Dry January Can Jump-Start Your Recovery




Try Abstaining for a Month and See Where It Takes You

You don’t necessarily have to have a drinking problem to take part in Dry January. Maybe, you’ve simply noticed that you’ve started to drink more and more. You might just be a recreational drinker and only drink during the weekends. It doesn’t matter.

Dry January can help you better understand your relationship with alcohol. You’ll learn more about yourself in the process. For example, you might figure out that you tend to drink when you’re stressed.

If you’ve been upping your alcohol intake, now is a good time to reset your body and mind. They’ll thank you! A little break from drinking can do wonders for your health.

If you’re like most people, you should be able to get through Dry January without a hitch. Sure, you might be tempted, but you won’t experience any intense withdrawal symptoms.

If you do experience intense withdrawal symptoms, at least you now know that you have a problem. Don’t let your addiction fester. Instead, get help for it as soon as possible.

Here, at Northpoint Recovery, we can help you do just that! If abstaining from alcohol is a lot more difficult than you thought it would be, our experts can assess your situation to determine whether you’re abusing alcohol. We’ll teach you more about addiction and create an individually-tailored treatment plan for you that will help you get back on the right track.

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