What Are the Symptoms of Alcohol Withdrawal?

Medically Reviewed By Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
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Alcohol withdrawal occurs when you cut down on or stop drinking alcohol after heavy alcohol use. The symptoms can increase in severity if you experience multiple periods of withdrawal. There are many risks of long-term or heavy alcohol use. It is important to contact your doctor if you feel you may be experiencing alcohol use disorder or dependent drinking. They will be able to offer advice on how to reduce your intake safely while helping you manage any symptoms of withdrawal.

Keep reading to learn about the symptoms of alcohol withdrawal, alcohol withdrawal syndrome, how to manage withdrawal symptoms, and more.

What are the symptoms of alcohol withdrawal?

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Symptoms you may experience with alcohol withdrawal include:

  • sweating
  • sleeping difficulties
  • hallucinations
  • mood changes, such as depression or anxiety
  • agitation
  • hand tremors
  • seizures

Kindling

If you experience multiple episodes of alcohol withdrawal, you may find that the symptoms begin to worsen each time. This is known as kindling.

Kindling can cause more severe symptoms, such as seizures. These result from the activation of brain and nerve cells that happens when you remove alcohol from your body following heavy use. This activation causes hyperexcitability, or excessive excitability, which can lead to seizures.

Kindling can also involve tremors and agitation.

Withdrawal delirium

Alcohol withdrawal delirium, or delirium tremens, is a rare but potentially serious complication of alcohol withdrawal that can be fatal. Almost 2% of people with alcohol dependence will experience alcohol withdrawal delirium.

The symptoms of alcohol withdrawal delirium can include agitation and hallucinations.

Having a doctor monitor your symptoms can help you reduce your alcohol intake as safely as possible and lower the risk of more serious complications.

Learn about the symptoms of alcohol use disorder.

What is the timeline for alcohol withdrawal symptoms?

It is useful to have an awareness of the stages of alcohol withdrawal so that you know what to expect and can better manage your symptoms.

However, it is important to note that the exact timeline for withdrawal symptoms can differ for each person.

When do alcohol withdrawal symptoms start?

The symptoms of alcohol withdrawal will typically begin within 6–12 hours of stopping drinking alcohol.

You may find that the symptoms progress rapidly. It is possible to develop severe symptoms such as delirium tremens within the first 48 hours, according to the Alcohol Rehab Guide.

The Alcohol Rehab Guide also explains that the expected stages of alcohol withdrawal symptoms after you stop drinking alcohol are as follows:

6–12 hours

Symptoms you may experience in the first 6–12 hours include:

12–24 hours

Symptoms you may experience within 12–24 hours include:

  • hand tremors
  • disorientation
  • seizures

48 hours

Symptoms you may experience after about 48 hours include:

How long does alcohol withdrawal last?

Alcohol withdrawal symptoms will typically last for about 5 days. However, some people may find that their symptoms persist for longer.

Learn more about withdrawal.

What is alcohol withdrawal syndrome?

Alcohol withdrawal syndrome (AWS) is a term that medical professionals use to describe the set of symptoms a person with an alcohol use disorder typically experiences when they stop using alcohol.

About 8% of people who require a hospital stay for alcohol use disorder experience AWS. In severe cases, an individual may require treatment in an intensive care unit.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‐5) outlines the criteria for an AWS diagnosis as follows:

  1. There is clear evidence that an individual has stopped or reduced their alcohol intake following frequent or heavy use.
  2. There is no other medical condition or mental or behavioral disorder that may be responsible for the symptoms.

What is acute alcohol withdrawal syndrome?

Acute AWS is a term that describes the initial symptoms of alcohol withdrawal. These may occur anywhere from a few hours to about 5 days following cessation.

These symptoms can be intense and may progress in severity.

Following acute AWS, some people may experience post-acute withdrawal syndrome (PAWS).

What is post-acute withdrawal syndrome?

PAWS refers to prolonged side effects that some people experience following alcohol withdrawal.

PAWS can last anywhere from a few weeks to a year.

