Addiction Alcohol Use Withdrawal and Relapse Common Alcohol Withdrawal Symptoms Prolonged Drinking Means You May Need Treatment to Minimize 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 October 29, 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 Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Verywell / JR Bee Table of Contents View All Table of Contents What Is Alcohol Withdrawal? Symptoms of Alcohol Withdrawal Causes Timeline Duration Treatment Getting Help 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. What Is Alcohol Withdrawal? Alcohol withdrawal refers to the physical and mental effects a person experiences after stopping prolonged and heavy alcohol use. When you suddenly stop drinking, your body is deprived of the effects of alcohol and requires time to adjust to functioning without it. 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. This article discusses the causes, common symptoms, and different stages of alcohol withdrawal. It also discusses various treatment options for alcohol withdrawal and how you can get help. How to Detox From Alcohol Safely Symptoms of Alcohol Withdrawal The symptoms of alcohol withdrawal relate proportionately to the level of alcohol intake and the duration of the person's recent drinking habit. 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 mood swings 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 in your hands What Is the CIWA Protocol for Alcohol Withdrawal? Causes of Alcohol Withdrawal 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. Mild, Moderate, and Severe Alcohol Withdrawal Symptoms Timeline of Alcohol Withdrawal Symptoms The severity of alcohol withdrawal is categorized into three stages. The symptoms of these stages range from mild to severe. Not all people progress through all of the stages of alcohol withdrawal. Symptoms of Alcohol Withdrawal Syndrome Stage 1: Mild Withdrawal Stage 1 is considered mild withdrawal. Mild withdrawal symptoms often begin within 6 to 12 hours after your last drink. These first symptoms of withdrawal include: Decreased appetite Headache Heart palpitations Insomnia Mild or moderate anxiety Shaking Upset stomach Mild symptoms may appear similar to a hangover, but they last longer than 24 hours. The exact timeline for alcohol withdrawal varies from person to person. It's based on several factors, including how long, how much, and how regularly you have been drinking alcohol. Stage 2: Moderate Withdrawal Stage 2 is considered the moderate stage of withdrawal. This stage of alcohol withdrawal includes Stage 1 symptoms plus the following moderate symptoms: ConfusionExcessive sweatingFast heart rate (more than 100 beats per minute)FeverIncreased systolic blood pressureMild tremorModerate anxietyRapid, shallow breathing These symptoms generally appear 12 to 24 hours after your last drink. While these symptoms are more severe than Stage 1, they are not life-threatening. Stage 3: Severe Withdrawal Stage 3 is considered severe alcohol withdrawal. In addition to experiencing Stage 2 symptoms, those with severe alcohol withdrawal experience severe anxiety and moderate to severe tremors. Complicated Withdrawal If left untreated, withdrawal can progress to complicated alcohol withdrawal. The symptoms of alcohol withdrawal delirium include withdrawal seizures that can occur between 8 and 28 hours after your last drink. Signs of an impending seizure include tremors, increased blood pressure, overactive reflexes, and high temperature and pulse. Having a history of seizures increases your risk for withdrawal seizures. Alcohol withdrawal delirium (AWD), commonly known as delirium tremens (DT), is the most serious symptom of alcohol withdrawal. AWD usually lasts 48 to 72 hours. 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: AgitationConfusion (which can be severe)Dangerous changes in blood pressureExcessive sweatingFeverHallucinationsHeart arrhythmia (irregular heartbeat)Rapid changes in moodSeizuresSensitivity to touch, light, and/or soundTremors 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. Delirium Tremens: Causes, Symptoms, and Treatment Duration of Alcohol Withdrawal 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. You'll likely begin to feel better between five to seven days after you stop drinking, though some symptoms—like changes in sleep patterns, fatigue, and mood swings—can last for weeks or months. Alcohol Withdrawal Day-by-Day Treatment of Alcohol Withdrawal 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 use. Outpatient Treatment Treatment varies depending on the severity of withdrawal symptoms. People experiencing mild to moderate alcohol withdrawal symptoms often receive outpatient care—meaning there is no extended time spent in a hospital or facility. It's recommended, however, that they have someone stay with them who can help during recovery. A healthcare provider may request daily visits during which they will likely run blood tests and monitor vital signs until symptoms stabilize. Inpatient Treatment Inpatient treatment, or staying at a hospital or care facility, may be necessary for someone with moderate to severe symptoms of alcohol withdrawal. Inpatient treatment allows healthcare professionals to monitor you for DT or hallucinations, monitor your vitals, and administer fluids or medicine intravenously if needed. Ruling Out Other Conditions A healthcare provider will also run tests to rule out other medical conditions that have similar symptoms of alcohol withdrawal or occur alongside withdrawal. These conditions include gastrointestinal bleeding, infection, intracranial hemorrhage (acute bleeding in the brain), and liver failure. Counseling Counseling is usually recommended for someone experiencing alcohol withdrawal. A counselor can advise on ways to cope with the mental and emotional aspects of withdrawal. A counselor can help someone prepare for life after withdrawal and provide support as they navigate quitting drinking. Medications for Alcohol Withdrawal Symptoms A doctor may also prescribe a sedative drug, such as a benzodiazepine, to help reduce withdrawal symptoms such as restlessness or agitation. Benzodiazepines like Librium (chlordiazepoxide) and Ativan (lorazepam) may also help to prevent minor withdrawal symptoms from becoming more severe. Other drugs a healthcare provider might prescribe include anxiolytics , vitamins, and suboxone. What Helps With Alcohol Withdrawal? Getting Help for Alcohol Withdrawal Once you have gone through withdrawal, you'll also need a plan to remain alcohol-free. Start by talking to a 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. Get Help Now We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Find out which option is the best for you. 9 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. 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 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 Muncie HL Jr, Yasinian Y. Outpatient management of alcohol withdrawal syndrome. Am Fam Physician. 2013 Nov 1;88(9):589-595. Munda SK, Khess CRJ, Bhattacharjee D, Singh NK. Clinical manifestations of complicated alcohol withdrawal and uncomplicated alcohol withdrawal: A comparative study. Mental Health and Substance Use. 2013;7(3):243-255. doi:10.1080/17523281.2013.806950 Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914 Jesse S, Bråthen G, Ferrara M, et al. Alcohol withdrawal syndrome: Mechanisms, manifestations, and management. Acta Neurol Scand. 2016;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 National Library of Medicine. Alcohol withdrawal. Hoffman RS, Weinhouse GL. Management of moderate and severe alcohol withdrawal syndromes. UpToDate. Additional Reading American Society of Addiction Medicine. The ASAM clinical practice guideline on alcohol withdrawal management. J Addict Med. 2020;14(3S Suppl 1):1-72. doi:10.1097/ADM.0000000000000668 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. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! 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