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What is Alcohol Withdrawal?

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By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

an image of a stethoscope representing what is alcohol withdrawal

Authored By: Joe Gilmore

Table of Contents

What is alcohol withdrawal syndrome and why is it potentially dangerous?

Well, it’s unfortunate that confusion over this issue stops so many people struggling with alcohol use disorder from obtaining the treatment they need. Research suggests that only 10% of those with alcohol addiction connect with professional treatment. The more you know about the alcohol withdrawal process, the less you will have to fear.

Studies show that 50% of those with alcohol use disorder experience withdrawal symptoms during the detoxification phase of rehab. While detox is only one phase of the recovery process, it is vital to your overall success.

What can you expect from alcohol withdrawal, then?

What is Alcohol Withdrawal Like?

Alcohol withdrawal syndrome, commonly abbreviated to AWS, refers to the adverse withdrawal symptoms a heavy drinker experiences when they moderate or discontinue alcohol consumption. These symptoms can be both physical and emotional.

Mild alcohol withdrawal is characterized by feelings of fatigue and anxiety, as well as nausea and vomiting. More severe alcohol withdrawal symptoms can include disturbing hallucinations and potentially deadly seizures.

Why do you experience alcohol withdrawal symptoms, though?

Drinking alcohol excessively long-term can trigger significant changes to your central nervous system (CNS).

Alcohol exerts a sedative effect on the brain. Drinking heavily and/or long-term means you are continuously exposed to the depressant effects of alcohol. In response, your brain produces chemicals to address this imbalance and to counteract the sluggish feeling heavy drinking can induce.

When you drink alcohol regularly, the brain produces serotonin and norepinephrine – chemical messengers called neurotransmitters – at increased levels. Removing alcohol from the equation means your brain is suddenly overstimulated. With your brain running at full speed and your CNS finding the absence of alcohol challenging, alcohol withdrawal symptoms manifest as your brain’s response.

Alcohol withdrawal symptoms will differ according to the severity of AWS. Symptoms unfold over the following stages:

  • Stage 1: Mild alcohol withdrawal syndrome
  • Stage 2: Moderate alcohol withdrawal syndrome
  • Stage 3: Severe alcohol withdrawal syndrome (delirium tremens)

Stage 1: Mild alcohol withdrawal syndrome

The symptoms of mild alcohol withdrawal are correspondingly benign. These include:

  • Anxiety
  • Depression
  • Tremors
  • Headaches
  • Insomnia
  • Abdominal pain
  • Gastrointestinal issues
  • Vomiting
  • Appetite loss

Stage 2: Moderate alcohol withdrawal syndrome

Moderate alcohol withdrawal syndrome is associated with all of the above symptoms in addition to the following:

  • Rapid heartbeat
  • Raised body temperature
  • Shallow breathing
  • Heavy sweating
  • Increased systolic blood pressure levels

As well as these physical symptoms, moderate AWS often triggers a sense of overall confusion, as well as irritability and pronounced mood changes.

Stage 3: Severe alcohol withdrawal syndrome (delirium tremens)

Around 5% of people detoxing from alcohol experience the most severe form of alcohol withdrawal in the form of delirium tremens (DTs). It is advisable to withdraw from alcohol in a medical detox center or inpatient treatment center if you are at risk of manifesting severe symptoms of AWS.

Many factors impact the extent and severity of withdrawal symptoms, including:

  • How long you have been drinking
  • How much you have been drinking
  • Relevant medical history
  • Co-occurring mental health disorders
  • Stress levels
  • Family history of alcoholism

Not everyone experiences all of the above symptoms, and all situations are different. That said, alcohol detox follows a predictable pattern once your body is purged of toxins.

Here’s what to expect as alcohol withdrawal unfolds over 7 to 10 days:

  • 24 hours after the last drink: The first phase of withdrawal begins anywhere from 8 hours after the last alcoholic drink.
  • 24 to 72 hours after last drink: Withdrawal symptoms typically peak after 3 days. This is also the stage at which severe symptoms of AWS can present.
  • End of first week of detox: Symptoms become less intense toward the end of week one of sobriety.
  • Second week of detox: Most physical withdrawal symptoms should dissipate. Some psychological symptoms can linger for weeks, so make sure you seek treatment.

