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Disease and Not a Hangover: What Is the Danger of Withdrawal Syndrome?

24.09.2019 Author: Psychologist Pavel Khoroshutin

“My husband has been drinking for 10 years. He used to drink earlier without stopping for a couple of weeks, and then could stay for a month without even a drop of alcohol. He sweared he would stop drinking, we were looking for the ways to fight alcoholism, went to doctors together. But it hasn’t brought any result. After another bottle, he forgot about all given promises.

My husband already for 2 years “has been on the drink”. He was fired from work, since he could no longer hide either the booze breath or the shiver in his hands. He wakes up the next morning after the drinking totally exhausted – he barely can speak, the legs and hands do not move, he has nausea. He convinces me that he cannot stop and give up drinking, because he feels very bad, his body requires alcohol.

A year ago, I tried not to let my husband go out of the house to his alcoholic friends. But everything ended in an ambulance, as he had a high temperature and convulsions began. Diagnosis was a withdrawal syndrome. He stayed in the narcological dispensary for 2 weeks. Doctors suggested his treatment of alcoholism. But he refused and said that he would manage himself. Persuasions didn’t help.

Of course, he wasn’t able to manage himself, a month after narcology he started drinking again. Several times already this year he has been in the hospital under a drip with a post-binge withdrawal syndrome”.

– Elena, 40 

withdrawal symptoms

Many people believe that it is enough only to recruit one’s willpower and say to oneself “no” in order to fight any harmful habit. But in the case of long-term intake of alcoholic beverages, this process is complicated by the development of a withdrawal syndrome. A person after stopping drinking so badly feels that he/she is “drowning” the pain with another portion of alcohol. This can last for a very long time. Both an addict and his/her relatives suffer. In the article we will find out what a withdrawal syndrome is. Why is it dangerous? Is it possible to make the physical and mental condition of a person easier if he/she has an alcohol withdrawal?

Contents:

What is alcohol withdrawal syndrome

hangover

Alcohol withdrawal syndrome is a complex of somatic, neurological and mental disorders that occur in patients with alcoholism after their quitting alcohol. This is the main sign of alcoholism, since painful symptoms against the background of refusal of alcohol-containing drinks occur exclusively at the 2nd and 3rd stages of the disease. Narcologists give patients, who have arrived in the hospital, an accurate diagnosis by the presence or absence of a withdrawal syndrome. [1]

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Alcohol abstinence many be mistakenly called a hangover. This is not a completely correct comparison, because the withdrawal syndrome has more pronounced symptoms, which manifest for a long time. The signs of a hangover are easily removed in just a day, if you observe the drinking regimen, eat correctly and rest more. The duration of a withdrawal syndrome can reach 10-14 days. And many home methods for removing hangovers to ease the state of an addict simply do not work.

What are the risks of withdrawal syndrome for a drinker?

  1. Physical state

All the painful sensations that an alcoholic experiences after abandoning alcohol are caused by a large number of toxins in the body. The severity of symptoms will depend on the stage of alcoholism. 

As a rule, the withdrawal syndrome begins to manifest at the 2nd stage of alcoholism. At this stage, it is characterized by an acute desire to drink to remove the abstinence. An addict again drinks alcohol, feeling that unpleasant symptoms in the form of shivering hands and headache left. It can lead to long drinking periods, which can last for weeks and even months. Alcoholism is progressing. So, it is already very difficult for an addict to abandon alcohol – he/she is physically ill without another drink.

The withdrawal syndrome often occurs with numerous complications at the 3rd stage of alcoholism. The health of an addict is undermined by the long-term use of alcohol, and therefore, the symptoms of abstinence bring strong physical torments. At this stage of the disease it is extremely difficult to say goodbye to the pernicious habit, since in some cases after abandoning alcohol , alcoholic psychosis is observed in addicted people. Alcoholic delirium tremens can develop because of abstinence (jimjams). This is a serious condition that has serious consequences for human health – up to coma and even death.

  1. Emotional state

Alcoholism is not just a physical addiction. A person is tied to alcohol at the psychological level. 

