Common Alcohol Withdrawal Symptoms

Prolonged drinking means you may need treatment to minimize symptoms

Man With Headache
Could You Have a Drinking Problem?. Getty Images

If your nightly glass of wine or beer has turned into several, or you've noticed that your drinking has started to negatively impact your home, work, or family life, you may be wondering what to expect once you start to curtail the habit. Or maybe you have a loved one who drinks heavily and you're urging him or her to pursue sobriety and you want to know what he or she might be facing on the journey there.

When you suddenly stop or cut back on your drinking after chronic or prolonged use of alcohol, you may experience physical and psychological symptoms of alcohol withdrawal. The severity of these symptoms can range anywhere from mild to severe depending on how long you've used alcohol and how much you normally drink.

Causes

Alcohol has depressing effects that slow your brain down. When you drink heavily, frequently, or for prolonged periods of time, your brain eventually adjusts to these depressing effects and compensates accordingly by releasing more stimulating chemicals than it does when you're not drinking. This overproduction becomes your brain's new normal, so when you stop drinking, your brain is still producing these extra chemicals, potentially causing you to experience unpleasant withdrawal symptoms that are associated with overstimulation. Eventually, your brain readjusts, but in the meantime, you may not feel your best.

Not everyone who stops drinking experiences withdrawal symptoms, but most people who have been drinking for a long period of time, drink frequently, or that drink heavily when they do drink, will experience some form of withdrawal symptoms if they stop drinking suddenly. If you have health problems or you've been drinking heavily for a long period of time, it's more likely that you'll experience severe withdrawal symptoms.

Psychological Withdrawal Symptoms

The mild to moderate psychological symptoms you may experience when quitting drinking include:

  • Feeling jumpy or nervous
  • Shakiness
  • Anxiety
  • Irritability or becoming easily excited
  • Rapid emotional changes
  • Depression
  • Fatigue
  • Difficulty thinking clearly
  • Bad dreams

Physical Withdrawal Symptoms

The mild to moderate physical symptoms you may experience with alcohol withdrawal include:

  • Headache
  • Sweating, especially the palms of your hands or your face
  • Nausea and vomiting
  • Loss of appetite
  • Insomnia
  • Paleness
  • Rapid heart rate (palpitations)
  • Pupils of different sizes (enlarged, dilated pupils)
  • Skin, clammy
  • Abnormal movements
  • Tremor of your hands
  • Involuntary, abnormal movements of your eyelids

Delirium Tremens

Severe symptoms of alcohol withdrawal are called delirium tremens (or DTs) and can occur anywhere from two to four days and up to seven to 10 days after your last drink. DTs may be more likely to happen if you haven't eaten enough food.

Delirium tremens occurs in about 5 percent of people who experience alcohol withdrawal. Of that 5 percent, about one in 20 die as a result. Since it can be life-threatening, it's important that you get emergency help for someone who has these symptoms.

The symptoms of delirium tremens include:

  • Confusion, which may be severe
  • Hallucinations
  • Agitation
  • Fever
  • Seizures
  • Heart arrhythmia (irregular heartbeat)
  • Excessive sweating
  • Tremors
  • Falling into a deep sleep that lasts for a day or more
  • Rapid changes in mood
  • Sensitivity to touch, light, and/or sound
  • Feeling restless or short periods of feeling energetic

These symptoms may get rapidly worse. A person with delirium tremens will need to be hospitalized for a period of time to get the symptoms under control and possibly to save his or her life.

Withdrawal Duration

Those who have suddenly stopped drinking and are experiencing alcohol withdrawal symptoms usually have the same two questions: "Is this normal?" and "How long does it last?" The problem with these questions is that withdrawal can be different for everyone, so there really is no "normal" so to speak.

Typically, withdrawal symptoms begin within hours to a day or two after your last drink and are usually at their worst around 24 to 72 hours after you stop drinking, but certain minor symptoms like changes in your sleep patterns, fatigue, and changes in your mood can last for weeks or months. You'll likely begin to feel better around five days to a week after you stop drinking. It may be helpful to learn about alcohol withdrawal symptoms day by day.

Treatment

With the proper medical care, alcohol withdrawal symptoms can be greatly reduced or even eliminated. There are specific treatments available for anyone who wants to stop drinking, even after long-term, chronic alcohol abuse.

For those drinkers who have decided to quit drinking, for whatever reason, withdrawal symptoms can be a significant stumbling block in maintaining sobriety. One of the main causes of relapses during the early stages of recovery are the effects of withdrawal symptoms.

When the withdrawal symptoms begin, many people who are trying to stop drinking give up if the symptoms become aggravating enough and decide to take a drink just to ease the discomfort. Thankfully, there are medications available called benzodiazepines like Librium (chlordiazepoxide) and Ativan (lorazepam) that can help control your withdrawal symptoms without the need to drink alcohol.

As long as your symptoms are mild to moderate, you can safely stop drinking alcohol at home. Long-time or heavy drinkers should involve a doctor in this process but because it's impossible to predict just how severe withdrawal symptoms will be. If you go into delirium tremens without supervision, it could prove fatal.

Your doctor can prescribe a benzodiazepine and/or other medications for you and help you come up with a quitting plan that will likely include daily doctor's visits. You'll also need someone to stay with you to make sure you aren't developing more severe symptoms that need medical attention like seizures, hallucinations, severe vomiting, fever, or high blood pressure.

Getting Help and Support

Once you've gone through withdrawal, you'll also need a plan to remain alcohol-free. Ask your doctor for advice on treatment for alcohol dependence. There are many other resources available for anyone who is sincere about stopping drinking for good, or who wants to reduce the harm alcohol may be causing in their life by cutting down. You may greatly benefit from the encouragement and support that you can find at a support group meeting like Alcoholics Anonymous (AA) or even an online meeting. These groups are known to help people get and stay sober, which is important not only for your relationships but for your health as well.

You can also contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) for free, confidential resources and referrals for treatment and support groups. They can connect you with local services and they're available 24/7 every day of the year. SAMHSA also has an online treatment services locator that will find treatment facilities that are near you.

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View Article Sources
  • Medline Plus. Alcohol Withdrawal. U.S. National Library of Medicine. Updated August 14, 2018. https://medlineplus.gov/ency/article/000764.htm

  • Medline Plus. Delirium Tremens. U.S. National Library of Medicine. Updated August 14, 2018. https://medlineplus.gov/ency/article/000766.htm

  • Substance Abuse and Mental Health Services Administration (SAMHSA). National Helpline. Department of Health and Human Services. Updated April 19, 2018. https://www.samhsa.gov/find-help/national-helpline

  • Harvard Health Publications. Alcohol Withdrawal. Drugs.com. Updated March 26, 2018. https://www.drugs.com/health-guide/alcohol-withdrawal.html