Alcohol withdrawal delirium is a serious condition affecting heavy drinkers trying to quit drinking. This condition of withdrawal must be treated in a clinical setting to avoid serious complications or death. Alcohol withdrawal delirium affects nearly half of all individuals who struggle with drinking too much.
Today’s blog discusses alcohol withdrawal delirium, which can cause hallucinations and a host of other serious issues that require medical treatment.
Keep reading to learn everything you need to know about alcohol withdrawal delirium.
What is Alcohol Withdrawal Delirium?
Alcohol withdrawal delirium (AWD) impacts your brain and nervous system when you suddenly quit drinking. Its effects are so severe because of the body’s dependence on alcohol. Suddenly eliminating the alcohol creates withdrawal symptoms.
Of the 50% of people who experience alcohol addiction, around three to five percent will have grand mal seizures and severe confusion if they suddenly stop drinking.
What Causes Alcohol Withdrawal Delirium?
Enjoying a drink or two during a night out with friends will not lead to AWD, so don’t worry if that’s in your plans! AWD only occurs in individuals who drink heavily.
Heavy drinking in women is four or more drinks in one sitting or eight or more drinks in one week. In men, it’s 15 drinks per week or five or more drinks in one sitting.
What’s the equivalent of one drink?
- 1.5 ounces of distilled spirits or liquor, which includes gin, rum, vodka, or whiskey
- 5 ounces of wine
- 8 ounces of malt liquor
- 12 ounces of beer
So, drinking 20 ounces of wine in one sitting would make you a heavy drinker if you’re a woman. Sixty ounces of beer in one sitting would be considered heavy drinking for a man.
Even if you’re a heavy drinker, AWD isn’t guaranteed. One or more of the following usually triggers it:
- If you suddenly stop drinking
- If you vastly reduce how much alcohol you drink
- If you don’t eat enough while cutting down on alcohol
- If you suffer a head injury
- If you’re sick
So, how do those actions cause AWD? It happens when the nervous system is overly excited and irritated from lack of alcohol because it’s become so dependent on it to stay calm.
Alcohol also affects the neurotransmitters in your brain. Those neurotransmitters communicate with the rest of your body, sending signals and providing direction to allow the body to function properly.
That’s why many people drink alcohol. Inhibiting neurotransmitters can help you relax and forget your worries for a little while. If you suddenly stop drinking, you’ll send your brain into a dangerous state of overexcitement. The neurotransmitters go crazy from not being inhibited.
Who Is At Risk for Alcohol Withdrawal Delirium?
Anyone can experience AWD, but you’re especially at risk if the following apply to you:
- If you’ve been drinking heavily for a prolonged period
- If you have a history of alcohol withdrawal
- If you’ve had AWD before
- If you have underlying health conditions
- If you’ve suffered brain damage or have a seizure disorder
Anyone who drinks heavily is at risk of AWD. Everyone experiences AWD differently, but there are universal symptoms.
Symptoms of Alcohol Withdrawal Delirium
There are a ton of symptoms associated with AWD:
- Becoming easily agitated or irritated
- Feeling anxious
- Having chest pain
- Feeling confused
- Experiencing delirium
- Having delusions
- Sweating excessively
- Feeling abnormally excited
- Trouble moving your eyes or muscles
- Feeling tired
- Running a fever
- Experiencing hallucinations
- Having an increased heart or breathing rate
- Feeling easily startled
- Having involuntary muscle contractions
- Feeling nauseous
- Having nightmares
- Being restless
- Suffering a seizure
- Having sensitivity to light, sound, or touch
- Feeling sudden stomach pain
- Having a sudden mood change
If you aren’t feeling well, it’s a good idea to go to the doctor. Seek medical help immediately if you have chest pain, feel confused, are delirious, or are experiencing hallucinations, etc. Serious symptoms require immediate treatment.
Timeline for Alcohol Withdrawal
If you’re going to experience AWD, it will happen pretty quickly. There are four stages of alcohol withdrawal. You’re most likely to experience delirium after six hours of not drinking but within one day.
