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Alcohol Withdrawal

Learn the symptoms and timeline of alcohol withdrawal and when to reach out for help.

When someone who is physically dependent on alcohol suddenly stops drinking or significantly reduces their alcohol consumption, a set of symptoms known as alcohol withdrawal syndrome can occur. This sudden reduction of drinking disrupts brain activity, which leads to numerous withdrawal symptoms — physical reactions that can appear the same day that drinking stops.

Common Symptoms of Alcohol Withdrawal

Physical

Mental

  • Shakiness 
  • Sweating 
  • Loss of appetite 
  • Nausea or vomiting 
  • Insomnia 
  • Headaches 
  • Tremors 
  • Agitation 
  • Restlessness 
  • Irritability 
  • Anxiety 
  • Confusion 
  • Mood swings 
  • Fatigue 

Alcohol Withdrawal Timeline

Stage one: Mild symptoms can begin within an hour of the last drink and usually include minor physical discomfort and changes in mood. These symptoms can feel similar to a hangover — but for those who have routinely consumed large quantities of alcohol over a long period of time, it’s important to not disregard these symptoms but rather work with a medical professional to treat them immediately.

Stage two: Moderate symptoms can begin within 12 hours after the last drink and are more intense compared with Stage One symptoms. It is important that these signs are closely monitored by a medical professional to reduce the likelihood of severe symptoms.

Stage three: Severe symptoms can begin around two days after the last drink and can last for several days. Of these symptoms, delirium tremens and seizures can occur without warning. Because these pose serious health risks and can be fatal, it is very important that individuals in Stage Three withdrawal be closely monitored by a medical professional.

Delirium Tremens 

While most symptoms of alcohol withdrawal tend to ease within a week, for some people these symptoms can last for weeks after their last drink. During Stage Three, some individuals may experience seizures as well as one of the more severe side effects of alcohol withdrawal, delirium tremens (DTs). This condition affects people who have stopped drinking but have a history of consuming large amounts of alcohol (eight or more drinks per week for women and 15 or more drinks per week for men). Individuals who have been drinking for a long period of time, have experienced alcohol withdrawal in the past, or have a seizure disorder are at a higher risk of developing DTs.

While only 5% of people going through withdrawal experience DTs, the symptoms are serious and potentially fatal:

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

Delirium tremens is potentially fatal. If you or someone you know is experiencing symptoms, call 911 and seek medical care immediately.

Seeking Treatment 

The severity of alcohol withdrawal symptoms ranges from person to person. If symptoms are difficult to control or affecting someone’s daily life, medication and detox can help the body overcome the chemical dependence. If withdrawal symptoms are severe, such as delirium tremens, hallucinations, seizures, high blood pressure, fever, or heavy sweating, hospitalization may be necessary to help start the detox process, whether through inpatient rehab or medication- assisted therapies.

Working with a medical professional can help make the process of quitting alcohol easier and safer. There are numerous resources available to ensure those in recovery remain safe during the process and in a supportive environment that helps them refrain from drinking.

Whenever possible, those in recovery should work with a licensed professional to determine which approach or approaches are best, based on needs and circumstances. Those without a primary care provider can use the Substance Abuse and Mental Health Services Administration’s National Helpline for treatment information and a referral.

Life After Withdrawal  

For some people, withdrawal symptoms such as cravings and depression may never fully subside, but they will become less severe. After six to 12 months of abstaining or substantially reducing alcohol consumption, managing these symptoms and triggers will become more natural and less recurring.

Some may experience a relapse: That doesn’t mean failure or having to start all over again. Knowing what to expect and how to manage alcohol withdrawal symptoms will prepare individuals if a relapse ever does occur. Recovery is a lifelong process, but there are many resources and communities available to help people stay on that path.