Alcohol Withdrawal Effects: Delirium Tremens, Hallucinations and More

Signs of Alcohol Withdrawal

Alcohol use disorder is now the accepted name for the disease of alcoholism or alcohol addiction. When someone regularly drinks too much, they’re at risk for becoming addicted to alcohol.

Alcohol affects certain neurotransmitters in the brain, including GABA. That’s why people who drink feel pleasure, relaxation or euphoria. That’s also why alcohol can be addictive—it creates a reward response in the brain. Along with psychological addiction, there is something else that occurs with frequent alcohol abuse, which is dependence.

Over time as the brain is repeatedly exposed to alcohol, it becomes dependent on it to function in a certain way. Chronic alcohol use and abuse cause ongoing changes in the brain, including to the GABA neurotransmitter as well as to dopamine.

When you regularly drink and then you stop suddenly, your brain has a difficult time trying to readjust, leading to withdrawal. Signs of alcohol withdrawal are the result of your brain and entire central nervous system going into a type of shock because of the removal of alcohol.

The signs of alcohol withdrawal often begin soon after a person takes their last drink, and while alcohol withdrawal symptoms can be severe, they are usually treatable in a professional setting.

Physical Side Effects

The signs of alcohol withdrawal and alcohol withdrawal effects can vary based on individual factors including how long and how often someone drank alcohol, their age, their health and their sex, and also underlying medical conditions. Some of the alcohol withdrawal effects that are possible in general include:

• Nausea and vomiting
• Rapid heartbeat
• Agitation and anxiety
• Headache
• Sleep disturbances and insomnia
• Sweating

As with other substances that lead to physical dependence, alcohol withdrawal effects are often paradoxical. This means they’re the exact opposite of the effects of using the substance. Since alcohol is a central nervous system depressant, when you’re drinking you will often feel sleepy, relaxed or as if you’re experiencing slow reflexes and reaction times. When you’re going through alcohol withdrawal, you will often feel anxious, awake and as if your blood pressure and heart rate are rising.

Delirium Tremens

Alcohol withdrawal delirium is a possible severe effect of alcohol withdrawal. It doesn’t happen to everyone, but it is a possible side effect of alcohol detox. Alcohol withdrawal delirium is also called delirium tremens or DTs. This condition can be deadly, and more information is provided below.

Signs An Alcoholic Needs a Drink

Unfortunately, going through alcohol withdrawal is often a big deterrent to getting sober and seeking treatment. Someone who’s struggling with alcohol addiction has to fully detox before they can begin any kind of treatment program. However, when they start to experience withdrawal symptoms they often see it as a sign they need a drink. There is a sense of anxiety about the thought of going through withdrawal for many alcoholics as well.

Detox

The signs of alcohol detox are fairly easy to spot, even in the earliest hours. The signs of alcohol detox usually mean that someone should seek medical attention or go to a supervised medical detox since they do have the potential to become severe or deadly.

The signs of alcohol detox have an official medical name, which is alcohol withdrawal syndrome. Alcohol withdrawal syndrome or AWS refers to the combination of both psychological and physical symptoms that occur as someone stops drinking.

Withdrawal Signs

Alcohol withdrawal signs will usually begin within around six hours after you take your last drink if you’re a heavy drinker or severe alcoholic. These earliest alcohol withdrawal signs and symptoms will include things like shaky hands, anxiety, nausea, vomiting, and sweating. The more severe symptoms usually occur anywhere from 12 to 24 hours after someone takes their last drink of alcohol.

For someone people, alcohol withdrawal signs might not begin until up to a few days after they’ve had their last drink. Regardless of the length of the alcohol withdrawal timeline, it will usually include at least two symptoms listed above.

For a period of two to three weeks, people may experience the more severe alcohol withdrawal signs. Milder symptoms may continue for several weeks, especially in people struggling with severe alcohol use disorder. The symptoms of alcohol withdrawal also tend to be more pronounced and noticeable when someone first wakes up in the morning.

Hallucinations

Alcohol withdrawal hallucinations or alcoholic hallucinosis is a possible severe symptom of detoxing from alcohol. Alcohol withdrawal hallucinations are fairly rare, however.

It’s believed that this is a psychotic disorder, which is induced by alcohol use or alcohol withdrawal.

Alcohol withdrawal hallucinations usually only occur in people who are chronic, long-term alcoholics who have been heavy drinkers for many years. Alcohol withdrawal hallucinations can occur anywhere from 12 to 24 hours after someone stops drinking, and they may last for several days.

Alcohol withdrawal hallucinations can be both visual and auditory, and people will often hear voices they see as being threatening. Certain symptoms are believed to occur before the actual hallucinations start. These symptoms can include irritability, dizziness, headache, and insomnia.

