Alcohol Withdrawal and the DT’s

Many of my patients work on reducing harmful substance, including smoking, vaping, and alcohol. In most cases, many of my patients may want to reduce their alcohol to low-risk levels or reduce or stop binge drinking. In many cases, reducing alcohol intake is straightforward. However, in cases when a patient has become physically dependent on alcohol, usually after sustained period of regular heavy consumption, they can become very unwell within hours if they suddenly stop:  “withdrawal”.

Alcohol “withdrawal” happens when someone who often drinks large amounts of alcohol suddenly stops. Sometimes the symptoms are mild. But sometimes, the symptoms are much more serious and can even be life-threatening.

First things first:  what if you’re worried about alcohol withdrawal?  For mild symptoms, you can contact your GP.  If someone is very unwell out of hours, contact an Out of Hours GP  or take them to an Emergency Department.

What is “mild”?  Trouble sleeping, tremor or shaking, anxiety, tummy upset, headache, sweats, or feel like their heart beating faster or harder. These symptoms can start 6 -8 hours after a person stops drinking and can go on for 48 hours. If they are mild, you should still always contact your GP.

More severe alcohol withdrawal symptoms start 12 – 24 hours after stopping drinking.  Someone may be very unwell, and can include seizures or hallucinations (see or hear things that aren’t there).

Delirium tremens, or “DTs” – This is the most serious form of alcohol withdrawal. Symptoms – actually described quite well in Christy Moore’s iconic song! –  include hallucinations, confusion, anxiety, severe shakes/tremors, racing heart, high blood pressure, fever, and sweats.  These usually start 48 hours after someone stops drinking but can last up to 5 days.  DTs can be very serious, and may require admission to ICU.

What if I’m not sure if it’s mild or not?  Get qualified medical help.

Does a patient always have to go to hospital?  Not always.  If it’s very mild, your GP will be able to help and might prescribe medicines to take at home. But to do this, s/he will usually want to be sure that you have a family or reliable friend who can stay with you for a few days to make sure your symptoms are not getting worse.  S/he will likely ask you to check in at the surgery for a few days.   They might recommend you should go to hospital, even with mild symptoms, if you have risk factors for withdrawals complications such as being pregnant or having another physical or mental health condition, use other substances, or have previously had complicated alcohol withdrawal.

After withdrawal, patients who are dependent on alcohol will need ongoing whole person support.  This can include short-term medications, addiction counselling, residential recovery programmes, and Alcoholics Anonymous.

Need more information on finding resources and support for you or someone else?  Call HSE confidential freephone helpline on 1800 459 459 from Monday to Friday between 9:30 am and 5:30 pm or Email helpline@hse.ie