Common Alcohol Withdrawal Symptoms

Table of ContentsView AllTable of ContentsWhat Is Alcohol Withdrawal?Symptoms of Alcohol WithdrawalCausesTimelineDurationTreatmentGetting Help

Table of ContentsView All

View All

Table of Contents

What Is Alcohol Withdrawal?

Symptoms of Alcohol Withdrawal

Causes

Timeline

Duration

Treatment

Getting Help

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Alcohol withdrawal refers to the physical and mental effects a person experiences after stopping prolonged and heavy alcohol use.When you suddenlystop drinking, your body is deprived of the effects of alcohol and requires time to adjust to functioning without it. Depending on how long you have used alcohol and how much you typically drink, the severity of these symptoms can range frommild to severe.

This article discusses the causes, common symptoms, and different stages of alcohol withdrawal. It also discusses various treatment options for alcohol withdrawal and how you can get help.

Pros and Cons of Tapering Off Alcohol Intake

The symptoms of alcohol withdrawal relate proportionately to the level of alcohol intake and the duration of the person’s recent drinking habit.

Not everyone whoquits drinking alcoholexperiences withdrawal symptoms, but many people who have been drinking for a long period of time, drink frequently, or drink heavily, will experience some withdrawal symptoms if they stop using alcohol suddenly.

There are several mild to moderate psychological and physical symptoms you might experience when you stop drinking.

Psychological SymptomsAnxietyBad dreamsDepressionDifficulty thinking clearlyFatigueFeeling jumpy or nervousIrritability or becoming excited easilyRapid mood swingsShakinessPhysical SymptomsClammy skinElevated blood pressureHeadacheInsomniaLoss of appetiteNausea and vomitingPalenessRapid heart rate or palpitationsSweating, especially the palms of your hands or your faceTremor in your hands

Psychological SymptomsAnxietyBad dreamsDepressionDifficulty thinking clearlyFatigueFeeling jumpy or nervousIrritability or becoming excited easilyRapid mood swingsShakiness

Anxiety

Bad dreams

Depression

Difficulty thinking clearly

Fatigue

Feeling jumpy or nervous

Irritability or becoming excited easily

Rapid mood swings

Shakiness

Physical SymptomsClammy skinElevated blood pressureHeadacheInsomniaLoss of appetiteNausea and vomitingPalenessRapid heart rate or palpitationsSweating, especially the palms of your hands or your faceTremor in your hands

Clammy skin

Elevated blood pressure

Headache

Insomnia

Loss of appetite

Nausea and vomiting

Paleness

Rapid heart rate or palpitations

Sweating, especially the palms of your hands or your face

Tremor in your hands

What Is the CIWA Protocol for Alcohol Withdrawal?

Causes of Alcohol Withdrawal

When a person stops drinking, their brain is still producing extra chemicals, which can potentially cause unpleasant alcohol withdrawal symptoms that are associated with overstimulation. The brain will readjust, but until it does, a person in withdrawal might feel unwell.

Mild, Moderate, and Severe Alcohol Withdrawal Symptoms

Timeline of Alcohol Withdrawal Symptoms

The severity of alcohol withdrawal is categorized into three stages. The symptoms of these stages range from mild to severe.Not all people progress through all of the stages of alcohol withdrawal.

Symptom Stages for Alcohol Withdrawal

Stage 1: Mild Withdrawal

Stage 1 is considered mild withdrawal. Mild withdrawal symptoms often begin within 6 to 12 hours after your last drink.

These first symptoms of withdrawal include:

Mild symptoms may appear similar to ahangover, but they last longer than 24 hours.

The exact timeline for alcohol withdrawal varies from person to person. It’s based on several factors, including how long, how much, and how regularly you have been drinking alcohol.

Stage 2: Moderate Withdrawal

Stage 2 is considered the moderate stage of withdrawal.This stage of alcohol withdrawal includes Stage 1 symptoms plus the following moderate symptoms:

These symptoms generally appear 12 to 24 hours after your last drink. While these symptoms are more severe than Stage 1, they are not life-threatening.

Stage 3: Severe Withdrawal

Stage 3 is considered severe alcohol withdrawal.In addition to experiencing Stage 2 symptoms, those with severe alcohol withdrawal experiencesevere anxietyand moderate to severe tremors.

Complicated Withdrawal

If left untreated, withdrawal can progress to complicated alcohol withdrawal.

