Alcohol Withdrawal: Quitting, Symptoms, Timeline, & Help

While drinking alcohol is legal and socially acceptable, alcohol abuse can lead to dependence, addiction, and alcohol withdrawal symptoms.

Because of the intensity of alcohol withdrawal symptoms, many people delay getting the help they need at addiction treatment centers. However, managing this challenging withdrawal phase effectively is vital to begin a sustained and successful recovery from substance abuse.

In this blog, we’ll break down what you can expect if you engage with treatment for alcohol use disorder and how to find a safe and effective program for alcohol withdrawal.

Alcohol Withdrawal

Alcohol withdrawal syndrome (AWS) is a term used to describe the withdrawal symptoms moderate to heavy drinkers experience if they stop drinking abruptly, or cut back on their consumption. Data shows that roughly half of those diagnosed with alcohol use disorder will experience withdrawal symptoms at some stage during detox.

Withdrawing from alcohol is an intense process that should never be done at home. Because of the severity and danger of alcohol withdrawal syndrome, it’s critical that someone coming off of alcohol be treated under the supervision of medical professionals.

When you drink excessive amounts of alcohol long-term, it changes your central nervous system. Alcohol has a strong sedative effect. When you drink large amounts of alcohol, or if you drink to excess long-term, you’ll be almost continuously exposing yourself to a powerful depressant effect. Your brain responds to this imbalance by producing chemicals to negate the sluggish feeling alcohol can induce.

If you are actively addicted to alcohol, your brain will have higher levels of both norepinephrine and serotonin. If you suddenly remove alcohol from the equation, your brain will feel overstimulated. As this happens, your CNS struggles to cope with the absence of alcohol. It is at this point that AWS often manifests.

If you are alcohol dependent or if you have an alcohol use disorder, you should speak with your healthcare provider if you are thinking of committing to sobriety. You should not stop abruptly and without medical guidance, as severe withdrawal symptoms can be fatal if not treated.

How Is Alcohol Withdrawal Syndrome Diagnosed?

To diagnose alcohol withdrawal syndrome, your doctor will use questions from the CIWA-Ar, which assesses the following 10 symptoms:

• Headaches
• Anxiety
• Visual disturbances
• Tactile disturbances
• Auditory disturbances
• Inability to think clearly
• Agitation
• Nausea and vomiting
• Sweating
• Tremors

Your doctor will also ask you some questions to determine whether you’re thinking lucidly.

Even if you find the idea of opening up to your healthcare provider distasteful, you need to be completely transparent if you want to commit to recovery. Also, if you have been drinking to the extent that it induces symptoms of alcohol withdrawal when you stop, you may have caused more damage inside your body.

Your doctor may also give you some basic nutritional advice if you’ve been eating poorly as a result of alcohol abuse.

Alcohol Withdrawal Symptoms

Alcohol Withdrawal Syndrome (AWS) occurs when someone who has been drinking heavily stops or significantly reduces alcohol consumption. While the symptoms of alcohol withdrawal can be intense, it is critical to go through alcohol detox in order to break free from alcohol addiction or dependence. Even mild symptoms of alcohol withdrawal can be dangerous, especially when alcohol dependence is an issue.

For those engaging in moderate to severe alcohol use, a medically supervised withdrawal is necessary for safety, as alcohol withdrawal can be dangerous. Alcohol withdrawal is treated in a specialized alcohol detox facility or hospital setting, supervised 24/7 by licensed medical staff.

Withdrawal symptoms range from mild to severe, depending on factors like duration of alcohol use, overall health, and co-occurring conditions.

Withdrawal symptoms from alcohol can be categorized as follows:

• Mild alcohol withdrawal
• Moderate alcohol withdrawal
• Severe alcohol withdrawal

Mild Alcohol Withdrawal Symptoms

Physical Symptoms:

• Headaches, tremors, and gastrointestinal discomfort (nausea, vomiting, abdominal pain).
• Disrupted sleep patterns and appetite loss.

Psychological Symptoms:

• Feelings of depression early in withdrawal, which typically improve over time.

Moderate Alcohol Withdrawal Symptoms

In addition to mild symptoms, moderate alcohol withdrawal may include:

Physical Symptoms:

• Increased heart rate, sweating, shallow breathing, and raised body temperature (hyperthermia).
• Elevated blood pressure, particularly an increase in systolic pressure.

Psychological Symptoms:

• Mood swings, irritability, and confusion.

Severe Alcohol Withdrawal Symptoms

Severe withdrawal symptoms can be dangerous and require medical supervision.

Physical Symptoms:

• Fever and dangerously high blood pressure.
• Increased risk of seizures.

Psychological Symptoms:

• Disorientation, hallucinations, and delirium tremens (DTs), a life-threatening withdrawal complication.

Alcohol Withdrawal Symptoms Timeline

There are several alcohol withdrawal stages you can expect when going through detox from alcohol use. Here’s what to expect over the first week without alcohol in your system:

• 24 hours after the last drink: Alcohol withdrawal symptoms can occur at any stage during the first 9 hours of abstinence.
• 72 hours after the last drink: Symptoms typically peak in intensity after the first 3 days. Some severe alcohol withdrawal symptoms manifest at this point, including delirium tremens.
• 5 to 7 days after the last drink: Alcohol withdrawal symptoms should start diminishing toward the end of the first week.
• First week after the last drink: Most physical withdrawal symptoms should be gone by now. Psychological effects may linger if not properly managed.

