Alcohol Withdrawal Explained

For a person with a long-term alcohol addiction, suddenly stopping will present a constellation of difficult and painful withdrawal symptoms. In the best case, symptoms might only be mild enough to impair sustained sobriety. In the worst case, symptoms develop into life-threatening risks if left untreated.

No two people will experience identical processes of alcohol withdrawal, but understanding which symptoms to expect and how they progress can make the path to recovery safer and less overwhelming.

What is alcohol withdrawal?

Alcohol withdrawal refers to the collection of physical and psychological symptoms that happen when someone with alcohol dependence suddenly stops drinking. The length and severity of withdrawal symptoms depend on a multitude of factors and range from mild to life-threatening.

Going through alcohol withdrawal can be incredibly difficult, with a spectrum of symptoms that range from major to minor, affecting people in different ways. Although a physical examination for alcohol withdrawal is usually sufficient to diagnose alcohol withdrawal syndrome clinically, the severity of withdrawal can sometimes mean that broad and varied psychological disorders develop.

The diagnostic criteria for alcohol withdrawal include:

• Cessation of alcohol use that has been heavy and prolonged
• Two (or more) of the following symptoms within a few days after criterion A:
  • Profuse sweating or pulse rate greater than 100 BPM
  • Increased hand tremors
  • Nausea or vomiting
  • Visual or auditory hallucinations
  • Psychomotor agitation
  • Mal seizures
  • Anxiety

• The above symptoms cause clinically significant distress or impairments in social, occupational, or other important areas of daily functioning.
• The symptoms are not due to another medical condition and are not better accounted for by another mental disorder.

Why does alcohol withdrawal happen?

Doctors and medical professionals describe how alcohol has a depressive effect on many systems in the body. One of the biggest causes of alcohol withdrawal stems from how alcohol slows down your brain function, which alters the way your nervous system sends messages around the body.

Alcohol’s impairments to the central nervous system (CNS) are well known, which, over prolonged periods of drinking, force your nervous system to adjust to alcohol’s presence. Your body strives to maintain stability under the duress of alcohol’s depressive effects, so when alcohol is suddenly removed from the system, the brain stays in an overactive state and lays the foundation for uncomfortable and painful withdrawal symptoms.

What are the symptoms of alcohol withdrawal?

We have listed some of the symptoms needed for an official diagnosis above, but there is a constellation of symptoms inherent to alcohol withdrawal. Below, we’ve broken down some of the most prevalent symptoms for a person experiencing alcohol withdrawal.

Mild to moderate symptoms include:

• Anxiety and nervousness
• Irritability or mood swings
• Fatigue or low energy
• Depression
• Difficulty concentrating
• Restlessness or jumpiness
• Insomnia and frequent nightmares
• Nausea or vomiting
• Loss of appetite
• Headaches
• Sweating or clammy skin
• Rapid heart rate
• Enlarged pupils
• Shaky hands or body tremors
• Pale or blotchy skin

Severe symptoms (in more serious cases) include:

• Hallucinations (seeing or feeling things that aren’t there)
• Agitation and confusion
• High fever
• Seizures

One of the most dangerous severe symptoms is delirium tremens (DT), believed to be experienced in up to 1.5% of cases of alcohol withdrawal syndrome. DT is characterised by profound confusion, fever, sweating and hallucinations. Seizures are also possible, along with a dangerously high heart rate and elevated blood pressure. Because of its severity, anyone experiencing symptoms of delirium tremens should seek urgent medical attention.

What is the alcohol withdrawal timeline?

Drawing up an alcohol detox timeline may provide general guidance and help you know what to expect. However, it is important to note that the exact progression varies, depending on many factors. These factors include the severity of the dependence, the person’s general health and how long they’ve been drinking.

We can look at how an alcohol detox timeline progresses by using a four-stage approach, which includes:

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Are some people more prone to alcohol withdrawal than others?

Though every person can experience alcohol withdrawal differently, there may be some people who are more prone to severe withdrawal than others. Research shows that significant alcohol withdrawal is unlikely for people aged less than 30.

Significant withdrawal with more dangerous symptoms is likely:

• In men who drink more than 8 standard drinks a day (80 mL of pure alcohol) and women who drink more than 6 (60 mL)
• If the person has been drinking at the above level daily for at least two weeks
• If the person has previously experienced withdrawal syndromes
• If the person frequently has their first drink early in the morning

How professional help supports safer withdrawal

If a person chooses to withdraw from alcohol at home without professional support, there can be unpredictable and dangerous risks involved. In severe cases, symptoms can escalate quickly into serious health complications. This is why professionally supported withdrawal is best for a person who doesn’t know how to stop drinking safely.

Clinical withdrawal management helps to:

• Prevent severe withdrawal complications, such as seizures or delirium tremens
• Reduce the risk of harm to oneself or others due to confusion or agitation
• Monitor important metrics like hydration, nutrition and correct any imbalances in electrolytes
• Identify other medical issues that may mimic or worsen withdrawal symptoms

In medically-supported detox, staff are trained with tools like the CIWA-Ar scale (Clinical Institute Withdrawal Assessment for Alcohol, revised) to carefully track symptom severity and adjust care as you need it.

Being in the presence of trained detox professionals is especially important for a person who:

• Has previously experienced severe withdrawal, seizures or hallucinations
• Lacks stable housing or someone to help monitor them during withdrawal
• Lives with health conditions like liver or heart disease
• Has tried to quit multiple times without success
• Is using more than one substance

With the right support network, the tumultuous risks of alcohol withdrawal can be more safely managed, giving you the best possible foundation for long-term and sustained recovery.

I need help with my alcohol addiction

Alcohol withdrawal can be a challenging and uncertain time, but you don’t have to face it alone. At UKAT, we provide expert support for those struggling with alcohol and drug addiction.

Our experienced team is here to help you manage withdrawal safely and guide you through evidence-based therapies that build the tools for lasting recovery.

Reach out today—your first step toward healing starts with a simple phone call.