Sometimes alcohol withdrawal hallucinations are compared to or confused with delirium tremens. The two are separate conditions, and alcoholic hallucinosis is considered less serious than delirium tremens.

Headaches

An alcohol withdrawal headache is undoubtedly one of the most common symptoms of alcohol withdrawal. Even when someone isn’t addicted or dependent on alcohol, they can experience a headache after they drink heavily, as part of what’s called a hangover. Even people who wouldn’t be considered alcoholics but who do regularly drink may experience an alcohol withdrawal headache if they stop suddenly.

Seizures

Alcohol withdrawal and seizures may occur together. Seizures can occur in as little as a few hours after the last time someone has alcohol, or they can occur up to two days later. If someone has an existing history of seizures related to any other medical condition, they may be more likely to experience seizures during alcohol withdrawal.

If someone does have seizures because of alcohol withdrawal, it increases their risk of also developing delirium tremens.

Nausea

Nausea is a symptom that often accompanies the use of alcohol, hangovers from alcohol, and alcohol withdrawal. If someone has alcohol withdrawal and nausea is a symptom they experience, it can actually be dangerous. If that nausea leads to vomiting, the person is at risk for becoming dehydrated. This is something that can be treated during a medical detox, to avoid complications of nausea and vomiting.

Withdrawal with Delirium

Delirium tremens is something that occurs in around five percent of people who go through withdrawal from alcohol. Of the five percent of people who experience DTs, around one in 20 ultimately die. This life-threatening condition requires professional help. The best way to ensure the safety of someone going through alcohol withdrawal is for them to go through it in a medical detox center. Otherwise, they may need emergency treatment if there are symptoms of DTs that start to occur.

What is Delirium?

Alcohol withdrawal delirium occurs suddenly. For people who are severe, long-term alcoholics, their central nervous system has a very difficult time adjusting without the presence of alcohol which is a contributing factor to the development of alcohol withdrawal delirium. People who are most at risk for alcohol withdrawal delirium include:

• Anyone who’s been a long-time, heavy drinker
• Someone with a history of alcohol withdrawal or alcohol withdrawal delirium
• A person that has underlying health problems along with alcoholism
• Someone with brain damage or a history of seizure disorders

Symptoms or signs of alcohol withdrawal delirium may include:

• Agitation
• Anxiety
• Irritability
• Confusion
• A disturbed state of mind known as delirium
• Delusions which means believing untrue things
• Excessive sweating
• Over-excitement
• Muscle and eye movement problems
• Chest pain
• Fatigue
• Fear
• Fever
• Hallucinations
• Increased breathing or heart rate
• Increased startle reflex
• Involuntary contractions of the muscles
• Nausea
• Restlessness
• Seizures
• Excessive sensitivity to stimuli
• Rapid changes in mood

It’s not uncommon for people to have alcohol withdrawal tremors, which are sometimes called the shakes. This shaking can occur in any part of the body as someone goes through alcohol withdrawal, but it’s most commonly seen in the hands.

The reason for alcohol withdrawal tremors or shakes is because alcohol affects areas of the brain that control muscle movement. If someone is experiencing anxiety as they go through alcohol withdrawal, they’re more likely also to experience tremors or shaking. Essentially, this symptom occurs because the brain is flooded with a sense of hyperactivity as it tries to readjust without the effects of alcohol.

In some cases, if a person experiences tremors, these may turn into more serious convulsions or seizures.

After Binge Drinking

Binge drinking is one of the most common alcohol-related situations people engage in in the U.S. According to research, many Americans say they binge drink or drink heavily, even if they wouldn’t necessarily be diagnosed as an alcoholic.

Binge drinking is defined as having five or more drinks within a two-hour period for men. For women, binge drinking is considered having four or more drinks within a two-hour period.

If someone does binge drink, they may experience alcohol withdrawal as the effects start to wear off. However, binge drinking doesn’t necessarily mean you’re dependent on alcohol, so you may instead experience something more similar to a hangover as opposed to withdrawal.

Get Help for Alcohol Withdrawal

Alcohol withdrawal is one of the most dangerous forms of substance withdrawal. The symptoms can range from mild such as headaches and nausea, to severe or deadly. It’s important to go through alcohol detox and withdrawal in a medically managed environment. Contact Amethyst Recovery Center for more information about getting help for alcohol withdrawal and detox.

Sources:

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830167/
• https://www.ncbi.nlm.nih.gov/pubmed/8654316
• https://medlineplus.gov/ency/article/000764.htm
• https://medlineplus.gov/ency/article/000766.htm
• https://emedicine.medscape.com/article/166032-overview
• https://www.nejm.org/doi/full/10.1056/nejmra1407298