Detoxification - alcohol; Detox - alcohol DefinitionAlcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking alcohol. CausesAlcohol withdrawal occurs most often in adults. But it may also occur in teenagers or children. The more often you drink, the more likely you are to have alcohol withdrawal symptoms when you stop drinking. You may have more severe withdrawal symptoms if you have certain other medical problems. SymptomsAlcohol withdrawal symptoms tend to occur within 8 hours after the last drink, but can occur days later. Symptoms tend to peak by 24 to 72 hours, but may go on for weeks. Common symptoms include:
Other symptoms may include:
Delirium tremens is a severe form of alcohol withdrawal. It can cause:
Exams and TestsYour health care provider will perform a physical exam. This may reveal:
Blood and urine tests, including testing for toxins and drugs, may be done. An electrocardiogram (ECG) may also be done. TreatmentThe goals of treatment are to:
INPATIENT TREATMENT People with moderate-to-severe alcohol withdrawal symptoms may need to be treated at a hospital or other facility that treats alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens. Treatment may include:
OUTPATIENT TREATMENT If you have mild-to-moderate alcohol withdrawal symptoms, you can often be treated in an outpatient setting. During this process, you will need someone to stay with you and keep an eye on you. You will likely need to make daily visits to your provider until you are stable. Treatment usually includes:
It is important to go to a living situation that supports you in avoiding unhealthy alcohol use. Some areas have housing options that provide a supportive environment for those trying to stay sober. Total and lifelong avoidance of alcohol (abstinence) is the best treatment for those who have gone through alcohol withdrawal. Support GroupsMore information and support for people with alcohol use disorder and their families can be found at:
Outlook (Prognosis)How well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition. Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver, heart, and nervous system disease. Most people who go through alcohol withdrawal make a full recovery. But, death is possible, especially if delirium tremens occurs. When to Contact a Medical ProfessionalAlcohol withdrawal is a serious condition that may quickly become life-threatening. Call your provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Call for an appointment with your provider if symptoms persist after treatment. Go to the emergency room or call 911 or the local emergency number if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur. If you go to the hospital for another reason, tell the providers if you've been drinking heavily so they can monitor you for symptoms of alcohol withdrawal. PreventionReduce or avoid alcohol. If you have a drinking problem, it is best to stop drinking alcohol completely. Total and lifelong avoidance of alcohol (abstinence) is the safest approach. ReferencesFinnell JT. Alcohol-related disease. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 137. Kelly JF, Renner JA. Alcohol-related disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 26. Mirijello A, D'Angelo C, Ferrulli A, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-365. PMID: 25666543 pubmed.ncbi.nlm.nih.gov/25666543/. O'Connor PG. Alcohol use disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 30. | |
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Review Date: 2/28/2023 Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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