Addiction Alcohol Use Withdrawal and Relapse Symptoms of Alcohol Detox By Sanjana Gupta Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness. Learn about our editorial process Updated on August 25, 2022 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 Maria Korneeva / Getty Images Table of Contents View All Table of Contents Why Do Alcohol Withdrawal Symptoms Occur? Symptoms of Alcohol Detox Evaluating the Symptoms Symptoms of Delirium Tremens Managing Symptoms If you have alcohol use disorder and are seeking treatment for it, alcohol detox is often the first step. This is a process that involves stopping your alcohol intake and flushing out any alcohol that is remaining in your system. You may experience withdrawal symptoms such as sweating, shaking, and insomnia during the detox process, particularly if you drink heavily or regularly. Some people may experience a severe form of withdrawal, known as delirium tremens. This article explores the symptoms of alcohol detox, as well as some strategies to manage the symptoms at home or at a treatment facility. Why Do Alcohol Withdrawal Symptoms Occur? Harvard Medical School notes that if you stop drinking suddenly, your brain is like a racing vehicle without brakes. Your body starts to experience withdrawal symptoms because your brain is overstimulated. These symptoms generally follow a predictable pattern after the last alcoholic drink. According to a 2013 study, there is a common misconception among people who drink regularly that quitting alcohol causes more problems than continuing to drink. However, it's important to note that while the alcohol detox process can be difficult due to the withdrawal symptoms, continuing to drink can be extremely harmful to several parts of your body, including your brain, heart, and liver. In addition to harming your health, it can also hurt your work, academics, family, relationships, and community. Symptoms of Alcohol Detox Symptoms of alcohol withdrawal usually occur within eight hours of your last drink and peak between 24 to 72 hours; however, in some cases, they can start days later or persist for weeks. The severity of the symptoms can vary depending on how often you drink, how much you drink, and whether you have any health conditions or organ damage. While the symptoms can be unpleasant and uncomfortable, they are not life-threatening in most cases. The alcohol detox process can involve both physical and emotional symptoms. Physical Symptoms These are some of the physical symptoms you may experience during the alcohol detox process: Sweating Clammy hands and skin Looking pale Enlarged pupils Rapid heart rate High blood pressure Headache Insomnia Lack of appetite Nausea Vomiting Fever Tremors Seizures Emotional Symptoms These are some of the emotional symptoms you may experience during the alcohol detox process:3 Anxiety Depression Agitation Fatigue Irritability Mood swings Hallucinations (seeing or hearing things that are not real, such as falling coins or crawling insects) Vivid dreams or nightmares Inability to think clearly How Long Does Alcohol Stay in Your System? Evaluating the Symptoms of Alcohol Detox These are some of the emotional symptoms you may experience during the alcohol detox process: AnxietyDepressionAgitationFatigueIrritabilityMood swingsHallucinations (seeing or hearing things that are not real, such as falling coins or crawling insects)Vivid dreams or nightmaresInability to think clearly What Are Hallucinations? Symptoms of Delirium Tremens Delirium tremens is a severe version of alcohol withdrawal that affects approximately 15% of people experiencing alcohol withdrawal. You may experience delirium tremens if you: Stop drinking suddenly after a period of heavy drinking, particularly if you haven’t eaten enough foodHave a health condition or head injury, in addition to a history of heavy alcohol useHave a history of complications related to alcohol withdrawal The symptoms of delirium tremens typically occur within 48 to 96 hours after the last drink and escalate quickly. In some cases, they might appear seven to 10 days after you have your last drink. People who may be at risk for delirium tremens need to be under medical care during the detox process as this condition is a medical emergency that can be life-threatening if it’s not treated immediately. These are some of the symptoms of delirium tremens: Blurry consciousness such as reduced clarity of awareness of the environment, with reduced ability to focus, sustain, or shift attention Disturbance of cognitionDisturbance in psychomotor activity (i.e. typing, driving a car, throwing a ball)Difficulties with sleep or the sleep–wake cycleRapid onset and fluctuations of the symptoms over the course of the day If you are undergoing alcohol detox, your healthcare provider may need to perform certain tests to evaluate your symptoms. They may perform a physical exam, which can reveal symptoms such as: Rapid breathingIrregular eye movementsIrregular or rapid heartbeatDehydrationFeverShaking hands In addition, your healthcare provider may perform other tests, such as blood tests, urine tests, and toxicology screening tests. According to Harvard Medical School, if you have withdrawal symptoms, it likely means you’ve consumed enough alcohol to cause organ damage as well. These tests can therefore help your healthcare provider check for alcohol-related damage to your heart, liver, nerves, and digestive system. It’s helpful to be honest with your healthcare provider about your drinking habits, so they can accurately evaluate your condition. Managing the Symptoms of Alcohol Detox You may need to undertake the alcohol detox process at a hospital or treatment center if: Your healthcare provider thinks your withdrawal symptoms may be severe You have a long history of chronic alcoholism You have had a seizure or experienced delirium tremens during a previous episode of alcohol withdrawal You have other health conditions that may exacerbate the withdrawal symptoms Your healthcare provider may prescribe medications to curb the symptoms of withdrawal. They may also prescribe medication to ease the headaches and nausea, as well as vitamin and mineral supplements to address any nutrition deficiencies you have as a result of alcoholism. If you have delirium tremens, you may need to be shifted to an intensive care unit where your heart rate, blood pressure, and breathing can be monitored, in case you need emergency care. Can You Detox at Home? You may be able to manage the alcohol detox process at home if your healthcare provider determines that the symptoms won’t be too severe, based on their evaluation of your condition. However, you may still need the help of a caregiver at home and may need to stay in constant contact with your healthcare provider, with daily calls or visits so they can monitor your symptoms. A Word From Verywell It’s important to consult with your healthcare provider about the best way to manage the symptoms you may encounter. As difficult and painful as the alcohol detox process may be, it's an important first step in the journey toward recovering from alcoholism. How To Help Someone With A Drinking Problem 8 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. MedlinePlus. Delirium tremens. Harvard Medical School. Alcohol withdrawal. Harvard Health Publishing. National Library of Medicine. Alcohol withdrawal. Medline Plus. University of California San Diego Health. Alcohol withdrawal. Jesse S, Bråthen G, Ferrara M, et al. Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurol Scand. 2017;135(1):4-16. doi:10.1111/ane.12671 Grover S, Ghosh A. Delirium tremens: assessment and management. J Clin Exp Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012 Sachdeva A, Choudhary M, Chandra M. Alcohol withdrawal syndrome: Benzodiazepines and beyond. J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538 Michigan State University. Alcohol can lead to malnutrition. Additional Reading Icahn School of Medicine at Mount Sinai. Alcohol withdrawal. By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness. 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