Alcohol Withdrawal: Symptoms, Timeline and Treatment

What is Alcohol Withdrawal?

Withdrawal from alcohol, also called the 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 Symptoms of Alcohol Withdrawal?

The nature and severity of the alcohol withdrawal symptoms that you experience will be influenced by a number of personal factors, including how much you have been drinking and how regularly, plus your general mental and physical health.

Alcohol withdrawal symptoms can vary from mild, uncomfortable physical and psychological sensations to those that are severe and life-threatening. Aside from withdrawal, there are lots of other signs and symptoms of alcohol use disorder to look out for.

Common symptoms of alcohol withdrawal

• 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

Severe withdrawal symptoms

The most severe symptoms of AWS are called delirium tremens (DT) and are 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 delirium tremens occur in around 3%-5% of people experiencing withdrawal.

If you know someone experiencing delirium tremens, consider it a medical emergency and seek immediate medical attention.

The symptoms of delirium tremens include:

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

It is important to understand that every person will have a unique experience when going through alcohol withdrawal. The symptoms that you experience, their severity and the risk that they pose to you will depend upon 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 12-24 hours.

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

Note:pending upon 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 on the substance. 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 to 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 individuals 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.