What Are Alcohol Withdrawal Symptoms? (And Which Are an Emergency?)
Alcohol withdrawal most commonly occurs in adults, but may also happen to teenagers or children who use alcohol.1
Common Alcohol Withdrawal Symptoms
With continued use, the brain adapts to the presence of alcohol. Therefore, when alcohol use suddenly stops, the body is not used to this drastic change within its internal environment.2 A lack of alcohol results in the body responding with symptoms of withdrawal.2
Withdrawal symptoms may include any of the following:1
- Anxiety, nervousness
- Jumpiness, shakiness
- Mood swings
- Not being able to think clearly
- Sweaty/clammy skin
- Dilated pupils
- Difficulty falling asleep or staying asleep
- Loss of appetite
- Nausea, vomiting
- Pale skin
- Rapid heart rate
- Tremor (shaking) of the hands or other body parts
If you are experiencing alcohol withdrawal symptoms, call 877-640-2220 Who Answers? to talk to a treatment specialist who can help you find the right care.
Severe Withdrawal Symptoms
It’s important to note also that if you have pre-existing medical conditions, your withdrawal symptoms may be more severe.1
Some individuals experience a severe form of alcohol withdrawal referred to as delirium tremens. Delirium tremens may appear within the first 48-72 hours after the person has stopped drinking.3 Symptoms that indicate severe withdrawal/delirium tremens include:1
- Seeing, feeling, or hearing things that other people cannot see, feel, or hear (referred to as hallucinations)
- Severe confusion
Alcohol Withdrawal Symptoms Timeline
The initial symptoms of alcohol withdrawal occur at different times depending on the person, as it depends on a number of factors, such as:3
- Whether you have any underlying medical conditions
- How long you have been abusing alcohol
- How much alcohol you drink
- The type of alcohol you drink
- How recently you had your last drink
- Whether or not you have previously experienced alcohol withdrawal
- If you are on prescription medication that interacts with alcohol
However, there is a general timeline for when you will start seeing the signs and symptoms of alcohol withdrawal:3
- Mild/early symptoms of alcohol withdrawal will appear within 6-12 hours of your last drink.
- By 24 hours, you may begin to experience things that other people are not experiencing (such as visual or tactile hallucinations).
- Within 24-72 hours, various symptoms begin to peak and may become more stable or begin to improve. However, some symptoms may linger for weeks or longer. Persistent symptoms include things such as fatigue and/or difficulty falling asleep.
- Seizure risk is highest from 24-48 hours after the last drink.
- Delirium tremens symptoms may appear within the first 48-72 hours after the drinking has stopped.
In addition, according to the American Academy of Family Physicians, there are 3 potential stages you may experience when going through alcohol withdrawal:6
- Stage 1: Symptoms considered to be “mild” appear. These include physical symptoms such as headache, difficulty sleeping, shaky hands, nausea, and heart palpitations. Stage 1 often begins within 8 hours of your last drink.
- Stage 2: Symptoms considered to be “moderate” begin to appear. These include physical symptoms such as increased blood pressure or heart rate, rapid or abnormal breathing patterns, and confusion. Stage 2 often begins within 1-3 days of your last drink.
- Stage 3: Symptoms considered to be “severe” begin to appear. These include a combination of symptoms from stage 2, in addition to seizures, hallucinations, difficulty paying attention, and/or general disorientation. Stage 3 often begins within a week of your last drink.
Symptoms can progress from Stage 2 to Stage 3 rapidly, especially when you do not receive medical treatment.3 Because of this, and because alcohol withdrawal can be lethal, it is recommended to seek medical attention when experiencing alcohol withdrawal symptoms.1 Most people will recover fully from alcohol withdrawal with proper medical attention and withdrawal management from healthcare professionals.3
How Long Do Symptoms Last?
The symptoms of alcohol withdrawal tend to peak within 72 hours of your last drink.3 However, you may continue to experience physical discomfort for up to a week, and some symptoms may linger for a few months after you stop drinking.1 Most commonly, this includes symptoms such as insomnia (difficulty falling or staying asleep) and fatigue (feeling tired throughout the day).1
Treatment for Alcohol Withdrawal Symptoms
Once you commit to stopping drinking, you should seek out the help of a physician or other healthcare provider to navigate the symptoms and management of alcohol withdrawal as it can be life-threatening.1
Treatment for alcohol addiction and withdrawal may be done in an outpatient setting, in a person’s home, or in a hospital or drug treatment facility. Alcohol withdrawal is rarely recommended to be undergone at home, as it has the potential to be lethal and should be done under close supervision.1
Treatment for Mild to Moderate Withdrawal Symptoms
If you have mild to moderate withdrawal symptoms you are advised to receive support from healthcare professionals in the outpatient setting. This may include care from a rehabilitation or day treatment program. Treatment from healthcare providers in the outpatient setting often includes the following:1
- Medication use in treatment, such as those that are sedating, to help ease the discomfort of withdrawal symptoms.
- Blood tests to check organ functioning that may be impacted by alcohol use/withdrawal.
- Patient and family counseling to provide support and open discussion regarding your alcohol use.
- Testing and treatment for other medical problems typically associated with alcohol use.