Stage 1: Six to 12 Hours Without A Drink
This first stage of alcohol withdrawal comes with minor symptoms that shouldn’t be too concerning, although there are exceptions.
You might experience:
- Loss of appetite
- Increased or irregular heart rate
Stage 2: 12 to 24 Hours Without A Drink
If you hallucinate, it will most likely happen during this period. Your hallucinations could be tactile, meaning you feel things that aren’t occurring. You might feel itching, burning, or numbness when nothing is causing you to feel that way.
You could experience auditory hallucinations, where you hear things that aren’t there. Finally, you could experience visual hallucinations, where you see things that aren’t there.
While hallucinations can last longer, they don’t usually last for more than two days during alcohol withdrawal.
Stage 3: 24 to 48 Hours Without A Drink
You’re most likely to suffer from a seizure during this time frame. Note that you could have a seizure, especially if you have a history of seizures, but there’s no guarantee you will.
Stage 4: 48 to 72 Hours Without A Drink
Alcohol withdrawal delirium will set in during this time frame. The worst of your symptoms should start to become alleviated after the first five days. You’ll start feeling better after the first week.
Diagnosis of Alcohol Withdrawal Delirium
Are you worried you may be experiencing AWD? Seek medical help right away. If you don’t have someone who can take you to the hospital, you may want to call 911.
Once you’re under a doctor’s care, explain how you feel. They’ll monitor you for hand tremors, an irregular heart rate, dehydration, or a fever. Your doctor might also run a toxicology screen to determine how much alcohol is in your body. This can help the doctor determine the best course of treatment.
Your doctor might order tests for blood magnesium levels, blood phosphate levels, a comprehensive metabolic panel, ECG, and EEG.
Diagnosis might also include the CIWA-Ar, a series of questions from the Clinical Institute Withdrawal Assessment of Alcohol Scale. Your doctor will look for the following 10 symptoms:
- Auditory disturbances
- Cloudy thinking
- Uncontrollable sweating
- Tactile disturbances
- Visual disturbances
Your doctor might ask questions like, “Who am I?” “What day is it?” “Are you sick to your stomach?” “Do you feel like bugs are crawling under your skin?” or “Do you feel like you have a band around your head?”
This helps the doctor determine the severity of your AWD and how to best treat it.
Treating Alcohol Withdrawal Delirium
So, how does a doctor treat AWD? Is there a level of relief they can provide?
These are the ways AWD is treated:
- IV fluids
- Antipsychotic medications
- Medication for fever or body aches
- Treatment for other conditions related to alcoholism
AWD is a life-threatening condition that your doctor will take seriously. They will encourage you to seek rehabilitation to fully recover, not only from your AWD but also from alcoholism. The doctor will likely provide you with treatment options and offer referrals.
Complications of Alcohol Withdrawal Delirium
It’s possible to develop severe complications from AWD, which is why seeking medical care is so important. You could develop one of the following conditions:
- Alcohol-related liver disease
- Alcoholic cardiomyopathy, which is related to heart failure
- Alcoholic neuropathy, which affects your nerves
- Wernicke-Korsakoff syndrome, a brain disorder that involves permanent memory loss
In addition to these conditions, you could injure yourself by having a seizure, hurt someone else if you get confused, or develop an irregular heartbeat.
The sooner you seek medical help, the better. Not only can treatment help you get through AWD without drinking, but you’ll have a lower risk of developing a complication.
Preventing Alcohol Withdrawal Delirium
The best way to prevent AWD is to drink in moderation, if you drink at all. If you drink and are unsure if you’re drinking too much, talk to your doctor before trying to quit. Your doctor can help you stop drinking safely.
If you’re severely addicted to alcohol, it’s best to go to a treatment center where they can monitor you. The faster you receive treatment, the better your chances are of a full recovery.
Ardu Recovery Center Can Help
If you or someone you love is addicted to alcohol and needs help, contact Ardu Recovery Center. We have everything you need to help you recover from alcoholism, including a safe place to detox.
Located in northern Utah, Ardu Recovery Center offers inpatient, day, and intensive outpatient treatment for all types of addiction, including alcohol. Contact us today to get started.