Withdrawing from alcohol, whether from a night of binge drinking or a longtime addiction, often results in the human body rebelling in various ways. Excessive alcohol intake and long-term alcohol use affect nearly every system in the body. The effects, both psychological and physiological, can range from short-term to long-term and mild to severe. No matter the form of alcohol abuse, the substance can alter brain chemistry, creating dependence. The more one binge drinks or continues to consume regularly, the greater the risk of developing an addiction or alcohol use disorder. Fortunately, Compass Detox can guide individuals through learning to recognize the symptoms of alcohol abuse and how to find the right support to heal.
Hangover Symptoms vs. Severe Withdrawal Symptoms
Many people have experienced the stereotypical hangover. After a night of excessive drinking, the body makes its displeasure known. These symptoms often appear the next morning but can start the same night as the alcohol intake. A hangover can be felt throughout the whole body with a general sense of fatigue, aches and pains, headache, dizziness, light and sound sensitivity, and a myriad of gastrointestinal problems. More than anything, the body needs time to rid itself of the alcohol and to re-hydrate. In cases of extremely excessive alcohol consumption, medical attention and intervention may be required.
For an individual who has been drinking more regularly over an extended period of time, the body’s response to the abrupt elimination of alcohol will be more pronounced and will often require medical attention. This more pronounced reaction is due to the body’s dependence on alcohol’s interference within the body and its systems. Continued alcohol intake results in the body adapting to its presence, developing tolerance, and eventually dependence.
Understanding Alcohol Withdrawal Syndrome (AWS)
Under these circumstances, the body responds with a collection of symptoms commonly referred to as Alcohol Withdrawal Syndrome (AWS). AWS has symptoms that are a mixture of physical and emotional effects. The severity of the symptoms is tied to the length of time the person has been drinking alcohol regularly, the amount of alcohol usually consumed, the individual’s general health, and any other substances taken with the alcohol. Combined alcohol and drug use will typically result in more severe symptoms. Symptoms will typically appear within 4-6 hours of the last alcoholic drink and often peak 24-48 hours since that drink. These symptoms may include tremors, anxiety, hallucinations, nausea, and seizures.
Physician offices and hospitals use the Clinical Institute Withdrawal Assessment of Alcohol (CIWA-Ar) to assess the severity of withdrawal symptoms so that treatment can be prescribed accordingly. A copy of this form is available online and may help evaluate symptoms when deciding whether to be seen by a doctor. The CIWA-Ar requires the doctor or clinician completing the assessment to rate the patient’s symptoms in the following areas:
- Nausea and vomiting
- Tactile disturbances
- Auditory disturbances
- Paroxysmal sweats
- Visual disturbances
- Headache, fullness in the head
- Agitation, and
- Orientation and clouding of sensorium.
How Alcohol Withdrawal Causes Nausea
Alcohol withdrawal does cause nausea. Nausea and vomiting are not limited to severe cases of AWS. Both mild and severe cases of AWS display nausea as a symptom. The mildest cases may not exhibit any nausea, but the most severe cases will often exhibit constant dry heaving. When evaluating AWS using the CIWA-Ar, the doctor or nurse must rate the symptom on a scale from 0, representing “no nausea and no vomiting,” to 7, representing “constant nausea, frequent dry heaves, and vomiting.”
Mild nausea can often be treated at home in the same way that nausea from any cause would be treated. Over-the-counter medications such as bismuth subsalicylate (Pepto-Bismol or Kaopectate) or antihistamines containing dimenhydrinate (Dramamine) or meclizine hydrochloride (Dramamine Less Drowsy). Hydration is a key component of treating nausea, but drinking water may not be enough. Vomiting and/or diarrhea can lead to an imbalance in electrolytes such as potassium, leading to bigger problems. Drinking items such as Pedialyte, Gatorade, Powerade, or Coconut Water will contribute to re-hydration while also replenishing electrolytes. A bland diet can also help; it’s time to think BRAT (banana, rice, applesauce, and toast) until nausea has passed. Finally, there is some evidence that acupuncture can reduce nausea, and a quick online search will bring up a quick demonstration.
It is important to treat nausea associated with alcohol withdrawal as, left untreated, vomiting can result in more serious complications. If vomiting lasts more than one day, the individual develops a fever of greater than 102 degrees Fahrenheit, or there are other signs of dehydration, at-home treatment might not be working. Signs of dehydration include rapid breathing, increased heart rate or palpitations, lethargy, confusion, severe abdominal pain, or a severe headache. Any blood in the vomit, which may appear as if there are coffee grounds in the vomit, requires more immediate medical attention.
Finding the Right Alcohol Addiction Treatment
If at-home treatment fails or symptoms worsen more quickly medical intervention, either through a physician’s office, urgent care, or the emergency room, may be required. A physician will prescribe medication such as benzodiazepines (Valium, Ativan), anticonvulsants (Tegretol), and more to better manage the withdrawal process and reduce the risk for further complications.
Whether the management of the withdrawal happens at home or in a hospital will likely be related to both the severity of the symptoms, the individual’s overall health, and the presence of a support system for the individual. Because the symptoms can progress, the individual must have a support system to help manage the symptoms and continue abstinence from alcohol. Often those experiencing AWS are not in optimum health. Regular alcohol consumption can lead to nutritional deficiencies and chronic medical conditions. The individual’s health status will impact the ability of the individual to manage the symptoms at home.
Our Addiction Treatment Programs
Treatment for AWS is focused on managing the symptoms to prevent further health complications, including seizures, delirium tremens (DTs), and death. These more severe withdrawal complications are not as common as some of the less severe symptoms. However, failure to successfully manage AWS or repeated cases of AWS in the same individual greatly increases the risk. Additionally, successful management of the symptoms associated with AWS enables the individual to focus on creating and maintaining an alcohol-free lifestyle. This change will require additional treatment that is more focused on the psychological and emotional aspects of remaining alcohol-free on a long-term basis.
At Compas Detox, we have designed several addiction treatment programs to correspond to the degree of dependency an individual experiences. Our programs include:
- Inpatient treatment
- Intensive outpatient program
- Partial hospitalization program
- Transitional living
- Aftercare treatment
Across all these programs, we offer a unique variety of therapies to address the specific needs of each person, such as:
- Acceptance and Commitment Therapy (ACT)
- Contingency management
- CRAFT (Community Reinforcement and Family Training)
- Dialectical behavior therapy
- Cognitive-behavioral therapy
- Family Therapy
- Group Therapy
Thus, no matter what your needs are, our team at Compass Detox can help.