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Alcohol Withdrawal Fever: Causes and What to Do

What is Alcohol Withdrawal Fever?

Regular and chronic drinkers may experience alcohol withdrawal if they suddenly stop drinking. One of these withdrawal symptoms is a fever

A fever happens when the body temperature exceeds 99.5 degrees F (37.5 degrees C). It’s usually the result of the body fighting an infection.  

Alcohol withdrawal fever is not like the typical fever; It’s the result of the body adjusting to the absence of alcohol. It can have other causes like a kidney infection due to dehydration.  

Fever is a very common symptom of alcohol withdrawal. Delirium tremens (DTs), a severe form of alcohol withdrawl, can also include fever. 

In a study involving 110 cases and 98 people recovering:1

  • Low-grade fever was present in 65% of cases
  • High-grade fever was present in 21% of cases
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Why Do Alcohol Withdrawal Fevers Occur?

Alcohol is a central nervous system (CNS) depressant. It disrupts the balance of certain  neurotransmitters, forcing the brain to work hard to counter alcohol’s effects. 

When a person stops drinking, the body will adjust and return to a normal state. However, the brain will still work hard to counter the substance (alcohol) that isn’t present anymore.2 This hyperactivity leads to withdrawal symptoms, which may include a fever. 

Alcohol withdrawal fever is not like the usual fever that happens when the body fights an infection. It results from the body adjusting to the absence of alcohol.

Several metabolic functions are upregulated during the adjustment period. This upregulation is a known source of increased body temperature.

If a fever becomes severe, healthcare providers will look for other underlying causes. For example, the fever may be due to a kidney infection from alcohol-related dehydration or vein inflammation from an IV line.6 

A high-grade fever that persists for more than 72 hours is likely connected to delirium tremens (DTs).3, 4, 5, 6

Alcohol Withdrawal Fever Timeline

Acute alcohol withdrawal symptoms may kick in within 6 to 24 hours after the last drink. Among these symptoms are nausea, tremors, anxiety, and insomnia.2, 4, 5, 6, 7

Roughly 10% of people will show additional symptoms like rapid breathing, sweating, and low-grade fever.5

Delirium tremens is the most severe form of alcohol withdrawal. It may happen 1 to 4 days after the onset of acute symptoms. DTs symptoms include:3, 4, 6

  • High-grade fever
  • Sweating
  • Agitation
  • Severe confusion
  • Disorientation
  • Nightmares
  • Withdrawal seizures
  • Visual and auditory hallucinations
  • High blood pressure
  • Increased heart rate

Severe DTs symptoms like seizures, hallucinations, and disorientation are typically more dangerous than fevers related to DTs.

DTs is life-threatening and is considered a medical emergency that requires admission to the hospital for treatment. 

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What to Do if You Develop a Fever From Alcohol Withdrawal

Here are some tips on how to manage an alcohol withdrawal fever:8

  • Take ibuprofen, acetaminophen, aspirin, or naproxen if body temperature exceeds 101.3 degrees F (38.5 degrees C)
  • Do not take medications containing codeine or other opioids
  • Drink lots of fluids, such as water, to cool the body and prevent dehydration
  • Get plenty of rest
  • Take a warm bath or apply a damp cloth to the forehead and wrists to help lower body temperature
  • Dress lightly to reduce body heat
  • Call your healthcare provider or go to the nearest hospital if the fever exceeds 104 degrees F (40 degrees C), lasts for more than 72 hours, or comes with seizures and other severe symptoms

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Treatment Options for Alcohol Addiction

There’s no one-size-fits-all approach for treating alcohol use disorder (AUD). Discuss treatment options with your doctor to determine the best fit.

Here are a few common treatment approaches: 

Inpatient Treatment

People with severe symptoms or at high risk of complications often require inpatient rehab

Inpatient treatment involves staying in a rehab facility. Medical staff will provide 24/7 care and supervision.

Inpatient addiction treatment usually lasts for 30, 60, or 90 days. People with prolonged alcohol use problems may need a longer stay.4, 9

Outpatient Treatment

This approach is less expensive and intensive than inpatient treatment. 

People with mild or moderate alcohol withdrawal symptoms can often be treated in outpatient alcohol rehabs. They can go home to continue their normal daily routines after attending treatment sessions.2, 4, 9

Medication-Assisted Therapy (MAT)

People with moderate to severe alcohol withdrawal symptoms may need medication(s). 

Benzodiazepines and anticonvulsants can reduce psychomotor agitation and prevent alcohol withdrawal symptoms from worsening. 

Thiamine and folic acid may also be given. These essential vitamins are typically depleted in people with alcohol withdrawal.2, 4, 6, 10

Individual Counseling

One-on-one counseling focuses on reducing or stopping alcohol use. 

The counselor may also encourage the person to join a 12-step program, like Alcoholics Anonymous (AA), or refer them to additional medical and psychiatric services.9

Support Groups

Recovery continues long after treatment. Support groups can help people maintain abstinence, prevent relapse, and achieve successful recovery. 
Some examples of alcohol-focused support groups are Alcoholics Anonymous and Al-Anon.9

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Updated on June 16, 2022
10 sources cited
  1. Otero-Antón, E et al. “Fever during alcohol withdrawal syndrome.European Journal of Internal Medicine vol. 10,2 : 112-116.
  2. DeSimone, Edward, Jennifer Tilleman, and Trenton Powell. “Treatment of Alcohol Withdrawal Syndrome.” U.S. Pharmacist, Jobson Medical Information LLC, Nov 17, 2014.
  3. Carlson, Richard et al. “Alcohol withdrawal syndrome.” Crit Care Clin vol. 28,4 :549-85.
  4. Muncie, Herbert, Yasmin Yasinian Y, and Linda Oge'. “Outpatient management of alcohol withdrawal syndrome.” Am Fam Physician vol. 88,9 :589-95. 
  5. Trevisan, Louis et al. “Complications of alcohol withdrawal: pathophysiological insights.Alcohol Health Res World vol. 22,1 : 61-6. 
  6. 4 Physical Detoxification Services for Withdrawal From Specific Substances.” In: Detoxification and Substance Abuse Treatment [Internet]. Treatment Improvement Protocol (TIP) Series, No. 45. Rockville (MD): Substance Abuse and Mental Health Services Administration (US). 2006.
  7. Mirijello, Antonio et al. “Identification and management of alcohol withdrawal syndrome.” Drugs vol. 75,4 : 353-65. 
  8. “Treating fever in adults.” Harvard Health Publishing. March 25, 2020.
  9. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).National Institute on Drug Abuse (NIDA). January 2018.
  10. Hayashida, Motoi. “An overview of outpatient and inpatient detoxification.” Alcohol health and research world vol. 22,1 : 44-6.

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