Alcohol Addiction

The Stages Of Alcohol Withdrawal And Their Symptoms

Alcohol is one of the most difficult substances to give up. This is partly because alcohol use is so socially acceptable – even expected in some cases – and partly because of the nature of withdrawal. Quitting any substance can be an unpleasant experience. In the case of alcohol, it can actually be dangerous if the right supports are not in place.

In this article, we will talk about the stages of alcohol withdrawal, what symptoms you may experience, and crucially, how you or a support person can tell when it’s time to call for medical help.

What Is Alcohol Withdrawal?

If you have been drinking large amounts of alcohol on a regular basis, you will have become used to it. You may still feel the effects of intoxication, but your body and mind will have reached the point of needing that alcohol in order to function. You may feel anxious or unable to concentrate without a drink, the smallest amount of stress can result in cravings, your hands may tremble until you’ve satisfied that thirst.

Why Does Alcohol Withdrawal Happen?

Most Canadians who drink do so in mild or moderate amounts – they do not experience withdrawal simply because they do not drink enough for their bodies to start relying on alcohol. The problem of withdrawal arises when you consume significant amounts of alcohol on a regular basis over a sustained period of time.

The more you drink, the more you need to drink: you may find yourself consuming larger amounts to achieve the same effects. Since alcohol is a depressant that slows down the central nervous system, your brain starts to compensate by producing what for most people would be an overabundance of natural stimulants, such as serotonin and norepinephrine.

If you abruptly reduce or eliminate your intake of alcohol, your body ends up with a massive surge of stimulants that have no place to go. This creates a potentially dangerous imbalance in your physiological functions, such as breathing and cardiac functioning.

The Stages Of Alcohol Withdrawal

Alcohol withdrawal should be seen as a process that happens over a period of time rather than an event that is over and done with quickly. Many people believe that withdrawal is the process of the alcohol working its way out of your system, but it is more complex than that. Because of the physiological and neurological changes that happen, alcohol withdrawal includes a period of the brain chemistry trying to get itself back to the way it was prior to the period of alcohol abuse.

Stage 1: Tremors


5-10 hours after your last drink, you will start to experience the initial stages of alcohol withdrawal, which include:

  • Shaking or tremors
  • Nausea and vomiting
  • A raised pulse and/or elevated blood pressure
  • Insomnia, nightmares or vivid dreams
  • Hyperventilation
  • Anxiety and/or irritability

These symptoms typically peak after about 24 hours before starting to ease off on the second or third day. Some symptoms, such as insomnia and mood disturbances, can persist for several weeks or months.

Stage 2: Alcohol Withdrawal Seizures

Seizures can start between 6 and 48 hours after the last drink, although the risk is at its highest after around 24 hours. The frequency, duration, and severity of seizures depends on how heavily and frequently you used alcohol.

Stage 3: Alcohol Hallucinosis

12-24 hours after your last drink, you may see the onset of visual or tactile hallucinations. In other words, you see or feel things that are not there. Common hallucinations include the illusion of small moving objects and the sensation of crawling insects under the skin. These symptoms can last for up to two days.

The Dangers Of Delirium Tremens

Delirium tremens is the most severe form of alcohol withdrawal. People at highest risk are those who have used alcohol extremely heavily over a long period of time, and people with a prior history of substance abuse. Delirium tremens causes dangerous changes in key physiological functions, like breathing, circulation, and temperature regulation. It can also temporarily reduce blood flow to the brain, leading to long-term cognitive difficulties. If left untreated, it can lead to catastrophic health effects and death.

The symptoms of delirium tremens include the following:

  • Dehydration: for a quick test, press down on a fingernail until it blanches. If it does not return to its normal colour immediately after being released, the individual is probably experiencing dehydration.
  • Confusion or disorientation
  • Stupor, extreme drowsiness or loss of consciousness
  • Nervous or angry behaviour
  • A racing pulse and short, rapid breaths
  • Sweating to the point of soaking
  • Seizures
  • Hallucinations

If you are with someone who is experiencing these symptoms, it is critical that you get medical care for them as quickly as possible.

dangers of delirium tremens

Planning For Safe Alcohol Withdrawal

While it may seem that people with alcohol addictions are caught between two bad options – to quit or not to quit – there are things you can do to ensure your safety during the withdrawal process. Here are some steps you can take:

