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Alcohol Withdrawal Symptoms, Timeline, and Treatment

by | Last updated Sep 13, 2021 at 11:58AM | Published on Jun 11, 2014 | Alcohol Addiction

Alcohol Withdrawal Symptoms

Our society widely accepts alcohol use, even when they know, it comes with a high potential for abuse. Alcohol abuse and alcoholism are not new, and every year over three million new cases appear in the US. 

However, like other drugs, alcohol withdrawal symptoms are real. Those struggling with alcoholism can suffer life-threatening side effects, especially when they try to stop drinking without medical supervision. 

What is Alcoholism?

To understand alcohol withdrawal, we first have to know the meaning of alcoholism. This chronic disease happens to those with an inability to control drinking. Those who abuse alcohol have a physical and emotional dependence on the substance. People have problems controlling their drinking and continue to use it, even when it causes them problems. 

Understanding the signs of alcoholism gives us a better idea of how this chronic disease begins. 

While people think alcoholism is a choice, it’s a chronic disease, of the likings of diabetes, for example. Alcohol rewires someone’s brain chemicals and functions, which can lead to addictive behaviors. Those dependent on alcohol often struggle with mental health disorders and need a medical professional to stop drinking safely.

What is Alcohol Withdrawal Syndrome?

Alcohol withdrawal syndrome (AWS) encompasses all the symptoms when heavy drinkers suddenly stop or significantly reduce their alcohol consumption. 

People suffering from AWS experience a combination of physical and psychological symptoms that go from mild anxiety and fatigue to nausea and depression. Some AWS are as severe as seizures and hallucinations that can be life-threatening. 

Alcohol Withdrawal Symptoms

Symptoms of alcohol withdrawal happen when someone suddenly stops drinking alcohol after long-term use or excessive drinking. Severe withdrawal symptoms are rare, but when they occur, they can be fatal. When people stop drinking, the body becomes hyper excited, anxious, and restless. For heavy drinkers, these symptoms can include high blood pressure, seizures, and tremors. 

For most alcohol abusers and alcohol addicts, initial or common withdrawal mild symptoms include: 

  • Anxiety
  • Irritability
  • Lethargy
  • Shakiness
  • Mood swings
  • Nightmares
  • Difficulty thinking clearly
  • Sweating
  • Headaches
  • Insomnia
  • Tremors
  • Appetite loss

However, around five percent of people struggling with alcohol withdrawal symptoms experience delirium tremens or “the DTs.” When this happens, signs of alcohol withdrawal syndrome include:

  • Fever
  • Agitation
  • Seizures
  • Confusion
  • Hallucinations
  • High blood pressure

When people experience these symptoms, checking into a clinically supervised addiction rehab facility or detox program is vital to prevent fatal consequences. 

Acute Alcohol Withdrawal

Some people will experience acute alcohol withdrawal symptoms, even weeks after their last drink. During this time, people are at risk of losing consciousness, developing delirium tremors and seizures. This condition is associated with mortality rates of 1 to 5%

Patients who experience acute withdrawal symptoms can benefit from medication-assisted treatments that can help manage these symptoms more effectively and prevent life-threatening consequences. 

Post-Acute Withdrawal Syndrome

While most people will stabilize once the initial alcohol withdrawal symptoms subside, others will experience prolonged side effects. This phase is known as post-acute withdrawal syndrome (PAWS). Depending on the severity of someone’s addiction and other factors, PAWS can last anywhere from a couple of weeks to a year. 

Typical PAWS symptoms include:

  • Anxiety
  • Difficulty sleeping
  • Memory problems
  • Intense cravings
  • Chronic nausea
  • Dizziness
  • Low energy 

PAWS is one of the leading causes of relapse for individuals that completed alcohol addiction treatment. The issue is that people experience PAWS in waves – it comes and goes. The spontaneity of the symptoms makes resisting temptation difficult. This is why it’s essential to continue rehab efforts in an aftercare program or other form of a supportive environment. 

What Causes Alcohol Withdrawal Symptoms?

Alcohol is a central nervous system (CNS) depressant. When people drink daily, their bodies become dependent on alcohol. At this point, the CNS can no longer adapt to the lack of alcohol, so it malfunctions with withdrawal symptoms. 

For heavy drinkers and regular drinkers, their brain is exposed to the depressant effects of alcohol. Once the body becomes dependent on alcohol, it needs more and more of the substance to produce the same effects. However, the body becomes so accustomed to the substances that it requires them to function correctly. 

When someone abruptly stops drinking, these neurotransmitters are no longer available to the brain, creating a chemical imbalance. This is what causes the debilitating side effects of withdrawal. 

However, you don’t need to have an alcohol use disorder to experience withdrawal symptoms. People might experience nausea and vomiting, headaches, and blackouts after binge drinking or heavy drinking episodes. 

Who’s at Risk?

