Alcohol Withdrawal Complications: What Can Happen
Updated: November 1, 2020
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While alcohol can be safe in moderation, alcohol abuse is dangerous and can lead to various problems, such motor vehicle crashes, health issues, and even alcohol addiction. The development of an alcohol addiction, which medical professionals refer to as an alcohol use disorder, is more likely when a person drinks heavily.

Heavy drinking, as described by the National Institute on Alcohol Abuse and Alcoholism as women consuming more than three drinks in a day and men consuming more than four drinks on a given day, can lead a person to become dependent upon alcohol. This means that when a person stops drinking, he or she will experience uncomfortable withdrawal symptoms.

Undergoing alcohol withdrawal is one of the symptoms of an alcohol use disorder. While withdrawal symptoms can sometimes be mild and relatively harmless, there are cases when a person can experience complications from alcohol withdrawal.

Mild Alcohol Withdrawal

Mild alcohol withdrawal symptoms tend to begin about six hours after a person stops drinking, according to a report in the Industrial Psychiatry Journal. These mild withdrawal symptoms include tremors, sweating, fast heart rate, upset stomach, headache, and anxiety. These symptoms tend to last about a day or two, and they are not considered alcohol withdrawal complications, since they are rather mild.

Alcohol Withdrawal Hallucinations

Alcohol Withdrawal Hallucinations

Some people experience only mild alcohol withdrawal symptoms, but for others, withdrawal will be more serious. The first alcohol withdrawal complication that tends to appear is withdrawal hallucinations. According to a 2015 report in the professional journal Drugs, nearly one-quarter of people who undergo alcohol withdrawal will experience hallucinations, which involve seeing, hearing, or feeling things that aren’t really there.

While a person who has hallucinations early in alcohol withdrawal will understand that they are not real, the hallucinations can cause paranoia and agitation, which is why they are considered to be one of the alcohol withdrawal complications. Withdrawal hallucinations typically begin about a day after a person stops drinking.

Alcohol Withdrawal Seizures

Alcohol Withdrawal Seizures

While some patients who experience alcohol withdrawal may have troubling hallucinations, this complication is typically not as severe as alcohol withdrawal seizures. According to the report in Drugs, about 10 percent of people who suffer from alcohol withdrawal will have a seizure.

Most alcohol withdrawal seizures are tonic-clonic, and they can be difficult to treat. A person who experiences a seizure is at risk of progression to the most severe of alcohol withdrawal complications, which is a condition called delirium tremens.

Delirium Tremens

If seizures are not treated, a person who has alcohol withdrawal complications can suffer from a potentially fatal condition called delirium tremens, which occurs in 5 percent of people who suffer from symptoms of alcohol withdrawal. This condition begins about two to three days after a person’s last drink and can persist for five to seven days.

Delirium Tremens

According to experts, someone who is suffering from delirium tremens will experience agitation and hallucinations, but unlike those who hallucinate in the absence of delirium tremens, someone who is suffering from this dangerous condition will also appear very disoriented. Delirium tremens is associated with other symptoms, such as psychosis, anxiety, confusion, elevated body temperature, dangerously high blood pressure, and seizures.

If not treated, delirium tremens can be deadly. Per the report in Drugs, 1 to 5 percent of people who experience delirium tremens will die as a result of this condition. Delirium tremens is associated with other alcohol withdrawal complications, such as heart attack and aspiration pneumonia, which can ultimately lead to death in some patients.  A person who suffers from delirium tremens may also experience a coma, which is an additional complication associated with this condition. In some cases, patients who are experiencing delirium tremens may harm themselves or others because of agitation and psychotic behavior.

Preventing Alcohol Withdrawal Complications

Early, quality treatment is essential for preventing alcohol withdrawal complications like delirium tremens. While some patients may experience only mild alcohol withdrawal and never suffer from complications, others will undergo life-threatening withdrawal symptoms, making treatment an essential component of recovering from the symptoms of alcohol withdrawal. Those who have been drinking heavily should seek the advice of a medical professional when detoxing from alcohol. Even if a patient never experiences complications, a doctor can provide monitoring to ensure that a patient remains safe and comfortable during alcohol withdrawal.

For patients who experience severe withdrawal symptoms, medical treatment is often necessary. As the authors of the report in the Industrial Psychiatry Journal have explained, seizures are indicative of severe alcohol withdrawal, meaning that a patient should be given medication. Benzodiazepine drugs like Ativan, Valium, and Librium are the preferred treatments for alcohol withdrawal complications. Doctors may prescribe a sedative drug called phenobarbital if patients do not respond to benzodiazepines. In some cases, antipsychotic medications may be given to patients who suffer from agitating hallucinations during alcohol withdrawal.

Alcohol withdrawal complications are possible with heavy alcohol use and addiction, but they can be managed with proper treatment, which often includes benzodiazepine drugs. Those who plan to stop drinking and undergo the alcohol detox process should contact a medical professional for an assessment. If a patient presents with severe symptoms or is at risk of alcohol withdrawal complications, medications can be administered to prevent severe and potentially fatal withdrawal side effects, such as seizures or delirium tremens.

It is important to remember that detoxing from alcohol and overcoming withdrawal complications is just the first step in the treatment process for alcohol addiction. After detoxing, it is important for patients to receive ongoing psychological treatment to address the underlying issues that have led to alcohol abuse.

Sources & Resources

  1. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/
  3. https://link.springer.com/article/10.1007/s40265-015-0358-1