Source: National Institutes of Health

Withdrawals Can Be Mild, Moderate or Severe
Alcohol withdrawal refers to a group of symptoms that may occur from suddenly stopping the use of alcohol after chronic or prolonged ingestion.

Not everyone who stops drinking experiences withdrawal symptoms, but most people who have been drinking for a long period of time, or drinking frequently, or drink heavily when they do drink, will experience some form of withdrawal symptoms if they stop drinking suddenly.

There is no way to predict how any individual will respond to quitting. If you plan to stop drinking and you have been drinking for years, or if you drink heavily when you do drink, or even if you drink moderately but frequently, you should consult a medical professional before going "cold turkey."

Withdrawal Symptoms:
Mild to moderate psychological symptoms:
Feeling of jumpiness or nervousness
Feeling of shakiness
Anxiety
Irritability or easily excited
Emotional volatility, rapid emotional changes
Depression
Fatigue
Difficulty with thinking clearly
Bad dreams

Mild to moderate physical symptoms:
Headache - general, pulsating
Sweating, especially the palms of the hands or the face
Nausea
Vomiting
Loss of appetite
Insomnia, sleeping difficulty
Paleness
Rapid heart rate (palpitations)
Eyes, pupils different size (enlarged, dilated pupils)
Skin, clammy
Abnormal movements
Tremor of the hands
Involuntary, abnormal movements of the eyelids

Severe symptoms:
A state of confusion and hallucinations (visual) -- known as delirium tremens
Agitation
Fever
Convulsions
"Black outs" -- when the person forgets what happened during the drinking episode

Liver Patients Offered a Lifeline
Jo Revill, Health Editor
Observer (London)
Sunday, January 2, 2005

The increasing number of middle-aged patients with chronic liver disease caused by heavy drinking is forcing doctors to look at new ways of saving their lives.

A pioneering trial to help seriously ill people will begin this month, using the patient's own cells to regenerate the organ. By injecting patients with their own stem cells, the basic 'building blocks' for all kinds of cells, doctors hope that the liver can regrow itself to a point where the organ starts to work again.

The trial is experimental, but follows other work which shows that stem cells have helped patients with heart failure. The dire shortage of donor organs for transplant has encouraged the specialists to think of new ways of helping patients who otherwise have a very bleak future.

One in 20 people in Britain is now dependent on alcohol and a similar number are at serious risk of liver disease. Physicians and government experts have warned that alcohol-related harm - severe liver disease and injuries caused by drink-related violence - are on the rise as the nation's drinking habits become heavier.

Deaths from liver disease in patients under 50 have risen sevenfold in the past 30 years and surgeons have warned they are seeing a growing number of patients with cirrhosis of the liver, a condition where the healthy liver tissue is gradually replaced by scarred, useless tissue. The disease is insidious, because apparently healthy people may have it without knowing and the first signs do not occur until a late stage of the disease.

When alcohol is drunk, it is quickly absorbed and passes in the bloodstream to the liver, where it can cause excessive fat to be deposited within the liver cells. Between 20 and 30 per cent of those who drink heavily beyond the initial stages of liver damage will develop alcoholic hepatitis, a condition which can be fatal. A smaller number, about 10 per cent, go on to develop cirrhosis. Although alcohol is the leading cause of cirrhosis, it can also be brought on by forms of hepatitis or by some toxic chemicals.

Scientists at Imperial College London believe stem cell therapy holds out enormous hope for those who need new organs. Professor Nagy Habib, head of liver surgery at London's Hammersmith Hospital, who is running the trial, said: 'The liver is a wonderful organ in the way it can regenerate itself, but if there is a lot of damage it stops functioning properly. If we can get 15 to 20 per cent of the organ regenerated, then that is enough to really improve the patient's condition. These cells seem to have the fantastic ability to become whatever is needed in order to repair the damage.'

By injecting the patient's own stem cells, taken from their blood, directly into the bloodstream, the researchers hope they may be able to improve the function of the liver by getting the stem cells to repopulate the liver.

The procedure, known as leukapheris, involves taking blood from a patient and then separating it into its component parts. The stem cells are taken from the white blood cells, while the red blood cells are returned to the body through the arm. Habib and his team then inject the stem cells into the hepatic artery, the vessel which goes into the liver.

Habib believes they have to look at all the potential cures. There are about 700 liver transplants in the UK each year, but 7,500 die annually from liver disease. Alcohol is the major reason for a transplant, followed by the virus hepatitis C. 'The demand for a transplant has really risen,' said Habib. 'We don't have the equivalent of a kidney dialysis machine for these patients, so unfortunately most of them will die while waiting for an organ.'

It is not yet known how many stem cells may be needed for the trial to succeed. The worse the patient's liver function, the more cells may be necessary. 'If you can provide 1 per cent of liver cell mass, and then allow that 1 per cent to grow over a three-month period, it's possible that the liver will have enough healthy cells to behave properly, and start to produce what it needs,' said Habib.

Like many specialists, he worries that people do not understand the damage that can be done by heavy, prolonged drinking. 'If people could see what life was like in the final stages of liver failure, they might think seriously about giving up at a much earlier point,' he said. 'The liver is a very forgiving organ, but there's a limit to how much alcohol it can process before the damage sets in.'