Alcohol is a commonly used substance in the USA - nearly 90% of adults consume alcohol in their lifetime. While alcohol can be safe when used in moderation, it has negative ramifications in many areas of life when abused. When consumed in excess, this can lead to addiction, and alcohol withdrawal does not follow as automatically. According to the NIAAA, alcohol accounts for 3.3 million deaths globally, and approximately 178,000 American deaths a year, from excessive alcohol use.
Alcoholism is chronic, and occurs when a person’s uncontrolled drinking turns problematic. Withdrawal from alcohol is challenging, and may seem insurmountable to someone who has not yet started on the path to recovery. However, sobriety is always possible with proper treatment and a long-term care plan. Join Avenues Recovery, leading addiction rehabilitation specialists, as we clarify what withdrawal from alcohol is, how long it each stage takes, and which medication can help you deal with the symptoms.
What Is Withdrawal From Alcohol?
Alcohol withdrawal is the body’s reaction to the sudden lack of alcohol, after a period of heavy, excessive drinking, triggering a physical response of uncomfortable symptoms. Alcohol is a depressant that affects the brain and causes it to produce more GABA (a neurotransmitter with a calming and euphoric effect) and less glutamate (a neurotransmitter responsible for making you excitable). When alcohol is continuously misused, the opposite effect occurs, and the brain will produce more glutamate to maintain balance. Once the alcohol is withdrawn, the brain will be overstimulated due to the extra production of glutamate. This causes withdrawal symptoms, which last until the brain readapts to the absence of alcohol and resumes normal production levels.
Alcohol Withdrawal Symptoms
Alcohol detox can lead to physical symptoms ranging from mildly uncomfortable to severe and dangerous.
For many people, alcohol detox symptoms follow a pattern:
- Symptoms are mild
- Symptoms increase in intensity
- Symptoms peak in intensity
- Symptoms subside
The most typical signs of alcohol withdrawal include:
- Shaking
- Mild sweating
- Mild anxiety
- Fatigue
- Headaches
- Insomnia
- Nausea
- Vomiting
- Irritability
- High blood pressure
- Elevated body temperature
- Elevated heart rate
- Irregular heartbeat
- Seizures
- Tremors
- Depression
- Altered consciousness
- Hallucinations
- Delirium tremens (DTs)
How Long Does Alcohol Withdrawal Last?
Withdrawal from alcohol starts approximately six hours after the last drink, and includes both physical and mental symptoms. The length and intensity of symptoms vary according to each individual. Among other variables, it will depend upon the length and strength of abuse and each person’s physical condition. That being said, there are typically three stages of alcohol withdrawal symptoms:
Stages of Alcohol Withdrawal
Stage 1: During the first stage, symptoms tend to be mild. They include anxiety, sleeplessness, stomach pain, and nausea. It is common for many people to recover from withdrawal symptoms after this stage.
Stage 2: Serious symptoms, which can include seizures, usually begin 48 hours after the last drink. More than 5% of people will experience this phase during withdrawal. Symptoms can include high blood pressure, irregular heartbeat, elevated body temperature, and mental confusion.
Stage 3: The third stage begins 72 hours (about 3 days) after the last drink and can include fever, seizures, agitation, and hallucinations. Delirium tremens can also develop during this stage.
Some people will experience post-acute withdrawal syndrome (PAWS) as well. This syndrome is characterized by withdrawal symptoms lingering for a longer period of time than usual.
Alcohol Withdrawal Risk Factors
Some of the risk factors affecting the severity of alcohol withdrawal symptoms include:
- Duration and frequency of alcohol use: The greater the frequency of alcohol use and the larger the quantity ingested, the more severe withdrawal symptoms tend to be.
- Age: The older a person is, the more likely they are to experience severe symptoms.
- Physical or mental disorders: Both physical and mental conditions can complicate and exacerbate withdrawal symptoms.
- Previous history of severe alcohol withdrawal symptoms: If a person has prior experience of severe withdrawal symptoms, it is likely that they will suffer from intense withdrawal symptoms again.
- Earlier withdrawal attempts: Withdrawal symptoms increase in severity each time a person attempts to quit alcohol use.
Can You Die From Alcohol Withdrawal?
Alcohol is one of the only substances that carries the risk of fatality during withdrawal.
Can You Manage Alcohol Withdrawal at Home?
No, it is critical that one seeks medical care in an alcohol detox facility when stopping to drink and not try to manage alcohol withdrawal at home.
Severe Alcohol Withdrawal Symptoms
The symptoms described below can be dangerous and potentially fatal. If someone experiences these symptoms, they should seek medical attention immediately. Hospitalization may be necessary.