  • Book yourself into a detox facility. This way, you will have doctors and nurses taking care of you throughout your withdrawal, and treating withdrawal symptoms as they arise.
  • If you are unwilling or unable to go to detox, at least make sure you’re not alone. Go to a friend or family member’s house, or have someone stay with you. It is important to ensure that there is someone with you who can call for medical help should the need arise.
  • Keep a list of emergency phone numbers with you. This could include your local hospital, your doctor, and some emergency contacts.
  • Make sure there is an easy way to get to the hospital. Whoever is with you should know the route, and the car should have gas in it.
  • If you’re taking prescription medications, write down the names and dosages so that medical professionals can give you appropriate care.

Getting Help For Alcohol Use Disorders

Withdrawal is just the first step in your recovery from an alcohol addiction. At 1000 Islands Rehab Centre, we will get you through your detox safely, and then we will put together a customized addiction treatment program that will get you on the path to recovery. Call us today for more information, or to book your spot.

Alcohol Addiction

How Quickly Do Alcohol Withdrawal Symptoms Start?

Alcohol addiction is a tragic condition that affects around 4% of the Canadian population. In 2016, almost 7,000 Canadians died as a result of liver disease, cancer, and traffic accidents attributable to alcohol. In addition to the health effects and loss of life, alcohol use disorders can have a significant economic and social cost, resulting in job loss , food insecurity, spousal separation, and the removal of custodial children.

One of the tragedies of alcohol addiction is that it is so difficult to overcome. Many people make unsuccessful attempts to quit drinking before they are finally able to enter into long-term recovery. This is because it does not take long for early withdrawal symptoms to appear. These symptoms are so uncomfortable – and sometimes dangerous – that the individual resorts to having a drink just to make them go away.

As difficult as it may seem when you are in the thick of it, you can quit drinking. The initial challenge is knowing how to get through withdrawal. In this article, we will talk about why withdrawal happens and how soon you can expect to start experiencing symptoms.

Why Do Alcohol Withdrawal Symptoms Happen?

If you regularly overuse alcohol over a sustained period of time, your brain is constantly exposed to its depressant effects. To compensate, it increases production of natural stimulants, such as serotonin and norepinephrine. If you suddenly deprive your brain of alcohol, it becomes flooded with stimulants. The excess results in mental confusion and erratic changes in the way your breathing and circulation are controlled. Harvard Health Publishing likens this to a speeding vehicle abruptly losing its brakes.

What Are The Signs Of Alcohol Withdrawal?

Alcohol Withdrawal Syndrome, or AWS, is a condition affecting people who have developed a physical dependence on alcohol, and then abruptly reduced their alcohol consumption.

What Is Alcohol Dependence?

alcohol dependence

While most people who consume alcohol are casual recreational drinkers – in other words, they drink moderate amounts of alcohol simply because they enjoy it – there are some who drink in order to achieve the effects that alcohol produces. For example, you might drink because it generates a feeling of confidence, or because it reduces social anxiety.

The problem is that over time, it takes progressively larger amounts of alcohol to achieve these effects, and the more you drink, the more stimulants your brain produces to compensate. This results in a situation where your body needs alcohol in order to function.

A Sudden Reduction In Drinking

The Diagnostic & Statistical Manual of Mental Disorders Edition 5 (DSM-V) stipulates that a condition for diagnosis of AWS is a sudden reduction or cessation of alcohol consumption after having been a heavy drinker for a sustained period of time. This is a fairly subjective criterion: DSM-V does not quantify either the amounts of alcohol consumed or the duration of the heavy drinking.

Additional Diagnostic Criteria

DSM-V lists eight primary alcohol withdrawal symptoms. In order to be diagnosed with AWS, you need to be displaying at least two of these in the absence of other medical causes.

