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Alcohol Withdrawal: Symptoms, Signs, Causes, and Support

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 9 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 9 minutes

Learn about alcohol withdrawal symptoms, their signs, and causes, and discover recovery support options at Rolling Hills Recovery Center.

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About 95,000 Americans die each year from alcohol-related causes. This includes around 68,000 men and 27,000 women. This information comes from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Addiction therapy is critical to lowering these figures.

Therapy is important for your recovery and well-being. However, it is common to relapse after being sober. This often happens because of strong withdrawal symptoms.

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Deciphering the Differences

Hangovers Vs. Withdrawal

There are many similarities between a hangover and alcohol withdrawal syndrome (AWS), but they are different. The primary distinction between the two disorders is the underlying reason.

A hangover happens when you consume excessive alcohol in a single sitting. Alcohol withdrawal happens when you cut back on drinking or stop suddenly. This often occurs in people with alcohol addiction.

Overindulging in alcoholic beverages may irritate the stomach lining, dehydrate the body, and trigger inflammatory reactions. When the effects of the drink wear off, this results in typical hangover symptoms such as:

  • Headaches.

  • Nausea.

  • Lethargy.

This is entirely different from the withdrawal symptoms of alcoholism.

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Understanding Alcohol Withdrawal

Alcohol Withdrawal: What Is It?

Alcohol withdrawal is a set of symptoms. These symptoms happen when someone who drinks a lot suddenly stops or cuts back on alcohol. When you drink a lot of alcohol for a long time, your body and brain get used to it.

Alcohol acts as a depressant on the central nervous system. It slows down brain activity and changes the balance of neurotransmitters. These are chemicals that send messages in the brain.

Gradually, your brain adapts to the depressive impact of alcohol by enhancing the activity of excitatory neurotransmitters to sustain normal operation. When someone stops consuming alcohol suddenly, they disturb the equilibrium.

The brain persists in generating elevated amounts of excitatory substances. Yet, it misses the soothing influence of alcohol to counterbalance them. This leads to an excessive stimulation of the nervous system, ultimately causing withdrawal symptoms.

These symptoms clearly show that the body is reacting to the sudden stop of alcohol. They can range from mild to severe.

Typical symptoms encompass anxiety, irritability, tremors, perspiration, nausea, and sleeplessness. In more severe cases, people may experience hallucinations, seizures, or a serious condition called delirium tremens (DTs). This condition is marked by confusion, a fast heart rate, and high blood pressure.

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Exploring the Root Causes

Causes of Alcohol Withdrawal

Whenever you consume alcohol, you experience what specialists call a depressing effect on the central nervous system. This is because alcohol has a sedative effect on the brain and changes the way nerves carry information.

There are close relationships between GABA, a neurotransmitter that suppresses activity, and glutamates (excitatory neurotransmitters).

When you drink alcohol, the GABA (and some glutamate) receptors in your brain change, making you less anxious and sleepy. The brain reacts by reducing GABA release and increasing glutamate transmission to compensate. As long as you keep drinking alcohol, a change called “tolerance” takes hold.

After developing tolerance, you will require more significant amounts of alcohol to feel the same effect. In addition, the brain grows so acclimated to alcohol that your body can’t operate effectively without it. At this point, the brain goes into overdrive when you don’t drink. This may cause withdrawal symptoms a few hours after taking the last drink.

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Identifying the Stages and Symptoms

Signs and Symptoms of Alcohol Withdrawal

In the beginning, their brain does not realize that they have stopped drinking and continue overproducing the stimulating chemicals. However, when alcohol isn’t in the mix, these compounds cause many withdrawal symptoms.

Symptoms usually appear after eight hours of your last drink, although they may not show up for many days afterward. After your last drink, these symptoms usually peak within 24 to 72 hours. However, milder symptoms may last longer for some people.

Phase One: Mild Symptoms

Within six hours following your last drink, you may start to feel the effects of alcohol withdrawal. The early symptoms are usually modest, although they may be painful. They may include:

  • Nausea.
  • Shakes or tremors.
  • Blood pressure changes.
  • Anxiety.
  • Insomnia and other sleep-related issues.

After experiencing these signs of alcohol withdrawal, most individuals will be able to recover.

