According to the National Institute of Alcohol Abuse and Alcoholism (NIAAA), alcohol withdrawal is a spectrum of conditions ranging from mild tremors to life-threatening delerium tremens, or DTs. Alcohol works as a sedative and, as a consequence of chronic alcohol use, the brain grows accustomed to a constant state of sedation. Abrupt cessation of alcohol causes the brain to be more sensitive to sensory stimuli. The severity of symptoms depends on the amount of alcohol consumed on a daily basis as well as the length chronic abuse. First alcohol withdrawal symptoms generally occur within 72 hours of a persons' last drink, but can occur even while still intoxicated.
Minor Withdrawal
Minor withdrawal symptoms occur generally between six and 36 hours after the last drink. These symptoms can include tremulousness, anxiety, sweatiness, nausea and vomiting. In all cases, the person undergoing minor withdrawal does not experience any confusion or disorientation with respect to their surroundings. Symptoms generally resolve within 48 hours.
Withdrawal Seizures
Withdrawal seizures occur anytime between 12 and 48 hours after the last drink. As previously mentioned, the brain of a chronic alcohol user becomes extra-sensitive to stimuli after alcohol use has been abruptly stopped. This lowers the threshold for seizure, which is uncontrolled electrical activity in the brain typically characterized by shaking or jerking movements. Withdrawal seizures generally do not indicate the presence of a permanent seizure disorder.
Alcoholic Hallucinosis
Alcoholic hallucinosis is a condition characterized by visual, auditory or tactile perceptions which do not actually exist. They typically occur 12 to 48 hours after the last drink and resolve by 72 hours. Typically, persons experiencing alcoholic hallucinosis can relate seeing or hearing things that are abnormal but do recognize these hallucinations as abnormal. There is no confusion or disorientation as is seen in delerium tremens.
Delerium Tremens
Delerium tremens, or DTs, is a potentially fatal consequence of alcohol withdrawal that is characterized by confusion, sweatiness, hallucinations and increases in heart rate and blood pressure. It occurs between 48 to 72 hours after the person's last alcoholic drink. Uncontrolled elevated blood pressure and heart rates cause less blood to reach the brain which may lead to death. The NIAAA estimates that 5 percent of patients who experience DTs die from the effects on the heart and brain. Treatment for DTs requires high-dose sedatives and close monitoring in an intensive care unit.
References
- "Merck Manual for Health Professionals;" O'Connor, Patrick G. MD; July 2008
- "Adams and Victor's Principles of Neurology; Alcohol and Alcoholism"; Ropper AH, Samuels MA; March 2009
- National Institute of Alcohol Abuse and Alcoholism; "Introduction to Alcohol Withdrawal"; Richard Saitz, M.D., M.P.H.; 1998