Treatment for Moderate to Severe Symptoms
If you have moderate to severe symptoms of alcohol withdrawal you may require treatment at an inpatient facility with access to around-the-clock care.1 Access to nurses, doctors, and other healthcare professionals is critical as symptoms of delirium tremens such as seizures or hallucinations may occur.1 In the inpatient setting, treatment may include the following:1
- Use of benzodiazepine medications to help prevent or control seizure activity.6
- A physical examination may be conducted to look for signs and symptoms of alcohol withdrawal, such as abnormal heart rate, dehydration, fever, rapid breathing, and shaky hands.
- Blood and urine tests, such as a toxicology screen, to understand the extent of your substance use.
- Therapy to help you remain sober from alcohol and learn healthier coping mechanisms.
The detoxification can last for some time and requires medical care to keep you safe. Once you’ve gone through alcohol detoxification, it is recommended that you attend longer rehabilitation to help improve your chances of remaining sober.3
Note that if you have had a long or severe history of alcohol use you may have incurred organ damage from drinking. As a result, you may be more at risk of developing certain health problems, such as liver disease or heart disease.1 However, there is hope. Most people who go through alcohol withdrawal will make a full physical recovery, and 30% of individuals who receive treatment will remain free from alcohol for the rest of their lives.1,8
After receiving rehabilitation treatment, evidence suggests those recovering from alcohol should follow a few rules in order to remain healthy.1 First, it is important to find a long-term living situation that helps people to remain sober. Some places in the United States have housing options available that are a designated safe space for those in recovery.
Second, permanent and life-long abstinence from drinking alcohol is suggested to be the best treatment for those who have struggled with alcohol use.1 Third, support groups are suggested as a wonderful source of support. Support groups such as Alcoholics Anonymous offer peer support, shared experiences, and new strategies to live a sober lifestyle.
Is Alcohol Withdrawal Dangerous?
Alcohol withdrawal is very serious and potentially life-threatening due to the impact alcohol has on the body. With continued use, the brain and other organs in the body become accustomed to the presence of alcohol in the bloodstream.1 As a result, when you use alcohol frequently or in large amounts and suddenly stop drinking alcohol, this sends the body into a state of shock as it readjusts to an absence of alcohol.1
Alcohol detoxification leads to nervous system hyperactivity in the body and results in symptoms such as increased blood pressure, increased heart rate, and a change in breathing patterns, among other symptoms.1 This process can be uncomfortable, and at times, painful. The change in nervous system functioning can also be lethal.1 For these reasons, alcohol withdrawal should always be done under the close supervision of a healthcare professional.
In some cases, alcohol withdrawal can be done at home. However, this is rarely recommended due to the dangerous nature of alcohol detoxification. If you or someone you know is struggling with alcohol use disorder and is ready to commit to a life free from alcohol use, help is available by calling 877-640-2220 Who Answers? .
After undergoing detoxification with medical support, rehabilitation either in the outpatient or inpatient setting is recommended. You may choose to continue therapy or receive support in other ways, such as medication management to reduce the risk of relapse and support from peer groups like Alcoholics Anonymous. For more information about addiction treatment options and professional help for alcohol use, please call us at 877-640-2220 Who Answers? .
Alcohol Use Disorder: The Cause of Alcohol Withdrawal
Alcohol use disorder, commonly referred to as “alcoholism,” involves excessive alcohol use that causes symptoms affecting your body, thoughts, and behavior. The hallmark characteristic of the disorder is that you continue to drink alcohol, despite the problems your alcohol use may cause.2 If you have alcohol dependence or alcohol addiction you may have a physical, psychological, and/or emotional reliance on alcohol use.2
There is no set number of drinks per day or quantity of alcohol that indicates you have an alcohol use disorder.2 However, above a certain level (specifically, greater than 4 drinks per day for men or above 3 drinks per day for women), the risk of developing an unhealthy relationship with alcohol increases significantly.2
There are some defining behaviors consistent with alcohol dependence and addiction. They include the following, among others:2
- Drinking more than you intended to drink
- Losing control over the amount of alcohol being used
- Having the desire to stop drinking, but an inability to do so
- Excessive time spent getting or using alcohol, or recovering from alcohol use or “hangovers”
- Craving alcohol or having a preoccupation with alcohol use
- Having problems stemming from using alcohol, and ignoring these problems
- Drinking despite the harm it may cause, such as physical danger
- Falling behind or not performing well in work, family, and social roles
- Experiencing alcohol tolerance (needing more and more alcohol to feel the same effects, or the ability to drink more than others without getting drunk)
- Experiencing withdrawal symptoms
If you drink alcohol frequently or in high amounts, you are at risk of experiencing alcohol dependence and therefore are at a higher risk of experiencing alcohol withdrawal.
1. U.S. National Library of Medicine. (2020, November). Alcohol withdrawal.
2. Harvard Health Publishing. (2019, April). Alcohol Use Disorder (Alcoholism).
3. American Addiction Centers. (2020, November). Alcohol Withdrawal Symptoms, Treatment, and Timeline.
4. National Institute on Alcohol Abuse and Alcoholism. (2020, October). Alcohol Facts and Statistics.
5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
6. Muncie Jr., H. L., Yasinian, Y., & Oge, L. K. (2013). Outpatient management of alcohol withdrawal syndrome. American Family Physician, 88(9), 589-595.
7. U.S. National Library of Medicine. (2020, November). Delirium tremens.
8. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment.