Treating Severe Alcohol Withdrawal

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Knowing the dangers of alcohol use may convince you to cut back on drinking, but wanting to quit may not be enough. Depending on how much or how often you drink, completely cutting out alcohol can cause alcohol withdrawal symptoms, which can be just as dangerous to your health as continuing to drink.

Talk to your doctor before making changes to your drinking behavior because severe alcohol withdrawal can be life-threatening. Talking to your doctor can also help you understand what to expect from your body when you stop drinking and how to manage your symptoms.

What is Alcohol Withdrawal?

Alcohol withdrawal happens when you significantly reduce your alcohol consumption after drinking heavily for an extended time. The collection of symptoms you experience during alcohol withdrawal is called alcohol withdrawal syndrome (AWS).¹

Heavy drinking affects the body’s organs and nervous system. When you drink daily, your body becomes dependent on alcohol. When you suddenly reduce your drinking, your body needs to readapt to not having alcohol, causing AWS.

If you regularly drink excessive amounts of alcohol, you are at risk for developing AWS. The Centers for Disease Control and Prevention (CDC) defines excessive drinking as:²

• More than 8 drinks a week for women
• More than 15 drinks a week for men

Binge drinking is the most common form of excessive drinking. The CDC defines binge drinking as consuming the following amount of alcohol within 2 hours:

• 4 drinks for women
• 5 drinks for men

AWS is most common in adults but can occur in children and teens. Additional risk factors include those who previously experienced withdrawal symptoms and those suffering from alcohol use disorder.

Signs and Symptoms of Alcohol Withdrawal Syndrome

Alcohol withdrawal can range from mild to severe, depending on the severity of your drinking. When symptoms are at their most severe, AWS can be life-threatening.

AWS affects everyone differently but generally adheres to an alcohol withdrawal timeline.³ Starting as soon as 5 hours after your last drink, you may experience symptoms such as:

• Changes in blood pressure
• Sweating
• Trouble sleeping
• Irritability
• Increased heart rate

If you’re experiencing AWS for the first time, or your body’s dependency on alcohol is low, this may be the extent of your symptoms. However, if you’re gone through AWS before or your body developed more of a dependency, you may begin experiencing more severe symptoms such as hallucinations and seizures within 10 hours.

You may also develop delirium tremens (DT) in more severe alcohol withdrawal cases,⁴ which can occur between 3 to 7 days after your last drink. Symptoms of DT include:

• Dehydration
• High blood pressure
• Confusion
• Soaking sweats
• Loss of consciousness

DT is a medical emergency. If you or a loved one experiences signs of DT, call 911.

In general, alcohol withdrawal symptoms subside after 5 days, although you may experience symptoms for a few weeks. As symptoms improve, it’s important to continue caring for your body. Make sure to stay hydrated and consume nutrient-rich foods such as fresh produce and lean meats.

Treatment for Alcohol Withdrawal

No matter the severity of AWS, treatment options are available. However, because withdrawal can be life-threatening, it’s important to speak with a medical professional before you quit drinking.

Inpatient vs. Outpatient Rehab

Depending on the severity of the withdrawal, your doctor may suggest inpatient treatment, especially if you’re experiencing severe symptoms such as high blood pressure, seizures, and hallucinations. Inpatient care is also crucial for those suffering from additional health conditions such as diabetes or seizures not related to drinking.

If it’s your first time with AWS, you may receive outpatient treatment. With outpatient care, you’ll be supervised by a trusted loved one in a supportive environment free of alcohol. When deciding on a place to recover, consider somewhere quiet with soft lighting. You should also ensure you have access to plenty of fluids to keep hydrated and healthy foods to nourish your body.

Detox

Whether you choose inpatient or outpatient care, the first step of treatment will likely be detox. Alcohol is toxic, and when you use it excessively, your body becomes dependent on it to function. For your body to readjust to functioning without alcohol, it first needs to flush the body of the toxin. The longer you drink, the greater the chances of experiencing intense withdrawal symptoms.

Behavioral Therapy

Beyond treating the physical symptoms of alcohol withdrawal, your doctor may suggest behavioral therapy to address your drinking patterns. During therapy, a licensed therapist provides you with tools to better identify and change your drinking behaviors.

Group Counseling

You may feel isolated from friends and family while treating AWS because they may not understand your situation. Group therapy provides a safe space to connect with others dealing with similar challenges. Through counseling, you can hear how others work toward successful sobriety.

Medications

Your doctor may prescribe medications to help reduce symptoms and decrease the craving for alcohol.⁵ Medications are sometimes prescribed alone but often work best when used with other treatment options. There are 3 medications currently approved by the FDA:

• Naltrexone: This can be prescribed daily or monthly and reduces cravings for alcohol by blocking the receptors responsible for igniting a desire in the brain.
• Acamprosate: This is taken 3 times a day and works to reduce alcohol cravings.
• Disulfiram: This is taken daily and causes physical reactions to drinking, such as nausea and vomiting.

If you need help finding the right treatment or rehab center, call 800-948-8417 Who Answers? to speak to a treatment specialist.

1. Healthline. (2018). Alcohol Withdrawal Syndrome. Retrieved 2021.
2. Centers for Disease Control and Prevention. (2021). Alcohol Use and Your Health. Retrieved 2021.
3. Khan, G. (2020). Alcohol Withdrawal Symptoms: What You Need to Know. Retrieved 2021.
4. Rahman, A. and Paul, M. (2020). Delirium Tremens. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
5. Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Medication for the Treatment of Alcohol Use Disorder: A Brief Guide.