Drug Withdrawal details

Alcohol

Alcohol is a legal, depressant drug.
It is a liquid produced by fermentation. Further processing produces alcoholic drinks such as beer, wine, cider and spirits.
Pure alcohol has no colour. It has a very strong taste that feels like a burning sensation.

Onset & Duration

Onset

Within 24 hours and up to 48 hours
(depending on Blood Alcohol Level; hours after last drink and level of neuro-adaptation)

Duration

Clinical Features

Anxiety, agitation, sweating, tremor, vomiting, abdominal cramps, diarrhoea, craving, insomnia, elevated blood pressure, pulse and temperature; headache, seizures, confusion, perceptual distortions, disorientation, hallucinations, seizures, delirium tremens, arrhythmias and Wernicke’s encephalopathy
Potential Complications
Seizures - Convulsions, sensory disturbances, loss of consciousness
Hallucinations - Visual or tactile transient hallucinations, paranoia, psychological disturbances, abnormal affect, auditory or visual delusions
Delirium - Agitation, hyperactivity, tremor, confusion and disorientation. Can occur without progressing to delirium tremens
Agitation - Anger, aggression, irritability, violent outbursts
Wernicke-Korsakoff’s Syndrome (WKS) - Cognitive impairments in memory, deficits in abstraction and problem solving, confusion, ocular and gait disturbances, apathy and amnesia
Dehydration - Increasing thirst, dry mouth, weakness or light-headedness, darkening of the urine or decrease in urination
Cardiac arrest and death - can occur in very severe alcohol withdrawal syndrome

Care & Treatment

Diarrhoea

Headaches

Nausea and Vomiting

Metoclopramide (Maxolon)
Prochlorperazine (Stemetil)
Eat small meals and snacks often
Drink plenty of water
If vomiting, stop eating solid food and try small sips of liquid, or sucking an ice cube. Try a small amount of food once you have kept fluids down for a few hours
Rehydration/sports/isotonic drinks such as ‘Powerade'
Avoid citrus and caffeine on an empty stomach

Pronounced agitation or insomnia

Benzodiazepines: Diazepam, Temazepam tablets* (*Risk/benefit analysis required due to propensity for misuse and exacerbation of depressive symptoms)
Reduce coffee, tea, cola and energy drinks during the day and have none after 2 pm
Eat 3 meals a day and avoid heavy, spicy meals late at night
Avoid napping during the day and keep to regular bed and wake times
Exercise regularly (in the day, not after 6 pm)
Use relaxation techniques
Avoid doing things (i.e. tough phone calls) that might upset you before going to sleep
Have a bath in the evening

Stomach cramps

Aches and pains

Cravings

Remove ‘cues’ or reminders of use as these intensify craving.
Keep busy, use distractions
Focus on what is happening at the moment and take each hour and day as it comes. Thinking too far ahead can often be overwhelming and counterproductive.

Sweating