When you quit drinking, your body goes through many symptoms of withdrawal such as:
- Physical discomforts
- Psychological distress
- Mood changes
- Autonomic dysfunction
Over 50 percent of those who are struggling with alcohol abuse experience withdrawal when they stop drinking. Withdrawal symptoms can onset when alcohol exposure decreases, whether or not someone has alcohol use disorder (AUD). Chronic heavy-drinkers can even experience withdrawal if they lessen the amount of alcohol they consume. These symptoms, ranging from mild to life-threatening, are not guaranteed, but likely.
Is Alcohol Withdrawal Dangerous?
For some people, alcohol withdrawal can cause a few minor symptoms, seemingly unnoticeable. But for someone who has drank every day for ten years, their symptoms would look different. The range of withdrawal symptoms relies on these factors:
- How long someone consumed alcohol for
- The amount of alcohol someone consumed
- Pre-existing co-occurring disorders
- Older age
- Past polysubstance use
- Previous detoxification
- Current medications or illicit drug use
Severe symptoms of alcohol withdrawal can be life-threatening and require medical attention. According to the Center for Disease Control and Prevention, alcohol withdrawal kills roughly 800 people per year. Countless others end up being rushed to the emergency room for medical treatment. Detoxing under the care of medical professionals prevents symptoms from spiraling out of control and helps monitor the progress.
Symptoms of Acute Alcohol Withdrawal
Acute alcohol withdrawal refers to the onset of symptoms someone experiences when they first stop drinking alcohol. An “acute” condition is sudden—meaning, the symptoms that come with detoxing from alcohol are from an abrupt chemical change. When someone drinks, the intoxicating effects derive from ethanol, a depressant. The brain adapts by stimulating neurochemicals to counteract the sedative effects. As alcohol consumption continues, the brain becomes accustomed to this hyperactivity. When the depressant (alcohol) leaves the system, the imbalance can lead to psychological and physical manifestations.
Symptoms of withdrawal typically begin after six to eight hours and last for up to four days. If someone is a frequent, heavy consumer of alcohol, their symptoms may begin as early as two hours after drinking and last for several weeks.
Symptoms of alcohol withdrawal, ranging from milder discomforts to potentially fatal conditions include the following:
Insomnia – Restless sleep during withdrawal occurs for many; a study 91% of patients with alcohol dependency experienced sleep disturbances during withdrawal. Frequent waking, night terrors, and difficulty falling asleep occur during withdrawal, especially because alcohol consumption reduces the body’s natural levels of melatonin.
Digestive issues – Appetite loss, diarrhea, nausea, and vomiting are all traits of alcohol withdrawal. Loss of appetite is not uncommon, although usually resolves within the first two days.
Tremors – Beginning within three to six hours after drinking, “the shakes” are most often caused by anxiety or stress.
Pains – Abdominal pains, pins and needles, joint pain, and discomfort from touch can happen during withdrawal. Emotional pain can exacerbate physical symptoms, and as the brain experiences emotional and psychological distress, it can trigger flareups.
Hyperreflexia – This overreaction of the nervous system results in changes in heart rate, excessive sweating, muscle spasms, blurry vision, bladder control issues, dizziness, and possible fainting.
Fatigue – Alcohol dehydrates the body and leads to lower level of vitamin C, causing people to feel the full effects of malnutrition during sobriety. A lack of energy and sluggishness weighs the body down, and some people have trouble moving and staying out of bed.
Hypertension – Elevated blood pressure can be treated by replenishing the body with electrolytes and water. Hypertension can lead to tachycardia, in which case, further medical treatment would be required.
Heart palpitations – Having a racing or fluttery heart isn’t uncommon. A lot of alcohol withdrawal can lead to bouts of anxiety, but if heart palpitations are a persistent problem and accompanied by dizziness and fainting, medical attention is necessary.
Seizures – Even without other withdrawal symptoms, seizures can onset after one to two days, but can begin as early as seven hours after quitting. Often people become stiff, lose consciousness, and begin to convulse. Untreated seizures increase the risk of developing delirium tremens by 33 percent.
Disorientation – Usually in tandem with a co-occurring mental health disorder, withdrawal can lead to states of confusion, speech issues, and memory loss. Patients of alcohol withdrawal aged 55 and older are also more likely to experience disorientation.
Hallucinations – Visual, auditory, and tactile hallucinations usually occur within patients before the onset of delirium tremens. These patients are usually younger, consume other drugs, and drink larger quantities of alcohol.
Delirium tremens – Early recognition and treatment decreases mortality rates to below 5 percent of patients with delirium tremens, but unfortunately up to 5 percent of people going through alcohol withdrawal experience this condition. Symptoms include tremors, seizures, hyperactivity, extreme sensitivity, and confusion. When left untreated, it can lead to a stroke, heart attack, or death.
Coma – The likelihood that someone who has quit drinking will enter a coma will depend on how much they drank previously, and will usually only happen after a seizure. This rare occurrence is an unfortunate result of cerebral hemorrhage, as heavy drinking can lead to bleeding of the brain.
Where Should I Detox from Alcohol?
While there is no specific protocol in place to determine whether someone is a good candidate for inpatient (residential) or outpatient detoxification, there are a few factors to consider. While some people are able to get through alcohol withdrawal without facing more than a few minor symptoms, people who consume large amounts of alcohol need to be more careful. Some people make the choice to detox at home, but severe symptoms can onset without warning—detoxing from alcohol alone can be very dangerous.
Inpatient detox programs are a vital step for many. Being in a safe environment away from drugs and alcohol is important for those experiencing cravings, particularly when withdrawal symptoms become painful. Having around-the-clock care, with medical providers checking vitals and monitoring symptoms, can be lifesaving, or at the very least, comforting. On average, detoxing from alcohol takes five days, but can last up to ten.
Reasons to enter a detoxification program at a rehab or a hospital include:
- A history of withdrawal seizures
- Co-occurring mental health disorders
- A history of psychosis
- Suicidal thoughts
Medical care is advised for people who consume large amounts of alcohol, as medications can be prescribed to alleviate more severe symptoms, such as trazadone for insomnia. Anti-seizure medications such as carbamezapine and benzodiazepines like Valium are prescribed for withdrawal seizures.
Treating the body doesn’t end with detox, as symptoms may continue to persist.
Post-Acute Withdrawal Symptoms for Alcohol Use
Post-acute withdrawal syndrome (PAWS) begins when detoxification has ended. PAWS can last for weeks, months, and in some cases, years. 50-70 percent of people who go through alcohol withdrawal suffer from PAWS. These symptoms are usually psychological, and are exacerbated by co-occurring disorders or other chronic illnesses.
Sleep disturbances and changes in mood, such as depression or anxiety, are common PAWS symptoms. Other symptoms include brain fog, fatigue, chronic pain, and mood disorders. PAWS is often treated with antidepressants, mood stabilizers, and sleep medications.
During this time, it is important to take care of the mind just as much as the body. Individual and group therapy, self-care routines, and healthy coping mechanisms to deal with triggers and cravings are important aspects of recovery.
Detoxing from alcohol is a complicated and delicate process. The understanding of alcohol’s physical and psychological effects helps create a more comfortable and less daunting experience. Taking care of one’s self in detoxification begins with knowing what’s to come.