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Can You Die From Alcohol Withdrawal?

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Key Takeaways

  • Excessive alcohol consumption leads to alcohol use disorder (AUD). The brain and body adapt to regular alcohol intake.
  • When you suddenly stop consuming alcohol after heavy, prolonged use, the brain, which has become dependent on alcohol, tries to adjust to life without it. The resulting symptoms are known as alcohol withdrawal.
  • Alcohol withdrawal symptoms vary from person to person and can be mild, moderate, or severe.
  • With symptoms like seizures and delirium tremens (DTs), withdrawal can cause death if not properly managed.
  • A safe alcohol withdrawal process is usually possible under medical supervision. Never try to self-detox at home if you have severe symptoms. 

How Death Can Occur From Alcohol Withdrawal

Long-term alcohol use causes physiological changes in the brain and body. Stopping long-term alcohol use may cause alcohol withdrawal.1

During withdrawal, your body goes through some changes to adjust to the low blood alcohol content (BAC). Some normal body functions may stop working, or at least not work properly.

Depending on the severity of addiction, the symptoms are usually unpleasant. Severe symptoms such as seizures and delirium tremens (DTs) can cause death.2 

DTs are the most severe alcohol withdrawal symptoms. They usually occur within 3 to 5 days after your last drink. About 5% of people undergoing alcohol withdrawal will have DTs.

Symptoms and side effects of DTs include:

  • Uncontrollable tremors
  • Nervous system breakdown
  • Irregular heartbeat
  • High blood pressure
  • Seizures
  • Coma
  • Death

A controlled detox and rehabilitation program (like inpatient rehab) can help you manage withdrawal symptoms and recover safely. 


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Why Does Alcohol Withdrawal Happen?

Excessive drinking affects 2 neurotransmitters in the brain: gamma-aminobutyric acid (GABA) and glutamate

GABA blocks the activity of certain brain signals to produce a calming effect.3 Glutamate, on the contrary, creates excitability.4

Because alcohol produces a calming effect similar to that caused by GABA, regular alcohol intake decreases GABA production in the brain. 

It also decreases glutamate production. As a result, the brain depends on alcohol to bring about the calming effect GABA produces. 

Heavy drinking makes increasing GABA and decreasing glutamate more difficult, which requires more alcohol to achieve the same result. This is known as alcohol tolerance. When your body becomes used to this, it produces more glutamate and less GABA.

When you stop drinking, the brain continues to underproduce GABA and overproduce glutamate. 

Trying to reach this balance causes unpleasant withdrawal symptoms such as shakiness, restlessness, and headaches, among others.

What are the Symptoms of Alcohol Withdrawal?

Alcohol withdrawal symptoms range from mild to moderate or severe.5 Symptoms can begin as early as 6 hours after the last drink and worsen with time. 

Minor Symptoms

The first minor symptoms include: 

  • Headache
  • Dilated pupils
  • Restlessness 
  • Insomnia
  • Sweating
  • Appetite loss
  • Nausea
  • Vomiting

Moderate Symptoms

Moderate symptoms, which can occur later in withdrawal, include:

  • Low-grade fever
  • Anxiety/ depression
  • Nightmares
  • Mood swings
  • Irritability
  • Rapid breathing
  • Tremors  
  • Profuse sweating

Severe Symptoms

Severe symptoms can be deadly and include:

  • Hallucinations (seeing spiders or ‘pink elephants’)
  • Pale skin
  • Extreme mental confusion
  • Convulsions or seizures 
  • Status epilepticus (seizure that lasts more than 5 minutes)
  • Delirium tremens (DTs)

If you or someone you know is experiencing severe alcohol withdrawal symptoms, call 911 and seek medical help immediately.

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Who is at Risk of Alcohol Withdrawal Symptoms?

People with alcohol use disorder (AUD) are most at risk of severe withdrawal symptoms. AUD is the inability to control drinking due to mental and physical dependence.

