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Alcohol Withdrawal - Signs, Symptoms, and Treatments

What is alcohol withdrawal and how does it affect the well-being of others? Learn about signs, symptoms, and treatment options. 

What is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) is increasingly common globally. Alcohol withdrawal can be very tricky and challenging to navigate without proper medical intervention, considering the severity of possible alcohol withdrawal symptoms. 

Nevertheless, successful management of alcohol detox symptoms and overall alcohol withdrawal treatment is possible. It is important to consider treatment of not only withdrawal, but of treating the root of the problem: Alcohol Use Disorder.  

Addiction Misuse

There are several different substances of addiction, including popular substances of abuse like opioids, marijuana, and alcohol. As seen and experienced with other substances of abuse, alcohol addiction does not happen spontaneously; instead, it happens with repeated and consistent intake of alcohol.1 

Alcohol Intake Consequences and Risks

This constant alcohol intake could have harmful health, social and psychological effects on people addicted to repeated alcohol intake. However, there is also the danger of alcohol withdrawal symptoms and effects linked with any attempt to halt alcohol intake. 

First Look at Alcohol Dependence and Withdrawal

alcohol withdrawal

What Is Alcohol Withdrawal?

Alcohol withdrawal, also known as alcohol withdrawal syndrome (AWS), refers to the combination of symptoms that accompanies a partial or total decrease in alcohol intake levels. Simply put, alcohol withdrawal relates to the symptoms or side effects of quitting drinking.2 

These alcohol withdrawal symptoms usually vary in severity ranging from mild to much more severe effects. These withdrawal symptoms from alcohol can be so severe that they are life-threateneing.2  

Timeline of Alcohol Withdrawal 

As earlier mentioned, the alcohol withdrawal symptoms that a person who drinks alcohol will experience upon partial or total withdrawal from alcohol vary in severity; that is, you can experience both mild and severe symptoms.  However, you should note that the severity of withdrawal symptoms from alcohol experienced varies with the time you took your last drink and how long you have been drinking. There is a withdrawal from alcohol symptom “timeline” (alcohol withdrawal timeline).

Six Hours After Last Drink

According to the alcohol withdrawal timeline, you may begin to experience some mild symptoms of alcohol withdrawal, such as shaking hands, nausea, headache, anxiety, increased sweating, and even insomnia. All these are early signs of alcohol withdrawal. 

12-48 Hours Post-Drinking

At this point, you may begin to experience more severe signs of alcohol withdrawal such as auditory and visual hallucinations and seizures. Seizures usually begin within 24-48 hours after you withdraw from alcohol intake.3

After 72 Hours

As the duration of alcohol withdrawal increases, the symptoms of alcohol withdrawal syndrome also increase in severity. After 72 hours, you may begin to experience delirium tremens. This alcohol withdrawal symptom can be so severe that withdrawal patients must be admitted into an intensive care unit.

The symptoms of delirium can include dehydration, elevated blood pressure levels, insomnia, hallucinations, and even a decrease in brain blood flow. Although not everyone who undergoes alcohol withdrawal experiences delirium, it has been known to lead to the death of up to 5% of individuals that develop it.3  

For the most part, alcohol detox withdrawal symptoms tend to improve after a short while, so most patients will experience relief after the duration of the above-listed alcohol withdrawal stages (alcohol detox symptoms should improve after five days).3 However, in a few cases, people who withdraw from alcohol may continue to experience signs of alcohol withdrawal well after a week. 

alcohol withdrawal

Signs of Alcohol Withdrawal

If you withdraw from alcohol use, you will exhibit several signs and symptoms. Some of these signs are mild, while others are much more severe. Some typical (mild) signs of acute alcohol withdrawal include the following:

  • Anxiety
  • Mood changes
  • Headaches
  • Fatigue
  • Hallucinations
  • Tremors or shakes
  • Seizures

Severe Alcohol Withdrawal Symptoms

As earlier mentioned, acute alcohol withdrawal can lead to very severe withdrawal symptoms. Some of these painful withdrawal symptoms that can accompany a sudden stop of alcohol consumption include:

  • Extreme confusion
  • Extreme agitation
  • Fever
  • High blood pressure

Alcohol Withdrawal Timeline of Symptoms

Alcohol craving symptoms usually follow a somewhat specific timeline, so you will often be able to quickly identify the level or stage of alcohol withdrawal a person is in by the signs they exhibit or that you can observe. 

6 to 12 Hours Post-Ingestion

In this stage, you will be able to observe common alcohol withdrawal symptoms like increased sweating, headache, vomiting, anxiety, shaky hands, and insomnia. At this stage, the symptoms seen due to your decision to withdraw alcohol will still be relatively mild but observable.

12 to 24 Hours Post-Ingestion

12 to 48 hours after you decide to withdraw alcohol, you may begin to experience some much more severe alcohol withdrawal symptoms such as seizures and hallucinations. 

