Confusion During Alcohol Withdrawal: Is This Normal?

Alcoholism is a disease that can affect anyone from any background. Experts have long tried to pinpoint factors, such as genetics, race, sex, or socioeconomic background, that might make someone more likely to become addicted to alcohol, but no single cause is responsible. Genetic, behavioral, and psychological factors all play a role in the disease.

More than 14 million people over the age of 12 had alcohol use disorder in 2019. Withdrawal can present with many varying symptoms, one of which may be confusion. This delirium occurs in advanced withdrawal and can severely impact the brain and nervous system.

What is Alcohol Withdrawal Confusion?

Delirium is a severe symptom of alcohol withdrawal. It causes sudden and significant problems for the brain and nervous system. It’s estimated that half of the people with an alcohol addiction would experience unpleasant symptoms if they suddenly quit drinking. Of that group, up to 5% will experience confusion and other signs of alcohol withdrawal delirium (AWD), including grand mal seizures.

AWD only affects heavy drinkers who:

  • Have a head injury
  • Suddenly quit drinking
  • Have an infection or are sick
  • Too quickly reduce their use of alcohol
  • Don’t eat enough while reducing their use of alcohol

When a person drinks heavily, they excite and irritate their nervous system daily. Regularly drinking forces the body to rely on alcohol, which has a devastating impact on the nervous system; it will no longer be able to adapt to not having alcohol in the body. Alcohol similarly impacts the brain’s neurotransmitters. These chemicals communicate with the irritated nervous system that relays messages back to the brain.

Why Withdrawal Leads to Symptoms

alcohol withdrawal confusion

Alcohol has a sedating, depressant effect on the brain, which means it slows it down. In heavy, long-term drinkers, the brain is continuously exposed to alcohol and its tranquilizing effects and, over time, adjusts its chemistry to compensate. It produces stimulating chemicals like serotonin and norepinephrine in more significant quantities than usual.

After long periods of this inequitable chemistry, the nervous system also gets used to the feeling of constant alcohol exposure. Your body works harder to keep the brain alert so it can keep talking to your nerves. When a heavy drinker suddenly quits drinking, their brain remains in this keyed-up state, leading to withdrawal symptoms.

In severe cases, alcohol withdrawal can be life-threatening. Symptoms can manifest suddenly and last for several hours or days after alcohol use. The heaviest drinkers may experience symptoms for as long as a week. Withdrawal can begin as early as two hours following a drink. Harsher symptoms are more likely for those who have previously suffered them before.

As beneficial as quitting alcohol may be, trying to detox without medical supervision can be a dangerous effort.

Symptoms of Alcohol Withdrawal

AWD usually presents symptoms within three days after reducing or ceasing alcohol use. For some, the signs may take a week or longer to manifest. People struggling with AWD may experience:

  • Fear
  • Fever
  • Fatigue
  • Nausea
  • Anxiety
  • Agitation
  • Excitement
  • Chest pain
  • Seizures
  • Irritability
  • Nightmares
  • Stomach pain
  • Restlessness
  • Hallucinations
  • Excessive sweating
  • Increased heart rate
  • Sudden mood swings
  • Increased breathing rate

Alcohol withdrawal confusion can occur during alcohol withdrawal. Also, individuals may experience involuntary muscle contractions, delirium (disturbed state of mind), and sensitivity to sound, light, or touch. Eye and muscle movement difficulties can also occur. Individuals who are going through alcohol withdrawal may also have delusions, which cause them to irrationally believe things that cannot be true. Finally, an increased startle reflex may occur, causing people to react to unexpected stimuli in an exaggerated manner.

Complications of Prolonged Alcohol Addiction

Untreated alcohol addiction can lead to several complications, including:

  • Ulcers
  • Bone loss
  • Birth defects
  • Liver disease
  • Heart disease
  • Sexual problems
  • Vision problems
  • Diabetes complications
  • Increased risk of cancer
  • Suppressed immune function

These complications are just some of the many reasons why it’s essential to tackle addiction early. It is possible to avoid or treat nearly all risks associated with addiction with early intervention and successful long-term recovery.

Alcohol Withdrawal Timeline

Withdrawal symptoms may start as early as two hours following the last drink, but it’s more likely to begin sometime within the next day. Symptoms can be broken down into four distinct stages.

