Definition

What is Alcohol withdrawal syndrome (AWS)?

Alcohol withdrawal syndrome (AWS) is the name for the symptoms that occur when a heavy drinker suddenly stops or significantly reduces their alcohol intake. With AWS, you may experience a combination of physical and emotional symptoms, from mild anxiety and fatigue to nausea. Some symptoms of AWS are as severe as hallucinations and seizures. At its most extreme, AWS can be life-threatening.

How common is Alcohol withdrawal syndrome (AWS)?

Alcohol withdrawal syndrome (AWS) is common but can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Alcohol withdrawal syndrome (AWS)?

The signs and symptoms of AWS may appear anywhere from six hours to a few days after your last drink. These usually include at least two of the following:

  • Tremors
  • Anxiety
  • Nausea
  • Vomiting
  • Headache
  • An increased heart rate
  • Sweating
  • Irritability
  • Confusion
  • Insomnia
  • Nightmares
  • High blood pressure

The symptoms may worsen over two to three days and persist for weeks. They may be more noticeable when you wake up with less alcohol in your blood.

The most severe type of withdrawal syndrome is known as delirium tremens (DT). Its signs and symptoms include:

  • Extreme confusion
  • Extreme agitation
  • A fever
  • Seizures
  • Tactile hallucinations, such as having a sense of itching, burning, or numbness that isn’t actually occurring
  • Auditory hallucinations, or hearing sounds that don’t exist
  • Visual hallucinations, or seeing images that don’t exist

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have severe AWS symptoms, it’s a medical emergency. Call for help or go to the emergency room. A high fever, hallucinations, and heart disturbances are all reasons to seek immediate help.

If you or your loved one has any signs or symptoms listed above or you have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Alcohol withdrawal syndrome (AWS)?

Alcohol has what doctors call a depressive effect on your system. It slows down brain function and changes the way your nerves send messages back and forth.

Over time, your central nervous system adjusts to having alcohol around all the time. Your body works hard to keep your brain in a more awake state and to keep your nerves talking to one another.

When the alcohol level suddenly drops, your brain stays in this keyed up state. That’s what causes withdrawal.

Risk factors

What increases my risk for Alcohol withdrawal syndrome (AWS)?

People who are addicted to alcohol or who drink heavily on a regular basis and cannot gradually cut down are at high risk for AWS. AWS is more common in adults, but children and teenagers who drink excessively may also experience the symptoms. You’re also at risk for AWS if you’ve previously had withdrawal symptoms or needed medical detox for a drinking problem.

The Centers for Disease Control and Prevention define heavy drinking as more than eight drinks per week for women and more than 15 drinks per week for men. The following are the equivalent of one drink:

  • 5 ounces of distilled spirits or liquor, including gin, rum, vodka, and whiskey
  • 5 ounces of wine
  • 8 ounces of malt liquor
  • 12 ounces of beer

Binge drinking is the most common form of heavy drinking. For women, it is defined as four or more drinks in one sitting. For men, it is defined as five or more drinks in one sitting.

Please consult with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Alcohol withdrawal syndrome (AWS) diagnosed?

Your doctor will review your medical history, ask about your symptoms, and conduct a physical exam. Some signs your doctor will look for include:

  • Hand tremors
  • An irregular heart rate
  • Dehydration
  • A fever

Your doctor may also perform a toxicology screen. This tests how much alcohol is in your body.

The Clinical Institute withdrawal assessment of alcohol (CIWA-Ar) is a series of questions used to measure AWS. Your doctor may use this test to diagnose AWS. It can also be used to determine the severity of your symptoms. The scale measures the following 10 symptoms:

  • Agitation
  • Anxiety
  • Auditory disturbances
  • Clouding of sensorium, or the inability to think clearly
  • Headache
  • Nausea/vomiting
  • Paroxysmal sweats, or sudden, uncontrollable sweating
  • Tactile disturbances
  • Tremor
  • Visual disturbances

Questions your doctor may ask include:

  • Who am I?
  • What day is this?
  • Does it feel like there is a band around your head?
  • Do you feel sick to your stomach?
  • Do you feel bugs crawling under your skin?

How is Alcohol withdrawal syndrome (AWS) treated?

Home care

Mild symptoms of AWS can often be treated at home. A relative or friend must stay with you to monitor your condition. Their job is to make sure that if you develop any worsening of symptoms, they get you to a hospital or call 911 immediately. They should also help you to get to your counseling appointments and visit the doctor regularly for any routine blood tests that may be ordered. You may also need tests for alcohol-related medical problems.

If your home environment isn’t helpful for staying sober, talk to your doctor. Your doctor may be able to connect you with shelter programs for people recovering from alcohol addiction.

Hospitalization

If your symptoms are more severe, you may need to stay in the hospital. This is so your doctor can monitor your condition and manage any complications. You may need to get fluids through your veins to prevent dehydration and medications to help ease your symptoms.

Medications

Symptoms of AWS are often treated with sedatives called benzodiazepines. Commonly prescribed benzodiazepines include:

  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Xanax (alprazolam)
  • Valium (diazepam)

In addition, vitamin supplements may be given to replace essential vitamins that are depleted by alcohol use. Once withdrawal is complete, additional medications and supplements may be needed to address complications and nutritional deficiencies that occur as a result of chronic alcohol use.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Alcohol withdrawal syndrome (AWS)?

Unless you have a serious health condition or you’ve had serious withdrawals in the past, you probably won’t need more than a supportive environment to help you through. That includes:

  • A quiet place
  • Soft lighting
  • Limited contact with people
  • A positive, supportive atmosphere
  • Healthy food and lots of fluids

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 7, 2018 | Last Modified: April 7, 2018

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