Alcohol and the Kindling Effect: Everything You Need To Know
Published:
May 7, 2024
·
22 min read
Written by
Reframe Content Team
A team of researchers and psychologists who specialize in behavioral health and neuroscience. This group collaborates to produce insightful and evidence-based content.
Certified recovery coach specialized in helping everyone redefine their relationship with alcohol. His approach in coaching focuses on habit formation and addressing the stress in our lives.
Recognized by Fortune and Fast Company as a top innovator shaping the future of health and known for his pivotal role in helping individuals change their relationship with alcohol.
May 7, 2024
·
22 min read
Reframe Content Team
May 7, 2024
·
22 min read
How “Kindling” Stokes the Flames of Alcohol Withdrawal
The “kindling effect” refers to the tendency of alcohol withdrawal symptoms to get more intense over time, especially seizures.
It’s important to seek medical care for serious and potentially life-threatening alcohol withdrawal symptoms (such as seizures and delirium tremens) to avoid escalation.
Reframe can help you change your mindset around alcohol and get started on your journey of quitting or cutting back. We provide science-backed strategies for reframing your mindset and developing better habits.
There’s an age-old metaphor of addiction as the seemingly self-destructive flight of a moth toward a flame. Singer-songwriter Aimee Mann captures it vividly in her song “The Moth”:
“The Moth don't care when he sees The Flame.
He might get burned, but he's in the game.
And once he's in, he can't go back,
He'll beat his wings 'til he burns them black …”
However, there’s another lesser-known metaphor related to fire and alcohol misuse: “kindling,” a term that describes the tendency of seizures related to alcohol to get more frequent and intense with time. What is kindling, exactly? And how are kindling, alcohol and withdrawal connected? Let’s find out more about kindling, addiction, and how to stay safe!
All About Withdrawal
Why does withdrawal happen in the first place? To understand that, we need to take a look at alcohol’s effects on the brain and body.
How Misuse Morphs Into Dependence
When we drink, alcohol quickly enters our bloodstream and affects pretty much every system in the body, including the brain. It causes blood vessels to dilate (a process known as vasodilation, which leads to a temporary feeling of warmth) and raises our heart rate. The liver gets busy eliminating alcohol from the body and puts the metabolism of other nutrients on hold, while the kidneys open up the waterworks and send us to the bathroom throughout the night.
As far as the brain is concerned, a few changes take place:
Alcohol causes the release of dopamine, which accounts for that initial (and very brief) warm fuzzy “high” we get after the first drink or two. This illusory pleasure is what makes alcohol so addictive.
Alcohol boosts the release of GABA, a.k.a., gamma aminobutyric acid. GABA is an inhibitory neurotransmitter that dulls the nervous system and makes us feel relaxed (or, more accurately, numb).
Over time, the brain and body get adjusted to the presence of alcohol. The brain comes to expect the “free” influx of dopamine and makes up for it by producing less of the feel-good neurotransmitters naturally, making activities that used to be pleasurable lose their spark. At the same time, the body accepts the presence of booze as the “new normal” and adjusts its workings accordingly. Eventually, dependence sets in: we are no longer simply using alcohol to get a certain effect, but need it to function at baseline levels (or as close to them as we can get).
What Causes Withdrawal?
One of the hallmarks of dependence is withdrawal — a set of physical and psychological symptoms that crop up soon after our last drink. Here are the symptoms and their causes in more detail:
Anxiety and restlessness. When we drink regularly, our brain gets used to the new levels of GABA and glutamate. Suddenly stopping cuts off the supply of GABA and opens the floodgates on glutamate. The result, as we would expect, is the opposite of relaxation — anxiety, irritability, restlessness, and overall unease. The neurotransmitter imbalance is also responsible for the shakiness, or jitters, many feel during withdrawal.
Cravings. A sudden drop in dopamine levels causes strong cravings — it almost feels as if getting alcohol is a matter of survival. This makes it especially difficult to stay on track during this stage of recovery, before dopamine levels return to normal and we can once again find pleasure in other activities.
