Alcohol withdrawal

Definition

Alcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol every day suddenly stops drinking alcohol.

Causes, incidence, and risk factors

Alcohol withdrawal usually occurs in adults, but it may occur in teenagers or children as well. It can occur when a person who uses alcohol excessively suddenly stops drinking alcohol. Withdrawal usually occurs within 5 - 10 hours after the last drink, but it may occur up to 7 - 10 days later.

The following is generally considered excessive alcohol use:

• More than 15 drinks per week for men or 8 drinks per week for women
• More than 5 drinks per day for men or 4 drinks per day for women
• Habitual use of alcohol that disrupts a person's life and routines, regardless of amount consumed

In this definition, 1 drink has 12 grams of alcohol, and equals approximately 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 90 proof spirits..

The more heavily you drink every day, the more likely you will develop alcohol withdrawal symptoms when you stop drinking. The likelihood of developing severe withdrawal symptoms also increases if you have other medical problems.

Symptoms

Mild-to-moderate psychological symptoms:

• Jumpiness or nervousness
• Shakiness
• Anxiety
• Irritability or easy excitability
• Rapid emotional changes
• Depression
• Fatigue
• Difficulty thinking clearly
• Bad dreams

Mild-to-moderate physical symptoms:

• Headache -- general, pulsating
• Sweating -- especially the palms of the hands or the face
• Nausea and vomiting
• Loss of appetite
• Insomnia (sleeping difficulty)
• Pallor
• Rapid heart rate
• Eye pupils enlarged(dilated pupils)
• Clammy skin
• Tremor of the hands
• Involuntary, abnormal movements of the eyelids

Severe symptoms:

• Delirium tremens -- a state of confusion and visual hallucinations
• Agitation
• Fever
• Convulsions
• Black outs -- when the person forgets what happened during the drinking episode

Signs and tests

The health care provider will check for:

• Rapid heartbeat (tachycardia)
• Rapid breathing (tachypnea)
• Elevated temperature
• Abnormal eye movements
• Shaky hands
• General body shaking
• Abnormal heart rhythms
• Internal bleeding
• Liver failure
• Dehydration

A toxicology screen may be performed as well as other blood tests.