Here is a glimpse at when the following common symptoms occur:

• Tremors, breathing issues, and nausea: Begin within a few hours of the last drink. Shaking and tremors may occur and typically subside within 72 hours. Blood pressure and pulse may rise, and rapid breathing, sweating, vomiting, and nausea are common during the first 3 days. Psychological effects include nightmares, hyper-vivid dreams, anxiety, and increased alertness.
• Hallucinations: May manifest during the first 72 hours. Supervision is essential if these occur.
• Seizures: The risk peaks 24 hours after the last drink and is a major danger of unmanaged alcohol withdrawal.
• Delirium tremens (DTs): Usually appear after 48 to 72 hours of abstinence. Close medical supervision is crucial. Estimates show 3% to 5% of all cases result in DTs.

It’s important to understand that alcohol withdrawal should never be done at home. Symptoms can be extremely dangerous, with more severe withdrawal symptoms being fatal without immediate medical intervention. Detoxing from alcohol dependence should only be done in a detox facility or hospital to ensure safety.

How Long Do Alcohol Withdrawal Symptoms Last?

Most alcohol withdrawal symptoms begin between 5 and 24 hours after you stop or reduce alcohol intake. While mild withdrawal symptoms usually fade within the first week of abstinence, severe alcohol withdrawal can extend up to a week or more. Severe symptoms typically require medical treatment, often in a residential setting.

Alcohol Withdrawal Treatment

Alcohol withdrawal treatment creates a safer, more comfortable experience for those detoxing from alcohol. Medical professionals will use the CIWA protocol to assess withdrawal severity and create a customized treatment plan for each patient. Treatment helps reduce withdrawal symptoms, prevents withdrawal seizures and other complications, and provides long-term treatment for alcohol use disorder.

Treatment for alcohol withdrawal includes:

1. 24/7 Medical Supervision: For those with moderate to severe symptoms, round-the-clock medical care is critical to prevent or treat severe withdrawal symptoms like seizures.
2. Medication for Alcohol Withdrawal: Medications help reduce withdrawal symptoms and cravings. They include Gabapentin and benzodiazepines to prevent seizures, beta-blockers and Clonidine to control blood pressure and heart rate, and Naltrexone, Acamprosate, and Disulfiram to reduce cravings and prevent relapse. Medication-assisted treatment (MAT) is delivered in an intensive outpatient or partial hospitalization setting, often combined with psychotherapy.
3. Supportive Care & Nutrition: Individuals undergoing detox may receive vitamins, proper hydration, nutritious meals, and emotional support through therapy, counseling, or peer groups.
4. Individual and Group Therapy: Psychotherapy like CBT and DBT helps identify triggers and develop healthy coping strategies to prevent relapse.
5. Transition to Long-Term Substance Abuse Treatment: After detox, follow-up programs provide therapy and treatments to address underlying addiction and co-occurring mental health conditions.
6. Aftercare: Many programs offer aftercare services such as sober communities, career placement support, and exercise programs to help maintain sobriety and prevent relapse.

Is It Possible to Avoid Alcohol Withdrawal?

The only reliable way to prevent alcohol withdrawal is to discontinue substance abuse. However, if you’re dependent on alcohol and want to avoid more severe withdrawal symptoms, you can talk to your doctor about tapering off alcohol slowly. While most individuals with moderate to severe alcohol dependence will struggle to do this on their own, some people with mild dependence can do this effectively. That being said, it is never safe to detox from alcohol outside of a medically supervised environment, and you should never stop drinking abruptly.<

While only 5% of those withdrawing from alcohol experience delirium tremens, as many as 15% of that percentage die as a result. For this reason, along with the possibility of seizures, medically-supervised detox is critical if you are severely dependent on alcohol and at risk for DTs.

How about if you’re ready to stop drinking and undergo alcohol withdrawal?

Overcoming Alcohol Withdrawal at Renaissance Recovery

It’s important to understand that detox and alcohol withdrawal alone are not a cure for alcohol use disorder (AUD). Recovery is an ongoing process, not a one-time event.

At Renaissance Recovery’s Orange County rehab, we provide detox program referrals and long-term outpatient addiction treatment to ensure your alcohol recovery is as safe and comfortable as possible. Because no two individuals have the same recovery journey, our treatment programs are fully personalized to meet your specific needs and financial situation.

Severe alcohol withdrawal, including delirium tremens (DTs), can be life-threatening. Do not attempt to recover from alcohol abuse alone.

Call Renaissance Recovery’s addiction hotline at 866-330-9449 today to take the first step toward a healthier, alcohol-free future.

Sources

1. https://medlineplus.gov/ency/article/000764.htm 2. https://www.ncbi.nlm.nih.gov/books/NBK441882/ 3. https://pmc.ncbi.nlm.nih.gov/articles/PMC6084325/ 4. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-use-disorder-risk-diagnosis-recovery