Symptoms of AUD include:

  • A strong urge to drink
  • Tolerance to alcohol
  • The inability to stop drinking (even when the person decides they will stop or moderate their alcohol intake)
  • Neglecting important duties to drink alcohol instead
  • Involvement in risky behavior such as driving while drunk
  • Financial and relationship problems due to prioritizing alcohol over anything else

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How is Alcohol Withdrawal Diagnosed?

Your doctor will use a comprehensive medical history along with a physical examination to diagnose alcohol withdrawal. 

They may use the Clinical Institute Withdrawal Assessment of Alcohol (CIWA-Ar), which asks a series of questions to measure the following items:6

  • Irritability
  • Anxiety
  • Auditory disturbances
  • Inability to think clearly
  • Headache
  • Nausea
  • Vomiting
  • Sweating
  • Tactile hallucinations
  • Tremors
  • Visual disturbances

Your doctor might also conduct a toxicology test to determine your blood alcohol content (BAC).

How to Manage Alcohol Withdrawal

You can manage mild symptoms of AUD at home. Make sure you have a relative or close friend nearby to assist you in case you need urgent medical attention.

For severe cases of AUD, medical detoxification is critical to support your heart rate, blood pressure, and organ functions.

There are multiple treatment options to manage alcohol withdrawal, which include:


Detoxification is a safe, supervised withdrawal process that helps clear alcohol from your body as you regain control of GABA and glutamate production (and other functions). 

Detox programs, including inpatient and outpatient, may help you avoid dangerous complications, like seizures, that co-occur with withdrawal.

Inpatient treatment restricts you to the detox facility until you recover. Outpatient treatment allows you to live your life as you attend treatment during the day. The type of treatment needed depends on the severity of your AUD. 


Some prescription medicines can help relieve symptoms of alcohol withdrawal:

  • Benzodiazepines: They help ease withdrawal symptoms.7 Examples include diazepam, lorazepam, and chlordiazepoxide.
  • Anti-seizure medications: They can help prevent hyperactivity in the central nervous system (CNS) and lessen the risk of seizures. Examples include gabapentin and carbamazepine.
  • Vitamin supplements: Supplements replace essential vitamins lost through excessive alcohol use.

Detox treatment usually takes about 3 to 7 days. During this time, a doctor will monitor your vital signs and assist you if any issues arise. 

After-Care Therapy

This type of therapy usually involves individual or group counseling to help prevent relapse. 

Some rehabs also incorporate family therapy. This is when family members receive counseling to cope with the situation at hand.

Alcohol dependence and alcoholism affect the entire family, not just the person who drinks alcohol. Everyone has to learn new mechanisms for living life after rehab.

The Importance of Medical Detox for Alcohol Withdrawal

Depending on the level of alcohol dependency, stopping, especially abruptly or completely, can cause unpleasant symptoms. Severe symptoms like seizures and DTs may be fatal.

For this reason, a medically supervised detox process is the safest. The professionals in rehab facilities are trained to manage any dangerous withdrawal symptoms that can occur.

If you or a loved one would like to quit chronic alcohol use safely, talk to a qualified healthcare provider. You can also call the National Helpline at 1-800-662-HELP (4357) for professional referrals.

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Updated on May 27, 2022
7 sources cited
  1. Understanding Alcohol Use Disorder,” National Institute on Alcohol Abuse and Alcoholism (NIAAA)
  2. Dugdale D.,“Delirium tremens,” National Library of Medicine, 17 Jan. 2021
  3. John L.“Neurochemical Mechanisms Underlying Alcohol Withdrawal,”  National Institute on Alcohol Abuse and Alcoholism
  4. Glutamate as a neurotransmitter in the brain: review of physiology and pathology,” National Center for Biotechnology Information (NCBI), APpr. 2000
  5. Dugdale D.“Alcohol withdrawal,” National Library of Medicine,  17 Jan. 2021
  6. Knight E.“Clinical Institute Withdrawal Assessment for Alcohol–Revised might be an unreliable tool in the management of alcohol withdrawal,” National Center for Biotechnology Information (NCBI), Sept. 2017
  7. Sachdeva, A. et al.,“Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond,” National Center for Biotechnology Information (NCBI), 01 Sept. 2015

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