48 Hours Post-Ingestion

From the 48-hour mark upwards, the most severe alcohol withdrawal symptom occurs; this symptom is known as Delirium Tremens (DT). At this stage of alcohol withdrawal, the patient will experience much more vivid hallucinations that delusions may also accompany. Another feature that makes this stage the most severe in alcohol withdrawal is that it may also be accompanied by increased heart rate, elevated blood pressure, excessive sweating, alcohol withdrawal fever, and confusion.  

What Causes Alcohol Withdrawal Syndrome?

Alcohol, when it is initially consumed, has an irritating effect on the nervous system; however, it also has a stimulatory effect. Upon repeated excessive alcohol consumption, this excitatory effect comes to the fore (becomes very significant). The brain rewires itself and becomes increasingly dependent on alcohol intake to the point where the entire central nervous system will not be able to function correctly without it again.

A sudden or acute alcohol withdrawal at this point of high alcohol dependency usually results in alcohol withdrawal syndrome (AWS). This is because, at this point, the body has become used to and cannot function properly without alcohol, so sudden alcohol withdrawal, in essence, “grounds” boy function since the nervous system is unable to work as it should again.

Who is at Risk for Alcohol Withdrawal Syndrome?

Alcohol Withdrawal Syndrome (AWS) is a severe condition that affects people who have an alcohol dependency or who drink extensively daily and cannot progressively reduce their consumption.

Alcohol withdrawal syndrome occurs more frequently in adults, although it can also affect children and teens who often drink heavily. If you've ever experienced mild withdrawal symptoms like dizziness caused by alcohol withdrawal, chills from alcohol withdrawal, or needed medical detox for alcohol abuse problems, you are more likely to develop Alcohol Withdrawal Syndrome. 

Alcohol Withdrawal Management

alcohol withdrawal

When is Drinking Excessive?

Just in case you’re unsure what “heavy drinking” means, the Center for Disease Control and Prevention defines excessive drinking as a blanket term that includes binge drinking, heavy drinking, and drinking done by pregnant women and by people under the legal age limit.4

Binge Drinking

Of all the above-listed examples of excessive drinking, the most prevalent kind of excessive drinking is binge drinking, which is described as consuming a large amount of alcohol in a short period. It may include:

  • Four or more drinks at a single event for ladies. (Heavy drinking is eight or more per week)
  • Five or more drinks on a single occasion for males. (Heavy drinking is fifteen or more per week)

Alcohol Standard

In the US, the typical representation of a standard drink contains about 0.6 ounces of pure alcohol. This quantity of pure alcohol is typically seen in the following:4

  • Eight ounces of malt liquor
  • A 5-ounce glass of wine
  • A 12-ounce beer
  • 1.5 ounces of 80-proof distilled spirits or liquor such as gin, whiskey, vodka, and rum
alcohol withdrawal

Factors Affecting the Severity of Alcohol Withdrawal

Alcohol withdrawal can be quite challenging since it is accompanied by several mild symptoms (like chills from alcohol withdrawal) and many more severe ones like delirium and seizures. However, if present, some factors may impact the severity of symptoms you will experience from alcohol withdrawal. Some of these factors include the following:

Alcohol Dependence

Alcohol dependence refers to how well your body can function without the intake of alcohol. More often than not, this is linked with the duration of alcohol abuse and the quantity of alcohol consumed in that period. People with high alcohol dependence levels are more likely to have an increasingly severe alcohol withdrawal process since the brain and entire central nervous system will have to “re-learn” what it means to function without the presence of alcohol. 

How Long the Person Has Been Abusing Alcohol

This is one of the significant determinants of alcohol withdrawal severity. People who consistently use alcohol run the risk of developing alcohol dependence. This is because alcohol has a stimulatory effect on the brain and CNS. Repeated exposure to alcohol eventually results in the form of “rewiring” of normal brain functioning processes. 

The Quantity of Alcohol They Consume

According to a guideline by the CDC, “drinking less is better than drinking more4.” While “not drinking” is the best possible option, people who drink heavily (binge drinkers and heavy drinkers) are more likely to develop alcohol dependence quickly. Moderate alcohol drinkers, too, with enough time, will develop alcohol dependence. However, the withdrawal symptoms that accompany alcohol withdrawal for binge and heavy drinkers may be much more severe than withdrawal symptoms for moderate alcohol drinkers. Heavy alcohol drinkers also run the risk of alcohol poisoning.

Factors that Affect Severity of Alcohol Withdrawal

Other factors that may affect the severity of alcohol withdrawal include:

  • Pre-existing mental and physical health conditions
  • How frequently they drink
  • Family addiction history
  • Their age
  • Their history with addiction to other substances

How is Alcohol Withdrawal Diagnosed?

If you used to drink alcohol but chose to stop, your decision to withdraw from alcohol abuse will likely be accompanied by some withdrawal effects. There are a couple of other medical conditions that may present some symptoms similar to those of alcohol withdrawal, so how do you know if the symptoms you are experiencing are from alcohol withdrawal and not some other medical condition? Visit your doctor!