All his/her thoughts during the development of a withdrawal syndrome with the rejection of alcohol are occupied with only one thing – where to get alcohol. He/she ceases to behave adequately and to objectively perceive the situation. An alcoholic is irritable and anxious, has insomnia after refusing alcoholic drinks. He/she can even lose the sense of reality at all if abstinence is accompanied by delirium with hallucinations.

Unstable emotional state during the abstinence is directly reflected on relatives of an addict. Relatives have a hard time, since an alcoholic can show uncontrollable aggression after refusing alcohol, so intolerable for him/her it is to be sober.

  1. Social dimension

There is a general degradation of an addict’s personality during periods of alcohol abstinence. Family relations, friendly and professional ties are being destroyed. An addict cannot work normally, so he/she often doesn’t have a permanent salary and spends all the hard-earned money on alcohol, not caring for the family.

Patients with a withdrawal syndrome are often “breaking bad”. They can commit a crime to get a desired bottle of alcohol, because social responsibility, moral qualities and the instinct of self-preservation in alcoholics eventually refuse to work. This can lead to prison.

Classification of withdrawal syndrome

Specialists classify alcohol withdrawal depending on the symptoms of a patient. This helps the narcologists diagnose the stage of alcoholism, plan therapeutic measures to prevent a patient from drinking and make further treatment of this dependence.

The types of alcohol withdrawal are shown on the table. [1]

Uncomplicated abstinenceUncomplicated withdrawal syndrome lasts up to 5 days. A patient has one or more symptoms at a time. This is a number of somatic, neurological and mental disorders. There is a frequent exacerbation of the existing pathologies of the heart, liver and kidneys already at the 2nd stage of alcoholism during abstinence, which complicates the process of an addict’s rehabilitation. If a person takes a dose of alcohol, the symptoms of abstinence pass away. Therapy is recommended to be carried out exclusively in the hospital under supervision of a narcologist for the prevention of drinking periods and development of alcoholism. Home treatment of alcohol withdrawal cannot give any results and even make it worse.
Abstinence state with seizures    When classic signs of abstinence syndrome are complicated by seizures, an addict needs the urgent help of narcologists.Convulsions occur against the background of acute poisoning of the body with products of the decay of ethanol. The condition is dangerous because a dependant person can be injured during seizures. There were reported cases where seizures caused respiratory stoppage, as patient’s vomiting masses blocked the respiratory tract, but he/she could not even overturn.
Abstinence state with delirium    Alcoholic delirium tremens is an acute psychosis that develops in an addict on the 2nd or 3rd day after giving up alcohol. As a rule, it is characteristic for those addicts who regularly stay in weeks-long binges. A sharp quitting of alcohol consumption causes hallucinations and delirium. And even a portion of alcohol to relieve severe symptoms will not be effective – the condition is critical.Unless therapeutic measures are taken, a patient’s well-being will only deteriorate. It is impossible to treat a withdrawal syndrome with delirium in alcoholics at home!

Causes of alcohol withdrawal

after hangover

“I’ve never been against drinking in a big company at a party. I know well what a hangover is. More water and rest – and all symptoms are reduced.

But now the situation is critical. After the death of my mother 3 years ago, I drink almost constantly. I can go to work with a hangover, and then wait for the evening to drink again. I go on a binge for the weekend. There is a terrible lack of money, so I am not particularly choosy in the selection of alcohol. And if I stop drinking, it becomes so bad that I want to shout – there is pressure, high temperature, nausea with vomiting, numb limbs. It only becomes better in 3-5 days.

I called an ambulance a couple of times after such a drinking period, because I was afraid to die. The doctors said it was not a hangover, but a withdrawal syndrome. Did I become an alcoholic after 3 years of deep drinking? I need to survive the withdrawal syndrome in order to give up drinking, and it’s very hard for me”.

– Ekaterina, 33 

Withdrawal syndrome occurs at that stage of the development of alcoholism, when the products of the decay of ethanol in the concentrations to which the body of a patient is already accustomed, begin to participate in the metabolism. This is physical dependence on alcohol.

