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alcohol withdrawal

Alternative Names 
DT's, delirium tremens

Alcohol withdrawal is a set of symptoms that a person has when he or she suddenly stops drinking after using alcohol for a long time.

What is going on in the body? 
When a person has been drinking to excess for several months or years, his or her body comes to rely on alcohol and its effects. Alcohol is a depressant that acts like a sedative or tranquilliser on the body. When the intake of alcohol is suddenly stopped, the body will go through withdrawal.

What are the signs and symptoms of the condition? 
Symptoms of alcohol withdrawal usually occur within 12 to 72 hours after the last drink of alcohol. Major withdrawal symptoms may occur for up to 7 days, with recurring symptoms lasting for several months. A person going through withdrawal may have a wide variety of symptoms, including: If left untreated, alcohol withdrawal can lead to a more serious set of symptoms called delirium tremens or DTs. These symptoms usually appear about 2 to 10 days after the drinking stops. A person with DTs is anxious at first. Later, other symptoms occur that can include: What are the causes and risks of the condition? 
Alcohol withdrawal rarely occurs in a person who only drinks once in a while. Someone who has gone through alcohol withdrawal before is more likely to have withdrawal symptoms each time he or she quits drinking alcohol.

What can be done to prevent the condition? 
A person can prevent alcohol withdrawal by not drinking alcohol excessively. A person with alcoholism who wishes to stop drinking should consult his or her doctor to help prevent alcohol withdrawal. Certain treatment and programs may curtail alcohol withdrawal symptoms.

How is the condition diagnosed? 
A history and physical examination will be done to rule out other any other cause of the symptoms. While there is no test to determine if a person is an alcoholic, the negative effects of alcohol on the body can be seen. Liver function tests can measure liver damage. Special tests, called MRIs and ultrasounds, can check the different organs inside the body for damage.

What are the long-term effects of the condition? 
Alcohol withdrawal can lead to DTs, which can be fatal if untreated. A person may find it hard to handle stressful situations and may begin drinking again.

What are the risks to others? 
A person going through withdrawal may be a threat to others due to delusions and hallucinations. A person who has delusions and hallucinations may see others as being dangerous or "out to get them."

What are the treatments for the condition? 
The goals of treatment are to treat the immediate withdrawal symptoms, to prevent complications, and to begin long-term preventive treatment.

In mild forms of alcohol withdrawal, medication may be given to make the person feel relaxed and less agitated. A person with more severe forms of withdrawal needs to be hospitalised for the detoxification time. The person is usually given central nervous system depressants and sedatives to reduce the symptoms.

Because vitamin deficiency causes potentially life-threatening withdrawal symptoms, doctors in emergency departments usually give large intravenous doses of vitamins C and B, and thiamine. Close monitoring of the heart rate, breathing, temperature, and blood pressure are important during the first stages of alcohol withdrawal.

After the urgent medical problems are resolved, a detoxification and rehabilitation program should be started. In the first phase of treatment, alcohol is completely withdrawn. Then an alcoholic has to change his or her behaviour. Self-help groups, such as Alcoholics Anonymous, are encouraged.

What are the side effects of the treatments? 
Side effects vary, depending on the medications used. For instance, antidepressants may cause irritability and shakiness. Sedatives can be addicting.

What happens after treatment for the condition? 
A person who completes treatment often will continue some form of counselling or self-help group. A person in alcohol recovery will often voluntarily continue to attend self-help groups for the rest of his or her life. A person who starts drinking again will most likely go through alcohol withdrawal again.

How is the condition monitored? 
Watching for signs of withdrawal is ongoing, and symptoms are treated as needed. Once the person has remained sober, family and friends are very important in helping to keep him or her that way.

Author: Gail Hendrickson, RN, BS
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 25/04/2005
Potential conflict of interest information for reviewers available on request

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