What Is Alcohol Withdrawal?

If you drink alcohol heavily for weeks, months, or years, you may have both mental and physical problems when you stop or seriously cut back on how much you drink. This is called alcohol withdrawal. Symptoms can range from mild to serious.

If you drink only once in a while, it's unlikely that you'll have withdrawal symptoms when you stop. But if you've gone through alcohol withdrawal once, you're more likely to go through it again the next time you call it quits.

Causes of Alcohol Withdrawal

Alcohol has what doctors call a depressive effect on your system. It slows down brain function and changes the way your nerves send messages back and forth.

Over time, your central nervous system adjusts to having alcohol around all the time. Your body works hard to keep your brain in a more awake state and to keep your nerves talking to one another.

When the alcohol level suddenly drops, your brain stays in this keyed up state. That’s what causes withdrawal.

Timeline of Alcohol Withdrawal Symptoms

The symptoms of alcohol withdrawal can range from mild to serious. What yours are depends on how much you drank and for how long.

6 hours after you stop drinking: Mild symptoms can start as early as 6 hours after you put down your glass. They can include:

12-48 hours after your last drink: More serious problems, including hallucinations, can start in this timeframe and may include hallucinations (about 12-24 hours after you stop drinking) and seizures within the first 2 days after you stop. You can see, feel, or hear things that aren't there.  Learn more about the timeline of alcohol withdrawal symptoms.

48-72 hours after you stop drinking: Delirium tremens, or DTs as you’re likely to hear them called, usually start in this timeframe. These are severe symptoms that include vivid hallucinations and delusions. Only about 5% of people with alcohol withdrawal have them. Those that do may also have:

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Diagnosing Alcohol Withdrawal

If your doctor thinks you might be going through alcohol withdrawal, they'll ask you questions about your drinking history and how recently you stopped. They'll want to know if you've ever gone through withdrawal before.

They’ll also discuss your symptoms. During an exam, they’ll look for other medical conditions to see if they could be to blame.

Treatments for Alcohol Withdrawal

Unless you have a serious health condition or you’ve had severe withdrawals in the past, you probably won’t need more than a supportive environment to help you through. That includes:

  • A quiet place
  • Soft lighting
  • Limited contact with people
  • A positive, supportive atmosphere
  • Healthy food and lots of fluids

If you decide to get treatment, your doctor can recommend the type of care that you need.

If your blood pressure, pulse, or body temperature rises, or if you have more serious symptoms like seizures and hallucinations, seek medical care immediately (dial 911). Your doctor could suggest inpatient care and drug treatment.

Common medications include benzodiazepines to help treat symptoms like anxietyinsomnia, and seizures. You might also take anti-seizure meds and antipsychotics, along with other drugs.

Can You Prevent It?

Treating alcohol withdrawal is a short-term fix that doesn't help the core problem. When you talk to your doctor about symptom relief, it's a good idea to discuss treatment for alcohol abuse or dependence. The doctor can give you advice to help you stop drinking.

WebMD Medical Reference Reviewed by Nayana Ambardekar, MD on November 06, 2019

Sources

SOURCES:

Royal College of Physicians: “Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications. NICE Clinical Guidelines, No. 100."

American Academy of Family Physicians: "Alcohol Withdrawal Syndrome."

Alcohol Health & Research World: "Complications of Alcohol Withdrawal," "Introduction to Alcohol Withdrawal," "Treatment of Alcohol Withdrawal."

State Government of Victoria: "Withdrawal."

Cleveland Clinic: "Care of the Patient Undergoing Alcohol Withdrawal."

UpToDate: "Patient education: Alcohol use -- when is drinking a problem? (Beyond the Basics)."

Industrial Psychiatry Journal: “Clinical management of alcohol withdrawal: A systematic review.”

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