Stage 1: 6 hours

Minor withdrawal symptoms usually begin between 6 and 12 hours following your last alcoholic drink. These minor discomforts may include:

  • Anxiety
  • Nausea
  • Sweating
  • Insomnia
  • Headache
  • Loss of appetite
  • Increased or irregular heart rate

Stage 2: 12 hours

Alcohol Withdrawal

Alcoholic hallucinations may begin as early as 12 hours after your last drink and can last a day or longer. Hallucinations may include any of the following:

  • Visual hallucinations, in which the person sees images that don’t exist
  • Auditory hallucinations, in which the person hears things that don’t exist
  • Tactile hallucinations, in which the person feels numbness, itching, or burning that doesn’t exist

It’s unusual for someone to experience these hallucinations for longer than 48 hours after their last drink.

Stage 3: 48 hours

Heavy drinkers may start experiencing withdrawal seizures between 24 and 48 hours following their last drink.

Stage 4: 72 hours

Confusion sets in 72 hours after the last drink. In most cases, these symptoms peak five days later and subside within a week.

Confusion During Alcohol Withdrawal

Delirium tremens is an extremely unpleasant and severe symptom of alcohol withdrawal. People affected by this delirium have an altered state of mind and experience significant physical discomfort.

About 5% of people who drink alcohol in excess will experience this confusion if they stop or reduce alcohol use. Those who drink at least a pint of liquor every day for months in a row are most at risk for experiencing alcohol withdrawal confusion. In most cases, delirium tremens occurs two or three days after a person stops drinking, causing major challenges like:

  • Extreme confusion
  • Visual hallucinations
  • Auditory hallucinations
  • Tactile hallucinations

Post-Acute Withdrawal Syndrome

In some cases, symptoms experienced following withdrawal can occur for up to a year; this condition is called post-acute withdrawal syndrome (PAWS). People who struggle with PAWS may experience ongoing symptoms like:

  • Loss of consciousness
  • Emotional outbursts
  • Delayed reflexes

The onset of PAWS may require a former drinker to remain in a rehab facility until the disruptive symptoms go away. Rehab facilities generally recommend staying near specialized professionals who can provide appropriate treatment.

Are You At Risk?

Why Withdrawal Leads to Symptoms

Heavy drinkers are at an elevated risk of experiencing confusion during withdrawal. You may be at a higher risk if you have:

  • Been a heavy drinker for many months or years
  • Other health problems
  • A history of confusion during withdrawal
  • A seizure disorder or brain damage

Unfortunately, no long-term drinker has zero risk of AWD. Heavy drinking is defined as 15 drinks per week for men or 8 per week for women, or drinking 5+ drinks in one sitting. One drink is equal to:

  • 1.5 ounces of distilled spirits
  • 5 ounces of wine
  • 8 ounces of malt liquor
  • 12 ounces of beer

Professional Help for Alcohol Use Disorder

Detox is the first step for quitting alcohol. It allows people to safely navigate the uncomfortable and sometimes dangerous process of stopping drinking. However, it doesn’t address the psychological factors that impact behavior and thought patterns that also contribute to the disease. Various treatment settings can help provide the necessary support to help former drinkers maintain their long-term sobriety.

Since severe withdrawal can potentially be fatal, it’s crucial to seek out and rely on close medical monitoring to handle physical symptoms. In some cases, certain sedation medications may also help to minimize seizures and other severe difficulties.

It’s not recommended to attempt self-detox. A medical professional like a doctor can better determine what kind of support you will require to manage your withdrawal symptoms. A detox facility allows people to stay under medical supervision, giving them access to a nursing staff who can provide medications and ensure they receive ongoing care and treatment.

To help keep clients dealing with symptoms comfortable and safe, the supervising physicians and nurses develop individualized plans to monitor and medically intervene as necessary during the first few days. Generally, treatment may involve several medical professionals, including psychologists, social workers, a clinical support staff, and mental health counselors.

Coastal Detox Can Help You!

Alcohol abuse can significantly damage and disturb a person and their relationships. When you’re ready, there are many paths to treatment that can ensure your long-term recovery. Coastal Detox can help.