Symptoms of Alcohol Withdrawal

Your doctor will go over your medical records with you, inquire about what symptoms you are experiencing, and perform a physical examination. The following are some of the indicators your doctor will look for as pointers to alcohol withdrawal: 

  • Shaky hands (hand tremors)
  • Dehydration
  • Rapid or irregular heartbeats
  • Fever

Alcohol Withdrawal Diagnosis

Hand tremors are one of the most prominent physical symptoms of alcohol withdrawal. Your doctor may also ask you to state the last time you took a drink and conduct a toxicology screen to ascertain your body’s alcohol levels. Your doctor may also monitor symptoms like anxiety, agitation, headache, nausea, vomiting, visual and auditory disturbances, and excessive sweating.

Also, because excessive alcohol intake can have a harmful effect on several internal organs such as the liver, heart, and the Central Nervous System (CNS), your doctor may evaluate if these organs and systems are functioning properly.5 

Can Alcohol Withdrawal be Fatal?

Alcohol withdrawal is accompanied by several side effects, some of which can be very severe. Withdrawal symptoms such as elevated blood pressure, visual and auditory hallucinations, and delirium can easily result in patient death if not properly managed. Intensive care is often recommended for patients with delirium from alcohol withdrawal because this side effect is accompanied by several other symptoms that make it complex to manage.

Unless alcohol withdrawal is properly managed via alcohol withdrawal treatment at a reputable facility, there is an increased likelihood that it will be fatal.

How To Safely Treat Alcohol Withdrawal

Some people opt for a self-detox option in their alcohol withdrawal journey; however, it must be said that although it might be effective for people who only experience mild alcohol withdrawal symptoms, self-detox is not the safest treatment option for people with much more severe withdrawal symptoms. Other secure methods to treat alcohol withdrawal include the following:

Inpatient Treatment

Inpatient treatment for alcohol withdrawal is one of the safest treatment methods. You will be required to register at a residential facility where you will have access to a team (or teams) of alcohol withdrawal treatment specialists. Your withdrawal treatment team can include a doctor, a therapist, a psychologist, and a physiotherapist.

Inpatient treatment for alcohol withdrawal is usually an intensive process where you remain within the health care facility and have limited contact with people until the detoxing from alcohol timeline is run through. A complete detox timeline alcohol treatment usually lasts for about five days because, after five days, withdrawal symptoms reduce in severity drastically. The in-patient treatment option also features therapy sessions to help patients identify and cope with drinking triggers.  

Inpatient treatment is often preferred because it allows your caregivers to monitor your well-being and carefully track and efficiently deal with symptoms that may accompany alcohol withdrawal. There is also the advantage that inpatient treatment limits your contact with the outside world and allows you to entirely focus on getting better without any distraction.

Outpatient Treatment

The outpatient treatment option for alcohol withdrawal is recommended for patients who will be unable to go for the residential (inpatient) treatment option for one reason or the other. Patients will be able to go about their regular daily routine and report to their treatment center (or hospital) for medical appointments, therapy sessions, and overall treatment evaluation. Patients will also be advised to limit contact with people until the treatment regimen is complete. However, you should note that outpatient treatment may become an inpatient one if there are manifestations of severe withdrawal symptoms like seizures and delirium, as these symptoms usually require intensive care. 

Medication-Assisted Therapy

Medications are also employed in the successful management of alcohol withdrawal symptoms. Benzodiazepines (such as chlordiazepoxide, lorazepam, and alprazolam) are regarded as first-line treatments for managing withdrawal symptoms like seizures. They also play a vital role in preventing symptom progression. Other drugs used to manage alcohol withdrawal symptoms include barbiturates (effective for refractory delirium patients) and clonidine to reduce tremors and heart rate. However, you should note that because prolonged use or abuse of these medications can lead to dependence, so it is recommended that you strictly follow your treatment regimen.

Medication-assisted therapy with benzodiazepines may also be combined with vitamin supplements to ensure the restoration of previously depleted essential vitamins. This is also known as nutrient therapy.

Individual Counseling

Detox patients also simultaneously take part in several counseling sessions where they work with an experienced, certified therapist or psychologist to identify alcohol use triggers and develop strategies to overcome them effectively. Counseling also helps patients develop coping mechanisms and adjust to living in an addiction-free world.

Support Groups

Alcohol withdrawal patients may also belong to different support groups where they get to meet up and have discussions with people who are also going through similar challenges. Support groups are an important part of alcohol withdrawal therapy as they provide patients with a sense of community and support when they need it.

Types of Support Groups

Get Treatment for Alcohol Withdrawal at San Diego Detox

If you have been searching for where to begin your alcohol withdrawal journey, San Diego Detox is the perfect place for you. At San Diego Detox, patients have access to teams of addiction treatment specialists who can help provide excellent alcohol withdrawal management. 

At San Diego Detox, we have a healthy, supportive community that can help you properly manage your alcohol withdrawal and full effect recovery. Take the first step today by reaching out, and we’ll help you the rest of the way.