As a result of prolonged use of alcohol in the blood, the products of splitting ethanol accumulate. These are toxic substances that adversely affect the operation of internal organs and systems. In a healthy body, enzymes are produced that neutralize toxins. But in alcoholics who drink constantly, the liver no longer copes with such a load. Accordingly, enzymes that derive poisons are not enough.

Usually withdrawal syndrome appears after 5-7 years of uninterruptible drinking after quitting alcohol.  But the symptoms can also show before, if a person begins to drink already in adolescence. According to narcologists, early abstinence is also characteristic of women. The withdrawal syndrome in them can develop after 2-4 years of systematic drinking. [2]

Symptoms of alcohol withdrawal

Alcohol withdrawal syndrome occurs phase by phase in many patients of narcological clinics. It is often impossible to notice and clinically fix the transition of these phases, since some symptoms change very quickly, and can also manifest simultaneously. [3]

How long the withdrawal syndrome will take and how severe its symptoms will become, depends on several factors:

  • stage of alcoholism;
  • health and age;
  • quality of alcohol consumed;
  • duration of alcohol consumption before a sharp abandonment.

Abstinence begins with mild symptoms, which become more pronounced if measures are not taken. The course of the withdrawal syndrome can be represented graphically:

alcohol syndrome
  1. Weak abstinence

An addict has classic symptoms of the syndrome:

  • sharp mood swings and increased anxiety
  • insomnia and nightmares;
  • limb tremor
  • dizziness and headache
  • oral dryness
  • nausea and diarrhea.

If an addict is diagnosed with the 2nd stage of alcoholism, he/she can get rapid and effective relief of weak abstinence syndrome in the hospital. However, doubtful home remedies of elimination from drinking can only aggravate the state of an alcoholic.

Unfortunately, addicts themselves rarely ask for medical care with mild abstinence. They prefer to take another portion of alcohol to remove the withdrawal. Responsibility falls more on the family.

  1. Severe abstinence

Severe alcohol withdrawal symptoms include:

  • sudden increase in body temperature
  • fever;
  • periodic convulsions and hallucinations;
  • severe nausea accompanied by vomiting.

A patient’s condition deteriorates for 3-5 days after giving up alcohol intake. In some cases, there are patients with dehydration caused by persistent vomiting and diarrhea.

Treatment of severe symptoms is complicated by the fact that an alcoholic has a history of chronic diseases of internal organs and systems. As a rule, abstinence with complications is noted at the 3rd stage of alcoholism or at the 2nd stage after especially long drinking.

  1. Alcoholic delirium tremens (jimjams)
delirium tremens

Close ones of an alcoholic will never be able to predict whether weak abstinence will grow into jimjams or everything will be limited to hand tremor and high body temperature. It is important to consult a doctor in time to avoid the worst – alcohol withdrawal with delirium leads to death in some cases. A person doesn’t die from jimjams, but from those chronic diseases that at a critical moment have passed into the acute stage.

It is believed that jimjams occur exclusively at the late stages of alcoholism. But in some cases they develop even in those dependants who drink alcohol for 5-7 years. Everything depends on the general state of health of a particular person and the quality of those alcoholic drinks that he/she constantly drinks.

Jimjams consist of such symptoms:

  • visual and auditory hallucinations;
  • indistinct speech;
  • confused consciousness;
  • aggression;
  • increased anxiety
  • insomnia.

What should not be done with alcohol withdrawal

Alcohol withdrawal is not a normal hangover. This is why many methods aimed at easing the condition of a patient are under strict prohibition.

What exactly should NOT be done at home with withdrawal syndrome? [1]

  1. Taking medications

Any medications with the help of which you want to relieve the physical and mental state of alcohol in abstinence can harm! This applies to all drugs without exception – against headache and nausea, soothing, etc. Almost all of them are contraindicated for stopping signs of alcohol poisoning. 

Medical treatment is performed only after a doctor’s examination.

