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Understanding Alcohol Withdrawal – Treatment, Causes, Timeline & Dangers

When you make the decision to stop drinking, either gradually or suddenly, you may experience symptoms of withdrawal. While the exact symptoms of withdrawal will be different depending on the severity and longevity of addiction, there are some commonalities for withdrawal. Understanding the symptoms of withdrawal can help you prepare for the journey ahead. Keep reading to learn more about alcohol withdrawals and what to expect during the process.

What causes alcohol withdrawal?

Prolonged use of alcohol or alcohol abuse alters the brain’s chemistry. When copious amounts of alcohol are present or alcohol is used in high volumes, the body has to adapt. The mind adjusts to a new “normal” state with alcohol present. Once alcohol is removed, the body has to readjust to a new state of normal.

Alcohol withdrawal is caused by low levels of alcohol after an individual is used to consuming larger amounts of alcohol. When alcohol is consumed, it can suppress different parts of the brain. The liver is responsible for metabolizing the alcohol, but the brain absorbs alcohol that is not metabolized. Drinking can bring about feelings of relaxation or joy because of the suppression of the brain. However, once alcohol is removed, the body craves it. As the body and mind adjust to the lack of alcohol, withdrawal symptoms are common.

Who experiences alcohol withdrawal?

Individuals with an alcohol use disorder are likely to be impacted by alcohol withdrawal. An alcohol use disorder include binge drinking, heavy drinking, alcoholism, and alcohol dependence. A severe dependency on alcohol can increase the chance of experiencing alcohol withdrawal symptoms. Anyone who consumes a lot of alcohol and stops drinking abruptly is at risk of alcohol withdrawal. Adults who have been drinking for longer periods of time or consume greater quantities of alcohol are more likely to experience alcohol withdrawal than teenagers with an alcohol use disorder.

Symptoms of alcohol withdrawal

Alcohol symptoms are generally mild, but people with severe alcohol use disorders may experience more serious symptoms. Severe alcohol withdrawal symptoms can be potentially fatal if they are not treated properly under medical supervision. Alcohol withdrawal symptoms can begin within hours after the last drink. For some, symptoms can last a few days. For more severe alcohol withdrawal, symptoms can last for weeks.

Mild symptoms of withdrawal are often the first to appear after someone stops drinking. These symptoms often include anxiety, depression, nausea or vomiting, insomnia, sweating, and shaky hands. For some, there is a desire to go through alcohol detox at home. While mild symptoms may be manageable at home, withdrawal symptoms are unpredictable. If symptoms become more severe, it can be difficult to safely manage them at home without medical professionals.

Mild to moderate symptoms may require medication to ease discomfort and provide stability during detox. Serious withdrawal symptoms can include hallucinations or seizures. While scary, these symptoms can be managed under the care of a doctor.

Delirium tremens, or DTs, impact a small percentage of people experiencing alcohol withdrawal. Symptoms of DTs include delusions and more vivid hallucinations. These symptoms can be potentially fatal, and they may be accompanied by high blood pressure, fever, heavy sweating, racing heart, and confusion. DTs impact one out of 20 people going through withdrawal, and people who consume larger quantities of liquor on a daily basis are at a higher risk.  

Can you predict withdrawal symptoms?

Withdrawal symptoms are difficult, if not impossible, to accurately predict. Each individual going through detox will experience withdrawal in different ways. If you are ready to take the next step and detox from alcohol, you are likely wondering how severe withdrawal symptoms will be during the process. The severity of withdrawal symptoms can depend on a variety of factors, including:

  • Age
  • Size
  • Gender
  • Drinking habits
  • Genetics

An evaluation from a doctor can best predict the severity of your withdrawal symptoms. Your doctor will determine the optimal course of treatment, and prescribe any necessary medication. Inpatient and outpatient facilities monitor your progress through detox, treating withdrawal symptoms as they arise.

Diagnosing alcohol withdrawal

Your doctor can evaluate and diagnose withdrawal through a physical exam. The exam will also include a complete medical history to understand the severity of the alcohol use disorder and any potentially conflicting medical conditions. Blood tests and other exams are able to rule out other medical conditions when diagnosing alcohol withdrawal.

