What Are Alcohol Withdrawal Symptoms?

If you regularly drink large amounts of alcohol, especially if you’ve done that for an extended period, you may go through withdrawal when you stop. Alcohol withdrawal symptoms result from your body and brain trying to rebalance and learn to function again after you suddenly stop drinking. In this case, you may need alcohol detox treatment.

Alcohol use disorder changes your central nervous system, your brain chemistry and how your brain works. When your body adjusts to the effects of alcohol, it can be a shock to take that away, leading to withdrawal.

Symptoms of alcohol withdrawal can be mild, moderate, or severe. Severe withdrawal is most common in people who drink heavily, and it is a medical emergency that can be fatal.

Alcohol withdrawal syndrome tends to include a combination of physical and psychological symptoms.  Examples of uncomfortable withdrawal symptoms include fatigue, nausea, and anxiety. 

Severe symptoms in a person who is dependent on alcohol include seizures and hallucinations, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Alcohol Withdrawal Symptoms

The symptoms of withdrawal from alcohol may occur anywhere from six hours to a few days after the last alcohol intake. 

Doctors diagnose alcohol withdrawal when someone who has stopped or cut back on heavy drinking has at least two symptoms like these:

• Nausea and vomiting
• Other gastrointestinal disturbances 
• Tremors
• Anxiety
• Headaches
• Rapid heartbeat 
• Irritability
• Sweating
• Insomnia
• Confusion
• Nightmares or sleep disturbances
• High blood pressure
• Alcohol cravings 

The symptoms as you go through withdrawal may worsen up to three days after your last period of alcohol consumption. Some mild withdrawal symptoms may persist for several weeks and be most noticeable when you first wake up.

Severe Form of Alcohol Withdrawal

The most severe type of alcohol withdrawal syndrome is delirium tremens or DT. Symptoms of delirium tremens include:

• Extreme agitation and confusion
• Fever
• Alcohol withdrawal seizures
• Having a sense of burning, itching, or numbness that aren’t there, known as tactile hallucinations
• Hearing things that don’t exist, known as auditory hallucinations
• Visual hallucinations 
• Excessive sweating
• Rapid heart rate
• High blood pressure
• Fast breathing

AWS symptoms that are severe are a medical emergency. You should get immediate help from a healthcare provider if you or a loved one have these symptoms.

Some people wonder how they can predict whether they’ll experience severe symptoms following alcohol abuse. Risk factors for a more severe detox process include having an underlying medical condition, mental health disorder, or engaging in heavy drinking for years.

Treating Common Symptoms of Alcohol Withdrawal

The treatment protocol for alcohol withdrawal syndrome depends on the severity of symptoms. If your withdrawal is likely to be mild, a doctor may be able to manage it at home or as an outpatient. Talk to a medical professional before you try.

Due to the potential severity of withdrawing from alcohol, you should never attempt to do it on your own without any input from a medical professional. Even moderate symptoms can be tough to deal with. 

If you’re going through withdrawal and detox at home, along with talking to a medical professional, someone should stay with you for at least a few days.

For someone with more severe symptoms, hospitalization may be the right option, or you could go to a medical detox in a rehab facility. A medically supervised detox can help you stay safe and comfortable. Doctors and medical professionals can monitor your vitals and provide any treatment you might need based on the severity of withdrawal symptoms. 

 

How Long Do Alcohol Withdrawal Symptoms Last?

There isn’t one timeline that tells us how long alcohol withdrawal symptoms will last for every person. What we do have is a general guideline. 

Some of the things impacting the general timeline of withdrawal symptoms include your excessive drinking patterns, your overall health, and whether you’ve previously had severe withdrawal symptoms.

