In this article
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:
A controlled detox and rehabilitation program (like inpatient rehab) can help you manage withdrawal symptoms and recover safely.
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.
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.
The first minor symptoms include:
Moderate symptoms, which can occur later in withdrawal, include:
Severe symptoms can be deadly and include:
If you or someone you know is experiencing severe alcohol withdrawal symptoms, call 911 and seek medical help immediately.
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:
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
Your doctor might also conduct a toxicology test to determine your blood alcohol content (BAC).
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:
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.
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.
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.
In this article