Alcohol Withdrawal: When To Seek Hospital Treatment

Alcohol withdrawal can be a dangerous process that may require immediate medical intervention, depending on the severity of the symptoms. Symptoms can be mild, moderate, or severe, and they can start as early as 2 hours after the last drink, though they usually begin within 6 to 24 hours. Mild symptoms include nausea, vomiting, sweating, and shakiness. Moderate symptoms include anxiety, nervousness, upset stomach, and increased blood pressure. Severe symptoms include seizures, delirium tremens, and hallucinations. Severe alcohol withdrawal may require treatment in a hospital, sometimes in the ICU, and can even result in death. Therefore, it is important to seek medical help and guidance from a healthcare provider to ensure safety and comfort during the withdrawal process.

Alcohol withdrawal symptoms

• Anxiety, nervousness, or irritability
• Excessive sweating
• Upset stomach or nausea and vomiting
• Heart palpitations or increased heart rate
• High blood pressure or hypertension
• High body temperature or fever
• Tremors or "the shakes"
• Hallucinations
• Seizures
• Delirium tremens (DTs)
• Confusion
• Agitation or violence
• Trouble sleeping
• Vivid dreams
• Rapid changes in mood
• Fatigue

The severity of alcohol withdrawal symptoms depends on several factors, including the amount of alcohol consumed, the length of time the person has been drinking, and any existing organ damage. For heavy drinkers, withdrawal symptoms may begin as early as two hours after their last drink.

If you or someone you know is experiencing alcohol withdrawal, it is important to seek medical help, especially if symptoms are severe or persistent. Do not attempt to detox at home without medical supervision, as alcohol withdrawal can be life-threatening. Call 911 or your local emergency number if you experience seizures, severe confusion, hallucinations, irregular heartbeats, loss of consciousness, severe agitation, or any other concerning symptoms.

Your healthcare provider may recommend inpatient or outpatient treatment, depending on the severity of your symptoms. Treatment may include medications such as benzodiazepines and therapy to address alcohol use disorder. It is important to remove all alcohol from your home before beginning the detox process and to have a support system in place, such as friends or family members who can stay with you during this time.

When to go to the hospital

It is important to get medical help even if you have mild symptoms of alcohol withdrawal, as it is difficult to predict how much worse they may become. Mild symptoms include nausea, vomiting, sweating, shakiness, mild anxiety, insomnia, and upset stomach. Severe symptoms include seizures, confusion, irritability, hallucinations, trembling, and delirium tremens.

If you are experiencing any of the following symptoms, you should go to the hospital or call an emergency service:

• Seizures
• Fever
• Severe confusion
• Hallucinations
• Irregular heartbeats
• Passing out (losing consciousness)
• Violent behaviour
• Severe abdominal pain
• Vomiting blood or what looks like coffee grounds
• Trouble breathing

If you are a heavy drinker, it is recommended that you seek medical help when going through alcohol withdrawal. Alcohol withdrawal can be life-threatening, and severe and complicated withdrawal may require treatment in a hospital, sometimes in the ICU. Long-standing heavy drinkers can have bad symptoms, which may lead to seizures and can be deadly if not treated immediately.

Before you stop drinking, it is important to talk to your doctor about your detox plan. Your doctor will determine whether you need to detox in a supervised medical centre. If you decide to detox at home, ensure that you have round-the-clock supervision and that someone you trust is with you as much as possible.

Treatment options

If you are experiencing alcohol withdrawal, it is important to seek medical help. Mild symptoms of alcohol withdrawal can progress into more severe and dangerous symptoms.

For mild cases of alcohol withdrawal, a supportive environment may be enough to aid recovery. This could include rest and support from friends, family, or a supportive housing programme.

Moderate cases of alcohol withdrawal may require short-term medication to lessen symptoms and make the patient more comfortable. This could include anti-seizure drugs such as gabapentin and carbamazepine, which can help reduce cravings and improve sleep and mood. Beta-blockers can also be used to help restore a healthy heart rate and blood pressure.

Severe cases of alcohol withdrawal may require hospitalisation, sometimes in the ICU, and can result in lengthy stays. Benzodiazepines are the drugs of choice for pharmacological treatment of severe alcohol withdrawal, and are typically administered intravenously. Chlordiazepoxide (Librium) is often prescribed, and patients are continuously monitored to ensure they do not develop life-threatening complications.

