Common Alcohol Withdrawal Symptoms

What Is Alcohol Withdrawal?

Alcohol withdrawal refers to the physical and mental effects a person experiences after stopping prolonged and heavy alcohol use. When you suddenly stop drinking, your body is deprived of the effects of alcohol and requires time to adjust to functioning without it. Depending on how long you have used alcohol and how much you typically drink, the severity of these symptoms can range from mild to severe.

This article discusses the causes, common symptoms, and different stages of alcohol withdrawal. It also discusses various treatment options for alcohol withdrawal and how you can get help.

Symptoms of Alcohol Withdrawal

The symptoms of alcohol withdrawal relate proportionately to the level of alcohol intake and the duration of the person's recent drinking habit.

Not everyone who quits drinking alcohol experiences withdrawal symptoms, but many people who have been drinking for a long period of time, drink frequently, or drink heavily, will experience some withdrawal symptoms if they stop using alcohol suddenly.

There are several mild to moderate psychological and physical symptoms you might experience when you stop drinking.

Causes of Alcohol Withdrawal

Alcohol is a depressant, which means that it slows your brain. When a person drinks heavily, frequently, or for prolonged periods of time, their brain compensates for alcohol's depressant effects by releasing more stimulating chemicals (compared to when a person does not drink). Overproduction becomes the brain's new normal.

When a person stops drinking, their brain is still producing extra chemicals, which can potentially cause unpleasant alcohol withdrawal symptoms that are associated with overstimulation. The brain will readjust, but until it does, a person in withdrawal might feel unwell.

Timeline of Alcohol Withdrawal Symptoms

The severity of alcohol withdrawal is categorized into three stages. The symptoms of these stages range from mild to severe. Not all people progress through all of the stages of alcohol withdrawal.

Stage 1: Mild Withdrawal

Stage 1 is considered mild withdrawal. Mild withdrawal symptoms often begin within 6 to 12 hours after your last drink.

These first symptoms of withdrawal include:

• Decreased appetite
• Headache
• Heart palpitations
• Insomnia
• Mild or moderate anxiety
• Shaking
• Upset stomach

Mild symptoms may appear similar to a hangover, but they last longer than 24 hours.

Stage 2: Moderate Withdrawal

Stage 2 is considered the moderate stage of withdrawal. This stage of alcohol withdrawal includes Stage 1 symptoms plus the following moderate symptoms:

• Confusion
• Excessive sweating
• Fast heart rate (more than 100 beats per minute)
  
• Fever
• Increased systolic blood pressure
  
• Mild tremor
• Moderate anxiety
• Rapid, shallow breathing
  

These symptoms generally appear 12 to 24 hours after your last drink. While these symptoms are more severe than Stage 1, they are not life-threatening.

Stage 3: Severe Withdrawal

Stage 3 is considered severe alcohol withdrawal. In addition to experiencing Stage 2 symptoms, those with severe alcohol withdrawal experience severe anxiety and moderate to severe tremors.

Complicated Withdrawal

If left untreated, withdrawal can progress to complicated alcohol withdrawal.

The symptoms of alcohol withdrawal delirium include withdrawal seizures that can occur between 8 and 28 hours after your last drink. Signs of an impending seizure include tremors, increased blood pressure, overactive reflexes, and high temperature and pulse. Having a history of seizures increases your risk for withdrawal seizures.

Alcohol withdrawal delirium (AWD), commonly known as delirium tremens (DT), is the most serious symptom of alcohol withdrawal. AWD usually lasts 48 to 72 hours.

The symptoms of delirium tremens include:

• Agitation
• Confusion (which can be severe)
• Dangerous changes in blood pressure
• Excessive sweating
• Fever
• Hallucinations
• Heart arrhythmia (irregular heartbeat)
• Rapid changes in mood
• Seizures
• Sensitivity to touch, light, and/or sound
• Tremors

The symptoms of DT may get rapidly worse and can be fatal. A person with delirium tremens needs to be hospitalized until the symptoms can be controlled.

Duration of Alcohol Withdrawal

People who suddenly stop drinking and develop alcohol withdrawal symptoms often have two main questions: "Is this normal?" and "How long does it last?"

It's typical for withdrawal symptoms to begin within hours to a day or two after you have your last drink. Symptoms are often at their worst around 24 to 72 hours after you stop drinking.

You'll likely begin to feel better between five to seven days after you stop drinking, though some symptoms—like changes in sleep patterns, fatigue, and mood swings—can last for weeks or months.

Treatment of Alcohol Withdrawal

Alcohol withdrawal symptoms can be greatly reduced or even eliminated with proper medical care. There are specific treatments available for anyone who wants to stop drinking—even after long-term, chronic alcohol use.

Outpatient Treatment

Treatment varies depending on the severity of withdrawal symptoms. People experiencing mild to moderate alcohol withdrawal symptoms often receive outpatient care—meaning there is no extended time spent in a hospital or facility. It's recommended, however, that they have someone stay with them who can help during recovery.

A healthcare provider may request daily visits during which they will likely run blood tests and monitor vital signs until symptoms stabilize.

Inpatient Treatment

Inpatient treatment, or staying at a hospital or care facility, may be necessary for someone with moderate to severe symptoms of alcohol withdrawal. Inpatient treatment allows healthcare professionals to monitor you for DT or hallucinations, monitor your vitals, and administer fluids or medicine intravenously if needed.

Ruling Out Other Conditions

A healthcare provider will also run tests to rule out other medical conditions that have similar symptoms of alcohol withdrawal or occur alongside withdrawal. These conditions include gastrointestinal bleeding, infection, intracranial hemorrhage (acute bleeding in the brain), and liver failure.

Counseling

Counseling is usually recommended for someone experiencing alcohol withdrawal. A counselor can advise on ways to cope with the mental and emotional aspects of withdrawal.

Medications for Alcohol Withdrawal Symptoms

A doctor may also prescribe a sedative drug, such as a benzodiazepine, to help reduce withdrawal symptoms such as restlessness or agitation. Benzodiazepines like Librium (chlordiazepoxide) and Ativan (lorazepam) may also help to prevent minor withdrawal symptoms from becoming more severe. Other drugs a healthcare provider might prescribe include anxiolytics , vitamins, and suboxone.

Getting Help for Alcohol Withdrawal

Once you have gone through withdrawal, you'll also need a plan to remain alcohol-free. Start by talking to a healthcare provider about the treatment options for alcohol dependence.

There are many resources available for anyone who is ready to stop drinking for good, or who wants to reduce the harm alcohol is causing in their life by cutting down. As you continue to commit to long-term recovery, support group meetings like Alcoholics Anonymous (AA) or online support communities might be helpful.