What Are The Symptoms Of Alcohol Withdrawal? Signs, Causes & Treatments

What Are The Symptoms Of Alcohol Withdrawal? Signs, Causes & Treatments

For some people, drinking alcohol can exacerbate anxiety and depression. Drinking alcohol excessively for extended periods can also lead to physical dependence. Unassisted cessation of alcohol — quitting “cold-turkey” — can induce a life-threatening condition called alcohol withdrawal syndrome.

Alcohol withdrawal syndrome is a dangerous condition that all those who consume alcohol to excess regularly should be aware of. It’s distinct from other ailments brought on by excessive consumption such as alcohol poisoning or the symptoms of a vicious hangover.

According to medically reviewed research from the National Institute on Alcohol Abuse and Alcoholism, excessive drinking can also lead to nutritional deficiencies, adverse effects on your brain, heart, liver, and cancer.

So, what are the signs, causes, and treatments of alcohol dependency and alcohol withdrawal syndrome? And how do you treat it? 

Read on to learn more.

Excessive/Binge Drinking vs. Alcohol Dependency

Though symptoms of alcohol withdrawal syndrome can potentially affect light drinkers and heavy drinkers alike, it’s important to consider the differences between occasional excessive alcohol consumption — binge drinking — and full-blown alcohol dependency.

When someone consumes multiple drinks in a short period — about four to five drinks in a few hours — it’s considered binge drinking.

If a person who binge drinks regularly were to quit cold turkey, it may be unpleasant, but they wouldn’t necessarily experience alcohol withdrawal syndrome.

When someone has an alcohol dependency, they struggle to get through the day — or even the hour — without turning to alcohol. They are at a much higher risk of the coma, seizures, and vomiting associated with experiencing alcohol withdrawal syndrome.

What Are Withdrawals?

When an individual engages in chronic alcohol use, their body becomes accustomed to alcohol in the blood. When they suddenly stop drinking, their body often goes into a kind of revolt, called “withdrawal.”

Based on your medical history, a medical professional can tell if you are predisposed to severe alcohol withdrawal syndrome symptoms that could constitute a medical emergency.

Alcohol use reduction is never easy. If you’re a heavy drinker and suddenly stop drinking without seeking medical advice and treatment, you face a myriad of life-threatening withdrawal risks.

Withdrawal Risks

Symptoms of alcohol withdrawal syndrome can include: 

  • Seizures
  • Hallucinations
  • Coma
  • Alcohol Use Disorder
  • Post-Acute Withdrawal Syndrome
  • Tachycardia (increased heart rate)
  • Death

Withdrawal Vs. Hangover

While some might think of a hangover as a mild withdrawal, they are not the same. The causes behind hangovers and withdrawals are different and worth understanding.

Hangovers occur when you drink too much at once. Too much alcohol causes dehydration, stomach irritation, and inflammatory physical response. After your last drink, hangover signs of nausea, headache, and fatigue appear as the alcohol leaves your system. These effects are common with people who have had too many alcoholic drinks, but they are not necessarily a sign of physical alcohol dependency.

Withdrawal symptoms occur with the abrupt cutting off of a steady stream of alcohol to the body. For the withdrawals to be life-threatening, alcohol use typically has to have taken place over a prolonged period. At least long enough for the body to grow dependent on having alcohol in the system to function.

The central nervous system has had sufficient time to adapt to the presence of alcohol and change neurotransmitter production. Once the supply of alcohol is cut off or decreased, alcohol withdrawal symptoms begin to appear.

You can ask your doctor to provide medical advice for dealing with withdrawal, alcohol addiction, and more.

What Is Alcohol Withdrawal Syndrome?

Alcohol is often associated with fun and relaxation, but on a chemical level, this substance is a depressant. Alcohol slows brain function and influences how nerves communicate with each other.

When a person regularly consumes excessive amounts of alcohol, the central nervous system becomes accustomed to it and expects it. The body adapts chemical functions to account for the continuous presence of alcohol. If you drink heavily — even without being an alcoholic — you will experience some level of withdrawal when you stop drinking suddenly.

Medically reviewed research has shown that when you drink alcohol, the chemical balance in your brain gets thrown off, making it harder to communicate with your body. That can make it harder for alcohol to leave your system, leading to post-acute withdrawal syndrome.

Does Alcohol Withdrawal Cause Anxiety?

The short answer is yes. A common side effect of alcohol withdrawal is an increased level of anxiety. A big factor in this heightened anxiety is actually worrying about the other withdrawal symptoms, especially the physical ones such as nausea and increased heart rate. Another reason someone may feel heightened anxiety is the fact that they have lost their coping mechanism. No matter the reason, there is a good chance someone will feel increased anxiety going through withdrawal.