Elevated heart rate. Withdrawal can induce rapid heart rate and high blood pressure, putting stress on the heart and potentially leading to cardiovascular complications (such as heart attacks or strokes) in people with underlying heart conditions.
Insomnia. Many who have gone through withdrawal would agree that nights are often the hardest. As our system revolts against the sudden neurochemical changes, our sleep takes a hit. We’re exhausted, but with the stress response on high alert, sleep becomes more and more elusive.
Bad dreams. Chronic alcohol misuse can alter normal sleep architecture, disrupting the most restorative REM (rapid eye movement) phase of sleep. During withdrawal, there is often a rebound effect with increased REM sleep, which can disrupt other sleep phases and lead to vivid dreams or nightmares. This means that what little sleep we do get is of poor quality.
Nausea. Alcohol irritates the stomach lining and disrupts gut microbiota, often causing problems such as acid reflux, gastritis, or ulcers. During withdrawal, the digestive system continues to be sensitive, as it takes some time for the lining to heal and the beneficial gut bacteria to make a comeback.
Not Your Ordinary Hangover: Why Withdrawal Can Be Dangerous
At first glance, withdrawal symptoms might seem similar to those of a really bad hangover, which often comes with headaches, nausea, anxiety, and the shakes. However, that’s where the similarities end. A hangover is caused by the aftermath of booze in our system, specifically dehydration, inflammation, and toxin buildup related to alcohol metabolism. It tends to last 48 hours max, but withdrawal is a different beast.
The timeline of withdrawal varies based on many factors, such as how long we’ve been drinking or if we have other medical conditions. In general, acute withdrawal usually lasts a few days to a week and tends to be a lot more intense than a typical hangover. Moreover, according to the National Institutes of Health 2023 guidelines, there are two categories of serious withdrawal symptoms, with the “moderate” one including seizures and the “severe” category reserved for delirium tremens, or DTs.
Seizures. Hallucinations and seizures (also known as “rum fits”) can set in 12 to 24 hours after the last drink. About half of those unlucky enough to experience a withdrawal-related seizure go on to develop delirium tremens.
Delirium tremens. This severe (and potentially life-threatening) condition is marked by an altered state of consciousness that wreaks havoc on the autonomic nervous system. Vital signs go haywire, the heart beats irregularly, blood pressure spikes, and hypothermia can set in. To make matters worse, it often brings on frightening hallucinations and can last for a week or longer after we put down the bottle.
Seizures and DTs are both medical emergencies. If you are experiencing these, contact emergency services immediately.
Kindling: Fanning the Flames of Seizures
The sneaky thing about alcohol withdrawal is that it tends to get worse every time we go through it, which is where the idea of kindling comes in. We’ll explore why this happens in more detail, but before taking a closer look at how kindling functions in withdrawal, let’s find out what role it plays in the dynamics of seizures in general.
Goddard’s Rats and the Seizure “Kindling” Phenomenon
Back in the 1960s, researcher Graham V. Goddard noticed something curious about some lab rats, which made an important (albeit involuntary) contribution to medical science by revealing an interesting fact about seizures. When Goddard induced seizures in the amygdala region of the rats’ brains by administering electric shocks, he noticed that the seizure threshold seemed to get lower with repetition: each time, it took less and less stimulation to induce the same effect.
Goddard compared this situation to using kindling to light a fire. As anyone who has ever tried to get a barbecue pit (or living room fireplace) started knows, the hardest part is to get the fire going. After the initial flame has been lit, it’s a matter of adding kindling to the fire.
The findings were originally applied to the study of epilepsy. It seemed that prior seizures lowered the threshold for subsequent ones. Later, the same principle was applied to substance misuse — in particular to alcohol withdrawal, which is known to induce seizures especially in those who’ve been drinking frequently for a long time.
What Is Kindling in the Context of Alcohol Withdrawal?
What is the link between kindling, addiction to alcohol, and withdrawal? In the context of alcohol use disorder (AUD), kindling refers to the progressive response of the body and brain to alcohol withdrawal, which gets more intense over time. While seizures are the main kindling symptom, there are several others to look out for:
More intense withdrawal symptoms. “Regular” withdrawal symptoms, such as anxiety, sweating, tremors, and irritability tend to get amped up as the kindling effect takes hold.