Doctors assess the presence and severity of withdrawal symptoms by searching for physical symptoms. Shaky hands, a fast heartbeat, dilated pupils, fever, and high blood pressure are common signs that alcohol withdrawal is occurring. There is also a 10-question scale to measure the severity of symptoms called the Clinical Institute Withdrawal Assessment. Symptoms like agitation, anxiety, auditory disturbances, headache, and confusion are all included on the assessment.

Treatment for alcohol withdrawal

There are multiple treatment options available for alcohol withdrawal, and your doctor can recommend the best course of action. At-home detox is not recommended due to the unpredictable nature of withdrawal symptoms. More severe symptoms can be life-threatening, so it is important to detox under medical care.

Treatment for alcohol withdrawal requires a supportive and comfortable environment. Alcohol detox can be a physically and emotionally draining process, so putting aside personal and professional responsibilities is required for several days. The best detox environment is quiet with soft lighting, limited contact with others and nutritional support. Staying hydrated is also key to lessen the symptoms of withdrawal and replenish the body during detox.

Inpatient and outpatient treatment

Inpatient detox treatment involves 24-hour care. Patients are under medical supervision and programs can last for 30, 60 or 90-days. Doctors or nurses can intervene if a patient experiences severe withdrawal symptoms, medication is monitored, and the environment is safe and stable.

Outpatient treatment may be recommended for people with less severe alcohol use disorders. Patients can check in with their doctor daily to evaluate their symptoms, and they may be able to continue carrying out daily tasks and responsibilities.

Medication-assistant treatment

Some medications can relieve the symptoms of withdrawal and provide comfort during detox. Doctors may prescribe medication to help patients focus on their recovery from addiction instead of the symptoms of withdrawal. Medication that treats anxiety and insomnia as well as anti-seizure medication or antipsychotics may be used during detox and withdrawal.


Recovery from alcohol addiction or dependence is an ongoing process. Rehab facilities and doctors often recommend individual counseling to manage emotions during and after detox. Working with a counselor can help determine factors that contributed to alcohol abuse and setting up support to prevent a relapse.

Support groups

After detox, recovery can continue with help from groups like Alcoholic Anonymous. Support groups offer a place to share goals or work through challenges with people in similar situations. Transitioning into other therapies and treatment paths after withdrawal can help you continue on the path to recovery.

Dangers of alcohol withdrawal

Alcohol withdrawal symptoms can shift suddenly and unexpectedly. Symptoms can be minor one hour and severe the next. Seizures and hallucinations can cause serious health conditions and even lead to death. At professional medical facilities, staff is trained to recognize the dangers of alcohol withdrawal and treat symptoms as they arise.

What is acute alcohol withdrawal?

Acute alcohol withdrawal syndrome can occur when a heavy drinker suddenly stops drinking alcohol or reduces their alcohol intake. People who drink for prolonged periods of time and suddenly stop are at a higher risk of experiencing more severe symptoms. Within the first few days after the last drink, they may lose consciousness or develop DTs. Seizures are also possible with acute alcohol withdrawal, and the symptoms can be life-threatening due to health complications from withdrawal.

Medical supervision is necessary to safely detox from alcohol with acute alcohol withdrawal syndrome. A detox center or rehab facility can provide treatment for detox while managing the more dangerous symptoms of withdrawal with medication and care. Medical professionals frequently assess your condition and intervene if symptoms escalate.

What is post-acute alcohol withdrawal syndrome?

For most people, the symptoms of withdrawal last several days or a week. However, some people may experience symptoms of withdrawal for prolonged periods. Post-acute withdrawal syndrome, or PAWS, occurs when withdrawal symptoms continue after acute withdrawal. For people with PAWS, life can be difficult after detox treatment. PAWS episodes can occur for a few days at a time, but the symptoms often resolve quickly.

Alcohol Withdrawal FAQs

Can You Have Withdrawals from Alcohol?

This question is surprisingly common. Many people do not realize just how strong of a hold alcohol has on them until they try and stop drinking. When you stop drinking alcohol after a long-period of misuse, it affects your body. You can have several types of withdrawal symptoms. Here are a few of the most common:

-Aches and pains
-Issues with your stomach
-Headaches or migraines
-Irritability or sudden mood changes
-Struggles with your blood pressure
-Inability to sleep soundly or fall asleep
-Feeling anxious about having another drink

In more extreme cases, you may face more significant withdrawal symptoms, such as a racing heart, trouble breathing, hallucinations, or even seizures. Ideally, you want to experience your withdrawals in the presence of people with training to keep you safe. That way, if something goes awry, you can still be safe during your detox.