The symptoms of alcohol withdrawal delirium include withdrawal seizures that can occur between 8 and 28 hours after your last drink. Signs of an impending seizure include tremors, increased blood pressure, overactive reflexes, and high temperature and pulse.Having a history of seizures increases your risk for withdrawal seizures.

Alcohol withdrawal delirium (AWD), commonly known as delirium tremens (DT), is the most serious symptom of alcohol withdrawal. AWD usually lasts 48 to 72 hours.

DT can be life-threatening: About one in 20 people who develop the condition die from it.If you or a loved one has symptoms of DT, seek immediate emergency medical care.

The symptoms of delirium tremens include:

The symptoms of DT may get rapidly worse and can be fatal. A person with delirium tremens needs to be hospitalized until the symptoms can be controlled.

Delirium Tremens: Causes, Symptoms, and Treatment

Duration of Alcohol Withdrawal

People who suddenly stop drinking and develop alcohol withdrawal symptoms often have two main questions: “Is this normal?” and “How long does it last?”

Withdrawal is different for everyone; there really is no “normal” and it can be hard to predict an individual person’s experience.

It’s typical for withdrawal symptoms to begin within hours to a day or two after you have your last drink. Symptoms are often at their worst around 24 to 72 hours after you stop drinking.

You’ll likely begin to feel better between five to seven days after you stop drinking, though some symptoms—likechanges in sleep patterns, fatigue, and mood swings—can last for weeks or months.

Treatment of Alcohol Withdrawal

Alcohol withdrawal symptoms can be greatly reduced or even eliminated with proper medical care. There arespecific treatments availablefor anyone who wants to stop drinking—even after long-term, chronic alcohol use.

Outpatient Treatment

Treatment varies depending on the severity of withdrawal symptoms. People experiencing mild to moderate alcohol withdrawal symptoms often receive outpatient care—meaning there is no extended time spent in a hospital or facility.It’s recommended, however, that they have someone stay with them who can help during recovery.

A healthcare provider may request daily visits during which they will likely run blood tests and monitor vital signs until symptoms stabilize.

Inpatient Treatment

Inpatient treatment, or staying at a hospital or care facility, may be necessary for someone with moderate to severe symptoms of alcohol withdrawal.Inpatient treatment allows healthcare professionals to monitor you for DT orhallucinations, monitor your vitals, and administer fluids or medicine intravenously if needed.

Ruling Out Other Conditions

A healthcare provider will also run tests to rule out other medical conditions that have similar symptoms of alcohol withdrawal or occur alongside withdrawal. These conditions include gastrointestinal bleeding, infection, intracranial hemorrhage (acute bleeding in the brain), and liver failure.

Counseling

Counseling is usually recommended for someone experiencing alcohol withdrawal.A counselor can advise on ways to cope with the mental and emotional aspects of withdrawal.

A counselor can help someone prepare for life after withdrawal and provide support as they navigate quitting drinking.

Medications for Alcohol Withdrawal Symptoms

A doctor may also prescribe a sedative drug, such as abenzodiazepine, to help reduce withdrawal symptoms such as restlessness or agitation. Benzodiazepines likeLibrium(chlordiazepoxide) andAtivan(lorazepam) may also help to prevent minor withdrawal symptoms from becoming more severe.Other drugs a healthcare provider might prescribe includeanxiolytics, vitamins, andsuboxone.

What Helps With Alcohol Withdrawal?

Getting Help for Alcohol Withdrawal

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We’ve tried, tested, and written unbiased reviews of thebest online therapy programsincluding Talkspace, Betterhelp, and Regain. Find out which option is the best for you.

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs.2015;75(4):353-65. doi:10.1007/s40265-015-0358-1Sachdeva A, Choudhary M, Chandra M.Alcohol withdrawal syndrome: Benzodiazepines and beyond.J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538Muncie HL Jr, Yasinian Y.Outpatient management of alcohol withdrawal syndrome.Am Fam Physician. 2013 Nov 1;88(9):589-595.Munda SK, Khess CRJ, Bhattacharjee D, Singh NK.Clinical manifestations of complicated alcohol withdrawal and uncomplicated alcohol withdrawal: A comparative study.Mental Health and Substance Use.2013;7(3):243-255. doi:10.1080/17523281.2013.806950Kattimani S, Bharadwaj B.Clinical management of alcohol withdrawal: A systematic review.Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: Mechanisms, manifestations, and management.Acta Neurol Scand. 2016;135(1):4-16. doi:10.1111/ane.12671Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Exp Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012National Library of Medicine.Alcohol withdrawal.Hoffman RS, Weinhouse GL.Management of moderate and severe alcohol withdrawal syndromes. UpToDate.Additional ReadingAmerican Society of Addiction Medicine.The ASAM clinical practice guideline on alcohol withdrawal management.J Addict Med. 2020;14(3S Suppl 1):1-72. doi:10.1097/ADM.0000000000000668

