What does it look like?
What exactly is
alcohol withdrawal and what does it look like?
Alcohol withdrawal is a
condition that follows a reduction in alcohol consumption or when an
alcohol dependent individual stops drinking abruptly. In addition to a
high level of distress, alcohol withdrawal is also associated with
impairment in social, occupational, and other areas of an individualís
functioning. Relatively uncomplicated cases of alcohol withdrawal are
usually characterized by signs and symptoms of autonomic
hyperactivity, and could possibly include increased heart rate,
increased blood pressure, hyperthermia, tremor, nausea, vomiting,
insomnia and frequently anxiety. Symptoms of uncomplicated alcohol
withdrawal usually occur between 4 and 12 hours after an individual
has had his last drink of alcohol. The severity of symptoms tend to
peak around the second day, usually subsiding by about the fourth or
fifth day of abstinence. After this period of time, less anxiety,
insomnia and other autonomic symptoms may continue for the next few
weeks, with some individuals experiencing prolonged alcohol withdrawal
symptoms for up to five or six months after they quit drinking. A
minority, but significant number of alcohol dependent individuals
(10%) can experience complicated alcohol withdrawal episodes, an
alcohol withdrawal delirium also referred to as delirium tremens
can occur in approximately 5% of the cases, usually between 36 and 72
hours following alcohol cessation. This condition may be characterized
by delusions, auditory, visual or tactile hallucinations, psychomotor
agitation, fluctuating cloudiness of consciousness and disorientation.
Grand mal seizures are also associated with alcohol withdrawal in
between 3% and 5% of the cases, usually within the first 48 hours
following the reduction or cessation of alcohol consumption. In both
instances of complicated alcohol withdrawal, either the lack or delay
of instituting treatment is associated with increased mortality rate.
Prior history of delirium tremens and/or alcohol withdrawal seizures,
older age, poor nutritional status, comorbid medical conditions and a
history of high tolerance to alcohol are predictors of increased
severity of alcohol withdrawal.
The following criteria
define alcohol withdrawal:
(A) Cessation or
reduction of alcohol use that has been heavy and prolonged.
(B) Two or more the
following, developing within several hours to a few days after
criteria A above:
(sweating or pulse rate greater than 100)
increased hand tremor
nausea or vomiting
transient visual, tactile, or
auditory hallucinations or illusions
grand mal seizures
(C) The symptoms of
criteria B cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
(D) The symptoms
are not due to a general medical condition and are not better
accounted for by another mental disorder.
From DSM-IV-TR Mental
Disorders: Diagnosis, Etiology and Treatment by Michael B. First and
Information and webpage by
Licensed Psychologist Ph.D. Candidate
(Health and Geriatric Psychologist)
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Diagnosis - DSM-IV
Diagnosis and Codes: In Alphabetical Order and Psychiatric Medications