Awareness and First Aid
Many people think alcohol withdrawal is simply a bad hangover. In reality, it can be a serious medical condition with potentially life-threatening complications.
When a heavy drinker suddenly stops or significantly reduces their alcohol intake, their body may struggle to adjust. This can lead to withdrawal symptoms ranging from mild discomfort to serious medical complications that require urgent care.
Recognising the signs early can make a big difference in preventing complications, says Ziyaad Warasally, Branch Manager at ER24 Ladysmith.
What does alcohol withdrawal look like?
Alcohol withdrawal symptoms can vary from person to person and may worsen over time.
“In mild cases of alcohol withdrawal, patients may have sweaty, shaky hands, nausea, and anxiety," says Warasally. “More severe cases may include symptoms such as confusion, hallucinations and agitation.”
Symptoms usually begin 6-12 hours after a person’s last drink, although some individuals may only develop symptoms after 24-72 hours.
When is it more than a hangover?
The early stages of alcohol withdrawal can sometimes be mistaken for a hangover, particularly if a person has recently stopped drinking.
However, there are important differences.
“Signs such as a fast heartbeat, body tremors, and being unable to hold a glass of water steady can suggest alcohol withdrawal rather than a hangover,” explains Warasally. “Another key indicator is that the person becomes worse with time rather than gradually improving.”
As withdrawal progresses, these symptoms can affect an individual’s mental state and physical wellbeing.
When does alcohol withdrawal become an emergency?
While some people experience relatively mild symptoms, alcohol withdrawal can quickly escalate into a medical emergency.
Warasally explains that patients with mild withdrawal are generally alert and able to communicate, although they may be anxious, sweaty, or agitated.
“As the condition progresses, patients may become combative, confused, and experience severe nausea and vomiting. Their vital signs may also become unstable.”
Warning signs that require urgent medical assessment:
- Decreased levels of consciousness
- Hallucinations
- Severe nausea and vomiting
- Unstable vital signs
- Extreme confusion or agitation.
Alcohol withdrawal becomes particularly dangerous when a patient develops delirium, hyperthermia (an abnormally high body temperature) or significant changes in their vital signs. “There is also a high chance of seizures in patients experiencing alcohol withdrawal,” says Warasally.
How does alcohol withdrawal affect the body?
Alcohol affects multiple systems in the body, which is why withdrawal can have widespread effects.
“Alcohol withdrawal has a significant effect on a patient’s heart rate, breathing, body temperature, and on their mental health,” says Warasally. “The physical symptoms place stress on the body if left untreated.”
How do ER24 paramedics help?
“We try to calm the patient, keep the environment as quiet as possible, dim the lights in the ambulance, and speak calmly with them," says Warasally. “If these measures are unsuccessful, we may request advanced life support assistance to help manage the patient safely.”
Before reaching the hospital, paramedics may check the patient’s vital signs, insert a drip if necessary, and give medications they are trained and authorised to administer.
Why can alcohol withdrawal be difficult to recognise?
One of the challenges for emergency responders is that alcohol withdrawal can resemble several other medical emergencies.
Warasally says patients may have symptoms similar to hypoglycaemia (low blood sugar), head injuries, sepsis, psychiatric conditions, or stimulant overdoses.
“It’s very important to obtain a clear history from family members or people on scene,” he advises. This information can help emergency personnel identify the underlying cause of a patient’s symptoms and provide appropriate care.
Conditions that can complicate alcohol withdrawal
Alcohol withdrawal often occurs alongside other health problems, making assessment and treatment more complex. Liver disease and hypoglycaemia are among the most common conditions that can complicate withdrawal cases, explains Warasally.
Seek help early
Alcohol withdrawal is not something to ignore or attempt to “push through” if symptoms become severe. While some people may only experience mild symptoms, others can quickly develop life-threatening complications.
If someone develops confusion, hallucinations, seizures, severe vomiting, or changes in consciousness after stopping alcohol, seek medical help immediately.
Recognising the warning signs early and getting prompt medical attention can make a significant difference, helping people withdraw from alcohol as safely as possible and reducing the risk of serious complications.