Alcohol Withdrawal: Symptoms, Stages, and Safe Treatment Options

Alcohol withdrawal is common with alcohol use disorder (AUD) or heavy, uncontrolled drinking. It happens when there is a significant reduction or stoppage of alcohol consumption. Alcohol withdrawal can range from mild to severe.

At the NuView Treatment Center, we provide comprehensive and personalized treatment to our clients suffering from alcohol withdrawal. We believe in ensuring a safe, comfortable recovery.

What Is Alcohol Withdrawal?

In cases of heavy, uncontrolled drinking or AUD, when the body does not receive the same amount of alcohol as it is normally used to, a person experiences alcohol withdrawal. This is when a person reduces or stops their intake of alcohol.

Alcohol withdrawal is unpleasant and can affect a person both physically and psychologically. In fact, alcohol withdrawal is what makes it very difficult for people to quit alcohol. Therefore, seeking professional help becomes important for recovery and sober living.

Signs And Symptoms Of Alcohol Withdrawal

Alcohol withdrawal symptoms can range from mild to severe and a person may experience them between 6 – 12 hours of either decreasing or stopping alcohol intake. The signs and symptoms will look something like this:

• Anxiety or irritability

• Restlessness

• Wakefulness

• Fatigue

• Headache

• Sweating

• Upset stomach

• Increased blood pressure

• Increased heart rate

• Tremors

• Heart palpitations

• Hallucinations

• Seizures

• Hyperthermia

• Delirium tremens (characterized by confusion, psychosis, excessive sweating, seizures, rapid heart rate, and hyperthermia)

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What Are The Causes of Alcohol Withdrawal?

Alcohol slows down the central nervous system or CNS. Over a period of time, especially with heavy drinking, the CNS gets used to alcohol. Now, heavy drinking is different for males and females. For males, it is 5 or more drinks per day and 15 or more drinks per week. For females, it is 4 or more drinks per day and 8 or more drinks per week.

Back to the CNS, in cases of heavy drinking, it tries to keep the effects of alcohol at bay to keep the body going. When alcohol intake reduces or stops, CNS cannot accommodate the same as quickly. Therefore, there is an overload of activity, keeping the brain and body in an excited state. This is what leads to alcohol withdrawal.

Stages of Alcohol Withdrawal

There are 4 stages of alcohol withdrawal.

1. The first stage is when alcohol withdrawal symptoms begin. It takes place 6-12 hours after the last drink. During this stage, the symptoms, while uncomfortable, are still mild. Usually, these include changes in mood, upset stomach, heart palpitations, sweating, and a sensation of pricking in the limbs.

2. The second stage takes place 12-24 hours after the last drink. At this stage, the alcohol withdrawal symptoms range from mild to moderate. Generally, they can be as follows:

• Agitation

• Headache

• Confusion

• Fatigue

• Fever

• Increased breathing rate and heart rate

3. The third stage of alcohol withdrawal is 24-48 hours after the last drink. During this stage, the alcohol withdrawal symptoms intensify. Generalized tonic-clonic seizures or grand mal seizures are experienced, wherein there is decreased awareness and a loss of consciousness. These need to be addressed immediately.

4. The fourth stage of alcohol withdrawal takes place 48-72 hours after the last drink. Here, the alcohol withdrawal symptoms are severe and even life-threatening if immediate attention is not provided, as in the case of delirium tremens. Delirium tremens is characterized by cognitive changes, anxiety, agitation, hallucinations, and so on. Delirium tremens is also linked to heart attack and coma, hence, immediate attention is required.

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Risks and Complications of Alcohol Withdrawal

Alcohol withdrawal is a dangerous, life-threatening condition in itself. There are risks and complications to consider as well to provide holistic and personalized treatment and even save lives:

• Symptoms of alcohol withdrawal can appear as quickly as 6 hours after the last drink and can range from mild to severe.

• Seizures are severe alcohol withdrawal symptoms and occur in nearly 5% of the untreated clients.

• Wernicke-Korsakoff syndrome, which results from thiamine deficiency, leads to memory troubles and other cognitive and brain impairments.

• Cardiovascular problems like arrhythmia can arise from alcohol withdrawal.

• Protracted withdrawal syndrome, which can lead to anxiety, depressive symptoms, and sleep troubles, can even last for over a year.

• Delirium tremens, a life-threatening condition, develops between 1-4 days after the last drink and can increase the chances of a fatality by 25%.

Alcohol Withdrawal Timeline

The symptoms of alcohol withdrawal can differ from one person to another based on different factors, but a general timeline is as follows:

• Alcohol withdrawal begins 6-12 hours after the last drink, and at this time, the symptoms are still mild.

• 24 hours after the last drink, alcohol withdrawal symptoms intensify. One might experience more severe symptoms like seizures, and this also depends on the severity of the condition.

• Between 24-72 hours after the last drink, alcohol symptoms are their worst. Seizures and delirium tremens are experienced during this stage, and alcohol withdrawal can become life-threatening if immediate attention is not given to it.

If anyone is experiencing alcohol withdrawal symptoms, it becomes very important to contact the healthcare provider or doctor immediately. Even calling emergency services like 9-1-1 (in the U.S.) can help.

Treatment Options for Alcohol Withdrawal

The goal of treatment for alcohol withdrawal is to reduce withdrawal symptoms, prevent complications like seizures, and treat alcohol use disorder. Hence, medication is something very important.

For mild to moderate alcohol withdrawal symptoms, short-term medications like carbamazepine, gabapentin, and benzodiazepines are prescribed.

In cases of severe alcohol withdrawal, hospitalization is required. Usually, the person is kept in the ICU where they will be monitored and long-acting benzodiazepines are usually administered.

While medication helps in combating the symptoms of alcohol withdrawal, they cannot treat the main reason for alcohol withdrawal, which is alcohol use disorder or AUD. AUD treatment requires a combination of psychotherapy and medication to prevent relapse and promote sober living. Psychotherapeutic interventions include:

• Cognitive Behavioral Therapy – Here, the triggers that can contribute to drinking are identified, and coping skills are provided so as to not resort to drinking again.

• Motivational Interviewing – The goal of motivational interviewing is to instill the motivation required to change drinking-related behaviors. Some ways to do this are by identifying the pros and cons of change, making the changes, building confidence, and developing skills that are necessary to stick to recovery.

• Mindfulness Therapy – Focuses on developing strategies that lead to flexible responses to triggers that can lead to drinking rather than resorting to impulsive decision-making.

• 12-Step Recovery Programs – Informal peer groups like Alcoholics Anonymous follow a 12-step recovery program where people can come together, share their experiences, and take responsibility for their recovery. They are important for ongoing care and support.

Start Your Personalized Treatment Plan

Our dedicated professional staff is here to design a treatment plan tailored to your unique needs, guiding you or your loved one on the journey to lasting recovery.

(323) 307-7997

Frequently Asked Questions (FAQs)

How long does it take to withdraw from alcohol?

Alcohol withdrawal can begin as quickly as 6 hours after the last drink and the entire process can last anywhere up to 7 days.

What happens when you quit drinking alcohol?

When a person quits drinking alcohol, they experience alcohol withdrawal symptoms. These are unpleasant symptoms and in extreme cases can be life-threatening as well.

What is one of the first signs of withdrawal?

One of the first signs of alcohol withdrawal can be agitation, confusion, and mild to moderate tremors.

What's good for alcohol withdrawal?

For mild alcohol withdrawal symptoms, carbamazepine or gabapentin is prescribed. For moderate symptoms, benzodiazepines are prescribed. Meanwhile, for severe symptoms, hospitalization is necessary.