If you are experiencing alcohol withdrawal, it is important to contact your healthcare provider or go to the emergency room, especially if you have recently stopped drinking after a period of heavy alcohol consumption. SAMHSA's National Helpline is a free, confidential, 24/7 referral and information service for individuals and families facing mental and/or substance use disorders.

Detoxification

Alcohol detoxification, or detox, is the process of clearing alcohol from your body. It is important to understand that alcohol withdrawal can be life-threatening, and it is recommended to seek medical help.

If you are a heavy drinker and stop drinking, you may experience alcohol withdrawal symptoms within 6 to 24 hours of your last drink, although symptoms can appear up to several days later. Symptoms can be mild, moderate, or severe, and typically include anxiety, nervousness, irritability, sweating, upset stomach, heart palpitations, increased blood pressure, high body temperature, and tremors.

Mild symptoms can often be treated at home, but it is important to have a caregiver to help you and stay in close contact with a healthcare provider. They may prescribe sedatives and other medications to ease symptoms. However, severe alcohol withdrawal symptoms, such as seizures, fever, severe confusion, hallucinations, or irregular heartbeats, require immediate medical attention, and you should go to the nearest emergency room or call for emergency services.

Delirium tremens (DTs) is a severe form of alcohol withdrawal that can be life-threatening, with 5-10% of cases resulting in death. It involves sudden and severe mental or nervous system changes and can cause intense agitation, violence, and hallucinations. If you or someone you know is experiencing symptoms of delirium tremens, seek immediate medical care.

To prepare for detoxification, it is recommended to remove all alcohol from your home and seek support from friends and family. Joining support groups such as Alcoholics Anonymous can also be beneficial. It is crucial to be honest with your doctor about your alcohol consumption and any other relevant factors, as they can determine whether you need to detox in a supervised medical centre.

If you or someone you know is experiencing thoughts of suicide, self-harm, or any other type of emotional distress, there are crisis hotlines and text lines available to provide immediate support.

Prevention and support

Alcohol withdrawal can be a difficult process, and it is important to seek professional help if you are experiencing any symptoms of withdrawal. While mild symptoms can be managed at home, it is crucial to have a caregiver to support you and monitor your condition. Severe alcohol withdrawal can be life-threatening and requires immediate medical attention. Here are some important considerations for prevention and support during alcohol withdrawal:

• Prevention: The best way to prevent alcohol withdrawal is to avoid alcohol altogether. If you think you may be developing an alcohol use disorder, seek professional help as soon as possible. Alcohol rehab and treatment programs can provide valuable support and increase your chances of successful recovery.
• Medical Assessment: Before you stop drinking, consult your doctor or a healthcare provider. They will assess your drinking history, withdrawal symptoms, and any co-occurring disorders to determine the best detox plan for you. Be honest about your alcohol consumption and any other relevant factors.
• Inpatient vs Outpatient Treatment: Depending on the severity of your symptoms and other factors, your doctor may recommend inpatient or outpatient treatment. Inpatient treatment involves staying in a hospital or treatment centre, especially if severe withdrawal symptoms are expected. Outpatient treatment allows you to detox at home with proper medical supervision and regular visits or check-ins from a healthcare provider.
• Medications: Your healthcare provider may prescribe sedating medications to help control withdrawal symptoms. They may also provide additional medicines to alleviate specific symptoms such as headaches, nausea, or anxiety. It is important to take all medications as prescribed.
• Monitoring and Emergency Care: During alcohol withdrawal, it is crucial to monitor your vital signs, including blood pressure, body temperature, heart rate, and breathing. If you or the person you are caring for experiences seizures, fever, severe confusion, hallucinations, irregular heartbeats, loss of consciousness, or violent behaviour, seek immediate medical care.
• Support Groups: Consider joining support groups such as Alcoholics Anonymous or similar organizations. Sharing your experiences with others going through similar challenges can provide valuable emotional support and help you feel less alone in your journey.
• Emergency Resources: Keep a list of emergency contacts and resources, including your doctor, the nearest hospital, and emergency services. If you or someone you know expresses thoughts of suicide, self-harm, or experiences a mental health crisis, do not hesitate to reach out for help. Hotlines such as the Suicide and Crisis Lifeline (988 or 1-800-273-8255) and the Crisis Text Line (text HOME to 741741) are available 24/7 to provide support.

Remember, alcohol withdrawal can be unpredictable, and it is always better to seek professional guidance and support rather than attempting to manage severe withdrawal symptoms without medical supervision.

Frequently asked questions