Alcohol withdrawal occurs when someone who regularly consumes large amounts of alcohol suddenly moderates or discontinues their intake. The symptoms can range from mild discomfort to potentially life-threatening complications.
This page explains what to expect from the alcohol withdrawal process, from the symptoms to the timeline and risks involved. You will also discover how to get effective, science-backed treatment to streamline the detox process.
What is Alcohol Withdrawal?
Alcohol is a depressant of the CNS (central nervous system). The brain adapts to the presence of alcohol over time by working harder to maintain balance. Someone who becomes dependent on alcohol experiences withdrawal symptoms upon discontinuation as the brain remains in this heightened state.
The symptoms of alcohol withdrawal begin within hours of the last drink and can last for several days. In severe cases, withdrawal provokes dangerous complications, including seizures and DTs (delirium tremens), a condition that can be fatal and demands immediate medical attention.
Symptoms of Alcohol Withdrawal
The duration and presentation of alcohol withdrawal varies depending on factors like drinking history, overall health, and previous experiences with withdrawal. Symptoms typically appear in stages, with mild effects developing first and more severe symptoms emerging later.
Mild symptom (6 to 12 hours after the last drink)
- Anxiety
- Restlessness
- Insomnia
- Irritability
- Nausea
- Vomiting
- Sweating
- Headaches
- Increased heart rate
Moderate symptom (12 to 48 hours after the last drink)
- Tremors
- High blood pressure
- Fever
- Confusion
- Irregular heartbeat
- Increased breathing rate
Severe symptoms (48 to 72 hours after the last drink)
- Severe agitation
- Hallucinations
- Disorientation
- Seizures
- Delirium tremens
DTs are the most dangerous form of alcohol withdrawal. They can trigger extreme confusion, dangerously high blood pressure, and cardiovascular complications. This form of alcohol withdrawal can be fatal unless treated.
Who is at Risk of Alcohol Withdrawal?
Not everyone who drinks alcohol heavily will experience withdrawal, but some variables increase the risk. These include:
- Drinking heavily for an extended period: The longer and more frequently someone drinks, the greater the risk of withdrawal.
- Previous withdrawal episodes: Those who have gone through withdrawal before are more likely to encounter severe symptoms in future attempts to stop drinking.
- Underlying health conditions: Heart disease, liver problems, and mental health disorders can worsen withdrawal symptoms.
- Age: Older adults may have a more challenging time recovering from alcohol withdrawal due to slower metabolism and pre-existing health conditions.
CDC (Centers for Disease Control and Prevention) defines heavy drinking as more than eight drinks weekly for women or more than fifteen for men. Binge drinking—four or more drinks in a short period for women or five or more for men—can also increase the likelihood of withdrawal symptoms upon quitting.
Alcohol Withdrawal Timeline
While the alcohol withdrawal timeline is variable, symptoms follow a similar pattern:
- 6 to 12 hours: Mild symptoms manifest, including nausea, sweating, headaches, and anxiety.
- 12 to 24 hours: Symptoms typically worsen, and some people experience hallucinations.
- 24 to 48 hours: Seizure risk is highest during this phase of alcohol withdrawal.
- 48 to 72 hours: Delirium tremens may present, requiring urgent medical care.
- After 72 hours: Symptoms improve gradually, but mood swings and fatigue may linger for weeks.
How is Alcohol Withdrawal Diagnosed?
Doctors diagnose alcohol withdrawal based on a person’s symptoms, medical history, and drinking habits. A physical exam can help isolate signs like dehydration, tremors, and irregular heartbeat.
CIWA -Ar (the Clinical Institute Withdrawal Assessment for Alcohol) scale is often used to measure the severity of withdrawal. This scale evaluates symptoms like sweating, agitation, and hallucination.
Blood tests may also be performed to check for alcohol-related complications like liver damage or nutritional deficiencies.
Treatment for Alcohol Withdrawal
The best treatment for alcohol withdrawal hinges on the severity of symptoms. Some people can recover at home with medical supervision, but most benefit from clinical care.
At-home treatment for mild alcohol withdrawal
At-home treatment should only be considered if a healthcare provider determines that symptoms are mild and unlikely to worsen. The following tips can make the process smoother:
- Drink plenty of fluids to prevent dehydration
- Eat balanced meals to replenish lost nutrients
- Rest in a quiet environment
- Have a trusted friend provide support
- Use OTC medications for headaches or nausea
Medical treatment for moderate to severe alcohol withdrawal
For most people—especially those at risk of serious complications—a medically supervised detox in a hospital or treatment facility is the safest and most comfortable option. This usually includes:
- IV (intravenous) fluids: To prevent dehydration and restore electrolyte balance.
- Medications: Benzos like Valium (diazepam) or Ativan (lorazepam) help reduce the risk of seizures and ease anxiety.
- Monitoring vital signs: Blood pressure, heart rate, and oxygen levels are closely watched to mitigate adverse outcomes.
- Nutritional support: Vitamin supplements like thiamine (B1) are given to prevent the development of neurological issues.
People with frequent seizures or delirium tremens need intensive care in a hospital setting during alcohol withdrawal.
Long-term Support After Alcohol Withdrawal
Completing detox is the first step in overcoming alcohol dependence, but ongoing treatment is almost always required to address the psychological aspect of addiction. This is delivered in an inpatient or outpatient setting and may include:
- Therapy and counseling: CBT (cognitive behavioral therapy) helps probe the psychological component of alcohol use disorder, assisting people in identifying addiction triggers and changing behaviors.
- Support groups: Programs like AA (Alcoholics Anonymous) provide peer support and accountability in ongoing recovery.
- MAT (medication-assisted treatment): Prescription medications approved by the FDA (U.S. Food and Drug Administration), like naltrexone and acamprosat,e reduce cravings and help prevent relapse.
A solid support system combined with a structured recovery plan increases the chances of long-term sobriety.
Can Alcohol Withdrawal be Prevented?
The best way to prevent alcohol withdrawal is to avoid heavy drinking. If a person is dependent on alcohol, they should discontinue use under medical supervision to lower the risk of complications. Gradually lowering alcohol intake before quitting altogether may help ease symptoms, but this should be done with the guidance of a healthcare professional. Ongoing treatment after alcohol withdrawal strengthens the chances of sustained sober living.
Move Beyond Alcohol Withdrawal at Tree House Recovery
Alcohol withdrawal can be challenging and aggravating, but it’s also manageable with the proper clinical and emotional oversight. We can help you move from dependence to sustained sobriety at Tree House Recovery.
Once you have detoxed from alcohol under controlled conditions, you can continue your recovery with an outpatient program at an appropriate level of intensity. This enables you to attend therapy sessions and engage in MAT (medication-assisted treatment) around your existing commitments.
Get immediate assistance and evidence-based treatment for alcohol withdrawal and addiction by calling (855) 202-2138.
