Across the country, millions of people struggle with alcohol use disorder (AUD). According to the National Institute on Alcohol Abuse and Alcoholism, 14.5 million Americans over 12 live with alcohol addiction. This means that their drinking has developed into a pattern where they can no longer control the amount they drink, despite experiencing negative consequences of alcohol abuse.
The physiological health risks and emotional and personal repercussions of severe and heavy drinking are always worth leaving behind. However, the unfortunate truth is that stopping is not as safe or straightforward for people who have struggled with this condition for a prolonged period.
Often, AUD comes hand-in-hand with chronic binge drinking and the development of physiological alcohol dependence. When this happens, brain chemistry adapts to frequent exposure to the depressant. As a result, people struggling with AUD require higher, potentially dangerous amounts of alcohol to achieve their desired experience.
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The other side of this coin is that when alcohol is absent from an individual’s body, their nervous system doesn’t immediately return to normal functioning. Instead, it is thrown out of balance.
While people have many motives to pursue higher tolerances to alcohol, doing so is a sign that quitting cold turkey for health reasons without support might be dangerous and potentially fatal.
If you are hoping to find out more about how alcohol withdrawal works, we have shared a wealth of information for you to review below.
How Does Alcohol Withdrawal Work?
Embarking on your recovery journey requires understanding what alcohol withdrawal syndrome (AWS) means for you. Below, we break down what alcohol does to the brain and what it means for your body in the long-term.
Alcohol in the Brain
Like many other people, you may know that alcohol, ethanol, is a depressant substance. In practice, this means that when alcohol is consumed, toxins that reduce brain function are too. Enzymes in the liver break ethanol down to remove these toxins from the body. However, the liver doesn’t do this perfectly. Any ethanol that isn’t removed in this way passes into the bloodstream and, eventually, the brain.
Once in the nervous system, alcohol interacts with the production and reception of four major chemical messengers. This depresses brain function by:
- Stimulating gamma-Aminobutyric acid (GABA) receptors – This dampens activity, reduces anxiety, and slows respiratory and cardiovascular function.
- Releasing a wave of serotonin – This causes a sense of calm and contentment.
- Boosting levels of dopamine in the central nervous system – Increased dopamine results in a feeling of mild euphoria and logging alcohol as a desirable activity in the brain’s reward center.
- Binding to and inhibiting glutamate receptors – Once again, this reduces some of the brain’s most important excitatory highways.
Neurons that communicate with glutamate and GABA account for the vast majority of all brain cells. Altering the levels of these chemicals in the nervous system significantly impacts how your body works with and without alcohol.
In addition to altering your emotional and mental state, these transmitters dictate your heart rate, blood pressure, alertness, coordination, respiratory system, and gastrointestinal (GI) function. They even determine how much pain you experience.
Losing the Crutch: Alcohol Withdrawal Syndrome
It is easy to see why your brain tries to return to normal, homeostatic functioning with all of these short-term side effects. If you frequently drink heavily and do so over a long period, your brain will counteract its impairment by rebalancing its chemistry. In turn, GABA, serotonin, and dopamine production will reduce while sending glutamate production into overdrive.
When this happens, the system is trying to re-stimulate. Like a person trying to be heard in a deafening room, it has begun to shout. Yet, it doesn’t just switch back to normal when you kill the noise.
Essentially, this spells big trouble for a dependent nervous system once you stop drinking. When consuming alcohol results in an alcohol use disorder, quitting cold turkey will bring on a host of challenging, severe withdrawal symptoms.
Symptoms of Alcohol Withdrawal Syndrome
Alcohol withdrawal occurs as quickly as two hours following your last drink. Between two and three days later, withdrawal symptoms reach their most severe. However, in some cases, they last for far longer.
Three Stages of Withdrawal
Experiencing anxiety, headaches, sweating, irritability, tremors, nausea, or tiredness are all early signs that you have entered a state of alcohol withdrawal. However, the intense stimulation to bodily functions that follows can progress into more dangerous conditions over a three-stage process.
Not everyone who goes through alcohol withdrawal will progress to the second or third stage of AWS. However, severe cases of alcohol addiction are more likely to result in extreme cases.
Consulting with an addiction professional before embarking on unsupported detox is necessary to avoid what could be a life-threatening situation.
- After six to eight hours – Common alcohol withdrawal symptoms, including anxiety, difficulty sleeping, stomach pain, digestion problems, or palpitations, start to settle in. These symptoms usually arise within twelve hours of stopping drinking.
- After twenty-four hours – Dangerous alcohol withdrawal symptoms associated with abnormal vital signs are experienced. These include rapid heart rate, increased breathing, high blood pressure, sweating, mild hyperthermia to fever, and mental confusion.
- After forty-eight to ninety-six hours – The third stage of withdrawal is characterized by a dangerous condition known as delirium tremens (DTs). The risk of rare complications such as tonic-clonic seizures is highest during this period. If you encounter these symptoms, you may also experience uncontrollable muscle contractions, auditory or visual hallucinations, heavy vomiting, high fever, coma, and sometimes death.
While stage three withdrawal symptoms can resolve within a few days, they are known to last for up to five. If you or a person you know has begun to show any signs of stage three AWS, medical treatment is recommended. The tragic truth of this condition is that up to one-quarter of individuals who experience delirium tremens die.
When It’s Serious
Weight, genetics, age, gender, physical fitness, and severity of addiction all play a part in how challenging your withdrawal will be. Because of this, it is not easy to predict if you will experience severe AWS without an individualized assessment.
However, there are broad trends in what type of use is most likely to result in a dangerous withdrawal. To determine whether you will experience AWS, a medical professional might ask you the following questions:
- How many units of alcohol do you typically drink?
- How long have you been drinking heavily?
- Do you abuse other substances at the same time as alcohol?
- Do you suffer from any mental health disorders, such as anxiety, depression, or PTSD, that may intensify in withdrawal?
Treatment for AWS
The risks of unsupported dangerous withdrawal symptoms are real, but they don’t have to stand in the way of a healthy future. If you or a loved one wants to overcome alcohol dependence, medical supervision during detox can help you safely pass through the withdrawal process.
If you choose to detox in a licensed addiction center, a team of addiction professionals will be on call to supervise your health from start to finish. The careful prescription of medications such as lorazepam and diazepam can slow down and alleviate alcohol withdrawal symptoms so that later-stage conditions and delirium tremens can be avoided.
If you want to stop the cycle of alcohol abuse for good, seeking help in treating your symptoms can help you secure your future health without risking your present.