Withdrawal from Alcohol

Alcohol withdrawal is different for everyone and heavily dependent on genetics, type of alcohol consumption, and how long you’ve been dependent on the substance.

Last updated: June 1, 2018

A sick woman

Most people start to experience withdrawal 24 hours after their last drink, but some people have experienced symptoms as early as six hours after their last drink.

Alcohol withdrawal has three stages of side effects:

Stage 1 Symptoms

The stage 1 symptoms are mild and usually occur within the first 24 hours since your last drink.

  • Anxiety
  • Insomnia
  • Nausea
  • Abdominal pain
  • Loss of appetite
  • Vomiting
  • Depression
  • Confusion
  • Difficulty thinking/problem solving
  • Heart palpitations
  • Tremors
  • Fatigue

Stage 2 Symptoms

The stage 2 symptoms are more moderate occurring on the first full day abstinent and lasting up to three days.

  • Irregular heart rate
  • Mental confusion
  • Regular sweating
  • Irritability
  • Mood swings
  • Increased blood pressure
  • Heightened body temperature
  • Rapid or irregular respiration

Stage 3 Symptoms

Stage 3 symptoms start around day four and continue through day seven. Although for many people these symptoms continue for several weeks afterwards. This is when the symptoms of alcohol withdrawal are most severe.

  • Hallucinations
  • Seizures
  • Fever
  • Severe confusion
  • Agitation and heightened irritability

In addition to all these symptoms however, 3-5% of people going through alcohol withdrawal will experience delirium tremens (DT) which can be fatal if it goes untreated.

DT can start in the moderate stage and worsen over the course of the withdrawal period. Delirium tremens is caused because the central nervous system has been suppressed by alcohol for an elongated time. The sudden removal of said depressant can actually be life threatening. This is one of the many reasons it’s highly recommended that detoxing of alcohol is done with medical supervision.

Alcohol Withdrawal Treatment

As any alcoholic can tell you, the initial withdrawal – while taxing – is not biggest challenge. The biggest challenge is the day-to-day mental challenge that follows.

In regards to treatment, most medical facilities provide medications to control the physical symptoms. This way, nausea, dehydration, and insomnia can be dealt with without suffering or relapsing. In addition, many medical centers prescribe benzodiazepines in an effort to avoid DT. Again, the reason is, DT is caused by the overactivity of the CNS, so the benzodiazepines is used to lessen that sudden stimulation and help the body achieve a better balance.

Medical facilities also use medication to curb other potentially dangerous symptoms such as the irregular heartbeats, rapid respiration, and high blood pressure. Plus, many alcoholics suffer from malnutrition due to their addiction, so supplements are provided. In short, medical supervision is highly recommended to avoid relapsing or prolonged suffering. It’s meant to rebalance your body without the whiplash of withdrawal.

From there, the mental symptoms of withdrawal need to be dealt with. Some medical offices will prescribe medication to help with the initial symptoms of depression and anxiety, but others will not. The medications that are approved for dealing with alcohol use disorder are naltrexone, acamprosate and disulfiram. Naltrexone helps recovering alcoholics by blocking opioid receptors in the brain. Opioid receptors are a contributing factor to “instant gratification”, so this reduces the “reward” or “immediate” part of the brain and subsequently the cravings for the substance as well. Meanwhile acamprosate seems to have a long-lasting impact on treating AUD withdrawal symptoms and disulfiram is supposed to make people sick if they drink alcohol, thereby making the thought of drinking undesirable – more of a short term fix.

There is a fourth drug (topiramate) that is undergoing tests and seems to change the way alcohol rewards drinkers – namely, by not – but it is not yet FDA approved.

Not all medical facilities will offer prescription drugs, but almost all will prescribe some counseling treatment and/or therapy sessions as part of the recovery process. This can be a 12-step program or one-on-one counseling. This is instrumental in long-term care, continued abstinence, and ongoing support.

Count Your Days Sober From Alcohol

Staying sober from our addictions is difficult. One way you can get a little extra support and motivation is by using a sobriety tracker. I Am Sober is free to download, and you can get it for your iPhone or Android device.

Sobriety, one day at a time.

Download the app today!