  • Anxiety: new onset of anxiety symptoms, or exacerbation of symptoms in people with pre-existing anxiety diagnoses
  • Psychomotor agitation: restlessness, inability to sit still, self-stimulating activities like nail-biting and pacing, tapping the hands or feet, irritability or anger, bouts of tearfulness
  • Autonomic hyperactivity: arousal of the autonomic nervous system resulting in sweating, rapid heartbeat, dry mouth, lightheadedness, and stomach cramps
  • Hand tremors
  • Insomnia: difficulty falling or staying asleep, or difficulty going back to sleep after waking up
  • Nausea or vomiting
  • Hallucinations: may be visual, auditory or tactile
  • Tonic-clonic seizures: also known as a grand mal seizure, this results in severe muscle contractions and loss of consciousness

How Soon Do Alcohol Withdrawal Symptoms Start?

Alcohol withdrawal is a process rather than an event. There is a wide variety of withdrawal symptoms, and they appear, peak, and wane at different points of the process.

Initial Withdrawal Symptoms

If you have been drinking significant amounts of alcohol on a regular basis over a period of time, you can typically expect your first withdrawal symptoms to start about eight hours after your last drink. These symptoms include anxiety, insomnia, nausea and stomach cramps.

The initial withdrawal symptoms start as mild discomfort and get progressively more uncomfortable, peaking after around 24 hours. It is during this time that a lot of people with alcohol addictions relapse, preferring alcohol over the withdrawal symptoms.

Stage Two Withdrawal

At around the time your initial withdrawal symptoms are peaking, you may start to experience the next phase of symptoms. These include high blood pressure, rapid heart rate, elevated body temperature, and confusion.

Stage Three – The Danger Zone

2-4 days after your last drink, you may start to experience seizures, hallucinations, fever and agitation. In severe cases, you may experience delirium tremens, a severe withdrawal complication that can be fatal. Symptoms include seizures, disorientation, delirium, panic attacks, hallucinations, extreme shakiness, and loss of consciousness.

danger zone

Getting Through Alcohol Withdrawal Safely

The withdrawal process generally lasts for 5-7 days, although some of the psychological symptoms may endure beyond that.

Many people feel that they can break their dependence on alcohol simply by quitting drinking. It is not impossible: a lot of people have begun their long-term recovery in this way. It can be dangerous, though, especially if you have been a heavy drinker for a long time.

If you want to quit drinking, follow these tips to ensure your safety and reduce your risk of relapse:

  • Book yourself into a detox centre. This will ensure that you have medical attention throughout the most dangerous parts of withdrawal.
  • If you are unwilling or unable to go through medical detox, ensure that you are not alone. Get a friend or family member to stay with you.
  • Keep your phone charged in case you have to call for medical help, and ensure that emergency services have a way of getting to you.
  • If you are using any prescribed medications, write them down along with the dosages. Keep this list nearby or on your person so medical professionals can find it.
  • Make a plan for what happens after detox. Your chances of maintaining sobriety are vastly improved if you enter an addiction treatment program.

Getting Help For Alcohol Addiction

At Thousand Islands Rehab Centre, we offer customized addiction treatment programs for people who want a life without alcohol dependence. We recognize and value the uniqueness of all people. No two addiction journeys look the same, so it makes sense that everyone’s recovery will look different. Call us today to learn about our alcohol addiction treatment programs. We will take care of you through detox and rehab, and our aftercare program will ease your transition back into the real world.


Symptoms Of Drinking Too Much Alcohol

Alcohol is like many things in life: in moderation it can be good, but overconsumption can lead to disaster. And like many things in life, it can be difficult to draw the line between what is reasonable and what is too much. The line is in a different place not only from one person to the next, but from one occasion to the next for the same person.

In other words, you might have a different level of tolerance to the person standing next to you. And what you consume today with no ill effects could give you a splitting headache next week.

This line is further blurred by the fact that alcohol inebriation is not merely accepted, in some instances it is celebrated and sought after. How many times have you heard someone state their intention of getting drunk at an upcoming party? Or brag about how many drinks they had last weekend? How often have you seen the most impaired person at a gathering being lauded as “the life of the party”?

In this article, we will look at some signs that it may be time for you to switch to water, and we will look at the troubling and sometimes tragic phenomenon of alcohol overdose.

How Much Is Too Much?

According to Canada’s low-risk alcohol drinking guidelines, people assigned male at birth (AMAB) should limit consumption to 15 drinks a week and no more than three drinks at a time, while those assigned female at birth (AFAB) should not exceed 10 drinks a week and two drinks at a time.

