Alcohol withdrawal syndrome is a set of symptoms that are associated with drinking too much alcohol for an extended period. When drinking alcohol, the body creates certain chemicals (neurotransmitters) that make the drinker feel good. These neurotransmitters are called endorphins. It triggers the brain into making the body feel euphoria.
The brain eventually adjusts to produce more endorphins when alcohol is consumed, which is why some people become dependent on it.
Alcohol withdrawal syndrome can cause serious health problems, like:
A person may also experience nausea, confusion, and shaking
People who drink too much alcohol for an extended period will experience withdrawal symptoms when they stop drinking.
These effects of withdrawals include:
Tremors are uncontrolled shaking of the hands, arms, legs, jaw, and other parts of the body. There are many possible causes for tremors such as caffeine withdrawal or low blood sugar. It is also a common symptom associated with alcohol withdrawal syndrome.
Nausea is the sense of unease, discomfort, or queasiness that makes one feel as if they are going to vomit. Many people experience nausea when coming off alcohol due to its depressive effects on the nervous system.
Confusion is a loss of insight into what’s happening around you and why. It can also involve disorientation.
Hallucinations are sensory experiences with no basis in reality, such as seeing things that aren’t there or hearing voices when there is nobody else present. They can be frightening and most often occur with schizophrenic disorder. However, they are also common symptoms of alcohol withdrawal syndrome.
An elevated pulse also feels like the heart is racing for no apparent reason.
High blood pressure, or hypertension, is a common ailment in which the arteries are chronically narrowed so that the heart must pump harder to circulate blood vomiting
This is a heightened state of agitation and easily brought frustration. If you find yourself snapping at friends and family, you may be experiencing withdrawal symptoms.
A headache that is severe enough to interfere with daily life may be an alcohol withdrawal symptom.
It is common for people who drink to have disrupted sleep patterns. This problem will continue into the first few days of withdrawal, making it difficult to get enough rest at night or sleep through the night.
You may feel more agitated than usual if you are going through alcohol withdrawal.
Symptoms of alcohol withdrawal can range from mild to life-threatening and include anxiety, seizure, and delirium tremens (DTs). DTs are extremely dangerous can be fatal. For this reason, it is essential for anyone considering quitting alcohol to do so under the care of a health professional.
After 6 hours, you may notice mild symptoms like nausea, vomiting, shakiness, and irritability. After 12-48 hours, you could develop more serious problems including seizures (convulsions), hallucinations, or delirium tremens (DTs).
If these problems occur, they usually show up two to three days after your last drink but can appear as early as 24 hours after you stop drinking. Some people will not experience any withdrawal symptoms when they quit drinking, while others will start having serious problems around 36 hours after the last drinks.
Delirium tremens are the most severe complication of alcohol withdrawal that causes changes in your mood and behavior, confusion, disorientation (memory loss), fever, seizures, and hallucinations. If you experience delirium tremens, it typically starts two to three days after you stop drinking. Delirium tremens can be life-threatening if not treated by a doctor or in a hospital.
DTs are a complication of alcohol withdrawal that may develop when you stop drinking after a period of heavy or long-term drinking. You can typically reduce your risk by slowly reducing the amount you drink over time.
The first stage of therapy is often referred to as detox. It is performed in a hospital or addiction treatment center where medical staff can monitor, diagnose and treat any problems that occur.
The second stage of therapy consists of psychological counseling to help you manage cravings, handle stress and deal with other factors that may contribute to your alcohol use disorder.
A variety of treatment methods including individual therapy, family therapy, or both are typically used to address these issues. Once you have been through detox and treatment, you will need to continue learning to cope with your disorder daily.
Long-term sobriety requires a strong support system and personal commitment. Relapse is common in the first year of rehab from alcohol use disorder, so you should know that setbacks and slips can happen. Part of your overall treatment will ensure that you have the resources to get back on track.
Reward yourself for sticking with your recovery plan by setting realistic goals and celebrating each milestone. Keep in mind that your recovery is not a destination; it’s an ongoing process. Maintaining long-term sobriety requires making smart choices about how you live your life, learning to handle challenges, and surrounding yourself with the right people and overcome obstacles.
Alcohol withdrawal can be life-threatening. Many people who try to quit drinking experience mild withdrawal symptoms that are uncomfortable but not life-threatening. If you experience severe alcohol withdrawal, it can lead to delirium tremens (DTs), an extreme form of alcohol withdrawal that causes changes in your mood and behavior, confusion, seizures, and hallucinations.
People who are addicted to alcohol may need to undergo medical detox before participating in an outpatient treatment program. This process involves slowly reducing the amount of alcohol you drink over some time so that your body can begin to heal. During detox, doctors and nurses monitor your condition and treat any problems that develop.
If you have experienced withdrawal symptoms in the past when quitting drinking, talk with your doctor about whether you should receive medication during detox to prevent or ease these symptoms. You may need a different medication than a person who does not have a history of alcohol withdrawal symptoms.
Safe tapering of alcohol may be difficult for some people with severe dependence. In this case, the best option may be an inpatient stay at a rehab center where medications can be closely monitored and given as needed. This is particularly important if you are taking benzodiazepines because tapering off these medications can be dangerous.
Even if you do not need medication during detox, doctors usually recommend that you remain under medical supervision for some time after your symptoms have subsided before going on to participate in an outpatient treatment program.
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Kosten, T. R., & O’Connor, P. G. (2003). Management of drug and Alcohol withdrawal. New England Journal of Medicine, 348(18), 1786–1795.
Kasser C, Geller A, Howell E, Wartenberg A. Detoxification: principles and protocols. American Society of Addiction Medicine. Accessed January 20, 2004, at: http://www.asam.org/publ/detoxification.htm.
Narasimha, V. L., Shukla, L., Mukherjee, D., Menon, J., Huddar, S., Panda, U. K., … & Murthy, P. (2020). Complicated alcohol withdrawal—an unintended consequence of COVID-19 lockdown. Alcohol and Alcoholism, 55(4), 350-353.
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Magnified Health Systems aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.
Dr. Bickley graduated from U.C. Irvine with honors: Phi Beta Kappa, Golden Key International Honor Society, Cum Laude. He has been featured on national radio and print media. He is also a frequent lecturer at National Conferences. He holds an A.S. degree in Drug & Alcohol Studies, and two B.A. degrees in Criminology & Psychology, and masters and doctoral degree in Clinical Psychology. He is a licensed California Drug & Alcohol Counselor Level II, a licensed Clinical Supervisor and is certified in treating Eating Disorders.
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