Alcohol withdrawal can occur when a person who is physically dependent on alcohol stops drinking or significantly reduces how much they drink.
As the body adjusts to the absence of alcohol, withdrawal symptoms can develop, ranging from anxiety, sweating and shaking to seizures, hallucinations and severe confusion. In some cases, alcohol withdrawal can be life-threatening.
This article outlines what alcohol withdrawal is, how it unfolds, and what you should do if you’re experiencing it.
Alcohol withdrawal happens when a person has been drinking heavily or regularly for a long period of time and their body has adapted to the effects of alcohol.
Alcohol slows down brain activity by increasing the effects of calming chemicals in the brain and reducing the effects of stimulating chemicals. Over time, the brain adjusts to the presence of alcohol by reducing its calming activity and increasing its stimulating activity to maintain balance.
When alcohol is suddenly removed, the balance is disrupted and the nervous system becomes overactive, causing both physical and psychological symptoms known as withdrawal symptoms.
The list of alcohol withdrawal symptoms below range from common early symptoms to more serious complications.
These can vary significantly from person to person. The severity and timing of symptoms can depend on several factors such as how much and how often you drink, your baseline physical health, and any co-occurring conditions.
They can overlap or progress overtime, so it’s important to seek medical advice if you’re concerned about your symptoms, particularly if you are experiencing seizures, hallucinations or severe shaking.
If you experience a seizure, hallucinations or delirium tremens, withdrawal may be a medical emergency, and you should call 999 immediately.
Delirium tremens (DTs) can involve severe confusion, agitation, shaking and physical symptoms including fever or a racing heart. A person may be unable to recognise what’s happening or be unable to ask for help so if you recognise these symptoms in somebody else, seek support.
The alcohol withdrawal timeline below is a guide rather than a prediction. Symptoms may start sooner or later, and serious complications don’t occur in a fixed order.
If you have been drinking heavily or regularly and may be dependent, get advice before stopping.
Alcohol withdrawal symptoms often last around 3 to 7 days. Symptoms tend to be most intense during the first 24 to 72 hours, but the timing varies, and symptoms don’t necessarily disappear after that point.
Symptoms such as shaking, sweating and nausea generally ease as acute withdrawal passes. However, sleep problems, anxiety and changes in mood can last longer, sometimes even weeks. Severe symptoms, such as confusion or tremor, can develop after the first couple of days and require urgent medical attention.
People often describe withdrawal as a mixture of physical discomfort and emotional distress. You might feel shaky, start to sweat and feel sick while also feeling on edge or unable to sleep. When symptoms occur together, it can be extremely uncomfortable and distressing, especially if you’re experiencing withdrawals for the first time.
When someone has become physically dependent on alcohol, stopping or cutting down can leave the nervous system temporarily in overdrive. This helps explain why the symptoms below can often co-occur.
Headaches can occur during alcohol withdrawal as your body adjusts to the absence of alcohol. Poor sleep or dehydration may contribute, though a headache can have other causes. Seek medical advice for severe, unusual or worsening headaches, particularly if it’s accompanied by confusion or other concerning symptoms.
Alcohol withdrawal can sometimes cause altered skin sensations, including itching, tingling or burning, as your nervous system adjusts. Itching can also have other causes, such as dry skin or liver disease. If it’s severe, persists or comes with yellowing of your skin or eyes, seek medical advice.
Alcohol affects how the brain regulates sleep. When you stop drinking, you may struggle to fall asleep, find yourself waking frequently or feeling restless at night. Sleep problems can continue after other withdrawal symptoms have eased.
Alcohol slows activity in the nervous system so when you suddenly remove alcohol, it can leave you feeling unusually alert, tense or anxious. Withdrawal anxiety can feel stronger when it comes with a racing heart or shaking. Seek support if it becomes intense or you feel unable to cope.
Sweating can happen because the body’s automatic responses, including heart rate and temperature, become more active during withdrawal. It often occurs alongside anxiety or shaking.
Shaking, particularly in the hands, is a common sign that the nervous system is adjusting to less alcohol. It may begin mildly but can become more pronounced. Call 999 if you have severe or worsening shaking, as this can be a sign of serious complications.
Withdrawal can upset the digestive system and leave you feeling sick or unable to eat. If you’re vomiting a lot, it can also make it harder to stay hydrated. If your vomiting gets worse and you can’t keep fluids down, seek medical advice, especially if other symptoms are worsening.
The first step in alcohol withdrawal treatment is an assessment of your symptoms and risks. Depending on your needs, a clinician may recommend medically assisted detox in the community or in an inpatient setting.
Depending on your level of risk and where detox takes place, care may include 24/7 monitoring, prescribed medication to manage withdrawal and thiamine to reduce the risk of complications related to vitamin B1 deficiency. For more information on the steps involved, medication and care options, read about medically supervised alcohol detox.
If you’re ready to stop drinking and feel worried about withdrawal, Priory offers a range of private addiction services that differ in intensity and format depending on your needs.
If inpatient detox is appropriate, you’ll receive 24-hour monitoring and medication where needed to manage withdrawal. To reduce the risks associated with vitamin B1 deficiency, you’ll also receive thiamine.
Priory offers medically assisted alcohol detox and alcohol addiction services at locations across the UK, as well as remote options. Book a free, confidential assessment, or call us on 0330 828 0247 to discuss what treatment option might be right for you.
Symptoms typically last 3 to 7 days, though some can last longer. Their severity and length of withdrawal differs between people and depend on factors such as how much and often you drink, your physical and mental health, and previous experience of withdrawal.
Severe withdrawal can cause life-threatening complications, including seizures and delirium tremens. If you may be physically dependent on alcohol, seek medical advice before stopping suddenly.
Trying to stop suddenly without assessment or support can be dangerous so it’s strongly advised not to detox from alcohol at home. However, some people are assessed as suitable for medically assisted withdrawal at home.
The safest approach to managing alcohol withdrawal depends on your individual risk. If you’re physically dependent, a clinician may recommend monitoring, prescribed medication and thiamine as part of a medically assisted plan. Seek medical advice before trying to manage withdrawal by yourself.
Headaches from alcohol withdrawal can happen due to poor sleep or dehydration, but headaches can have other causes. If your headache is severe or worsening, or accompanied by other concerning symptoms, seek medical advice.
If you’re experiencing seizure, hallucinations, severe shaking or confusion, you should call 999 or go to your nearest A&E. If you’re concerned about withdrawal but it’s not an emergency, contact your GP or an alcohol treatment service.