It is important to understand that these guidelines are based on generalizations about how AFAB and AMAB bodies work. People who are AFAB have lower body weight and blood volume, but their body fat percentage is higher, which puts them at higher risk of long-term health effects from overconsumption of alcohol. In addition, they produce less alcohol dehydrogenase enzyme, meaning their bodies do not break down alcohol as efficiently as the bodies of AMAB people.

Safety Limits Vary From Person To Person

The guidelines are just guidelines. Actual safe alcohol consumption limits vary widely from one person to the next based on several factors, including the following:

  • Age, weight and state of health
  • Whether you are taking any medications and if so, what those medications are
  • Whether you are pregnant or breast/chest-feeding
  • Whether you have a prior history of substance abuse

If you are in any doubt about if or how much alcohol you can consume, it is important that you seek the advice of a licensed medical practitioner. What is safe for your neighbour or relative may not be safe for you.

How Do I Know I’ve Been Drinking Too Much Alcohol?

In general, the human body is capable of metabolizing one standard unit of alcohol per hour. If you consume more than that, you will start to feel the effects of mild alcohol intoxication. These include the following:

  • Overinflated sense of confidence
  • Lowered inhibitions
  • Talkativeness
  • A sense of relaxation or tranquility
  • Mildly impaired motor skills, such as unsteadiness on the feet
  • Reddening or flushing of the skin

If you continue to drink in spite of these symptoms, you may experience moderate intoxication, which has the following signs:

  • Mood swings
  • Inhibitions that are lowered to the extent that you engage in potentially high-risk behaviour, such as driving impaired
  • Increased motor skill deficits, slurred speech, and blurred vision
  • Confusion, impaired attention, and poor judgment
  • Reduced reflexes and reaction time
  • Sleepiness
  • Headaches and dizziness
  • Nausea and vomiting

Legal Driving Limits Do Not Mean Safe Driving Limits

Few people would argue that driving while impaired is extremely dangerous, not only for the person driving, but for any passengers as well as other users of the road. In Ontario, the maximum legal blood alcohol content (BAC) while driving is 80 milligrams of alcohol for every 100 millilitres of blood, which translates to BAC of 0.08.

It is illegal to operate a motor vehicle with BAC over this level, and many people use this figure to determine how many drinks they can have in order to legally drive. But the question should not only be about legality, it should also be whether it is safe to drive. People have different levels of tolerance. One person can be over the legal BAC without showing any signs of impairment, while someone else could have a fraction of the legal BAC and be obviously intoxicated.

The best course of action is to avoid any drinking and driving. Arrange for alternative transportation prior to the party, or leave your car at the venue, get an Uber or a cab home, and retrieve your car the following day.

driving limits

The Dangers Of Alcohol Poisoning

When you consume alcohol, it gets absorbed directly into your bloodstream through the stomach wall, and it immediately starts to circulate through your body. A single glass of wine or a beer are not likely to produce effects: your blood will pass through your liver, which will break down the alcohol so the body can get rid of it.

But the liver can only do so much. The more you drink, the more alcohol you will have circulating in your body while the liver is working overtime trying to deal with it all. As the alcohol is being transported to various parts of your body, you start to feel the effects of intoxication.

If you continue to drink, you can eventually get to the point where the parts of your brain that are responsible for supporting life start to shut down – examples include breathing, heart function, and temperature control.

What Are The Symptoms Of Alcohol Poisoning?

The symptoms of alcohol poisoning include the following:

  • Difficulty maintaining or regaining consciousness
  • Slow or irregular breathing: fewer than eight breaths a minute, or gaps of at least 10 seconds between breaths
  • Vomiting
  • Extreme mental confusion
  • Slow or irregular heart rate
  • Loss of reflexes
  • Skin that is cold or clammy to the touch, or skin that is pale or blue-tinged
  • Seizures

How To Help Someone Who Is Experiencing Alcohol Overdose

If you are with someone who is showing signs of alcohol overdose, it is imperative that you do not leave them unattended. They could be at risk of falling or choking. Immediately call for medical help, and stay with the person until help arrives.

If you can, get the person onto the ground in a sitting or semi-reclined position. If they are lying down, roll them onto their side.