  1. Visiting Russian sauna and taking hot bath

Many persistently believe in the myth that hot air in a bath or sauna helps remove alcohol toxins from the body, thereby easing a withdrawal syndrome.

For people who rarely drink and are inevitably tortured with thirst and nausea without headache after a noisy party, staying in a lightly heated sauna may prove to be effective. But this kind of “sobering” is completely unsuitable for an addict in abstinence at the 2nd and 3rd stages of alcoholism. His/her condition is already severe, the pressure will surely jump and the heartbeat will increase from hot steam, which will only worsen the withdrawal syndrome after a long drinking period.

  1. Drinking again

The hand of an alcoholic will surely stretch for a glass of alcohol to remove withdrawal symptoms. But this is the risk of another drinking period,  which an addict may not survive.

  1. Fixing a person in horizontal position

People who experience abstinent syndrome often become aggressive. But it is impossible to tie their limbs or tie them to a bed to immobilize them. A person can get a serious self-injury in an attempt to escape.

Treatment of alcohol withdrawal is a fight against alcoholism

Treatment of abstinence syndrome in alcoholism is the prevention of manifested symptoms of various severity.

The therapy takes place in the hospital under the supervision of a narcologist. The main task of a doctor is to remove toxins from a patient’s body, normalize his/her physical and mental state, get to persistent remission aggravated by chronic diseases against the background of alcoholism. Special drugs (tablets, droplets) are prescribed. A person who drinks alcohol in large quantities often does not follow his/her diet at all, so abstinence in some cases is accompanied by avitaminosis. Therefore, a patient is given a course of vitamins together with medicines.

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When the state of a dependant after treatment of withdrawal syndrome is normalized, he/she can be discharged from the hospital. But this is not a victory over the disease. If a person starts to drink again, and then suddenly stops taking alcohol, the abstinent syndrome will again manifest itself. And the harder the withdrawal syndrome was, the more pronounced the signs of abstinence will be.

Only fighting with the cornerstone, which caused abstinence syndrome – alcoholism – will be effective. If you start treatment at the 1st and 2nd stages of the disease, you can avoid rapid progression of abstinence against the background of alcohol consumption.

Treatment of alcoholism is not only normalization of physical condition after a drinking period and a therapy of chronic diseases. Psychotherapy is important, because all harmful habits cause psychological dependence, which is even more difficult to get rid of than physical.

An alcoholic, even at critical stages of the disease, may not recognize the existing problems. Therefore, the relatives of an addict must convince him/her to start immediate treatment.

Bad habits are mostly unhealthy behavior and negative attitudes. Excellent effectiveness is shown by behavioral methods of psychotherapy in the fight against many dependencies. One of these methods is the 7Spsy behavior modification technique . This is a patented course based on the theories of I.P Pavlov, B. F. Skinner, A.A. Ukhtomsky.

The training will help a dependant on the 1st and 2nd stages of alcoholism to say firm “no” to addiction. Having mastered a healthy pattern of behavior, a person will learn to live without alcohol, receiving pleasure and rejoicing every day. Positive settings will allow an addict to find more rational ways to fight stress and complexes than alcohol. He/she will realize which great opportunities can a sober way of life give – peaceful family relations, successes in career, interesting leisure.

The 7Spsy behavior modification technique course is applied for the treatment of the 1st and 2nd stages of alcoholism and designed for a period of up to 6 weeks. Consultations with the psychologist are held in a convenient remote mode and remain strictly confidential. If it is difficult for a person to admit to the fight against addiction, he/she may not tell anyone about the course of psychotherapy. The specialist gives all necessary recommendations and answers to questions by e-mail, in chat rooms and by phone.

References:

  1. «Rukovodstvo po skoroj medicinskoj pomoshchi. Dlya vrachej i fel’dsherov», 2017 g., A. Vertkin, K. A. Sveshnikov i dr.
  2. «Spravochnik po lecheniyu zavisimostej», 2008 g., M. P. Bykov.
  3. «Klinika alkogolizma», 1981 g., A. A. Portnov.