• During the first eight hours after you have your last drink, you may begin to experience symptoms. Most symptoms start mildly and gradually. Some of the earliest symptoms include restlessness, pale, clammy skin, and nervousness. Shakiness, loss of appetite, and nausea can also occur.
• From the initial 12 to 24 hours after your last drink, your symptoms may become more noticeable. Symptoms may stay mild or get more severe. During this phase of alcohol withdrawal, you could have night sweats and nightmares, mood swings, depression, and brain fog. Some people will experience headaches or migraines, insomnia, and vomiting.
• From 24 to 72 hours after your last drink, symptoms will often peak. The most severe symptoms usually occur around this time, such as nausea, vomiting, and tremors.

Over the next few weeks, after you reach a peak of symptoms, you’ll begin to feel more like yourself again. Those initial few weeks are still challenging, so be mindful and don’t be too hard on yourself during this time. 

These are the weeks when your risk of relapse is highest, so be gentle with yourself as you progress through this period.

Withdrawal from alcohol, or from drugs such as opioids, heroin, cocaine or Xanax, should be managed by a healthcare professional. Silver Lining Recovery does not operate a detox unit. When detox is needed first, our admissions team coordinates the referral to a licensed program, then welcomes you into our intensive outpatient program when you step down. For alcohol use disorder, that care can include medication-assisted treatment with naltrexone or acamprosate.

Does Xanax Help with Alcohol Withdrawal Symptoms?

Doctors do use medications for alcohol withdrawal, always as part of medically supervised care. Benzodiazepines are the first-line treatment. They calm an overactive nervous system by strengthening GABA, a chemical messenger that slows nerve signals, and they lower the risk of seizures and delirium tremens.

Xanax (alprazolam) is a benzodiazepine, but it is not one doctors usually choose for alcohol withdrawal. It is short-acting, so its effect wears off quickly, which can let withdrawal symptoms, including seizures, break through between doses. The American Society of Addiction Medicine’s guideline prefers longer-acting benzodiazepines, such as:

• Valium (diazepam)
• Librium (chlordiazepoxide)

For people with liver disease, doctors often use Ativan (lorazepam) or oxazepam instead, and in some cases other medications, such as carbamazepine or gabapentin.

Never take Xanax or any other benzodiazepine on your own to get through withdrawal. Benzodiazepines carry their own risk of dependence, taking them with alcohol can dangerously slow your breathing, and the dose has to be adjusted by a medical team as withdrawal changes. Other medications, for example for nausea or sleep, can help with specific symptoms under the same supervision.

Does Exercise Help with Alcohol Withdrawal Symptoms?

Light exercise can help with some of the mood and sleep problems that follow withdrawal, but check with your doctor first, and wait until the worst symptoms have passed.

If you’re experiencing moderate to severe symptoms, you may not be able to exercise until you’re past the peak of symptoms. If you’re able, some of the ways exercise can help during this time include:

• Exercise does not speed up how fast your body clears alcohol (your liver does that at its own pace), but it can ease stress and restlessness.
• Exercise can lift your mood and ease anxiety, partly through its effects on brain chemicals such as dopamine and endorphins.
• Setting small goals for yourself and achieving them can help you feel more encouraged as you go through withdrawal. Something as simple as taking a walk can be one of those goals.
• When you start incorporating healthy activities into your life, including exercise, you’re establishing a new routine to follow in recovery.
• Exercise can help specific symptoms of withdrawal, including stress and poor sleep quality.
• Getting through those initial few weeks after you stop drinking is mentally tough, and the risk of relapse is high. Keeping your body busy will occupy your mind as you combat your physical dependence and go through the withdrawal process.
  
  

Getting Help

Your body goes through a lot during alcohol withdrawal. If you drink heavily, talk to your doctor before you stop, because stopping suddenly can be life-threatening.

If you’d like to learn more about drug & alcohol addiction treatment programs please call the Silver Lining Recovery admissions line at 866-681-0927.

Sources: ASAM Clinical Practice Guideline on Alcohol Withdrawal Management; MedlinePlus: Alcohol withdrawal; NIAAA: Alcohol use disorder; SAMHSA National Helpline.