- Tremors: These can begin between five to ten hours after the last drink and can last for two days. Tremors may be accompanied by a rapid pulse, rapid breathing, increased blood pressure, as well as psychological symptoms such as anxiety, hyper-alertness, irritability, nightmares or vivid dreams, and insomnia.
- Alcohol hallucinosis: This can begin between 12 to 24 hours after the last drink and last for two days. Hallucinosis is experienced as mental hallucinations, such as seeing objects moving, or other detailed visions.
- Alcohol withdrawal seizures: Beginning between 6 to 48 hours after the last drink, several seizures will usually occur within a few hours. The riskiest time for seizures is after the first 24 hours of withdrawal but seizures can occur any time between the first 6 hours up to 72 hours.
- Delirium tremens, or DTs: This severe condition can begin two or three days after the last drink. It is characterized by tremors, changes in breathing, temperature, and circulation. These shifts can divert blood flow from the brain, resulting in temporary loss of consciousness, stupor, nervous or angry behavior, irrational beliefs, soaking sweats, sleep disturbances, and hallucinations.
Alcohol Withdrawal Shakes
During withdrawal, patients will often experience withdrawal shakes, which can be caused by anxiety and/or stress. However, if such tremors are unabating, they may denote a more severe condition developed through years of alcohol abuse. Tremors can be a sign of damage to the cerebellum, the area of the brain that regulates balance and movement coordination. Another cause can be liver disease, which in its later stages will cause tremor-like symptoms.
How to Stop Alcohol Withdrawal Shakes
If one is experiencing shakes or tremors, they should consult with a doctor to determine if there is any serious underlying cause. A doctor may prescribe anti-anxiety alcohol withdrawal medication, or suggest a nutritious diet and increased hydration. Whether due to withdrawal or a more serious underlying condition, tremors should not be ignored.
Alcohol Detox and Sleep
Alcohol withdrawal can be mistaken for the commonplace hangover, and often, people are left alone to “sleep it off”. Sleepiness is a common symptom during alcohol detox. Since it may signify more serious problems, it is critical that symptoms of fatigue during detox are supervised and treated medically.
How to Manage Alcohol Withdrawal
The process of withdrawal from alcohol can be challenging, but it is definitely possible to get through safely. It is important to have support in place to safely endure the withdrawal process, and prevent failed withdrawal attempts.
Here are some ways to prepare for alcohol withdrawal:
- Inform friends and family: Prepare your loved ones so they can check up on you. It is important not to be alone in case of severe symptoms.
- Remove alcohol triggers: These can include friends who drink or alcohol itself, to prevent cravings.
- Prepare fluids: Dehydration may occur due to excessive vomiting. Stock up on fluids.
- Call for medical help: Be prepared to call for medical help in case of emergency.
- Check into a rehab: Alcohol detox can be a matter of life and death. It is far safer to detox in a licensed facility under supervision and professional care. Avenues Recovery can offer you expert rehabilitation options to safely withdraw from alcohol addiction.
It is helpful to keep in mind that proper nutrition in recovery can contribute to alleviating withdrawal symptoms.
Alcohol Addiction Treatment
It is always best to have a professional assess alcohol withdrawal symptoms and put together an individualized treatment plan. Withdrawal treatment may include behavioral programs, support, and medication if necessary.
Possible treatment options include:
- Outpatient care: This will include regular office visits for counseling, medication, and support.
- Partial hospitalization or intensive outpatient: Patients will receive outpatient care for complex needs.
- Inpatient rehab: It is often beneficial to seek treatment in an inpatient rehab facility, where one can receive 24-hour medical support and supervision.
Alcohol Withdrawal Medication
In some cases, alcohol withdrawal syndrome medication is necessary to alleviate symptoms. For severe symptoms, hospital treatment may be needed. Otherwise, a doctor may prescribe anxiety-relief medication (such as benzodiazepines) to alleviate psychological symptoms. The FDA has also approved three non-addictive medications for alcohol use disorder: naltrexone, acamprosate, and disulfiram.
Withdrawal From Alcohol at Avenues Recovery
Recovering from an addiction is often a long battle and can be incredibly challenging. However, many resources and support systems are available for those looking to begin alcohol withdrawal. With professional treatment and therapy, and a strong support system, lasting withdrawal from alcohol is always possible.
Wondering how to stop drinking alcohol? Our staff at Avenues Recovery are experts in addiction rehabilitation and are here waiting to help you along your journey! There’s no need to do it alone, contact Avenues Recovery today to hear how we can support you.