Common Alcohol Withdrawal Symptoms

Prolonged Drinking Means You May Need Treatment to Minimize Symptoms

Alcohol withdrawal symptoms

Verywell / JR Bee 

When you suddenly stop or cut back on drinking after chronic or prolonged use of alcohol, you might experience the physical and psychological symptoms of alcohol withdrawal. Depending on how long you have used alcohol and how much you typically drink, the severity of these symptoms can range from mild to severe.

Causes

Alcohol is a depressant, which means that it slows your brain. When a person drinks heavily, frequently, or for prolonged periods of time, their brain compensates for alcohol's depressant effects by releasing more stimulating chemicals (compared to when a person does not drink). Overproduction becomes the brain's new normal.

When a person stops drinking, their brain is still producing extra chemicals, which can potentially cause unpleasant alcohol withdrawal symptoms that are associated with overstimulation. The brain will readjust, but until it does, a person in withdrawal might feel unwell.

Symptoms

Not everyone who quits drinking alcohol experiences withdrawal symptoms, but many people who have been drinking for a long period of time, drink frequently, or drink heavily, will experience some withdrawal symptoms if they stop using alcohol suddenly.

There are several mild to moderate psychological and physical symptoms you might experience when you stop drinking.

Psychological Symptoms
  • Anxiety

  • Bad dreams

  • Depression

  • Difficulty thinking clearly

  • Fatigue

  • Feeling jumpy or nervous

  • Irritability or becoming excited easily

  • Rapid emotional changes

  • Shakiness

Physical Symptoms
  • Clammy skin

  • Elevated blood pressure

  • Headache

  • Insomnia

  • Loss of appetite

  • Nausea and vomiting

  • Paleness

  • Rapid heart rate or palpitations

  • Sweating, especially the palms of your hands or your face

  • Tremor of your hands

Delirium Tremens

A severe type of alcohol withdrawal is called delirium tremens (or DTs). It can occur anywhere from two to four days to up a week after you have your last drink. DTs might be more likely to happen if you are malnourished.

DT can be life-threatening: about one in 20 people who develop the condition die from it. If you or a loved one has symptoms of DT, seek immediate emergency medical care.

The symptoms of delirium tremens include:

  • Agitation
  • Confusion (which can be severe)
  • Dangerous changes in blood pressure
  • Excessive sweating
  • Fever
  • Hallucinations
  • Heart arrhythmia (irregular heartbeat)
  • Rapid changes in mood
  • Seizures
  • Sensitivity to touch, light, and/or sound
  • Tremors

The symptoms of DT may get rapidly worse and can be fatal. A person with delirium tremens needs to be hospitalized until the symptoms can be controlled.

Duration

People who suddenly stop drinking and develop alcohol withdrawal symptoms often have two main questions: "Is this normal?" and "How long does it last?"

Withdrawal is different for everyone; there really is no "normal" and it can be hard to predict an individual person's experience.

It's typical for withdrawal symptoms to begin within hours to a day or two after you have your last drink. Symptoms are often at their worst around 24 to 72 hours after you stop drinking.

Some symptoms—like changes in sleep patterns, fatigue, and mood swings—can last for weeks or months. You'll likely begin to feel better around five days to a week after you stop drinking.

Treatment

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

Withdrawal symptoms can be a significant stumbling block in maintaining sobriety. For example, a person might be hesitant to stop drinking because they are afraid of alcohol withdrawal.

Symptoms of withdrawal are also a major causes of relapses in the early stages of recovery. People who are trying to stop drinking might give up if the symptoms of withdrawal become aggravating enough to prompt them to have a drink to ease the discomfort.

If your withdrawal symptoms are mild, it's generally considered safe for you to stop drinking at home. However, if you drank heavily or for a long time, you need to involve a healthcare provider in the process.

It's impossible to predict how severe withdrawal symptoms will be, and you need to be monitored by a professional to ensure you get care in the event you develop serious, potentially life-threatening symptoms (such as DT).

If the symptoms of alcohol withdrawal are severe enough to threaten someone's recovery, there are medical treatments—including benzodiazepines like Librium (chlordiazepoxide) and Ativan (lorazepam)—that can help control symptoms.

Getting Help

Once you have gone through withdrawal, you'll also need a plan to remain alcohol-free. Start by talking to your healthcare provider about the treatment options for alcohol dependence.

There are many resources available for anyone who is ready to stop drinking for good, or who wants to reduce the harm alcohol is causing in their life by cutting down. As you continue to commit to long-term recovery, support group meetings like Alcoholics Anonymous (AA) or online support communities might be helpful.

If you or a loved one are struggling with substance use or addiction, 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.

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Article Sources
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  1. Mirijello A, D'angelo C, Ferrulli A, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-65. doi:10.1007/s40265-015-0358-1

  2. 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

  3. Grover S, Ghosh A. Delirium Tremens: Assessment and ManagementJ Clin Exp Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012

Additional Reading
  • Substance Abuse and Mental Health Services Administration (SAMHSA). National Helpline. Department of Health and Human Services. Updated April 19, 2018.

  • U.S. National Library of Medicine. Alcohol Withdrawal. Updated August 14, 2018.

  • U.S. National Library of Medicine. Delirium Tremens. Updated August 14, 2018.