Symptoms that may occur with PAWS include:

  • low energy
  • sleeping difficulties
  • irritability
  • emotional outbursts
  • anxiety
  • memory problems
  • chronic nausea
  • dizziness
  • delayed reflexes
  • intense cravings

Intense cravings can cause an individual to relapse. It is important to consult a doctor if you are experiencing PAWS so that they can help you manage your symptoms.

What causes alcohol withdrawal?

Alcohol affects the central nervous system and the brain. Excessive alcohol consumption can cause the brain and body to become dependent on alcohol.

When a person stops drinking alcohol after frequent or heavy use, the brain and body have to readjust to the chemical imbalances.

These imbalances can cause you to experience symptoms of alcohol withdrawal. Neurotransmitters no longer receive the sedative properties associated with alcohol, which can result in feelings of anxiety or irritability.

Additionally, the activation of brain and nerve cells can result in hyperexcitability. This can cause more severe symptoms, such as seizures.

Contact your doctor for more information about what happens to your body during alcohol withdrawal.

How do I relieve symptoms of alcohol withdrawal?

Doctors may recommend an alcohol treatment program to help you manage your symptoms of alcohol withdrawal. This program can include:

  • Inpatient rehabilitation: This offers a safe and supervised environment in which experienced medical professionals can assist you with managing your symptoms.
  • Outpatient rehabilitation: This option may be preferable in cases of less severe alcohol misuse.
  • Alcohol rehabilitation counseling: A counselor can help you manage your symptoms and identify any underlying causes of alcohol use disorder.
  • Support groups: You may find it helpful to meet and receive support from other people going through a similar experience.

Are there any alcohol withdrawal medications available?

Your doctor may prescribe medication to help you manage your symptoms of alcohol withdrawal. They might recommend chlordiazepoxide (Librium), which can also help alleviate symptoms of anxiety.

Some medications can also help reduce the urge to drink alcohol. These include acamprosate (Campral) and naltrexone (Vivitrol).

In cases of delirium tremens, your doctor may prescribe benzodiazepines.

Contact your doctor for more information about ways in which you can manage the symptoms of alcohol withdrawal.

When should I see a doctor?

Contact a doctor if you have concerns about alcohol dependency. The doctor will be able to provide you with information about safe ways to reduce your alcohol intake, and they will also be able to signpost you to specialized sources of support for people with alcohol use disorders.

You should also contact a doctor if you are experiencing alcohol withdrawal symptoms. They will be able to advise you on how to manage your symptoms and reduce the risk of delirium tremens.

How much alcohol is too much?

Excessive drinking includes binge drinking and heavy drinking.

According to the Centers for Disease Control and Prevention (CDC), binge drinking refers to drinking four or more drinks over 2–3 hours for females and five or more drinks for males.

Heavy drinking is eight drinks or more per week for females and 15 drinks or more for males.

In the United States, an individual drink is:

  • 5 ounces (oz) of 12% ABV wine
  • 8 oz of 7% ABV malt liquor
  • 12 oz of 5% ABV beer
  • 1.5 ounces of 40% ABV (80-proof) distilled spirits or liquor, which includes:
    • whiskey
    • vodka
    • rum
    • gin

Learn about daily drinking vs. binge drinking.

Summary

Alcohol withdrawal symptoms happen when a person stops drinking alcohol after frequent or heavy use. The symptoms can range in severity and may include nausea, vomiting, and mood changes. Some people also experience tremors and seizures.

In severe cases, you may develop delirium tremens. This is a potentially life threatening complication for which you may require medical attention.

It is important to contact a doctor if you have concerns about alcohol dependence or alcohol use disorder. The doctor will be able to explain which treatments are available to you and help you manage any symptoms you experience during alcohol withdrawal.

Seeking help for addiction may seem daunting and possibly even scary, but there are several organizations that can provide you with support. 

If you believe that you or someone close to you is experiencing addiction, you can contact any of the following organizations for help and advice:

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Medical Reviewer: Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
Last Review Date: 2022 Sep 28
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.