Alcohol Withdrawal Symptoms: Don’t Underestimate Going Sober

Last Updated: August 7, 2019

Alcohol Withdrawal Symptoms

Phillip Ross Board, 32, of Dunbar, South Carolina, was arrested on charges of child neglect. But he died the next day from, as his family alleges, complications from alcohol withdrawal. He never got a chance to plead his case or make amends to his child.

Alcohol withdrawal must be managed, or it can prove fatal. Unfortunately, not many people realize this. Often withdrawal symptoms are mistaken for a hangover headache, and the person is left alone to “sleep off” the symptoms. While some symptoms like shakiness and anxiety wear off on their own, others like seizures and delirium tremens are severe and can be life-threatening.

If you are a habitual drinker but want to quit, ensure that you learn about the symptoms of alcohol withdrawal, so you know what to expect and how to prepare to combat their effects.

What causes alcohol withdrawal?

Alcohol withdrawal is caused by the body and brain chemistry re-adjusting to a lack of alcohol when a drinker quits. Chronic alcohol consumption changes brain chemistry in the following ways:

  • Alcohol inhibits the functionality of GABA, a neurotransmitter that induces feelings of relaxation.
  • Alcohol also inhibits the effect of glutamate, a neurotransmitter that induces feelings of excitability.

When a person stops drinking, these neurotransmitters react by working feverishly. They exhibit a rebound effect and go on overdrive.

There is also a dangerous phenomenon called “alcohol kindling effect“. The withdrawal becomes more and more severe each time, even if the amount of alcohol consumed is the same or even reduced.

The classic symptoms of withdrawal are the opposite of the side effects of alcohol consumption.

What are the symptoms of alcohol withdrawal?

Mild symptoms of alcohol withdrawal include:

  • Shaking
  • Mild sweating
  • Mild anxiety
  • Fatigue
  • Headaches
  • Insomnia
  • Nausea
  • Vomiting
  • Irritability

More severe symptoms include:

In this context, it is worth noting that the condition of alcoholic hallucinosis differs from the hallucinations that a person with DTs experiences. In the former case, the person knows that he or she is “hallucinating.” A person experiencing DTs perceives the images to be real. Alcohol poisoning can also lead to alcohol induced dementia.

Alcohol Withdrawal Symptoms

DTs is the most severe form of alcohol withdrawal and constitutes a medical emergency.

Most of the severe symptoms of alcohol withdrawal warrant medical intervention. For instance, effects like high blood pressure, elevated heart rate, and irregular heartbeat can cause a life-threatening stroke or cardiac arrest if not treated promptly. Phillip Ross Board’s withdrawal symptoms worsened rapidly; his case is a point that alcohol withdrawal should never be ignored.

The severity of alcohol poisoning symptoms next day depend on the following factors:

  • Duration and Frequency of Alcohol Abuse: The longer that a person has been drinking and the larger amount of alcohol he or she drinks on an average in a session, the more severe the withdrawal symptoms will be.
  • Age: Seniors are more vulnerable to severe alcohol withdrawal symptoms.
  • Presence of Physical or Mental Disorders: The presence of co-occurring physical conditions like liver dysfunctionality and/or mental diseases like mood disorders aggravate the symptoms of alcohol withdrawal.
  • History of Severe Alcohol Withdrawal Symptoms: If you had tried to quit alcohol before and experienced severe withdrawal symptoms, it is likely that the effects will be just as intense every time you try to stop drinking.
  • Earlier Instances of Failed Withdrawal Attempts: Every time you fail to follow through on abstinence and sustain sobriety, the withdrawal symptoms are more intense the next time you try to stop drinking.

What is the alcohol withdrawal timeline?

The timeline of withdrawal from alcohol begins as soon as the level of alcohol in the blood comes down and the effects of intoxication begin to wear off.  Alcohol withdrawal symptoms can begin to show up as early as 2 hours after having the last drink.

Alcohol Withdrawal Timeline

Generally, the symptoms manifest within 6 to 12 hours of stopping alcohol.

Not all chronic users of alcohol exhibit withdrawal symptoms when they stop drinking. Nor do all the symptoms manifest in one person, or all at once. Alcohol withdrawal symptoms usually show up in various stages. The following is the timeline for the common symptoms of alcohol withdrawal:

  • Stage 1 (8 hours after the last drink): The common symptoms during this stage are anxiety and restlessness, sleeplessness, abdominal pain, and nausea and vomiting.
  • Stage 2 (24-72 hours after the last drink): The common symptoms during this stage are high blood pressure, irregular heartbeat, elevated body temperature, and mental confusion.
  • Stage 3 (72+ hours after the last drink): The classic symptoms during this timeframe are fever, seizures, agitation, and hallucinations. Delirium tremens can also develop during this period and its symptoms peak at the 5-day mark.