Stage Two: Seizures and Other Potentially Life-Threatening Symptoms

For most individuals, seizures and other life-threatening symptoms usually begin within two days after your last drink. Attacks can occur in up to 5% of people who experience withdrawal. The symptoms typically reach their climax about a day following the previous drink.

You will probably recover if you don’t have any severe symptoms (for example, seizures) after 48 hours. It is possible, however small, that you may develop them in the future. Thus, you should still consult a doctor.

Severe withdrawal symptoms that occur during stage two include:

  • Profuse sweating. 
  • Agitation.
  • Confusion. 
  • Hallucinations: These often include tactile, olfactory, or visual distortions.
  • Seizures.

Stage Three: Delirium Tremens (DTs)

DTs may occur in as many as half of the people with withdrawal seizures. They begin to manifest themselves between 48 and 72 hours after you stop drinking.

The time right after you decide to stop drinking is the most important and risky part of withdrawal. Symptoms of DTs may include:

  • Mood swings happen quickly.
  • Fever.
  • Severe sweat.
  • Fever or hyperthermia.
  • Extreme agitation.
  • If you have a grand mal seizure, you might have muscle spasms and lose some of your mental abilities for a short time.
  • Drowsiness or exhaustion.
  • Energy bursts.
  • Extreme disorientation.
  • Hallucinations.
  • High blood pressure.

Seeking medical attention is critical, particularly if you are experiencing signs of severe DTs. It is considered a medical emergency when a patient has DTS. At a medical or rehab facility, trained professionals understand these issues. They are ready to provide the right therapy.

Not all DTs result in death, although they may. Up to 25% of those are affected by DTs.

Stage Four: Post-acute Withdrawal Syndrome (PAWS)

After stopping drinking, some individuals may continue to suffer PAWS symptoms for a prolonged period (weeks to months). The following symptoms include:

  • Low energy.
  • Anxiety.
  • Dizziness.
  • Excessive irritability and emotional turbulence.
  • Sleeping problems.
  • Memory problems.
  • Intense cravings.
  • Delayed reflexes.
  • Chronic nauseous.

A Heart Attack and Alcoholism

You may develop cardiac difficulties during alcohol withdrawal (particularly if you suffer from DTs). This is due to the way alcohol impairs your organs.

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The Bottom Line

Guidance and Support for Alcohol Withdrawal

If you want to start a sober and alcohol-free life, an addiction expert can help you. People struggling with withdrawal symptoms or self-detoxing should immediately get help from a medical professional. The person will likely die if they experience acute symptoms like delirium tremens.

Consultation with a doctor or professional therapy is the safest way to deal with alcoholism and start detoxification.

Frequently Asked Questions About Alcohol Withdrawal:

Can alcohol withdrawal be prevented?

Withdrawal can be managed, but it’s impossible to completely avoid it if there’s alcohol dependency. Symptoms can be minimized through gradual reduction under medical guidance. Consulting a professional before cessation can offer tactics to lessen potential hazards.

Is it safe to quit alcohol “cold turkey”?

Abruptly stopping alcohol can pose risks for heavy consumers. They might encounter severe withdrawal symptoms, like seizures or Delirium Tremens. Opting for a medically monitored detoxification is a safer approach.

How long does it take to recover from alcohol withdrawal?

Usually, acute withdrawal symptoms lessen over a period of 5 to 7 days. Some symptoms, like emotional instability and sleep disruptions, can continue for weeks or even months. This condition is known as Post-Acute Withdrawal Syndrome (PAWS).

Does alcohol withdrawal lead to mental health problems?

Indeed, withdrawal can intensify pre-existing mental health issues or temporarily trigger symptoms such as anxiety, depression, and hallucinations. Prolonged alcohol consumption can also lead to the emergence of mental health disorders.

What are the common treatments for alcohol withdrawal?

The remedies might include:

  • Pharmaceuticals: Benzodiazepines are often recommended to alleviate withdrawal symptoms and avert complications.
  • Nutritional assistance: Thiamine and other vitamins to tackle deficiencies.
  • Hydration treatment: To handle dehydration.
  • Psychological therapies: Counseling to deal with psychological facets.
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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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