Alcohol Addiction (Alcoholism): How To Manage Alcohol Withdrawal Symptoms?

An addiction is, by definition, difficult to kick. It's a chronic disease that alters your brain function, after all. If addiction were a person, it'd be an abusive partner — even if you really want to leave and are well aware that you need to, for your physical and mental health, addiction would do everything it could to convince you to stay, and use force if that didn't work. If willpower alone was enough to break free, many current addicts would already have done it. 

This means that, for heavy drinkers and people who have been drinking every day for a long time, returning to alcohol isn't the only risk that comes with attempting abstinence. If you are are ready to commit to abstaining from alcohol, the first question you should ask is whether it's medically safe to stop on your own. 

What are the signs of physical alcohol dependence?

People who are physically dependent on alcohol may, when they cease to drink:

• Experience hand tremors ("shakes")
• Sweat excessively
• Experience nausea and vomiting
• Become physically restless
• Experience hallucinations — seeing, hearing, or feeling things that aren't there
• Be unable to sleep
• Suffer headaches
• Be mentally confused
• Have an abnormally fast heart beat
• Be pale
• Mentally, they may feel anxious, irritable, or depressed

If you've noticed symptoms like this sometime after you last have a drink, and your body needs alcohol to stop these symptoms, you are almost certainly physically dependent on alcohol. Addicts who drink extremely heavily (more than three liters of beer, more than 1.8 liters of wine, or more than half a liter of spirits, a day) or who have been abusing alcohol for many years are at risk of delirium tremens, the most severe form of alcohol withdrawal. 

Symptoms include severe confusion, hallucinations, cognitive dysfunction, sensitivity to light and touch, severe tremors, seizures, chest pain, irregular heartbeat, and a fever. While the symptoms of delirium tremens usually set in within 48 to 96 hours after the last drink, they can also be delayed and appear a week or more later.

Because delirium tremens is a medical emergency — this form of alcohol withdrawal can even be fatal if left untreated — consulting a doctor before attempting detox at home is by far the safest thing to do if you're at all at risk. People who have a habit of binge-drinking occasionally, or who exceed the safe drinking recommendations by having a few drinks every day but don't down liters upon liters of beer or tens of units of hard liquor are almost certainly safely able to detox at home. They may experience milder withdrawal symptoms that aren't medically dangerous. If you're not sure where you fall, however, it's best not to simply try to go "cold turkey". 

How should alcohol withdrawal be managed?

When someone who is — or is suspected to be — dependent on alcohol approaches a doctor for guidance, they can expect:

• To be asked about their daily alcohol intake. Addicts may be able to give a rough estimate, but are also often encouraged to keep an alcohol diary so the healthcare provider gains more precise insights. 
• To be asked about their support network. 
• To be invited for a physical checkup and blood tests so a complete picture of the state of their health can be formed. 

If such a support network is not available, the person already has serious medical concerns, or the person drinks more than 30 units of alcohol a day, inpatient detox is instead recommended. Round-the-clock care can be offered to make the withdrawal process as safe as possible, this way. 

A recovering addict's personal preferences also play a role in the setting in which alcohol detox takes place. Some may prefer to detox as inpatients coupled with rehab, knowing that this gives them the best chance of staying off the alcohol in the long-term. Others may not be comfortable with checking into a hospital, and may not detox at all unless their health services can support their home detox.