Alcohol Withdrawal: How Can Friends and Family Help?

Alcohol use disorder (AUD) is a chronic disease that changes the brain’s structure and functioning. Someone struggling with alcohol addiction likely will develop a physical dependence on the intoxicant since alcohol binds to brain receptors to manage some neurotransmitters. Without drinking regularly, the person may feel sick, depressed, exhausted, anxious, restless, or experience other withdrawal symptoms that lead them to believe they need to drink to feel normal.

One sign that someone struggles with an addiction to alcohol, and does not just drink for recreational reasons, is they try to quit repeatedly, or they often think or talk about quitting but can’t. If they try to quit without support from addiction specialists, friends, and family, the person is much more likely to relapse back into alcohol abuse because withdrawal symptoms can be very uncomfortable. In some instances, alcohol withdrawal can be deadly.

If you are concerned about someone’s alcohol consumption and behaviors around drinking, you should absolutely say something.

Withdrawal Symptoms: Uncomfortable to Life-Threatening

Some symptoms of alcohol withdrawal are more common than others. They include:

  • Nervousness
  • Anxiety
  • Fatigue or tiredness
  • Irritability
  • Mood swings
  • Jumpiness
  • Physical shaking
  • Nightmares and other sleep disturbances
  • Trouble thinking clearly
  • Difficulty remembering things
  • Cravings

Other symptoms, such as the ones listed below, are uncomfortable. Those are:

  • Sweating
  • Clammy skin
  • Dilated pupils
  • Headaches
  • Insomnia
  • Appetite loss
  • Nausea, vomiting, and stomach cramps
  • Pallor, or pale skin or complexion
  • Rapid heartbeat
  • Tremors in the hands and feet

These symptoms begin a few hours after the final drink and usually peak within one to three days. They are generally gone within a week.

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  • The more intense symptoms, including physical symptoms, may lead to alcohol withdrawal syndrome (AWS), which can prolong the withdrawal experience for another week or two.

    At their most severe, alcohol withdrawal symptoms can become a condition called delirium tremens (DTs), which includes serious symptoms such as:

    • Delirium, or sudden and severe confusion
    • Full body tremors
    • Changes to mental function
    • Extreme agitation and irritability
    • Falling asleep for a full day or more
    • Intense excitement and fear
    • Bursts of energy
    • Rapid mood changes
    • Sensitivity to sensory input like light or sound
    • Paranoia
    • Hallucinations
    • Fever
    • Chest pain
    • Stomach pain
    • Seizures

    DTs typically only sets in among people who drink large amounts of alcohol, and who have tried repeatedly to quit drinking and failed.

    High levels of daily alcohol consumption can lead to DTs.

    • 4 to 5 pints, or 1.8 to 2.4 liters, of wine
    • 7 to 8 pints, or 3.3 to 3.8 liters, of beer
    • 1 pint, or 0.5 liters, of hard alcohol

    If someone consumes this amount of alcohol every day for several months, they are at risk of developing DTs. If the person has abused alcohol for more than 10 years, they also are at risk of DTs.

    How to Help Someone Who Needs to Detox from Alcohol Abuse

    If you are concerned about someone’s alcohol consumption and behaviors around drinking, you should absolutely say something. Alcohol addiction is likely to get worse, not better, without professional treatment. Showing that you are concerned and want to support your loved one can help them find the strength to get help.

    It is also important to know that they should not detox at home even if you are there to support them. Because withdrawing from any drug, including alcohol, can be uncomfortable, trying to detox without help from addiction specialists can lead to relapse, or a return to drinking. This may cause the person to drink more alcohol than before, and that can increase AUD symptoms.

    When you help a loved one understand the need for alcohol treatment, including the need to professionally manage withdrawal symptoms, encourage them to get supervision through an appropriate professional detox program. This may require going to a physician for a diagnosis, a therapist for an assessment, or finding a detox program and asking for help.

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    You may consider staging an intervention. It is important to create an intervention that clearly expresses concern for your loved one, sets clear boundaries, and supports their efforts to get help. An intervention is a way for friends and family to express concern, allow health care professionals to discuss the signs of addiction and its harms, and present the consequences of the person’s actions if they do not seek and follow through with treatment.

    Follow these steps to create a successful intervention.

    This may start with reading information on how to create an intervention or consulting a doctor, therapist, or intervention specialist to create an outline of the intervention. This outline will include information such as where the meeting will be held, and when. Planning also involves making a list of who should be at the intervention, such as friends, coworkers, or spiritual leaders, and what treatment resources are available to help your loved one.

    Once you have created a plan, inform the people you wish to be at the intervention. It is crucial that they prepare what they want to say ahead of time and avoid blaming the person for harm caused by behaviors they were responsible for while under the influence.

    Make sure the intervention team is available to be present at the intervention and hold them to it. Send reminders and mark calendars as needed. Make sure it is at a location and a time when your loved one is most likely to be sober.

    Stick to your written statements about concern for your loved one, offer to help them get treatment, and establish boundaries and consequences if they refuse treatment.

    Research treatment options that best suit your loved one before the intervention starts. During the intervention meeting, show them the information and let them know how they can get in, if they are on a waiting list, and how you will support them through this effort. Treatment starts with a detox from alcohol, and that requires around-the-clock medical supervision. A therapist or professional interventionist may be useful here to help the person understand what the detox and recovery process entails.

    After the intervention, whether your loved one agrees to treatment or not, follow up to let them know you care about their well-being. Do not push them if they reject treatment, but if they push the boundaries you have set, stay firm. If they have agreed to treatment, make sure you follow up on the support you offered.

    Managing Alcohol Use Disorder Treatment

    An assessment from a physician or clinician can help you determine if your loved one struggles with AUD. A doctor or therapist also can refer you to detox programs that will suit your needs well.

    If you need further help finding detox treatment programs that are based in medical research, the Substance Abuse and Mental Health Services Administration (SAMHSA) has an online treatment finder and hotline to help you find local options.

    In addition, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has a treatment locator online that is focused on care for alcohol abuse and addiction.

    References

    (July 11, 2018) Alcohol Use Disorder. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243

    (January 14, 2017) Alcohol Withdrawal. Medline Plus. Retrieved from https://medlineplus.gov/ency/article/000764.htm

    (April 23, 2018) Alcohol Withdrawal Syndrome. Healthline. Retrieved from https://www.healthline.com/health/alcoholism/withdrawal

    (January 14, 2017) Delirium Tremens. Medline Plus. Retrieved from https://medlineplus.gov/ency/article/000766.htm

    (June 15, 2016) Staging an Intervention for an Alcoholic. Healthline. Retrieved from https://www.healthline.com/health/alcohol-addiction-intervention#process