Addiction Alcohol Use Withdrawal and Relapse Mild to Life-Threatening Alcohol Withdrawal Symptoms By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on September 14, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print George Doyle/Stockbyte/Getty Images When heavy or frequent drinkers suddenly decide to quit "cold turkey" they will experience some physical withdrawal symptoms—which can range from the mildly annoying to severe and even life-threatening. The severity of these withdrawal symptoms is usually dependent upon how "chemically dependent" the chronic drinker has become. Those who drink heavily on a daily basis, of course, have developed a high level of dependency, but even those who drink daily, but not heavily and those who drink heavily but not daily, can also be chemically dependent upon alcohol. When someone who has become "alcohol dependent" decides to stop drinking, they will experience some level of physical discomfort. For this reason, it is extremely difficult for them to merely stop drinking "on their own" without assistance and support. Why "Never Again" Doesn't Usually Mean Never for the Alcohol Dependent The scenario has been played over and over many times. After a particularly damaging or embarrassing binge, the hungover person will make an oath to never drink again and quite often is sincere about quitting. But with the onset of withdrawal symptoms also comes the craving for more alcohol. The body is telling the drinker that it "needs" alcohol. As the physical symptoms of withdrawal begin to increase, taking another drink simply becomes less painful than not taking one—or so it seems at the time. For those who have committed themselves to not drinking again, or forced by circumstances do not have access to alcohol, the struggle to fight the withdrawal symptoms can become a dangerous battle, one that can actually become life-threatening. Mild Symptoms of Withdrawl For those who are less chemically dependent, withdrawal symptoms might be as "mild" as getting the shakes or the sweats—or perhaps nausea, headache, anxiety, a rapid heartbeat, and increased blood pressure. Although these symptoms are uncomfortable and irritating, they are not necessarily dangerous. But they are often accompanied by the "craving" for more alcohol, making the decision to continue abstinence much more difficult to make. Even the "morning after" hangover of someone who only occasionally drinks to excess is actually a mild form of alcohol withdrawal from the excesses of the night before as the alcohol content of their blood begins to drop. The symptoms can appear within a few hours after not drinking. Common Hangover Symptoms Serious Symptoms of Withdrawal Within six to 48 hours after not drinking, hallucinations may develop. These usually are visual hallucinations but they can also involve sounds and smells. They can last for a few hours up to weeks at a time. Also within this time frame after quitting, convulsions or seizures can occur, which is the point at which alcohol withdrawal can become dangerous if not medically treated. The symptoms may progress to delirium tremens (DTs) after three to five days without alcohol. The symptoms of DTs include profound confusion, disorientation, hallucinations, hyperactivity, and extreme cardiovascular disturbances. Once DTs begin, they can cause cardiac disturbances, seizures and other medical complications that can be fatal. What Is Delirium Tremens (DT) Really Like? Getting Treatment for Alcohol Withdrawal The good news for those who are extremely alcohol dependent, and who wish to quit drinking, all of these symptoms can be alleviated and even eliminated with proper medical treatment. Typically, for those who are mildly dependent doses of vitamins (including Thiamine), a proper diet, and hydration will prevent most of the mild withdrawal symptoms from occurring. For the severely dependent, medication can be administered, but only by a physician. One approach is to substitute benzodiazepines such as Librium for alcohol and gradually reduce the dosage until the patient is drug-free. Don't Go It Alone If you are a heavy drinker and want to quit, consult a trained medical professional or a facility that specializes in alcohol and drug treatment, and be honest about your usual alcohol intake. You also can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. You don't have to do it "on your own" to prove anything to anyone. Help is available; take advantage of it. The psychological withdrawal is difficult enough without having to fight the physical symptoms as well. Top Medical Treatment Options for Alcohol Withdrawal 3 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edition. Washington DC; 2013. Long D, Long B, Koyfman A. The emergency medicine management of severe alcohol withdrawal. Am J Emerg Med. 2017;35(7):1005-1011. doi:10.1016/j.ajem.2017.02.002 Muncie HL, Yasinian Y, Oge' L. Outpatient management of alcohol withdrawal syndrome. Am Fam Physician. 2013;88(9):589-95. By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. 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