After detox, former drinkers can tackle addiction with holistic therapies that reduce stress and improve overall well-being. Taking a more holistic approach is essential for helping people regain their personal balance, allowing them to stay focused on recovery and preventing relapse. Contact Coastal Detox today to find out more about how we help Florida residents stay sober.

References:

https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics

https://www.nejm.org/doi/full/10.1056/NEJMra1407298

Real Client Testimonials

  • Before coming to coastal I was hopeless, helpless, and my family wanted nothing to do with me. It wasn’t the first detox I’d ever been to, but it was the only one who showed me so much love and compassion. They gave me hope. It’s hard to put into words the amount of gratitude I have for this facility. The employees were my family when I had none. The staff went out of their way to make sure not only were my physical needs taken care of, but my emotional needs as well. From the first phone call prior to admission, to helping me set up continuing care, they never missed a beat. Even going as far as to help me with my legal issues via Zoom court. This isn’t just a detox, they are the family I never had. All of the techs, especially Karen, are phenomenal. They will take the time to listen to you, laugh, and cry(if needed) with you. If you are reading this and you or your loved one is suffering like I was, go to Coastal Detox. The level of care is more than I could ever put into a review. It wasn’t the first detox I’d been to, but it has been my last; I owe them everything I have today, including my life.

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    Travis B.
    12/07/2020
  • Had a really good experience at Coastal. The staff really went above and beyond in helping me get in and gave me the respect l, space and care I needed after I first got there. As I started to fell better they encouraged me to take part in groups which helped get me out of my head and bring positivity and health to my thinking. They had a great massage therapist, who came daily and it was evident the nursing staff genuinely cared. Got to know some of the staff as well and I’m grateful for the cooks Joe and Chris. Those guys literally made us sirloins and pork chops for dinner. Also I gotta thank Chris and Chris for helping me get in and setting me up with a transition plan. Real grateful for that help, I’m not sure if it’s management intention to hire guys named Chris but they got a good thing going there. Overall, I’m clean and sober today and walking it out. Coastal gave me a base that set me up for the success that I’m walking in today

    Brandon B. Avatar
    Brandon B.
    1/16/2020
  • My family is very thankful for Coastal Detox. They have went above and beyond for my son a few times. Unfortunately he has needed their help more than once and they have ever turned their back on him, even when he was at his worst. Jeannie and Chris have been amazing and kept me informed through the entire process. They truly care about the addict and want to help them especially when it would be easy to give up on them. I had many detox facilities be rude and uncaring to me when I was searching for help for my son, but Coastal never did that to us. I don't know the names of all the team members that have helped my son but I know their are many and y'all are angels!! One day we will be able to pay it forward and help someone as you have helped us. Thank you for all you do!!

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    Brenda A.
    1/01/2020
  • Can not say enough nice things about Coastal Detox & staff. Family member was there, told me five stars for the facility & all whom she interacted with. Said the facilities, ambience..., cleanliness, grounds, food, (think their chef is five stars), were all top shelf. All I interacted with personally & on the phone were patient, professional, responsive & caring. Kudos to so many: Jeannie Jones, Clinical Director whom I spent the most face to face time with: great oversight, patience & follow thru. Raquel Barker, Therapist was so understanding & on spot with her assessments/care. Kris Garrigus Admissions Director, another Coastal professional whom I cannot say enough nice things about, always so patient & responsive to my probably too frequent inquires. Not to be forgotten is Judy Tucker, Director of Operations she too so patiently "put up with me"
    I highly recommend Coastal Detox

    Susan C. Avatar
    Susan C.
    11/13/2019
  • Can not say enough nice things about Coastal Detox & staff. Family member was there, told me five stars for the facility & all whom she interacted with. Said the facilities, ambience..., cleanliness, grounds, food, (think their chef is five stars), were all top shelf. All I interacted with personally & on the phone were patient, professional, responsive & caring. Kudos to so many: Jeannie Jones, Clinical Director whom I spent the most face to face time with: great oversight, patience & follow thru. Raquel Barker, Therapist was so understanding & on spot with her assessments/care. Kris Garrigus Admissions Director, another Coastal professional whom I cannot say enough nice things about, always so patient & responsive to my probably too frequent inquires. Not to be forgotten is Judy Tucker, Director of Operations she too so patiently "put up with me"
    I highly recommend Coastal Detox

    Susan C. Avatar
    Susan C.
    11/06/2019

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