Overview
Alcohol withdrawal syndrome occurs when a person who has been drinking heavily for a prolonged period suddenly stops or significantly reduces their alcohol intake. The central nervous system, which has adapted to the depressant effects of alcohol, becomes overactive, leading to a range of physical and psychological symptoms. Withdrawal symptoms typically begin within 6 to 24 hours after the last drink and can peak within 24 to 72 hours. In severe cases, alcohol withdrawal can be life-threatening and requires immediate medical attention.
Symptoms
Tremors, anxiety, sweating, seizures. Other common symptoms include nausea, vomiting, headache, insomnia, irritability, and confusion. Severe withdrawal may progress to hallucinations (visual, auditory, or tactile), and delirium tremens (DTs), which is characterised by severe confusion, agitation, fever, and autonomic hyperactivity. Symptoms can range from mild to severe and may fluctuate over time.
Causes
Stopping heavy alcohol use. The primary cause is the abrupt cessation or reduction of alcohol consumption in individuals who are physically dependent on alcohol. Risk factors for severe withdrawal include a history of heavy, prolonged drinking, previous withdrawal episodes, older age, poor nutritional status, and concurrent medical or psychiatric conditions.
Treatment
Medical supervision and medication. Treatment typically involves medical supervision to manage symptoms and prevent complications. Benzodiazepines are the first-line medication to reduce withdrawal symptoms and prevent seizures. Other treatments may include intravenous fluids and electrolytes, nutritional support (especially thiamine and folic acid), and medications to manage hallucinations or agitation. Long-term treatment focuses on rehabilitation, counselling, and support to maintain abstinence.