Commonly, the friends and family of a person who is drinking large amounts of alcohol tell that person ‘just stop.’ In cases where a person has consumed too much alcohol over time, however, it is not as simple as that. The body can become physically dependent on alcohol and once that is the case, suddenly consuming no alcohol, or even smaller amounts of alcohol than the body is accustomed to, can result in severe withdrawal symptoms and can, in some cases, lead to death.
Many people who drink excessive amounts of alcohol do so to feel relaxed. Alcohol provides this initially by increasing the amount of a neurotransmitter called GABA. GABA creates feelings of calm and euphoria.
Glutamate, which creates excitability, is decreased by alcohol.
When alcohol is used frequently, a tolerance is built up and more and more alcohol is required to achieve the same result i.e. the increase of GABA and reduction of glutamate. The body adapts to these changes and starts producing less GABA and more glutamate.
When alcohol is taken away (the person stops drinking) the body continues to over-produce Glutamate and underproduce GABA. Without the effect of alcohol on these two neurotransmitters, the person’s body becomes over-excited, restless, and shaky. In extreme cases, where alcohol consumption has been extremely high, the symptoms can be very severe and include very high blood pressure, seizures, and, in some cases, death.
Common Alcohol Withdrawal Symptoms
These symptoms can start any time after the last drink up to 72 hours later:
Nausea and vomiting
Increased heart rate
Increased blood pressure
General bodily pain
Loss of appetite (although this may have already been affected by heavy drinking)
Severe Alcohol Withdrawal Symptoms
Often, people talk about having Delirium Tremens (DTs) in humour. For example, people will describe themselves as suffering DTs when they don’t get their coffee early enough in the morning. What they don’t realise is that DTs, or Delirium Tremens is a very serious, life-threatening condition. The symptoms of Delirium Tremens include:
Very high temperature
Dangerously high Blood Pressure
Extreme confusion and agitation
And, in serious cases, death.
Because of the risks of alcohol withdrawal, it is important that a person who is physically dependent on alcohol is not forced to suddenly stop. Sufficient alcohol should be provided to stop the withdrawal symptoms until medical help is in place in the form of a properly supervised alcohol detox.
It is possible to reduce alcohol consumption over time, but it is extremely difficult to do as the body is constantly craving more and, in most cases, this fails.
Medically Supported Alcohol Detox
The most comfortable way to stop drinking, when physically dependent, is to do it using medication. The medications used for this are from the benzodiazepine group of drugs, most commonly chlordiazepoxide (Librium) or diazepam (Valium). Benzodiazepines stimulate GABA Receptors and reduce withdrawal symptoms to a level that is safe and more comfortable.
In many cases, where the situation is medically uncomplicated, this can be done at home, if the patient has a responsible adult who can supervise and ensure that help is sought if any issues occur. The patient should regard themselves as ‘out-of-action’ for a week as it is not recommended that they go out alone, drive a car, operate any machinery, or do anything else that could be risky for a person taking strong doses of medication that affects judgment and level of consciousness (in terms of sedation). Drinking alcohol with benzodiazepines can be dangerous and it is crucial that the patient commits to seeing the detox through to the end.