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs.2015;75(4):353-65. doi:10.1007/s40265-015-0358-1Sachdeva A, Choudhary M, Chandra M.Alcohol withdrawal syndrome: Benzodiazepines and beyond.J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538Muncie HL Jr, Yasinian Y.Outpatient management of alcohol withdrawal syndrome.Am Fam Physician. 2013 Nov 1;88(9):589-595.Munda SK, Khess CRJ, Bhattacharjee D, Singh NK.Clinical manifestations of complicated alcohol withdrawal and uncomplicated alcohol withdrawal: A comparative study.Mental Health and Substance Use.2013;7(3):243-255. doi:10.1080/17523281.2013.806950Kattimani S, Bharadwaj B.Clinical management of alcohol withdrawal: A systematic review.Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: Mechanisms, manifestations, and management.Acta Neurol Scand. 2016;135(1):4-16. doi:10.1111/ane.12671Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Exp Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012National Library of Medicine.Alcohol withdrawal.Hoffman RS, Weinhouse GL.Management of moderate and severe alcohol withdrawal syndromes. UpToDate.Additional ReadingAmerican Society of Addiction Medicine.The ASAM clinical practice guideline on alcohol withdrawal management.J Addict Med. 2020;14(3S Suppl 1):1-72. doi:10.1097/ADM.0000000000000668

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs.2015;75(4):353-65. doi:10.1007/s40265-015-0358-1Sachdeva A, Choudhary M, Chandra M.Alcohol withdrawal syndrome: Benzodiazepines and beyond.J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538Muncie HL Jr, Yasinian Y.Outpatient management of alcohol withdrawal syndrome.Am Fam Physician. 2013 Nov 1;88(9):589-595.Munda SK, Khess CRJ, Bhattacharjee D, Singh NK.Clinical manifestations of complicated alcohol withdrawal and uncomplicated alcohol withdrawal: A comparative study.Mental Health and Substance Use.2013;7(3):243-255. doi:10.1080/17523281.2013.806950Kattimani S, Bharadwaj B.Clinical management of alcohol withdrawal: A systematic review.Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: Mechanisms, manifestations, and management.Acta Neurol Scand. 2016;135(1):4-16. doi:10.1111/ane.12671Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Exp Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012National Library of Medicine.Alcohol withdrawal.Hoffman RS, Weinhouse GL.Management of moderate and severe alcohol withdrawal syndromes. UpToDate.

Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs.2015;75(4):353-65. doi:10.1007/s40265-015-0358-1

Sachdeva A, Choudhary M, Chandra M.Alcohol withdrawal syndrome: Benzodiazepines and beyond.J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538

Muncie HL Jr, Yasinian Y.Outpatient management of alcohol withdrawal syndrome.Am Fam Physician. 2013 Nov 1;88(9):589-595.

Munda SK, Khess CRJ, Bhattacharjee D, Singh NK.Clinical manifestations of complicated alcohol withdrawal and uncomplicated alcohol withdrawal: A comparative study.Mental Health and Substance Use.2013;7(3):243-255. doi:10.1080/17523281.2013.806950

Kattimani S, Bharadwaj B.Clinical management of alcohol withdrawal: A systematic review.Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914

Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: Mechanisms, manifestations, and management.Acta Neurol Scand. 2016;135(1):4-16. doi:10.1111/ane.12671

Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Exp Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012

National Library of Medicine.Alcohol withdrawal.

Hoffman RS, Weinhouse GL.Management of moderate and severe alcohol withdrawal syndromes. UpToDate.

American Society of Addiction Medicine.The ASAM clinical practice guideline on alcohol withdrawal management.J Addict Med. 2020;14(3S Suppl 1):1-72. doi:10.1097/ADM.0000000000000668

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