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Alcohol Withdrawal Symptoms

Reviewer Dr. Juan Harris MBA, MS, MCAP, CMHP, SAP, CIP, ICADC
Clinically Reviewed By Dan Schimmel, LCSW, CAP
Updated On
19 Shares

Alcohol withdrawal symptoms are rooted in human physiology and can manifest in minor to life-threatening health complications for chronic drinkers who abruptly stop.

What Causes Alcohol Withdrawal

Problem drinking is widely pervasive in the United States, and withdrawal can lead to side effects like anxiety and even more serious conditions like seizures, hallucinations and injuries.

According to a 2008 study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a part of the larger National Institute of Health (NIH), withdrawal from alcohol can create changes to genetic material in the brain that induce symptoms like anxiety.

The study simulated long-term alcohol use by feeding rats a liquid diet containing alcohol. When alcohol was withdrawn from rats in the control group with the alcohol-contained diet, they exhibited higher anxiety-like behaviors than rats that were fed a non-alcohol diet.

The two groups were presented with an “elevated plus-maze” structure with two open arms and two close arms connected to a central platform. The rats on the alcohol diet spent more time on closed-arms activity during a five-minute testing period than the rats on the non-alcohol diet. Literally, the rats withdrawing from alcohol were closed in a maze.

As seen in rats, alcohol is an irritant on the central nervous system. It acts as a sedative on the brain in that it suppresses certain neurotransmitters, leading to a feeling of happiness and sociability. For heavy drinkers, the body becomes dependent on alcohol to create the same initial “feel good” buzz. When alcohol is cut off, the neurotransmitters are no longer inhibited, and the brain becomes chemically imbalanced. This causes debilitating side effects that vary from drinker to drinker.

Alcohol Abuse Is Widespread

Though “rats in a maze” may be a grim metaphor for alcohol withdrawal, problem drinking is more widespread in the United States than one might think.

A 2018 National Survey on Drug Use and Health (NSDUH) reports that 139.8 million Americans age 12 and older were past month alcohol users, 67.1 million people were binge drinkers in the past month, and 16.6 million were heavy drinkers in the past month.

The same 2018 NSDUH study found that 14.8 million people age 12 or older had an alcohol use disorder. Excessive drinking can increase a person’s risk of stroke, liver cirrhosis, alcohol hepatitis, cancer and other serious health conditions.

Symptoms & Timelines

Symptoms can appear as soon as two hours after the last drink. They typically peak within the first 24-48 hours of stopping and lead to the most acute withdrawal symptoms like rapid heartbeat, insomnia, changes in blood pressure, sweating, tremors and fever.

In the first 48 hours, an alcoholic can experience delirium tremens or “DTs,” an uncommon but severe condition marked by confusion, severe shaking, hallucinations and high blood pressure.

Delirium tremens can be potentially life-threatening. For a chronic alcoholic suffering from “DTs,” withdrawal is best handled in a medically supervised treatment facility where he or she can detox. As detailed, alcohol withdrawal from any stage drinker can lead to a host of potentially dangerous side-effects that treatment rehab facility can mitigate medically. If you feel that you have a problem with alcohol and would like information on treatment, please contact us.

Long-Term Alcohol Withdrawal

Alcohol withdrawal is not limited to the first few hours after putting down a drink. Complications can stretch days and weeks beyond cessation.

When reducing the amount of alcohol after a spree, a chronic alcoholic might suffer from acute alcohol withdrawal syndrome where one is at risk of developing delirium tremens, having seizures or momentarily losing consciousness.

Such conditions are obviously severe. A chronic drinker should not consider “rehabbing” on their own, but, instead, choose an alcohol-treatment facility where specialists and medical personnel can minimize withdrawal symptoms and ensure that they do not escalate.

A few weeks to as much as a year into cessation, a chronic alcoholic can experience Post-Acute Withdrawal Syndrome or PAWS marked by symptoms such as irritability and emotional outbursts, anxiety, low energy, difficulty sleeping, dizziness, intense cravings and chronic nausea.

PAWS, for many, come in cyclical waves. One day, you feel fine and the next you are struck with intense cravings for alcohol and low energy. Long-term withdrawal symptoms such as PAWS are a common cause of relapse for chronic alcoholics.

Treatment for Alcohol Withdrawal Symptoms

From what could be considered minor symptoms like “rat in a maze” anxiety to serious afflictions like seizures and delirium tremens, problem drinkers with alcohol addiction are advised to recover in an alcohol treatment facility that offers 24-hour care where symptoms can be alleviated by medically-trained specialists.

Recovery programs differ in treatment and there is no “one-size-fits-all” solution. Programs include:

  • Inpatient treatment where alcoholics receive intensive, round-the-clock recovery in a safe, supervised environment for 30 days to as much as three months
  • Outpatient treatment where individuals with less severe alcohol abuse visit a facility but do not temporarily live there and receive strategies to overcome triggers and other influences that cause drinking
  • Medication-assisted therapy where medications are administered to problem drinkers, lessoning uncomfortable withdrawal symptoms
  • Individual counseling where rehab counselors coach a patient on the ups and downs of alcohol withdrawal, examine environmental and psychological factors that might lead to chronic drinking and coping strategies to overcome them
  • Support groups like Alcoholics Anonymous and Al-Anon where alcoholics in long-term recovery can discuss issues in recovery and receive support from peers on how to maintain sobriety after rehab

Whether it is a buzz from a few drinks to a days-long bender, alcohol physiologically alters the human brain and body. Cessation can cause baleful side effects from anxiety to severe “DTs” that require medical intervention. If you feel you have an alcohol problem and would like free yourself “from the cage,” there a litany of solutions and strategies to lesson withdrawal symptoms. Please contact us and we can find a way to help.


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