What is alcohol withdrawal?
Alcohol withdrawal is a change in the central nervous system after stopping drinking alcohol abruptly. Alcohol withdrawal occurs in people who drink alcohol continually for a long time. This change in the central nervous system results in symptoms that make the drinkers tormented. The longer time they stop drinking alcohol, the more suffering they will get from stopping drinking.
Timeline of the effect of alcohol withdrawal
Stage 1: After drinking for 6-8 hours
These are the symptoms of patients in this stage.
- Their nervous system is awake, especially the sympathetic nervous system.
- Their blood pressure is high.
- They have nausea and vomiting.
- They are moody, anxious, and hypervigilant.
- There is an appearance of high temperature on their face.
- Their hearts beat rapidly.
- They have mydriasis.
- They have so much sweat.
- They have a tremor.
Stage 2: After drinking for 8-12 hours
These are the symptoms of patients in this stage.
- They hallucinate.
- In patients whose symptoms are not severe, their perception is only abnormality. They will hear the sound more loudly than average. They will see the picture more brightly than usual.
- In patients whose symptoms are severe, there are hallucinations in seeing, hearing, and touching through the skin. They always see the image as an animal. They hear the sound that has meaning or does not have meaning. They feel that many insects are moving around their body.
Stage 3: After drinking for 12-24 hours
In this stage, the patients have seizures in the category of Grand mal seizures. This category of seizure was previously named Rum Fits. The chance of seizures after the time passes for 6-12 hours is 25 per cent. Only 3 per cent of drinkers will have status epilepmaticus, which is a symptom of continual seizure. These are the factors that cause the drinkers to have seizures:
- History of seizures from alcohol withdrawal
- History of alcohol withdrawal for many times
- Condition of lacking antidepressant and sleeping pills
After having a seizure, there is a high risk of drinkers having delirium tremens.
Stage 4: After drinking for 72-96 hours
After stage 3, the result of the symptoms depends on the severity of the symptoms that happen in each person.
Commonly, In the person whose symptoms are not severe, the most suffering they will receive will happen after stopping drinking for 24-36 hours. After that, they will continue to be healthier. However, after 24-36 hours, the body of the drinker is not recovered, and the symptoms are more acute. It causes the drinkers to have delirium tremens, which usually occurs between 72-96 hours after stopping drinking alcohol. The symptoms will probably be with you for 2-3 days. The factors that cause delirium tremens include a history of delirium tremens, seizure, old age, and degree of alcohol in blood for more than 300% mg during the time of alcohol withdrawal.
The symptoms usually happening in this stage include:
- Overalertness of the autonomic nervous system, such as rapid heartbeat, shaking hands, sweating, fever, etc.
- More muscle movement than usual: This causes the patient to lack water and minerals.
- Abnormality in sleeping: The patients tend to sleep during the day and be awake at night.
- Disorientation: The patients always need clarification on the time and place they are staying. For example, when treated in the hospital, they may think they are in another place. – Hallucination: The patients always see unreal images. They are suspicious of the environment around them. They cannot distinguish between reality and something unreal. It causes the patients to hurt themselves and others.
Timeline of medication
There are three stages for medication for alcohol withdrawal. These stages include:
Stage 1 Assessment to diagnose the disease
At first, the officials will ask you to do the test called Alcohol Use Disorder Identification Test (AUDIT). Then, the officials will diagnose your symptoms.
Stage 2: Preparing for medication
This stage can be done by doing the following:
- History taking
- Assessment of the problem and social support
- Giving information to the patients and their relatives about symptoms, effects, process of medication, and participation in medication
Stage 3 Medication
In this stage, the official must assess the severity of alcohol withdrawal and do the process of medication.
There are 4 medication types: sedatives, relief of physical symptoms, vitamin and mineral supplementation, and environmental organisation.
Timeline of intervention
In medication for alcohol withdrawal, there should be intervention from other parties, such as psychologists and social workers. These people help make the medication more effective. This article divides the stage of intervention into 3 stages.
Stage 1 Primitive alcohol withdrawal
This stage can be done by doing the following:
- Create rapport with the patients and their relatives.
- Inform the patients and their relatives of the process of taking medication.
- Ask for the contract from the patients and their relatives so that the official can communicate with them easily.
- Gather information by asking patients and their relatives about the social information of the patient such as job, relationship in the family, the cause of drinking alcohol and social support.
Stage 2 During alcohol withdrawal
This stage can be done by doing the following:
- Motivate the patients to demand medication.
- Advise about making a silent environment for the patient whose symptoms are not severe.
- Limit the chance of the patients to have a relationship with others to reduce the chance of them binge alcohol again.
- Give information to the family of the patients about the method to stop drinking alcohol.
- Give information to the family of the patients about mental disorders happening in patients with alcohol withdrawal.
- Do family counselling with the family of the patients. This is because alcohol withdrawal is a chronic disease. Therefore, the family may have problems with mental disorders after taking care of the patients. Therefore, there should be family counselling during the medication.
- After the patients go back home, visit the patients at home to gather more information about the environment of patients.
- If the patients are forsaken by their families, the official should find welfare.
- Assess the severity of mental disease in the patients.
Stage 3 Recovery from alcohol withdrawal
This stage can be done by doing the following:
- Ask for the patients to do the psychology assessment to diagnose the mental disease of the patients and find ways to do therapy for the patients.
- Do psychological therapy for the patient individually and in groups.
- Counsel and psychotherapy of the family of the patients continually.
