Why is it developing?
With prolonged use, alcohol constantly suppresses the excitatory systems of the brain, and the nervous system adapts, enhancing their function. When the alcohol suddenly disappears, the suppression stops, but the increased excitation remains - the brain seems to have no brakes. Hence trembling, insomnia, anxiety, convulsions, and in severe cases, delirium. The risk is higher in people with years of addiction, a history of delirium or seizures, or if withdrawal coincided with injury, infection, surgery, or dehydration.
- Overexcitation of the nervous system after alcohol withdrawal
- Vitamin B1 and magnesium deficiency
- Dehydration and electrolyte imbalance
- Long experience of use
- Past episodes of delirium and seizures
- Concomitant infection, trauma, surgery
How it develops and looks
The first signs of withdrawal appear after 6–24 hours: trembling hands, sweating, anxiety, nausea, rapid heartbeat, insomnia. After 1–2 days, convulsions may occur. Delirium usually develops on the 2-3rd day: a person ceases to understand where he is and what date it is, does not recognize loved ones, sees small animals, insects, threads and figures, talks with non-existent interlocutors, tries to defend himself or run away. The condition intensifies towards night, and periods of clarity are replaced by new excitement.
- Trembling in the hands and whole body
- Profuse sweating and palpitations
- Complete insomnia
- Disorientation in time and place
- Frightening visual hallucinations
- Motor excitement and fear
- Worse at night
- Increase in temperature and pressure
Why is it dangerous?
Delirium is a life-threatening condition. The danger is created not only by mental disorders, but also by severe physical complications: dehydration, disturbances in potassium and sodium levels, heart rhythm disturbances, seizures, and cerebral edema. In a state of excitement, a person can get injured, fall out of a window, or leave the house. Additionally, pneumonia, pancreatitis, gastric bleeding, and severe liver damage are often detected. A separate threat is vitamin B1 deficiency, which can lead to permanent damage to the brain and memory.
- Heart rhythm disturbances
- Dehydration and electrolyte disturbances
- Seizures and cerebral edema
- Agitated injuries
- Pneumonia and other infections
- Gastric bleeding and pancreatitis
- Brain damage due to vitamin B1 deficiency
What to do before the doctor arrives
The main thing is to call an ambulance by number 103 and do not leave the person alone. Before the doctors arrive, you need to ensure safety: remove piercing and cutting objects, close the windows, turn on soft lights, remove unnecessary noise. You should speak calmly and briefly, do not argue with hallucinations and do not frighten. If the person is able to drink, offer water in small sips. Under no circumstances should you give alcohol “for relief,” sleeping pills or other people’s medications, or try to hold it by force or treat it with home remedies.
- Call 103 and stay nearby
- Remove dangerous objects, close windows
- Mute the noise, leave soft lighting
- Speak calmly, do not argue with hallucinations
- Offer water in small portions
- Do not give alcohol or other people's medications
- Tell your doctor about your history of use, illnesses and medications.
Treatment and what next
Delirium is treated in a hospital, where observation and correction of the condition are possible. They carry out infusion therapy, replenish fluid and electrolytes, be sure to administer vitamin B1, use drugs that relieve anxiety, and monitor the heart, temperature and sugar levels. At the same time, concomitant diseases are looked for and treated. After leaving the acute state, something else becomes important: without giving up alcohol, the episode will repeat, and each subsequent one is usually more severe. Therefore, further work is needed with a narcologist, psychotherapy and family support.
- Hospitalization and 24-hour observation
- Infusion therapy and electrolyte correction
- Vitamin B1 is a must
- Drugs to relieve anxiety as prescribed by a doctor
- Treatment of concomitant diseases
- Complete abstinence from alcohol after discharge
- Observation by a narcologist and psychotherapy
- Family and self-help group support