How often have you heard someone say, “I need a drink”? How often has that someone been you? Have you heard it in your office or with friends? Those words are uttered all too often in a variety of contexts. Does that person, let’s call her Jill the banker, really know what it means to need a drink?
It’s safe to say that, in popular culture, alcohol is used to cope with stress, in social situations, at special events and in general as the single most abused substance in the world. Whatever the situation may be, problematic and/or heavy drinkers may exhibit physical symptoms that make the need for alcohol a debilitating reality.
So what about Jill the banker?
If Jill the banker actually feels like she needs a drink, she is likely suffering from an alcohol use disorder. Worse yet, if Jill the banker is dependent on alcohol and then quits, withdrawal symptoms set in, and they are not pretty. If and when Jill the banker quits drinking, she will be at increased risk for the many alcohol withdrawal symptoms that exist, together called alcohol withdrawal syndrome.
Let’s talk a little about alcohol use disorder, AKA alcoholism, and its symptoms, and then let’s talk about alcohol withdrawal symptoms. Then let’s talk about recovering from alcoholism properly.
Alcohol Use Disorder
In 2015, according to the National Institute on Alcohol Abuse and Alcoholism, 15.1 million Americans suffered from Alcohol Use Disorder, with males being more than twice as likely as women to experience distress around alcohol use. There are over fifteen million Jill the bankers… well, approximately 11 million Joe the bankers and 4 million Jills. You could be one.
So how do you know if you suffer from an alcohol use disorder? For one to have an alcohol use disorder, one would experience some or all of the following symptoms:
- Inability to control how much you drink
- Feeling the need to cut back on drinking, or trying to unsuccessfully
- Spending significant time recovering from alcohol use
- Strong urges to drink
- Interruptions at work or at home due to drinking
- Continuing to drink regardless of negative effects
- Losing interest in hobbies or social life due to drinking
- Drinking in unsafe situations, such as driving or watching your child
- High tolerance to alcohol
- Withdrawal symptoms when not drinking
The last bullet point is of interest because many problematic drinkers are not aware of the risk for alcohol withdrawal, which can be scary and even deadly. If you find yourself experiencing any of these symptoms, or especially several of them, please seek professional treatment immediately. Quitting without assistance can be extremely dangerous. The alcohol withdrawal symptoms can be managed with the proper care but can be fatal without it.
Alcohol Withdrawal Symptoms
According to an article published by Dr. Michael A. Rogawski, each year an estimated 2 million Americans experience the symptoms of alcohol withdrawal. The numbers speak for themselves – this is a significant problem across the country. We’re talking an average of 5,480 people every day. That’s almost four people a minute who suffer from these symptoms – and that’s just in the U.S.
Alcohol withdrawal has two general levels of severity: common symptoms and medical emergency. The difference is clear. While any form of alcohol abuse is dangerous, there is a clear line between the college weekend drinker and the homeless drunkard. Anyway, common symptoms of alcohol withdrawal are:
- Mood swings
- Unclear thoughts
Some of these may seem like everyday symptoms that may be experienced from a variety of causes, however, if you or someone you know struggles with alcohol abuse, these symptoms are signs of alcoholism. It is utterly important to pay attention to your body and recognize the difference between these withdrawal symptoms and those that warrant medical intervention. Please seek help if you or someone you love are exhibiting any of the following symptoms:
- Clamminess and/or sweating
- Enlarged pupils
- Appetite loss
- Nausea and/or vomiting
- Increased heartrate
All of that just because of alcohol? Yes. Alcohol is a depressant and it can wreak havoc on the brain and the body. During heavy alcohol use, your brain’s neurotransmitters become accustomed to being bathed in alcohol, and when you suddenly stop turn off the tap your brain goes into overdrive, sending shockwaves through your brain’s neurotransmitters and to your body as well. This results in the aforementioned withdrawal symptoms. Technically, alcohol has been suppressing those neurotransmitters for however long the abuse has been occurring.
