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Alcohol Withdrawal: Symptoms, Timeline, and Treatment

Alcohol withdrawal can occur when a person who is physically dependent on alcohol abruptly cuts back or stops drinking altogether.1 Alcohol withdrawal symptoms are extremely variable and can range from mild to severe.2, 3 Mild alcohol withdrawal symptoms can include anxiety, irritability, lack of appetite, and trouble sleeping, while severe alcohol withdrawal symptoms can include elevated blood pressure and heart rate, nausea and vomiting, sweating, tremors, and more.2, 3

Alcohol withdrawal can have several medical complications, including seizures and even death, which is one reason why attempting to quit “cold turkey” without the help of medical professionals is not safe.3

If you or someone you care about is ready to quit drinking, it’s important to talk to a doctor first, as they will be able to recommend treatment that will keep you as comfortable and safe as possible during the detox process.

What Is Alcohol Withdrawal?

Alcohol withdrawal refers to the symptoms that can occur when a person who is physically dependent on alcohol abruptly cuts back or stops drinking.4

Dependence is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.5

Signs & Symptoms of Alcohol Withdrawal

The symptoms of alcohol withdrawal are extremely variable and can range from mild to severe.3 Several factors can influence the severity of alcohol withdrawal including age, general health, nutritional factors, and if a person has any co-occurring medical or mental health conditions.3

Symptoms of alcohol withdrawal can include:2, 3, 6

  • Anxiety.
  • Agitation and/or irritability.
  • Restlessness.
  • Impaired concentration and judgment.
  • Loss of appetite.
  • Nausea and/or vomiting.
  • Increased blood pressure and heart rate.
  • Sensitivity to light and sound.
  • Tremor or shakiness.
  • Sleep issues (e.g., insomnia, nightmares, or vivid dreams).
  • Fever and/or sweating.
  • Delusions.
  • Hallucinations (seeing or hearing things that aren’t there).

These symptoms can appear at different stages of the alcohol withdrawal timeline or not at all depending on the person. With severe alcohol withdrawal more symptoms may be present and last for a longer amount of time.

Complications of Alcohol Withdrawal

While many people experience moderate or mild alcohol withdrawal symptoms, some people experience life-threatening complications, including dysregulation of body temperature, blood pressure, and pulse as well as seizures and delirium tremens (DTs).3 People who develop DTs may experience confusion, disorientation, and hallucinations as well as severe autonomic nervous system hyperactivity.3, 6, 7

Wernicke-Korsakoff (WKS) is a condition involving a combination of 2 different but closely related disorders: Wernicke’s encephalopathy and Korsakoff’s psychosis. Although not a complication of alcohol withdrawal, it commonly occurs during this timeframe.7 It results from a deficiency of thiamine (vitamin B1) from long-term alcohol use and can cause a variety of symptoms including eye abnormalities, confusion, tremors, coma, and death.8, 9

Fortunately, many  symptoms can be reversed if detected and treated promptly.8 However, if the condition progresses, permanent brain damage and memory impairment can occur. 9

How Long Does Alcohol Withdrawal Last?

How long alcohol withdrawal lasts can vary from person to person depending on several factors. While there are not alcohol withdrawal stages that are set in stone, a general alcohol withdrawal timeline may be as follows:3, 10

  • 6-12 hours after a person’s last drink, alcohol withdrawal starts, and mild symptoms including anxiety, headache, difficulty sleeping, sweating, and upset stomach arise.
  • 12-24 hours after a person’s last drink, more moderate symptoms may begin including auditory, visual, or tactile hallucinations.
  • 24-48 hours after a person’s last drink, mild and moderate symptoms may have become less intense or have resolved. People who experience withdrawal seizures typically do so 24-48 hours after their last drink.
  • 48-72 hours after a person’s last drink, delirium tremens may appear, as well as other symptoms including agitation, hallucinations, high blood pressure, low-grade fever, and elevated heart rate.

Although rare, a person can experience persistent alcohol withdrawal-related symptoms for months, which can lead to relapse.2 A formal detox, however, can help many people fully recover.11

Who Is at Risk for Alcohol Withdrawal?

Anyone who is physically dependent on alcohol can be at risk of experiencing alcohol withdrawal symptoms. Among people who are physically dependent on alcohol, around 50% will experience some symptoms of alcohol withdrawal.12

Several factors can influence a person’s risk of developing prolonged or severe alcohol withdrawal such as:

  • their pattern of alcohol use (e.g., how long and how much they have been drinking)
  • prior detoxifications
  • prior seizures
  • prior episodes of DTs
  • co-occurring medical or mental health conditions
  • genetic influences
  • and more 6, 7

Everyone is different and it can be hard to know who will and will not experience complications, so getting professional care and supervision during alcohol withdrawal is often recommended.

Alcohol Withdrawal Treatment

Medical detox from alcohol is often considered the first step in treatment and can help a person more comfortably and safely withdraw from alcohol while under the supervision of medical professionals. This process can take place in inpatient or outpatient settings depending on the needs of the individual and the expected severity of alcohol withdrawal symptoms. Alcohol withdrawal treatment may also include medications to assist in the process and help decrease the severity of symptoms.11

Professional assistance and treatment for alcohol withdrawal can help a person achieve an alcohol-free state and transition into ongoing treatment for alcohol addiction including therapy and holistic programming. This ongoing treatment can help address the behavioral, psychological, and social problems that are often associated with addiction and help place patients on the path to lasting sobriety.11

Getting Help

If you or someone you care about is struggling with alcohol use, you don’t have to go through alcohol withdrawal alone. There are professionals available that know how to help alcohol withdrawal and ease symptoms. Our directory of rehab centers lets you easily search for a facility near you that offer detoxification when you filter by “detox services,” and location. If you need help, our admissions navigators are available 24/7 when you call .

 

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