Do Alcoholics Get Withdrawal Symptoms?

Part of what defines an addiction is having withdrawals when the substance is no longer part of the routine. For an alcoholic, this means no longer consuming alcohol. Once the body detects that no alcohol is in the system, it begins to react to get you to drink more. This often happens around 6-8 hours after having the last drink in most instances. The reactions the body gives off are the symptoms associated with withdrawals. The more each person consumed, the stronger the symptoms. Not all alcoholics will have severe withdrawal symptoms, but each alcoholic will experience something when they stop drinking.

Can Alcohol Withdrawal Cause Hallucinations?

When you make the heroic decision to give up alcohol, you are likely going to face a lot of symptoms during the detox process. The one symptom we find most people nervous about is hallucinations. The truth is, hallucinations can happen during alcohol detox. The more you drank, the higher your chances of developing hallucinations become. Thankfully, by opting to go through alcohol detox under supervision, steps can be taken should any auditory, visual, or tactile hallucinations appear. Medications and other remedies can minimize the chances of having a hallucination while detoxing from alcohol.

Can Alcohol Withdrawal Cause Nausea?

During alcohol withdrawals, you may experience stomach upset. In some people, this does show up as nausea. In others, it can show up as diarrhea. Some people just feel sick to their stomach as their body detoxifies from alcohol. Each person’s experience will be different. Luckily, alleviating nausea is relatively easy if you start to experience it in detox.

Can You Get a Fever from Alcohol Withdrawal?

In most instances, you will not develop a fever going through alcohol withdrawals. However, there are times where this could happen. In specific, if you develop DTs, or what we commonly call Delirium Tremens, a fever is a common side effect. This is because of how severely your body is reacting to not having alcohol in most instances. This is an important symptom to monitor. That is another reason you should not opt to go through alcohol withdrawals on your own. It is always best to have a professional monitor you through the withdrawals process. That way, you are far less likely to develop any serious side-effects along the way.

How Long Do Alcohol Withdrawal Symptoms Last?

For many people, alcohol withdrawal symptoms go away after a week to two weeks. However, this is not the case for everyone. Some people, especially those who abused alcohol for a significant amount of their lives, have symptoms that last longer. While rare, some people get severe enough symptoms that they do not go away for weeks or even months. However, that is quite rare and usually only happens to those who are older and drank for the vast majority of their lives. When this is the case, it usually starts with DTs and those effects are what stick around.

How Serious is Alcohol Withdrawal?

This question is a little trickier to answer. For some people, alcohol withdrawals are a few days of feeling poor and life goes on. For others, they struggle far more symptoms for an extended period of time. Every journey through withdrawals to sobriety is unique. Overall, most people feel the most serious effects of alcohol withdrawals for 1-2 weeks and then they decrease until they are finally gone. There are several factors that come into play when trying to determine how serious withdrawals will be. They include:

-How much a person drank each day.
-How long the person drank in their lifetime.
-The types of alcohol the person consumed.
-How old and what gender the person was.
-The person’s weight and health issues.

The more a person drank, the longer they drank, the harder the alcohol, the older, and the heavier a person was all make withdrawals more serious. However, if the person only abused alcohol for a short time, the effects should be less.

How to Diagnose Alcohol Withdrawal

The best way to diagnose alcohol withdrawal is by seeing a doctor. However, most alcoholics have a pretty good idea what is going on. When they stop drinking alcohol, their body revolts in a way. It is not happy because the alcohol changed how the body functioned. As the person drank, the alcohol changed the way the brain was wired. The more alcohol the person consumed, the more changes were made.

Now, as the person chooses to stop drinking (or may simply not have any more alcohol to drink), the body shows signs of a struggle. When this struggle becomes noticed, it confirms alcohol withdrawals. The alcoholic is not going to feel good, will often feel quite agitated, and will focus on getting another drink. These symptoms point to alcohol withdrawals. This should lead the alcoholic to an alcohol detox facility. That way, they can be monitored to leave alcohol behind in a safe environment.

