Addiction Alcohol Use Withdrawal and Relapse Symptoms of Alcohol Withdrawal Syndrome By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on February 25, 2021 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 Image Source / Getty Images Alcohol withdrawal is an unpleasant set of symptoms that heavy drinkers experience when they stop drinking. Many people drink too much every once in a while, while others drink too much a lot of the time. While it is a great idea to quit drinking, you should also think through whether you might experience alcohol withdrawal symptoms, and how to manage them, before quitting cold turkey. 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. Depending on how much you have been drinking and for how long, alcohol withdrawal symptoms can be severe and even life-threatening, so talk to your doctor for individual advice. This article will help you to understand what could happen when you quit drinking but it is not a substitute for medical advice. Withdrawal Symptoms If you have been drinking heavily for a while, whether as a regular pattern, in binges, or if you have become addicted, you may want to know what to expect if you stop drinking and go into alcohol withdrawal. For those who have become addicted to alcohol, you are likely to experience some withdrawal symptoms when you quit, but withdrawal can also happen after periodic heavy drinking. The initial hangover can vary in time and intensity and can last for hours, but you will usually start to feel better within a day. In contrast, alcohol withdrawal worsens over the first few hours and days and lasts anywhere from a few days to a week or more. Some people experience weeks or months of withdrawal symptoms, known as post-acute withdrawal syndrome (PAWS). The exact experience and severity of alcohol withdrawal varies from person to person. Alcohol Cravings Most people who are withdrawing from alcohol experience a strong desire to drink more. This is known as experiencing cravings, and cravings are common among people withdrawing from many addictive substances. Part of the craving is driven by the wish to reduce the symptoms of alcohol withdrawal. Another part of it is the desire to re-experience the pleasure of alcohol intoxication. Mild, Moderate, and Severe Alcohol Withdrawal Symptoms Mood Changes Withdrawing from alcohol takes its toll on your mood. One way of thinking about withdrawal is that it is like having to pay back a loan. You get an advance on some good feelings while you are drunk, but then you are saddled with a debt of those same feelings during the withdrawal phase. This is called a rebound effect and is part of your body’s way of maintaining homeostasis. Once you have paid off the "debt," you can feel good again naturally. Many people drink to feel relaxed and happy. So when you withdraw from alcohol, you can expect to feel anxious and miserable, simply because your body is adjusting to the relaxant and mood-elevating effects of alcohol not being there. Another reason that withdrawal feels so bad is that many people drink to cover up negative feelings, like grief, anxiety, and frustration. Without the numbing effect of alcohol, and without having dealt with the underlying cause of those negative feelings, you can feel overwhelmed emotionally, just when you are at your most vulnerable. It can be helpful to go through withdrawal in a supportive atmosphere, where negative feelings won't be provoked. You can tackle alcohol withdrawal at home, but this is only a good idea if your family or other people at home are going to be kind, sensitive, and supportive during the process, so talk it over with them beforehand. And it is still a good idea to talk it over with a doctor. They can give you medication that may prevent the riskiest symptoms from happening. Sleep Problems Despite the tiredness you are probably feeling, alcohol withdrawal often causes insomnia (having trouble getting to sleep or staying asleep). Nausea or Vomiting Vomiting, or feeling as if you are going to vomit (nausea), is a recognized aspect of alcohol withdrawal. You probably won't feel like going out and about anyway, but wherever you are, make sure you have a bathroom close by. Physical Agitation People going through alcohol withdrawal often feel physically agitated. This is exacerbated by an increase in heart rate and sweating. You might also get physical tremors and notice your hands shaking. Obviously, this will make you feel unwell, but it is important to recognize these withdrawal symptoms for what they are, and not just the symptoms of a cold or flu. When to See a Doctor If you experience these symptoms and have not received treatment for alcohol withdrawal, see your doctor or go to the emergency room of your nearest hospital. Medication can prevent some of the more serious withdrawal symptoms, such as hallucinations and seizures. Hallucinations Hallucinations, which can occur on their own or be part of the severe withdrawal syndrome of delirium tremens (DT), are among the more severe symptoms of alcohol withdrawal—but not everyone who goes through withdrawal will experience them. Hallucinations involve seeing, hearing, or feeling things that are not there, and can be quite unpleasant. Some people who experience hallucinations find them frightening and think they are going crazy. While some people can develop substance-induced psychosis as a result of using alcohol or other drugs, in most cases, the hallucinations stop after treatment or after the withdrawal has run its course. It's better to see a doctor and get medication than to try and cope on your own, as this can also prevent one of the potentially most dangerous alcohol withdrawal symptoms: seizures. Seizures While seizures are uncommon, they are normal symptoms of alcohol withdrawal, and you should always prepare for and avoid the risk of seizures by getting appropriate medical attention and support. Seizures during alcohol withdrawal can be life-threatening, so call 911 if think you think someone going through alcohol withdrawal is having a seizure. Symptom Stages for Alcohol Withdrawal 7 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):353-365. doi:10.1007/s40265-015-0358-1 Becker HC. Alcohol dependence, withdrawal, and relapse. Alcohol Res Health. 2008;31(4):348-361. Haass-Koffler CL, Leggio L, Kenna GA. Pharmacological approaches to reducing craving in patients with alcohol use disorders. CNS Drugs. 2014;28(4):343-360. doi:10.1007/s40263-014-0149-3 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 Arnedt JT, Conroy DA, Brower KJ. Treatment options for sleep disturbances during alcohol recovery. J Addict Dis. 2007;26(4):41-54. doi:10.1300/J069v26n04_06 Saitz R. Introduction to alcohol withdrawal. Alcohol Health Res World. 1998;22(1):5-12. Caton CL, Drake RE, Hasin DS, et al. Differences between early-phase primary psychotic disorders with concurrent substance use and substance-induced psychoses. Arch Gen Psychiatry. 2005;62(2):137-145. doi:10.1001/archpsyc.62.2.137 By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.