Anyone with an addiction to alcohol or who engages in heavy drinking will likely experience alcohol withdrawal symptoms if they stop drinking. 

AWS is more common in adults, but teenagers who drink excessively may also experience these symptoms. If you drink heavily, you’re likely to experience withdrawal symptoms when you stop drinking or reduce the amount of drinking. 

About 80% of people with an alcohol use disorder will experience withdrawal symptoms.

Alcohol Withdrawal Timeline

Alcohol withdrawal symptoms, even among heavy drinkers, start almost immediately. Depending on the severity of the addiction and the amounts of alcohol in someone’s system, withdrawal symptoms might be more or less intense. 

In addition, many alcoholics struggle with co-occurring disorders such as drug abuse. In these cases, when someone stops taking substances, they might experience withdrawal symptoms from the various substances, and these can be very dangerous. 

6-12 Hours: People start experiencing withdrawal symptoms eight hours after their last drink. At this stage, insomnia, nausea, anxiety, and abdominal pain are the main symptoms. 

12-24 Hours: People start struggling with confusion about 24-72 hours after the last drink. Other symptoms include increased body temperature, high blood pressure, and an unusual heart rate. 

48+ Hours: People start experiencing mild and more severe symptoms after the second to the fourth day. Fever, hallucinations, agitation, and seizures are prevalent during this stage. 

How is Alcohol Withdrawal Syndrome Diagnosed?

A doctor will likely review your medical history and assess your symptoms. Doctors will look for signs such as hand tremors, irregular heartbeat, dehydration, and fever. A toxicology screen can also be used to help diagnose alcohol addiction. 

An addiction specialist will use the Clinical Institute Withdrawal Assessment of Alcohol (CIWA-Ar) to measure AWS. This test will help analyze the severity of your symptoms. The scale measures ten common symptoms, including:

  • Agitation
  • Anxiety
  • Auditory disturbances
  • Clouding of sensorium
  • Headache
  • Nausea and vomiting
  • Uncontrollable sweating
  • Tactile disturbances
  • Tremors
  • Visual disturbances 

Alcohol Addiction Treatment Options

Sadly, alcohol detox is rarely enough to help someone achieve a long-lasting recovery. Most people need to seek help from treatment facilities to find the proper treatment. 

Treating alcohol withdrawal and addiction will depend on the severity of their addiction. A specialist might recommend either an inpatient or outpatient setting. Other modalities will include individual counseling and support groups to encourage recovery. 

Treatment Programs

Inpatient Programs: These offer a temptation-free environment that’s designed to help people in recovery. In this case, people check into a living drug rehab facility, and they attend meetings and therapy sessions while remaining in a supervised environment. 

Outpatient Programs: For those with a mild addiction, an outpatient rehab program might be an option. In this case, they have a more flexible program that allows them to maintain their daily schedule and responsibilities like attending school, work, or caring for their family. 

Aftercare Programs: Addiction isn’t one thing people can shove under the rug. The remnants of addiction often stay with them for the rest of their life. To help users find happiness and purpose in their lives, aftercare programs offer relapse prevention classes, life skills, and other essential tools for a successful life after treatment. 

Behavioral Therapies

Individual Therapy: Beyond the detox process, it’s paramount to tackle the addiction. Through individual therapy, people can understand what drives addictive behavior and see an underlying cause of addiction. 

Group Therapy: Building a healthy and sober support team is a critical element of addiction recovery. By attending group meetings or 12-step programs, individuals can continue their sober lives and learn relapse prevention techniques, even months after detox. 

Finding Substance Abuse Treatment

If you or someone you know is struggling with alcohol use disorder, don’t wait any longer. Countless treatment options can help them conquer their addiction and manage any withdrawal symptoms. 

Remember, quitting potent drugs alone can be life-threatening. It’s essential to have the support and supervision of drug addiction specialists by your side. 

At Lighthouse Recovery Institute, we believe in offering customized drug addiction treatment plans for those struggling with drug abuse. We look at each program on a case-by-case basis to cater to your needs to get better and walk towards recovery. From detoxification programs to group meetings and more, everyone in our team is committed to helping you win the struggle with addiction. 

Geraldine Orentas

Geraldine Orentas

Geraldine is Lighthouse Recovery Institute’s Digital Marketing Manager. She has a Bachelor’s in Journalism and experience in the digital media industry. Geraldine’s writing allows her to share valuable information about mental health, wellness, and drug addiction facts, hoping to shed light on the importance of therapy and ending the stigma.
Medical Disclaimer:

Lighthouse Recovery Institute aims to improve the quality of life for anyone struggling with substance use or mental health disorder. We provide fact-based content about the nature of behavioral health conditions, treatment options, and their outcomes. The material we publish is researched, cited, edited, and reviewed by licensed medical professionals. The information we provide in our posts is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be used in place of the advice of your physician or another qualified healthcare provider.

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