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Addiction, or alcohol use disorder (SUD), is a disease that affects the brain and the body. As a person continues to drink heavily, they can grow dependent on it and require more and more just to feel any effects. The symptoms that come from stopping heavy substance use are known as withdrawal symptoms. Alcohol withdrawal symptoms can be incredibly painful and even deadly. It is a key reason why it can be so difficult to stop drinking.
What are the symptoms of withdrawal?
The Clinical Institute Withdrawal Assessment for Alcohol (CIWA)1 is a tool used by doctors and nurses to check how severe someone’s alcohol withdrawal symptoms are. They ask patients about these ten symptoms:
- Feeling sick or throwing up
- Shakiness or trembling
- Sweating more than usual
- Feeling very anxious or worried
- Feeling restless or unable to sit still
- Skin crawling, burning, or feeling itchy
- Hearing sounds that aren’t there or being very sensitive to noise
- Seeing things that aren’t there or being very sensitive to light
- Pain or pressure in the head
- Feeling confused or not knowing where you are
Most symptoms are scored on a level between 0-7. The scores are added up to a maximum total of 67. The higher the score, the more serious the withdrawal symptoms are, and providers can determine if a person needs medicine or special care.
What are the different levels of alcohol withdrawal?
Mild Withdrawal: Total score of 1–9. People with mild withdrawal usually do not need to go on medication and can recover with rest and supervision.
Moderate Withdrawal: Total score of 10–19. Moderate withdrawal symptoms might require medications such as benzodiazepines (ex. lorazepam/Ativan, diazepam/Valium) to help ease their symptoms and prevent them from getting worse, along with regular checkups.
Severe Withdrawal: Total score of 20 or higher. This can be very dangerous and may lead to seizures or delirium tremens (DTs), a life-threatening condition with confusion and shaking. People with severe symptoms usually need to go through an inpatient detox in the hospital for close monitoring and stronger medicines through an IV.
When is withdrawal an emergency?
Because withdrawal can be deadly, it’s important to know when someone needs immediate medical attention. If your loved one is experiencing any of these symptoms, contact emergency services right away:
- Severe shaking
- Seeing, hearing, or feeling things that aren’t there (hallucinations)
- Seizures
- Extreme confusion or not knowing where they are
- Unable to stay calm
- Significant changes in heart rate or blood pressure
It is important to remember that alcohol use disorder is complicated, and because of factors like withdrawal, many people can’t just “stop” using, even if they want to. And for some, it can be deadly to “just stop.” This may mean allowing someone to drink while en route to treatment, not as a last hurrah, but to avoid a seizure.
Understanding AUD as a disease makes us more compassionate and empathetic towards those struggling and motivates us to seek scientific, evidence-based solutions. Learn more about treatment options. If your loved one is experiencing substance use disorder and you’re not sure where to turn, contact our support services for more information or to speak with a trained professional.