What Happens When a Person Suddenly Stops Drinking?

It is inadvisable to stop drinking suddenly using the cold turkey method. Your body needs time to adjust to functioning properly without alcohol, with withdrawal symptoms the body’s response.

Not only can it be uncomfortable to detox at home, but severe AWS can even be life-threatening if not properly managed.

What Medication is Used for Alcohol Withdrawal?

For anyone expecting to experience severe alcohol withdrawal, medically-supervised detox is a safer and more comfortable alternative to home detox. A treatment team can administer a variety of medications to streamline alcohol withdrawal.

Benzodiazepines, often abbreviated to benzos, are a class of drug often used to mitigate alcohol withdrawal symptoms. Benzos, like alcohol, act as a CNS depressant, causing both sleepiness and drowsiness.

Benzos can help treat the following symptoms:

  • Headaches
  • Pain
  • Insomnia
  • Restlessness
  • Nausea
  • Vomiting
  • Panic
  • Anxiety
  • Seizures
  • Tremors
  • Irritability
  • Chills
  • Sweats

Tolerance to benzos forms rapidly and the medication has a strong potential for abuse. For these reasons, benzos are normally prescribed short-term.

Librium, Valium, Serax, and Tranxene are the benzodiazepines with FDA-approval for the treatment of acute alcohol withdrawal.

When benzos prove ineffective, barbiturates can be beneficial, although more research is needed into their effectiveness.

Sometimes, seizure medications are prescribed during severe alcohol withdrawal. The following anticonvulsants can be used during alcohol detox:

  • Tegretol
  • Neurontin 
  • Trileptal
  • Depakene

While the anticonvulsants used to prevent seizures have less potential for abuse than benzodiazepines, they do not always prevent delirium tremens or the associated grand-mal seizures.

As well as the above medications, there are three FDA-approved medications for the treatment of alcohol use disorder:

  1. Disulfiram
  2. Acamprosate
  3. Naltrexone

When used as part of an overarching treatment plan, these medications can help minimize the chance of relapse and promote sustained recovery. We offer medications like these and much more here at Renaissance Recovery Center.

Getting Help for Alcohol Withdrawal at Renaissance

Alcohol withdrawal is undeniably challenging, but it is nevertheless only the first stage of a lifelong journey of sobriety. If you require a medical detox, we can connect you with suitable facilities near you.

With your system toxin-free, you’ll be ready to engage with one of our outpatient programs for alcohol use disorder. For anyone requiring more intensive treatment, we offer both IOPs (intensive outpatient programs) and PHPs (partial hospitalization programs) alongside traditional outpatient programming.

If you’re suffering from a co-occurring mental health condition like depression or anxiety, we provide dual diagnosis treatment programs. Here, you’ll unpack your addiction and mental health condition simultaneously.

All of our treatment programs offer you access to the following combination of therapies:

  • MAT (medication-assisted treatment)
  • Psychotherapy (CBT or DBT)
  • Counseling (individual and group)
  • Holistic therapies

With alcohol withdrawal behind you and a firm foundation for recovery in place, we’ll ensure you leave with the aftercare and relapse prevention plan you need to stay sober in the face of temptation.

To kickstart your recovery, reach out to admissions at 866.330.9449.

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Pat C

“I owe my life and my happiness to these people. October 8th, 2019 marked two years of sobriety for me, and prior to finding Renaissance I hadn’t had 24 hours sober in nearly 20 years.”

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“They truly cared for me and the other people that I served with! From this group, I have made 8 new brothers and friends for life! We have continued on, after the program, to take care of each other”

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Diana Vo, LMFT

Diana is an addiction expert and licensed marriage and family therapist who has been in the field of mental health for over 10 years.

Joseph Gilmore

Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country