When paramedics arrive, be prepared to tell them everything you know about what and how much the person drank, and whether they used any other substances or medications.

Getting Help For Problem Drinking

Located in a beautiful setting, Thousand Islands Rehab Centre provides customized alcohol addiction treatment programs that respect and value the uniqueness of all people. We provide an environment conducive to healing, and you will be guided by staff who are compassionate and non-judgmental. Call us today to learn more, or to get started on your healing journey.

Alcohol Addiction

20 Warning Signs Of An Alcohol Drinking Problem

Around 80% of Canadians who are of legal drinking age consume alcohol. This number may seem high, but the majority of this alcohol consumption is within the bounds of what would be considered responsible.

Alcohol is a big part of life in Canada and around the world. It is a staple at most social gatherings for adults. It is used to celebrate milestones and accomplishments, or as a means to relax after a long day. If you are over the age of 19 and not notably inebriated, you can easily get your hands on some alcohol without spending enormous sums of money.

When Does Drinking Become “Too Much”?

Because of the availability and social acceptability of alcohol, it can be difficult to know when you have crossed the line from regular drinking to problem drinking.

Here are 20 signs that you or a loved one may have an alcohol drinking problem.

#1 You regularly exceed Canada’s low-risk alcohol drinking guidelines

According to Canada’s low-risk alcohol drinking guidelines, those assigned male at birth should consume no more than three drinks at a time and a total of 15 drinks per week, and those assigned female at birth should consume no more than two drinks at a time and a total of 10 drinks per week. These guidelines are based on averages: your safe alcohol limits may be different based on your age, weight, state of health, whether you are taking any medications, and any prior history of substance abuse.

#2 You experience cravings for alcohol

Most people who consume alcohol do not experience cravings. If you are consuming alcohol frequently, you may start to experience an overwhelming desire to drink. This can set in hours, days, or even weeks after the last consumption of alcohol. For many people, the only way to get rid of this craving is by drinking alcohol.

cravings for alcohol

#3 You are hiding your alcohol consumption from friends and family members

If you are doing anything to hide your alcohol consumption from the people who are close to you, you may have an alcohol drinking problem. For some people, this means physically hiding alcohol in strange places. For others, it means lying about how much alcohol is being consumed.

#4 You shift money around to finance your alcohol consumption

A single bottle of wine or six-pack of beer is fairly inexpensive. But if you are overusing alcohol on a regular basis, the cost starts to add up. You may find yourself moving money from one bank account to another, withdrawing larger amounts of cash, or using funds intended to pay bills to buy alcohol.

#5 Your alcohol consumption is getting in the way of your personal relationships

Most people don’t mind if their spouse or parent comes home from work and cracks open a beer. But if your drinking starts to cut into family time or make you behave aggressively toward your loved ones, your relationships may start to suffer. As alcohol occupies an ever-increasing part of your life, it may drive a wedge between you and the people you love.

#6 Your alcohol consumption is getting in the way of work or school

getting in the way of work or school

Alcohol can affect your professional life in several ways. Perhaps you have fallen into a habit of calling in sick to work – or asking someone to do so on your behalf – because of a hangover. Or maybe you have started showing up late. For some people, alcohol consumption extends into work or school hours, leading to declines in performance. If alcohol is regularly preventing you from performing at your best at work or school, it may be time to look at your consumption.

#7 You cancel social plans because they get in the way of your drinking

For most people, alcohol is a way of being social. We go to a gathering or a celebration, and it’s the most natural thing in the world to have a drink. Once alcohol dependence takes hold, though, the opposite starts to happen. You may start avoiding these gatherings because you don’t want people to see how much alcohol you are consuming. You would rather be alone so you can drink as much as you like without having to worry about social decorum.

#8 You buy alcohol from multiple retailers to avoid recognition

People who consume alcohol moderately or lightly can visit their local alcohol retailer without a second thought. If you are drinking large amounts of alcohol each day – and therefore having to replenish it – you may start to worry that the staff at your regular liquor outlet will notice your excessive purchases. A lot of people with alcohol addictions rotate between retailers to avoid suspicion.