Gastrointestinal distress. Kindling can bring on bouts of nausea and vomiting. We might have intense stomach discomfort and could have trouble keeping food down, increasing the risk of dehydration.
Seizures. The hallmark symptom of kindling — seizures — become more likely with each bout of withdrawal, as our seizure threshold drops.
Hallucinations. Hallucinations tend to accompany seizures (most likely due to the erratic nerve firing characteristic of seizures).
Why Kindling Happens
The neurological changes that are responsible for withdrawal in general are also at play in the kindling effect, but get amplified as the brain becomes more sensitive to the sudden “jolt” created by shifting neurotransmitter levels.
Scientists point to two neurobiological mechanisms behind kindling. The first has to do with GABA neurotransmitter levels, which plummet when we stop drinking. The second relates to NDMA — a type of glutamate receptor affected by alcohol. Receptors for both neurotransmitters undergo sudden shifts when alcohol is no longer in the picture, contributing to abnormal brain activity that can induce seizures. Even after the receptors have begun to re-balance, the kindling effect has already established itself.
Why Kindling Is Dangerous
The kindling effect is bad news for a few reasons.
Seizures are often followed by delirium tremens, and delirium tremens increases risk of seizures. Since delirium tremens is by far the most dangerous alcohol withdrawal effect, any increase in seizure risk is a major concern.
The fact that the kindling effect makes withdrawal increasingly difficult to go through with every attempt makes it easier to fall back into the clutches of booze and give up on trying to quit. The idea of facing what is already a difficult process while knowing it might be even worse can be daunting to anyone caught in the cycle of alcohol misuse.
Tips for Putting Out the Fire “Kindled” by Booze
If you’re going through alcohol withdrawal and suspect that kindling might be at play, these tips can help you stay on track.
Prioritize safety. Always seek medical assistance if you suspect your withdrawal might reach the level of seizures or DTs. There’s no shame in getting the help you need, and it might be a decision that saves your life! If you’re worried about having to spend time in a detox facility — don’t be. Ultimately, it’s a few days. Detoxing with the help of withdrawal medications is worlds away from doing it on your own. If it sets you up for future success, it might be totally worth it!
Find a tribe. Make sure you have a support team around you to help you through the challenging times and celebrate your victories. Having people you trust around you can make all the difference!
Self-care is key. During the early days in your alcohol journey, self-care is especially important. Your body needs time to recover from the weeks, months, and maybe even years of alcohol use, so make sure you give it the care it deserves. Drink plenty of water, eat nutritious food (high in vitamins and minerals to replenish what was lost), and get any psychological support you need to manage withdrawal and the early stages of recovery.
Discover new sources of joy. As you find your footing, don’t wait to start exploring life beyond booze. Find alcohol-free events in your area and get your creative juices flowing through projects such as photography, writing, gardening, creating videos, or building a website — activities like these can serve as natural dopamine-boosters that will help kickstart your neurological recovery.
Share your story. Talking about your experiences with friends, family, and members of supportive communities such as Reframe can be incredibly helpful and rewarding. For one thing, sharing our stories helps others see that it can be done. It also allows you to create meaning out of a challenging experience by seeing your own story as a continuing narrative — you have control over what the next chapter will be!
Sparking Change Beyond the Bottle
While all of this might sound a bit daunting, there’s certainly light at the end of the tunnel. In the end, it helps to see the challenges as part of the journey to a happier and healthier version of ourselves. As ancient philosopher Lao Tzu once said, “Life is a series of natural and spontaneous changes. Don't resist them; that only creates sorrow. Let reality be reality. Let things flow naturally forward in whatever way they like.”
Most importantly, let’s remember that although certain aspects of the alcohol journey (such as withdrawal) can be increasingly challenging, the reverse is also true. Positive changes in the brain have a type of “kindling” effect of their own: the more we explore life beyond booze and the more our brain chemistry restores to normal levels, the greater amounts of joy we tend to discover. In other words, positive change and the rewards that come with it tends to grow exponentially, if we let it. In the words of Joseph Cambpbell, “We must be willing to let go of the life we planned so as to have the life that is waiting for us.”
