Alcohol withdrawal: symptoms, timeline and treatment

The signs you’re experiencing alcohol withdrawal, and how the symptoms might affect you in the days after you stop drinking.

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Page medically reviewed by Dr William Shanahan, Medical Director (Private) and Clinical Director of Addictions (BAO, BCh, DCH, D'OBS, FRCPsych, MB), Priory Hospital Roehampton, in June 2022.

What is alcohol withdrawal?

Withdrawal from alcohol, also called alcohol withdrawal syndrome (AWS), is the uncomfortable process that your body goes through when you try to stop drinking alcohol or can't drink alcohol for any reason (for example, if you can't get it). Continued exposure to alcohol will make your body used to having it in your system. If you suddenly stop drinking, you may experience uncomfortable and dangerous withdrawal symptoms.

Alcohol addiction can cause physical changes in your body that make it hard to control your alcohol intake. It can also make it increasingly challenging to reduce or stop your misuse of alcohol.

This piece outlines the most common signs and symptoms you might experience during alcohol withdrawal. We also discuss how alcohol withdrawal symptoms interact with your body in the hours and days after you stop drinking, and how they can be treated.

What are the signs & symptoms of drug addiction?

If you or someone you know is struggling with drug addiction, it's vital to be aware of the various signs and symptoms that can impact all areas of life. This comprehensive section delves into the complete range of signs and symptoms associated with drug addiction, encompassing physical, psychological, and behavioural indicators.

Experiencing withdrawal is a common and challenging aspect of overcoming alcohol dependency. Recognising the symptoms of alcohol withdrawal is crucial, as they can range from mild discomfort to severe health issues. This list provides an overview of the common symptoms experienced during alcohol withdrawal, offering insight into the physical, mental, and emotional effects that can occur as the body adjusts to the absence of alcohol.

  • Nausea and vomiting
  • Headaches
  • Abdominal pain
  • Fatigue
  • High temperature and/or chills
  • Unpleasant, vivid dreams
  • Tics and tremors (‘the shakes’)
  • Irregular or increased heart rate
  • Excessive sweating
  • Shaking and shivering
  • Decreased appetite
  • Depression
  • Anxiety
  • Insomnia
  • Mood swings
  • Confusion
  • Irritability and agitation
  • Difficulty concentrating
  • Intense cravings for alcohol

The most severe symptoms of alcohol withdrawal are called delirium tremens (DTs) and can be potentially life threatening. While withdrawal symptoms are common for a lot of people reducing their alcohol intake, data shows that severe symptoms in the form of DTs occur in around 3% to 5% of people experiencing withdrawal.

If you know someone experiencing DTs, it's important that you treat this like a medical emergency and seek immediate medical attention.

The symptoms of DTs include:

  • Severe disorientation and confusion
  • Extreme agitation
  • Visual and/or auditory hallucinations
  • Seizures
  • Fever
  • High blood pressure

It's important to understand that every person will have a unique experience when going through alcohol withdrawal. The symptoms you experience, their severity and the risk they pose to you will depend on your personal history and your physical and mental health.

Alcohol withdrawal timeline

The first symptoms can begin to occur within a few hours of your last drink and withdrawal symptoms tend to be at their worst for the first 48 hours.

Early symptoms may be mild, such as headaches and hand tremors, with alcohol cravings and feelings of depression also building. For some, severe symptoms like DTs may begin after 12 to 24 hours.

After 48 hours, symptoms for most will begin to subside as your body starts to adjust to being without alcohol. The entire withdrawal process usually takes 3 to 7 days from the time of your last drink.

However, it's important to note that depending on the nature of your alcohol addiction and the extent of your previous alcohol misuse, how long withdrawal symptoms are experienced may vary.

Getting help for alcohol withdrawal

If you’re experiencing the symptoms of alcohol withdrawal, it can be one indication that you’re drinking too much and have developed a dependency. If you or someone you love is struggling with alcohol withdrawal symptoms, there are ways to get help and support.

Detox

For those struggling with severe or long-lasting difficulties with withdrawal, a medically-assisted alcohol withdrawal may be the most effective way to relieve yourself of your addiction. An alcohol detox takes place on an inpatient basis, where medical professionals can offer round-the-clock care, helping you to manage your challenging withdrawal symptoms. Medications such as chlordiazepoxide or diazepam will probably be used to limit the damage of any symptoms and maintain your wellbeing.

After a detox, patients typically stay within the residential inpatient environment for a course of alcohol rehabilitation. Here, you can fully focus on long-term recovery from addiction, engaging in therapy, support groups and other forms of treatment to bring about lasting results.

Therapy

Therapies, such as cognitive behavioural therapy (CBT), can help recovering alcoholics to identify and address the underlying causes of alcohol addiction. After detox, you’re still at risk of relapsing, especially if triggers arise that might lead you to want to drink to help you cope. Stressful life events or reminders of previous traumas are common triggers that can lead to relapses.

Therapy can help you understand and deal with the issues that have led to your addiction, and to develop coping strategies for dealing with triggers in the future. Therapy for addiction can be done on an individual, family or group basis.

Aftercare

Recovery from addiction is a lifelong endeavour. Aftercare programmes continue to support people after their initial course of treatment, allowing them to benefit from a support network of empathetic people that helps maintain abstinence in the long-term. Secondary care, which helps people ease back into normality after their initial course of treatment, it also an effective way of ensuring your recovery is lasting.

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