How to Treat Alcohol Withdrawal Symptoms

The best approach to treating alcohol withdrawal symptoms is to do it with help. Alcohol is not one of those drugs you want to just stop cold turkey over the weekend, figuring to go back to work on Monday. It is one that you should do while supervised, ideally by someone with at least basic medical training. Alcohol detox facilities exist to help guide people through alcohol withdrawal symptoms. Most recovering alcoholics learn to manage their symptoms day by day at first. They struggle to ask for help or feel like there are no options for relief. By going to a detox center, there are options to get many of the symptoms to subside. They may be relaxation, massage, medication, or even just talking with someone to manage the emotions attached.

How to Withdraw from Alcohol Use

Alcohol is not a drug you simply withdraw from unless you barely drank in the first place. However, if you rarely drink, then you may not be reading an FAQ page like this one. Alcohol becomes a substance your body relies on the more you use or abuse it. It changes how you breathe, how your heart beats, and how you think. The wiring from your brain to the rest of your body is never exactly the same after abusing alcohol for any period of time. When you want to give up alcohol, you need to do it the right way. This means either seeing your primary care physician, or coming to a detox facility like ours. We can then help manage your symptoms and help you through the transition from drinker to sober.

Is Alcohol Withdrawal Real?

This question is more common than you may think. Many alcoholics believe their symptoms are only in their head. “It’s just alcohol, it can’t do that much” is what many people think. The truth is, when you feel alcohol withdrawal symptoms, it is totally real. The pain you may experience, the stomach upset, or your inability to sleep is all real. That is the alcohol showing you how much control it had over you by making your body crave another drink. By having a rehab counselor there when these withdrawals hit, you can make it through them. When it gets rough, take everything moment by moment, then minute by minute. Before you know it, you will be up to hours, then days, then weeks. You can do this, and it all starts by knowing you can have help with everything you are thinking and feeling right now.

What Are the Physical Symptoms of Alcohol Withdrawal?

Aches and pains are the most common physical symptom of alcohol withdrawal. Your body will often hurt like when you get a bad case of the flu. Every part of your body will ache and moving is no fun. You may have headaches that range from mild to debilitating. Some people notice that they sweat a lot when going through alcohol withdrawals. In more extreme cases, some people have seizures or severe fevers as a result of their withdrawals. In the rarest of cases, alcohol withdrawals can even cause heart or breathing trouble, coma, or death. That is why having someone to monitor you through your withdrawals is so vital.

What Happens to the Body During Alcohol Withdrawal?

The extent of what you could go through during alcohol withdrawals depends on many different factors. However, the body goes through a similar process. As it is trying to rid the body of any remnants of alcohol, your body is going to hurt. You may feel like you are simply achy all over. Your mind is going to try and rewire itself to full-functionality without alcohol. This often leaves people struggling with headaches.

The desire for more alcohol can leave people facing anxiety or confusion. Your kidneys and liver are going to continue working through whatever alcohol is left in your system. Plus, they are going to attempt to flush anything toxic left behind from the alcohol out, too. Your body is going to start trying to heal itself quickly after your last drink, so do what you can to drink water, eat right, and rest so it can do its job.

When Do Alcohol Withdrawal Symptoms Start?

For most people, they notice the earliest alcohol withdrawal symptoms within 5 or 8 hours of their last drink. Some notice it sooner and some don’t notice symptoms for the first 12-24 hours. Each person’s experience will be unique.

When Do Alcohol Withdrawal Symptoms Stop?

For most, by the end of 5-7 days, they will have only minor alcohol withdrawal symptoms if any at all. Some will still have a few lingering effects into a second week. However, nearly all people notice that their symptoms have all but disappeared by the end of week two.

Who Is At Risk for Alcohol Withdrawal?

Anyone that has been drinking heavily for an extended period of time can face alcohol withdrawal. It doesn’t take being an alcoholic to get these symptoms. However, if you are an alcoholic, then you are more likely to get them. The longer your alcoholism has gone on will be part of what dictates the length and severity of your withdrawal symptoms.




Additional Resources

Compass Detox is not affiliated with any of the resources below and these resources are offered merely as additional sources of information on “alcohol withdrawal”.

Additional Video Resources

“Alcohol Withdrawal” by Strong Medicine via YouTube

“Alcohol Withdrawal Management & Treatment” by Medgeeks via YouTube

“Alcohol Withdrawal” by UCSDTraumaBurn via YouTube