Many physiological changes occur when a person stops drinking after a long period of alcohol consumption. Alcohol withdrawal symptoms follow an evidence-based, predictable pattern as follows.
Physiological Effects of Alcohol Withdrawal
The patient stops using alcohol after prolonged heavy use.
- 4 to 8 hours after their last drink, the patient experiences shakes, sweats, chills, and their heart rate and blood pressure are increased, causing severe anxiety
- 12 to 48 hours of the last drink, patients may experience a mild seizure (usually multiple mild seizures over a short period of time)
- 12 to 48 hours after their last drink, the patient may experience a mild seizure (usually multiple seizures over a short period of time)
- 3 to 5 days after their last drink, the patient may experience Delirium Tremens (DTs), which are a particularly nasty (and sometimes fatal) condition characterized by hallucinations, disorientation, tachycardia, hypertension, hyperthermia, and agitation
About 5% of DT cases are fatal. That figure is a lot better than what it used to be, as back in the 20th century before there was widespread knowledge about the serious health risks of alcohol abuse, it’s estimated that over 30% of DT cases were fatal.
Many people want to tough it out and do their detox at home because they’re concerned about treatment costs and/or they’re simply embarrassed. But without professional management, brain cell death can be irreversible, so a professionally supervised alcohol detoxification treatment center is highly recommended.
Neurobiology of Alcohol Use
Large amounts of alcohol consumption can cause blackouts and memory impairment. This is an especially significant problem with college students, as one survey found that 51% woke up after a night of drinking and had trouble remembering what happened the night before, and 40% had done so within the past year.
Alcohol addiction is associated with the dopamine reward system in the pleasure center of the brain – meaning that alcohol consumption is rewarded with dopamine, thus encouraging further drinking. Alcohol addicts literally have to fight what their brain is telling them to do to stop drinking.
Opioid receptors – the same receptors that make heroin as pleasurable and addicting as it is – have an effect as well, as they’ve been shown to respond to alcohol consumption.
During alcohol use, GABA receptor (inhibitory neurotransmitters) activity is enhanced and NMDA receptors (excitatory neurotransmitters) are blocked. This produces an anti-anxiety effect.
An opposite reaction occurs during alcohol cessation, resulting in low activity of GABA and high activity of NMDA, causing high anxiety, shakes, sweats, increased heart rate, high blood pressure, seizures, and DT.
Alcohol cessation also has an effect on amino acids (proteins). Alcohol use inhibits glutamate-induced amino acid excitation and abruptly stopping that alcohol use leads to unregulated excitation.
- There are additional neuroreceptors involved such as serotonin and other neurochemicals in the brain
- High NMDA activity is most likely the cause of brain cell death