Can You Die from Alcohol Withdrawal?

Severe symptoms of alcohol withdrawal, such as seizures and delirium tremens (DTs), can cause death.² Those severely addicted to alcohol should not quit cold turkey as it can be dangerous and even deadly.

If you’re going to quit drinking, consider getting help from a professional who can assist you in detoxing and managing withdrawal symptoms.

What is Delirium Tremens (DTs)?

The intensity of withdrawal symptoms depends on the severity of the addiction. Delirium tremens (DTs) is the most severe alcohol withdrawal symptom. It usually occurs within 3 to 5 days after your last drink.

About 5% of people undergoing alcohol withdrawal will experience 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. Speak with a professional if you have an AUD and want to quit drinking.

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Why Do Alcohol Withdrawals Happen?

Excessive drinking affects two chemical messengers in the brain: 

• Gamma-aminobutyric acid (GABA) 
• Glutamate

GABA regulates specific brain signals to produce a calming effect.³ Glutamate, on the other hand, creates excitability.⁴

When you drink heavily and consistently, alcohol can create an imbalance in GABA and glutamate production. As a result, the brain has a harder time regulating emotions and relies on alcohol’s calming effect.

When the body is continuously exposed to alcohol and develops an alcohol tolerance, it produces more glutamate and less GABA. Even when you stop drinking, the brain continues to underproduce GABA and overproduce glutamate.

Trying to regain a balance between GABA and glutamate production 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 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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How is Alcohol Withdrawal Diagnosed?

Your doctor will use a comprehensive medical history and 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).

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How to Manage Alcohol Withdrawal

You can manage mild symptoms of alcohol withdrawal at home. However, ensure you have a relative or close friend nearby to assist you if you need urgent medical attention.

You will want a professional there to help with severe cases of alcohol withdrawal. There are multiple treatment options to manage alcohol withdrawal, which include:

Detoxification

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 bodily functions).

Detox programs, including inpatient and outpatient treatments, may help you avoid dangerous complications like seizures. They also provide people with the necessary resources and professionals to help during detox.

Medications

Some prescription medicines can help relieve symptoms of alcohol withdrawal:

• Benzodiazepines: These help ease withdrawal symptoms
• Anti-seizure medications: They can help prevent hyperactivity in the central nervous system (CNS) and lessen the risk of seizures
• Vitamin supplements: Supplements replace essential vitamins lost through excessive alcohol use

Alcohol Withdrawal Prevention

If you are dependent on alcohol, it’s impossible to avoid withdrawals. If you misuse alcohol but don’t have a dependency and want to quit, try using alcohol in moderation as a way to lead you into sobriety.

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.

Summary

• Excessive alcohol consumption leads to alcohol use disorder (AUD)
• When you suddenly stop consuming alcohol after heavy use, the brain adjusts 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
• Never try to self-detox at home if you have severe symptoms