Alcohol Withdrawal Symptoms

What To Expect and How To Stay Safe

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There are many reasons people struggle to give up excessive drinking, but the symptoms of alcohol withdrawal are among the most intimidating.

It’s common knowledge that if you’ve been drinking heavily for some time, you’ll often experience unpleasant side effects if you decide to stop. This is especially true if you quit abruptly, or go “cold turkey.” But how serious is alcohol withdrawal, what should you expect, and how can you prepare for it?

Alcohol withdrawal symptoms exist along a spectrum. Your experience will vary depending on how much you generally drink, your own personal biology and psychology, and other factors. Below, we’ll discuss the most common symptoms of alcohol withdrawal you should be prepared for, and how to manage them.

An important disclaimer: If you intend on withdrawing from alcohol, it’s best to speak with a licensed physician first. This article should not substitute for medical advice.

Table of Contents

Why Alcohol Withdrawal Symptoms Happen

Alcohol is an addictive substance; many people who drink excessively become physically and psychologically dependent on it. When you remove alcohol from your system after a period of heavy drinking, your mind and body are thrown temporarily off balance—sometimes to an extreme degree. This is known as alcohol withdrawal, and its effects can range from uncomfortable to life-threatening.

Since alcohol is a depressant, eliminating it generally has the opposite effect: Your system becomes overstimulated and goes into overdrive.1 Many symptoms of alcohol withdrawal have their roots in this—particularly anxiety, which is among the most common consequences of giving up drinking.

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Common Symptoms of Alcohol Withdrawal

Alcohol withdrawal symptoms range from mild to severe, and vary depending on the person. Fatigue from alcohol withdrawal is common, as are headaches, nausea, and other hangover-like symptoms. It’s also common to experience mood swings after quitting alcohol. In more extreme cases, a person may experience a racing heartbeat, elevated body temperature, hallucinations, and even seizures.2

Here are some of the most common symptoms to be prepared for if you’re planning on quitting drinking—especially if you’re doing so cold turkey:

Mild to moderate symptoms of alcohol withdrawal:

  • Anxiety
  • Fatigue
  • Tremors, including shaking hands
  • Sweating
  • Headaches
  • Nausea or loss of appetite
  • Brain fog, or difficulty thinking clearly
  • Bad dreams or nightmares
  • Insomnia
  • Depression
  • Feeling “high-strung” or irritable
  • Rapid mood swings

More severe alcohol withdrawal symptoms:

  • Increased body temperature
  • Rapid breathing
  • Elevated heart rate
  • Irregular heartbeat
  • High blood pressure
  • Severe anxiety or mood disturbances
  • Tremors
  • Seizures
  • Hallucinations
  • Delirium tremens

If you experience any of the above severe symptoms, it’s best to seek medical attention, as some of these can be dangerous or fatal. Even if you are only experiencing moderate withdrawal, it’s best to have someone else checking in on you, to make sure you are safe.

What Is Delirium Tremens?

Delirium tremens (DTs) is among the most severe, and most notorious symptoms of alcohol withdrawal. It involves an alteration in your sensorium—which means severe disorientation, and seeing, feeling, and hearing things which are not there. DTs is most common in people with severe alcohol dependence, and generally appears two to four days after your last drink.3

Symptoms of delirium tremens:

  • Hallucinations
  • Severe confusion
  • Profuse sweating
  • Fever
  • Agitation
  • Tremors
  • Seizures
  • Irregular heartbeat
  • Changes in blood pressure

Read more: What Is Delirium Tremens and How Can You Treat It?

Can you die from alcohol withdrawal symptoms like delirium tremens?

The short answer is, yes. DTs is a serious medical condition, and is fatal for about one in 20 people who develop it.4 “Basically, your body can’t maintain its blood pressure or heart rate properly,” says Ria Health psychiatrist Dr. Paul Linde. If a person experiences delirium tremens after quitting drinking, and does not get medical attention, withdrawal could be deadly.

Alcohol Withdrawal Timeline

How long after you stop drinking do you feel better? And how long does alcohol withdrawal last? The answer varies from person to person, but alcohol withdrawal can start as early as six hours after your last drink, and often lasts for five to seven days.5 Peak severity can be anywhere from one to four days, depending on your symptoms. You may also continue to feel some effects for a few weeks after.6

Each person’s body reacts differently to alcohol withdrawal, but below is an approximate timeline of what many people experience:

  • Day 1: As withdrawal begins, you may experience hangover-like symptoms (hangovers are in some sense a mini-withdrawal). These can include headaches, nausea, vomiting, anxiety, irritability, sweating, and shaking hands. More severe withdrawal might include hallucinations, changes in blood pressure, a racing pulse, or rapid breathing, which may need medical attention.
  • Days 2-3: Initial withdrawal symptoms often peak during this period, and a person may experience additional symptoms such as mental confusion, an irregular heartbeat, and elevated body temperature. The risk of seizures becomes highest 24-48 hours after your last drink.7
  • Days 3-5: While some people may experience an easing of symptoms during this period, others may develop more serious conditions such as delirium tremens. This condition often develops after 72 hours, and can cause severe agitation, hallucinations, fever, and dangerous fluctuations in heart rate and blood pressure. This condition can last several days, and requires medical attention.8
  • Days 5-7: Many people see significant improvements in withdrawal symptoms at this point, although it can sometimes take a few weeks for symptoms like insomnia and mood disturbances to go away.

While alcohol withdrawal is generally a five to seven day process, a person will often experience a range of other symptoms as they adjust to sobriety over the longer term. This is often referred to as Post Acute Withdrawal Syndrome (PAWS), and is one reason people sometimes attend recovery programs for a few months after detox.

In other words, giving up alcohol is generally a marathon, not a sprint. Alcohol withdrawal is one of the first steps in what tends to be a longer process of readjustment.

Preparing for Alcohol Withdrawal Symptoms

If you’re planning on quitting alcohol, one way to handle withdrawal symptoms is to taper off slowly. Reducing how much you drink by a small amount every day can mute the symptoms of withdrawal, and help you avoid more dangerous consequences like seizures and delirium tremens.

If you are planning to quit cold turkey (all at once), make sure you have adequate support and supplies beforehand, and have a plan in the case of an emergency. Some important tips include:

  • Let friends, family, and loved ones know what you are doing, and ask them to check in on you. Ask people you often drink with to give you some space.
  • Stock up on electrolytes and easy-to-digest food. Nausea, vomiting, and dehydration are all common consequences of alcohol withdrawal.
  • Learn some deep-breathing, meditation, and mindfulness exercises beforehand, and be prepared with some movies, games, or other distraction techniques. This can help you cope with anxiety and cravings.
  • Have easy access to an emergency phone number, or a loved one who can help you if your symptoms become dangerous.

If you think there is a chance you may have severe withdrawal symptoms, it’s best to check into a detox facility, or find some other form of medical supervision to assure your safety.

Finally, it’s important to know that you don’t need to go through this process alone. There are many forms of support out there, including online programs like Ria Health. Our medical team can help you design a plan to taper off alcohol from home, prescribe medications to manage cravings, and support you in establishing new habits afterwards. We can also help you assess your risk, and refer you to safe medical detox as needed.

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