So, let’s say Jill the banker feels like she really needs a drink before her brain goes into overdrive. However, after a lengthy conversation with her desk mate, Kathy, about drinking habits and health and whatnot, she decides to quit. How does she do it? At some point you yourself may need to consider how to survive the symptoms and begin a safe journey to recovery.
The Road to Recovery
For those who are experiencing any of the above symptoms of alcohol withdrawal, just know that with care, they will generally improve within a five-day period. However there are some who experience prolonged symptoms, which can last for weeks. Remember, this is just the beginning of the journey.
The Best Alcohol Rehab Centers in the United States
Once you or someone you love has decided to seek help, you/they will need to consider the following. At this point we have already assumed that you/they have sought out a professional team and support network.
- Amount of alcohol consumed
- How long the person has been drinking
- How often the person has been drinking on a regular basis
- Nutritional considerations
- Weight and age
- Was the alcohol combined with other substances
- Does the person have any other co-occurring mental health issues such as depression, eating disorders, etc.
- Family history of alcoholism
These details will help aid any individual and their support team to build an individualized treatment plan and move forward towards a healthy new life.
There are a variety of options when it comes to seeking help. First and foremost, the decision to quit is one of the most important decisions you or someone you love will make in their lives. Develop a plan for long-term support, consult with medical professionals, pay attention to your body and health needs, and be sure to seek support groups after release from a program. There are many options out there once you or someone you love makes the decision to quit drinking.
Detox & Treatment
In the case of moderate to severe symptoms, an inpatient stay may be warranted. Ten percent of patients exhibit severe symptoms. Treatment for severe alcohol withdrawal may include monitoring of blood pressure, body temperature, heart rate, and blood levels of different chemicals in the body. It may also include fluids or medications given by IV and/or sedation until withdrawal is complete. Benzodiazepines have become a popular form of treatment.
With such pharmacological interventions being prevalent for moderate to severe symptoms, you have two possible approaches with benzodiazepines:
- Symptom-triggered approach involves treating with medications when the patient is a high-risk alcoholic.
- Fixed-regimen approach involves doses given at certain time intervals, and additional doses may be given as required based on symptoms. This is by far the more common approach.
Why use Benzodiazepines? They can be used in an outpatient context and are self-administered. As indicated earlier, seizures are possible during alcohol withdrawal and can be managed with proper use. Any other pharmacological treatment should be considered an add-on to meet individual needs such as vitamins for a vitamin deficiency or intravenous drugs for severe symptoms.
In the U.K., an alternative to using Benzodiazepines, Clomethiazole, has been successful in treating alcohol withdrawal but it can only be used in an inpatient setting, for now. More recently, an anticonvulsant, Lamotrigine, has gained traction but more clinical trials are needed in order for the drug to leap into everyday treatment settings.
For the more common and milder symptoms of alcohol withdrawal, the treatment may be more patient driven as the risk of death is much lower therefore something such as a harm reduction model (gradually scaling back drinking) will come into play as the patient has more choices. The most common treatment options for mild symptoms include:
- Sedative drugs to help ease withdrawal symptoms
- Blood tests
- Patient and family counseling to discuss the long-term issue of alcoholism
- Testing and treatment for other medical problems linked to alcohol use
Of those options, the area with the most variables is patient and family counseling as the other 3 options are generally straightforward tests used to obtain objective measures and make diagnostic impressions regarding prognosis. Make no mistake, using all 4 options concurrently is a possibility and sometimes recommended depending on the case.
For more information on treatment centers and resources available to aid you or someone you love in the journey to recover, please read here.
As popular culture depicts, alcoholics cause fights, chase fleeting moments of intimacy, crash cars and eventually alienate themselves from their friends and family. Alcoholics are often more successful with a trained interventionist to assist the family and friends. Those close to an addict can be enabling and can often be clouded by their unconditional love for the abuser.
When available, someone that decides to seek treatment after several mild bouts with alcohol withdrawal symptoms, the involvement of a trained professional(s) is a must to increase health, safety and adherence to alcohol abstinence. Whether it be a medical or psychological approach, no individual should have to do it alone.