Withdrawal

Alcohol

Withdrawal from alcohol may occur when one ceases to drink or when there is a substantial decrease in drinking. The reduction required to initiate withdrawal symptoms varies greatly from person to person, and symptoms can be physical or psychological, or include characteristics of both. When withdrawal symptoms do commence, they can begin as soon as a few hours after the cessation of drinking.

Alcohol is one of the more dangerous substances from which to experience withdrawal. Hallucinations—visual (e.g., pink elephants), auditory (e.g., voices), or tactile (e.g., bugs under the skin)—are common but tend to be transitory, beginning about 12 to 24 hours after drinking ceases. Other symptoms include anxiety, sweating, hand tremors, nausea, vomiting, insomnia, rapid pulse, anxiety, and the most dangerous, grand mal seizures.

Grand mal seizures, when they occur, can last 2 to 3 days; however, not everyone who stops drinking, even if they previously drank excessively, experiences seizures.

Delirium tremens (DTs) refers to specific indicators of withdrawal and usually indicates a physical illness. Characteristics of DTs include memory disturbances and other symptoms of withdrawal, the most common being tremors. DTs may last several days. Note that the term delirium tremens is no longer the preferred term, and when referring to physical and psychological symptoms, alcohol withdrawal should be used, as it is more inclusive of all symptoms.

At many times, those experiencing withdrawal realize that the tremors, hallucinations, and agitation are all a result of the decision not to drink, but this realization is not always the case and care should be taken when confronting someone with these symptoms. If seizures, tremors, or hallucinations occur, hospitalization is recommended.

Benzodiazepine and Other Sedatives

Withdrawal from many sedatives (and certain hypnotics may also be included in this category) depends on a number of factors that include whether the drug is a short-active or a long-active medication. Individuals taking a short-active medication may begin to experience symptoms within 12 to 24 hours after the last time the drug was taken, whereas individuals taking long-active medications will not experience withdrawal for 24 to 48 hours. In addition, the age and health of the person experiencing the withdrawal may also affect the intensity and duration of the withdrawal, with older individuals or those with poor liver functions experiencing symptoms gradually.

Regardless of the timing of the onset of symptoms, the specific signs are similar and include tremors, anxiety, sleeping problems (insomnia, nightmares), seizures, nausea, and vomiting. As with alcohol, the withdrawal from sedative drugs can be dangerous and should be medically monitored.

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