In some people, the symptoms may subside quickly within 5-7 days of manifesting. However, you should always keep in mind that some symptoms show up late or peak in severity long after you stop drinking.

You should be on alert or let you loved ones know when you plan to stop drinking.

Tips to Prepare for Alcohol Withdrawal

Quick Tips to Prepare for Alcohol Withdrawal

Congratulations on deciding to quit alcohol; you are on your way to reclaiming all that alcohol has taken away from your life! But before you go cold turkey, make sure that you have read up the symptoms of alcohol withdrawal. Then prepare yourself in the following ways:

  • Let your friends and family members know about your plans. If your friends and family members know about your plans, they can be around or check on you often to make sure you are okay.
  • Rid your house of alcohol. If you have been drinking for long, it is likely that you have a routine or daily habits built around alcohol. Make sure that you don’t have access to alcohol when habit kicks in and makes you long for a drink after coming back home from work or in the morning.
  • Request your drinking buddies not to visit you. It is not enough that you stay away from bars and pubs during the withdrawal period. You must also request your drinking buddies not to visit you at home. Whether or not they bring alcohol with them, their mere visit might act as a powerful drinking trigger.
  • Stock plenty of fluids at home. Nausea and vomiting can dehydrate you and deplete your body of life-sustaining electrolytes. Keep replenishing fluids like sports drinks handy.
  • Create distractions to guard yourself against cravings. When you have been drinking for long, your brain and body become used to having alcohol in the system. You will be racked by powerful cravings when you stop drinking alcohol. Ride out the urges by distracting yourself with books, movies, music, or hobby paraphernalia.
  • Learn deep breathing and meditating techniques. Learn deep breathing and meditation techniques, if you do not know these already, to keep calm when cravings strike. These mind-body techniques help you ride out the urges mindfully instead of giving in.
  • Write down the reasons for quitting alcohol. Put up this list somewhere you can see. These reasons will help you stay grounded and not reach out for a drink when cravings strike.
  • Be prepared to call for medical help. You learned about the symptoms of alcohol withdrawal. Be on your guard. You may be determined to go through the alcohol withdrawal process alone, but tell yourself that you will call for medical help if symptoms worsen.
  • Check into a specialized alcohol detox clinic. It is brave of you to decide to quit drinking, but it is foolhardy to take unnecessary risks. If you believe that you can’t manage withdrawal healthily, check into a clinic to detox from alcohol. Doctors can monitor you 24/7 and treat symptoms promptly there.

Why should you visit a rehab facility to withdraw from alcohol?

Whether or not you believe that you can pull off alcohol withdrawal without risking your health, there are certain instances when you must visit an alcoholics rehab facility before you try withdrawing from alcohol. Treatment for alcohol abuse is a preferable way to cope with severe withdrawal. You must never try to go cold turkey on your own in the following circumstances:

  • There is no one at home to monitor your symptoms.
  • You have a history of experiencing severe alcohol withdrawal symptoms.
  • You suffer from heart, lung, or liver diseases.
  • You have an existing mental condition.
  • You are more than 60 years old.
Attempting to withdraw from alcohol is the first step towards sobriety.

Make sure that you do not waste this chance because every failed shot at withdrawal makes the next attempt more difficult to pull off successfully. Ensure your health and safety by learning all you can about alcohol withdrawal timeline and symptoms. But most importantly, remind yourself that there is no shame in asking for help if withdrawal symptoms worsen or if you are not sure if you can manage the challenges of this process by yourself.

What matters more is you being able to quit alcohol forever.


Marixie Ann Manarang-Obsioma

Content Writer

Marixie Ann Manarang-Obsioma is a licensed Medical Technologist (Medical Laboratory Science) and an undergraduate of Doctor of Medicine (MD). She took her Bachelor’s Degree in Medical Technology at Angeles University Foundation and graduated with flying colors.

The combination of having a good medical background, being a mom, and wanting to help people, especially the elderly has cultivated her passion for working in remote areas with love and compassion.
Marixie likes to travel, read, and watch movies.

Medical review by Brian Obodeze

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