The Symptoms of Alcohol Withdrawal

Once withdrawal begins, the symptoms will range from severe to mild. The severity is likely to be contingent upon your history of alcohol abuse: how long you drank, and how much. Alcohol withdrawal symptoms are commonly referred to as ‘the shakes,’ or feeling jittery, shaky, sweaty, and generally unwell.

But the list of symptoms stretches much further than body tremors and an increased heart rate.

Common Withdrawal Symptoms

  • Shaky hands
  • Anxiety
  • Sweating
  • Headache
  • Nausea
  • Vomiting
  • Insomnia
  • Irritability

Severe Withdrawal Symptoms

  • Hallucinations
  • Seizures
  • Fever
  • High blood pressure
  • Confusion
  • Racing heart/increased heart rate
  • Cardiac arrest

Withdrawal Timeline

The entire detoxification process of alcohol withdrawal can take five to ten days and begins just hours after consumption ceases. 

Once you stop drinking, the liver starts to metabolize ethanol and move alcohol through the system. As the alcohol leaves your body, the symptoms outlined above may begin to appear.

Typically, withdrawal follows a general timeline for severe cases:

  • 6-8 hours: First signs appear, usually shaking, stress, anxiety, headaches, nausea, trouble sleeping.
  • 1-3 days: Symptoms begin to peak. Hallucinations, irritability, seizures, and high blood pressure can occur. There is a risk of cardiac arrest.
  • 5-10 days: Symptoms begin to subside, but cravings may be present for weeks.

When Do Alcohol Withdrawal Symptoms Start?

Withdrawal symptoms can start as quickly as 6 hours after your final drink. 

However, for some, withdrawal symptoms can start a few days later. Your experience of alcohol withdrawal depends on many factors like your age, height, weight, and how much alcohol you consumed daily before quitting. 

The potentially severe symptoms that may occur as a result of alcohol withdrawal syndrome mean that if you wish to quit drinking alcohol, it’s best to seek medically assisted detox. 

When Do Alcohol Withdrawal Symptoms Stop?

Alcohol withdrawal symptoms typically stop four to five days after your last drink. There are three stages to the detox process, and they typically occur over five days, but can last up to a week for some. 

The process breaks down into three components defined by the severity of the symptoms:

  • In the first 12-24 hours, mild withdrawal symptoms start. A person may experience headaches, anxiety, stomach issues, a change in appetite, nausea, and general malaise. 
  • After 24-48 hours, symptoms can escalate, and some people may experience hallucinations or seizures.
  • Beyond 48 hours, if you’re still experiencing withdrawal symptoms, you may have entered alcohol withdrawal syndrome territory. You should contact your doctor immediately.

How Severe Can Withdrawal Symptoms Be?

The severity of withdrawal depends upon the severity of the physical dependency. It also depends on the length of time over which a person heavily consumes alcohol.

In the most severe cases, a person may experience delirium tremens.

What Is Delirium Tremens?

Delirium Tremens — commonly referred to as the “D.T.s” — is a syndrome characterized by changes in mental states and autonomic nervous system excitation. Delirium Tremens is likely to occur in people who have a history of alcohol withdrawal symptoms, drink daily for months, or have abused alcohol for years. Delirium Tremens is the most severe symptom of alcohol withdrawal, but it only appears in less than 5% of people undergoing withdrawal.

Delirium Tremens usually occurs a day or two into withdrawal as all alcohol leaves the bloodstream. The condition occurs when the brain suddenly loses the alcohol depressant after long periods of suppression and vigorously springs into a dangerous rebound.

Signs of Delirium Tremens

  • Body tremors
  • Agitation
  • Fever
  • Severe confusion
  • Disorientation
  • Hallucinations
  • Seizures

While rare, Delirium Tremens is a dangerous reaction and requires immediate medical attention. It could be fatal without medical intervention. 

If a person has been dependent on alcohol for a long time, the risk of developing this condition is higher than usual.

***If you are reading this and experiencing symptoms of delirium tremens, call for emergency medical assistance immediately.***

How to Treat Alcohol Withdrawal

Depending on the severity of the symptoms, you may be able to handle alcohol withdrawal without medical assistance. For some people, a supportive, healthy environment is enough to navigate this process. The following is advisable for people seeking to recover from mild cases of alcohol withdrawal:

  • Soft lighting
  • Quiet environment
  • A supportive, positive atmosphere
  • Limited contact with others
  • Plenty of fluids and healthy food

Some treatments require prescribed medications like benzodiazepines for insomnia, anxiety, and seizures. These medications can alleviate some withdrawal symptoms but should only be used under medical supervision as they can be addictive themselves.

