Alcohol Withdrawal Headache

Alcohol withdrawal is a group of symptoms that occur when you drink alcohol daily and suddenly stop drinking.

• It can begin within 5 hours of your last drink and gets worse over 2 to 3 days.
• Withdrawal may also happen if you suddenly reduce the amount of alcohol that you normally drink.
• Alcohol cause a depressive effect hence the body adjusts to produce a stimulant (such as serotonin or norepinephrine, which is a relative of adrenaline) in the brain , if alcohol is suddenly stop the brain still produces the stimulants causing the withdrawal symptoms.
• The most dangerous form of alcohol withdrawal occurs in about 1 out of every 20 people who have withdrawal symptoms. This condition is called delirium tremens (also called DTs).
• In delirium tremens (DTs), the brain is not able to smoothly readjust its chemistry after alcohol is stopped. This creates a state of temporary confusion and emotion (delirium) and leads to dangerous changes in the way your brain regulates your circulation and breathing.
• The body’s vital signs such as your heart rate (fast heart rate-tachycardia) , increase body temperature and/or blood pressure (hypertension) can change dramatically or unpredictably, creating a risk of heart attack, stroke  and/or epilepsy or death.

Harvard health publications

The DSM-5 changed from differentiating alcohol abuse and alcohol dependence to a single category of alcohol use disorder. The DSM-5 criteria specify a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by two or more of the following, occurring at any time in the same 12-month period:

• Alcohol is often taken in larger amounts or over a longer period than was intended.
• The patient has a persistent desire or has made unsuccessful efforts to cut down or control alcohol use.
• A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
• The patient craves or has a strong desire or urge to use alcohol.
• The patient has recurrent alcohol use that results in a failure to fulfill major role obligations at work, school, or home.
• The patient has continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
• Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
• The patient recurrently uses alcohol in situations in which it is physically hazardous.
• Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
• Tolerance is demonstrated, as defined by either of the following:
  • A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
  • A markedly diminished effect with continued use of the same amount of alcohol.
• Withdrawal is demonstrated, as manifested by either of the following:
  • The characteristic withdrawal syndrome for alcohol is noted.
  • Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
• Specify if the alcohol use disorder is:
  • Mild: Presence of two to three symptoms
  • Moderate: Presence of four to five symptoms
  • Severe: Presence of six or more symptoms

Specify if the alcohol use disorder is:

• • In early remission: The individual who had once met criteria for alcohol use disorder has not met criteria for more than 3 months and less than 12 months (does not count the presence of cravings).
  • In sustained remission: The individual who had once met criteria for alcohol use disorder has not met criteria for more than 12 months (does not count the presence of cravings).
  • Another indication of an alcohol use disorder is the presence of alcohol-induced blackouts.