Summary FAQs
1. What causes alcohol withdrawal symptoms?
Alcohol withdrawal symptoms happen when the brain adapts to the presence of alcohol. Alcohol affects neurotransmitter levels by increasing GABA, which inhibits the nervous system, and decreasing glutamate, an excitatory neurotransmitter: the brain adjusts its chemistry to compensate. When alcohol is suddenly removed, the resulting imbalance leads to withdrawal symptoms, such as anxiety, restlessness, elevated heart rate, insomnia, and nausea.
2. How does kindling relate to alcohol withdrawal?
Kindling refers to the phenomenon where repeated alcohol withdrawal episodes lead to increasingly severe withdrawal symptoms over time. It is believed to result from the brain becoming more sensitive to the changes in neurotransmitter levels caused by alcohol use and withdrawal. This can lead to more intense withdrawal symptoms and an increased risk of seizures and delirium tremens with each subsequent detox.
3. What are the dangers of the kindling effect?
The kindling effect can make withdrawal increasingly difficult and dangerous, potentially leading to life-threatening conditions like seizures and delirium tremens. It also increases the risk of falling back into alcohol misuse, as the fear of severe withdrawal symptoms can deter individuals from attempting to quit.
4. Why is withdrawal from alcohol potentially dangerous?
Unlike a simple hangover, withdrawal can lead to severe health complications, including rapid heart rate, high blood pressure, seizures, and delirium tremens. These symptoms can be life-threatening, especially in individuals with underlying health conditions, making medical supervision during withdrawal crucial.
5. What steps can someone take to safely manage alcohol withdrawal?
To manage alcohol withdrawal safely, it's important to seek medical assistance, especially if there's a risk of severe symptoms like seizures or delirium tremens. Medical professionals can provide withdrawal medications and support to reduce the risk of complications. Staying hydrated, maintaining good nutrition, and having psychological support are also key components of a safer withdrawal process.
Ready To Change Your Relationship With Alcohol? Reframe Can Help!
Although it isn’t a treatment for alcohol use disorder (AUD), the Reframe app can help you cut back on drinking gradually with the science-backed knowledge to empower you 100% of the way. Our proven program has helped millions of people around the world drink less and live more. And we want to help you get there, too!
The Reframe app equips you with the knowledge and skills you need to not only survive drinking less, but to thrive while you navigate the journey. Our daily research-backed readings teach you the neuroscience of alcohol, and our in-app Toolkit provides the resources and activities you need to navigate each challenge.
You’ll meet millions of fellow Reframers in our 24/7 Forum chat and daily Zoom check-in meetings. Receive encouragement from people worldwide who know exactly what you’re going through! You’ll also have the opportunity to connect with our licensed Reframe coaches for more personalized guidance.
Plus, we’re always introducing new features to optimize your in-app experience. We recently launched our in-app chatbot, Melody, powered by the world’s most powerful AI technology. Melody is here to help as you adjust to a life with less (or no) alcohol.
And that’s not all! Every month, we launch fun challenges, like Dry/Damp January, Mental Health May, and Outdoorsy June. You won’t want to miss out on the chance to participate alongside fellow Reframers (or solo if that’s more your thing!).
The Reframe app is free for 7 days, so you don’t have anything to lose by trying it. Are you ready to feel empowered and discover life beyond alcohol? Then download our app today!
Reframe has helped over 2 millions people to build healthier drinking habits globally
At Reframe, we do science, not stigma. We base our articles on the latest peer-reviewed research in psychology, neuroscience, and behavioral science. We follow the Reframe Content Creation Guidelines, to ensure that we share accurate and actionable information with our readers. This aids them in making informed decisions on their wellness journey. Learn more
Updated Regularly
Our articles undergo frequent updates to present the newest scientific research and changes in expert consensus in an easily understandable and implementable manner.