#9 You cannot quit alcohol in spite of attempts to do so

Nobody picks up an alcoholic beverage with the intention of becoming addicted to alcohol. On the contrary, people in the early stages of alcohol addiction often have an awareness that they are drinking too much, and they decide to either quit or embark on a period of abstinence. The cravings may prove to be too overwhelming to handle, though, resulting in a relapse.

#10 You consume alcohol at times that are not considered socially acceptable

Most societies have evolved in such a way that “normal” consumption of alcohol is reserved for specific times. For instance, it is acceptable to have a drink in the evening, when the day’s work is done, but not in the morning. It is fine to drink at a gathering of adults, but not at a child’s birthday party. If you are starting to break those unwritten rules – for example, if you are drinking upon waking up or while driving to work – your alcohol consumption may be problematic.

#11 You experience withdrawal symptoms when you are not drinking

If you overuse alcohol regularly over a prolonged period of time, you may start to experience withdrawal symptoms when you’re not drinking. The severity of symptoms depends on several factors, including the frequency and amounts of alcohol consumption. Symptoms range from mild anxiety and irritability to high blood pressure and seizures.

#12 You are drinking progressively more alcohol

Sometimes people drink alcohol not for the simple enjoyment of it, but to achieve the effects it produces: confidence, relaxation, an escape from stress. The more frequently you drink, the more you have to consume in one sitting in order to achieve those effects. If your alcohol consumption is creeping up, you may have started to develop that tolerance.

#13 You are unable to control the number of drinks you have

One of the hallmarks of alcohol addiction is that it renders you incapable of controlling your consumption. You may go to a social gathering intending to have just one or two drinks, but after one or two drinks you may think, “Just one more”. Before you know it, you’ve had several drinks and you are unable to stop.

control the number of drinks you have

#14 You engage in potentially risky behaviour when you have been drinking

Alcohol lowers your inhibitions and numbs your sense of danger. These two effects can result in you doing things under the influence of alcohol that you would never consider while sober. The obvious example is impaired driving, but you may also perform dangerous stunts, engage in criminal activity, or engage in high-risk sexual behaviour.

#15 You are losing interest in previously enjoyed activities

As alcohol starts to take over your life, you may gradually stop participating in things you previously enjoyed. To begin with, you may back out of the occasional engagement or take longer to read a book or complete a drawing. But before long, your hobbies and interests may be all but abandoned, either because you would rather spend the time drinking, or because ongoing use of alcohol is affecting your motivation and mental health.

#16 You feel anxious or aggravated when you do not have easy access to alcohol

The more you drink, the more you need to drink. If your body and mind have become accustomed to receiving alcohol, they may revolt when you try to abstain. If you are craving a drink and you don’t have alcohol available to you, you may become agitated and anxious.

#17 Friends or family members have asked you to stop drinking

Alcohol abuse does not only affect the person who is drinking – it also affects family members and close friends. Your loved ones may be feeling the effects of a disintegrating relationship, or they may be concerned for your wellbeing when they approach you and ask you to stop drinking.

#18 You have started neglecting your personal health and hygiene

Alcohol abuse often goes hand-in-hand with declining self-care. If you are no longer maintaining basic hygiene, you have stopped exercising, or you have abandoned healthy eating, you should seek help as soon as possible. Addiction is hard on the body, and the sooner you can return to a state of physical health, the sooner you can focus on addiction recovery.

#19 You are experiencing legal problems as a result of alcohol consumption

People do strange things when they have been drinking, and some of these can lead to legal trouble. Being pulled over for impaired driving or having to go to court because of alcohol-induced criminal activity are signs that your alcohol consumption is a problem.

#20 You are questioning whether you have an alcohol drinking problem

Human beings are intuitive. We usually have a good sense of when something is not right within ourselves. If you are spending a lot of time wondering if you have an alcohol drinking problem, something in your behaviour has led you to ask this question. That alone could be a sign that you need to seek help.

Alcohol Addiction Help Is Within Your Reach

No matter where you are in your alcohol addiction journey, Thousand Islands Rehab Centre is ready to welcome you. We offer customized alcohol addiction treatment programs that respect your physical, mental, emotional, spiritual, cultural, and social needs. We will guide you through your recovery journey, from detox and rehab, right through to aftercare. Call us today to learn more or to reserve your spot.