Alcohol withdrawal is a side effect that occurs when someone with an alcohol addiction suddenly stops drinking. Symptoms can take place within the house and include physical and psychological reactions that are sometimes dangerous (and why it’s never recommended to quit cold turkey on your own). Symptoms of alcohol withdrawal include sweating, nausea, depression, anxiety, restlessness, and insomnia. The most severe kind of alcohol withdrawal known as delirium tremens (DT or DTS) is considered a medical emergency and can include hallucinations, seizures, severe confusion, tremors, stomach pain, chest pain, and fevers.
The severity of alcohol withdrawal largely depends on the severity of the addiction. However, not all alcoholics experience withdrawal symptoms. Just as the amount a person can drink before developing an addiction can vary, so too can the amount of alcohol that will induce withdrawal symptoms. The unpredictable nature of addiction means there’s no “safe” amount to drink. Here are a few factors that can help determine your risk of experiencing alcohol withdrawal, and the degree to which you might experience them.
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Is Alcohol Withdrawal Something You Can Predict?
While it’s impossible for anyone to know with certainty whether they’re going to experience withdrawal symptoms, there is one universal indicator that they won’t: dependence, or to be more precise, the absence of it. Withdrawal can only occur once the body developed a physical dependence on a substance, a condition that either precedes or is considered synonymous with addiction. As such, the most reliable way to determine your likelihood of alcohol withdrawal is to recognize the signs that you’re addicted to alcohol.
What Causes Withdrawal?
Long-term and heavy drug use upend neurochemical and hormone balances which throw the body into chaos. But being the remarkably resilient machines that they are, over time our bodies learn to compensate for these imbalances and come to expect the substance’s presence. The result of this is physical dependence. At this stage, we now require the substance in order to continue functioning as our bodies have become accustomed to (this also explains why some people are high functioning alcoholics). The biggest indicator of alcohol dependence is when you feel worse after not drinking for a few hours.
Factors That Can Determine If You Will Experience Alcohol Withdrawal
Unfortunately, there isn’t a simple test or even a complex method that can determine for certain if someone is going to develop withdrawal symptoms. What we do know, is that there are a variety of factors that are correlated with an increased or decreased likelihood of withdrawal. Addiction treatment coordinators will ask a variety of questions to get an idea of how mild or severe withdrawal to expect when an individual is admitted to their program.
Your Drinking Level
It’s pretty straightforward. The most impactful factors that determine whether or not someone will develop alcohol withdrawal symptoms when they stop drinking are:
- How often they drink
- How much they drink
Binge drinkers and heavy drinkers face the greatest risks. The standards of what defines these drinking levels vary based on gender. According to the NIAAA, for men, binge drinking is considered to be five or more drinks in a few hours and heavy drinking is having four or more drinks in a day or more than 14 drinks per week. For women, this is four or more drinks in a few hours or more than three drinks in a day or more than 7 drinks a week.
A standard drink size is:
- 12 oz of beer (~5% alcohol)
- 8-9 oz of malt liquor (~7% alcohol)
- 5 oz of wine (~12% of alcohol)
- 1.5 oz of hard liquor (~40% alcohol)
Someone who has been consuming alcohol on a daily basis for months or years is at significant risk for developing alcohol withdrawal symptoms when they stop drinking. Additionally, the longer they have been drinking and the more they drink, the more intense the detox process is likely to be. While this can serve as a loose guide to how much you have to drink to get withdrawal symptoms, this is just one of many factors.
Your Physical Fitness
The way our body tolerates alcohol (how quickly it can process it, how much it takes to get drunk etc.) is based on something quite simple: our body composition. This is made up of things such as:
- Muscle mass
These are all things that are largely determined by our gender. As demonstrated above, men can drink more than women and still be at the same drinking level. This is because men tend to have more muscle which means they have a faster metabolism and thus, break down alcohol more quickly (preventing it from building up in the body and brain). Males also have the advantage in that they possess a greater amount of alcohol dehydrogenase, the liver enzyme that breaks down alcohol.
Hydration levels, whether you’ve eaten or not, and even your current emotional state can affect the physiological factors that influence our alcohol is processed and experienced. Unlike the factors that deal with our metabolism and are largely fixed, these factors can fluctuate rapidly and are much harder to control.
There’s been a fierce debate amongst the addiction treatment community on whether addiction is inheritable or learned, and whether it’s a disease at all. So far, evidence continues to mount in favor that it is. Specific genes have been identified as being related to a person having an increased disposition to experiencing pleasure in drugs, addiction occurring more rapidly or intensively, or having an emotional disturbance that might cause them to be more likely to begin substance abuse in the first place.
Mental illness has a strong correlation with addiction, and this too has strong genetic influences. It’s long been known that psychiatric issues tend to run in families and can be tied to inherited neurotransmitter or hormone-based abnormalities. As such, a heavy drinker with a mental illness is much more likely to develop an alcohol addiction than someone who drinks a similar amount but has no risk of mental illness.
How To Manage Alcohol Withdrawal Symptoms
There is no definitive way to know whether an alcoholic will develop withdrawal symptoms or how severe they will be. There is also no magic maximum amount of alcohol that someone can drink without experiencing withdrawal symptoms. Due to the risk of serious compilations like tremors and hallucinations, it is always recommended to seek the help of professional alcohol detox or inpatient treatment facility to safely manage the onset of any potential withdrawal symptoms.