Have your doctor check any prescription recommendations against your medical history and only accept safe, medically reviewed medications.

Why You Need Professional Help When Treating Alcohol Withdrawal Syndrome

Not everyone who ceases drinking alcohol experiences alcohol withdrawal symptoms. However, symptoms may appear and escalate violently and quickly —  with mild symptoms rapidly becoming severe and potentially even life-threatening.

Seeking professional help to withdraw from alcohol dependence is crucial under the following circumstances:

  • A history of long-term and/or heavy alcohol use
  • Pre-existing medical conditions
  • Any visible withdrawal symptoms

If severe symptoms of alcohol withdrawal syndrome manifest, such as:

  • A higher heart (pulse) rate or pulse rises
  • Elevated blood pressure  
  • Temperature increases
  • Hallucinations or seizures

Seek emergency medical care immediately.


With monitored detox, a doctor will administer a physical exam and advise you or your loved ones of drug-assisted treatment and inpatient care options.

Seeking medical treatment when detoxing from alcohol is often advisable, even for milder cases of alcohol use. 

There is not a single solution that works for everyone, especially for addiction treatment. Your doctor can give you the full scope of options available to ease your path from alcohol dependence to recovery.

Treatment Options

There are professional treatment options to assist with alcohol addiction or a substance abuse problem of any kind. 

 Treatment typically begins with a Clinical Institute Withdrawal Assessment. The assessment charts your alcohol intake, duration of use, last day of alcohol intake, etc.

This information allows the clinician to create a medically-reviewed alcohol withdrawal timeline.

From there, your doctor can refer you to an addiction treatment program. 

Treatment facilities and specialists can help alleviate severe alcohol withdrawal symptoms while providing 24/7 support in a medical detox process

Regardless of whether you work long hours and can’t afford to take a week off, or if you have time and money at your disposal, there is a treatment plan that will work for you. 

Alcohol detox programs come in all shapes and sizes to help make the path to sobriety accessible and attainable for all.

Here are some of the most common treatment options:

Inpatient Treatment

Inpatient treatment provides a safe, supervised environment to help people overcome alcohol dependence. It is the most intensive treatment option and typically requires 30, 60, or 90-day programs. 

The patient will check into the facility and explore various treatment options, including medical detox, individual and group counseling, and coaching on how to successfully reenter the outside world.

Outpatient Treatment

Outpatient treatment allows you to continue with your daily responsibilities while recovering and is well-matched with mild cases of alcohol abuse and dependence. 

Outpatient treatment is a viable option if you can handle being around societal influences and drinking triggers in your daily routine while recovering.

Individual Counseling

Counseling focuses on mental health and helps uncover the underlying factors behind your alcohol addiction. Counseling also identifies tools to help you cope and work through recovery from alcohol dependence.

Medication-Assisted Therapy 

If your alcohol withdrawal is likely to be difficult or dangerous in light of your drinking history, medication-assisted therapy is a viable option. It utilizes prescription medication that can alleviate uncomfortable — or even life-threatening — withdrawal symptoms, leaving you better equipped to focus on the other elements of recovery.

Support Groups

Private and community-based support groups provide a non-judgmental environment to focus on treatment goals. Support groups also provide you with a sense of community, allowing peers who have faced similar challenges to help you heal and grow.

Professional Standards

Some people do not have access to a supportive, safe environment conducive to detoxification. Utilizing professional assistance can mitigate this concern and prioritize mental health in the process.

Professional aid means professional standards. If you detoxify under professional medical supervision, you will experience the following:

  • Humane treatment and protection of dignity during the withdrawal process 
  • A physically safe withdrawal process 
  • Treatment and coping strategies that can help you live alcohol-free
  • Ongoing treatment and support for alcohol independence after physical withdrawal symptoms subside

Contact Master Center for Addiction Medicine

Navigating alcohol withdrawal syndrome can be a challenging but crucial step towards recovery. For most people, getting sober is a prerequisite for getting to grips with the root causes behind their alcohol dependency.

Although challenging, detox, recovery, and sobriety are possible. The wide range of treatment options and support spheres means you don’t have to go it alone.

At Master Center our medically guided treatment programs have proven track records of success for our patients.

What’s more, we offer a uniquely compassionate and supportive treatment environment because many of our staff are in recovery themselves.Reach out to the experts here at Master Center for Addiction Medicine or your medical provider to learn more and determine what alcohol withdrawal treatment option is the next step to a healthier you.