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Written by Amethyst Recovery

Amethyst Recovery is a foremost authority on addiction and a trusted online source of substance abuse information. Their expert team of addiction professionals provide well researched content for people in the grip of addiction. All posts are fact checked and sourced.

What Is Alcohol Withdrawal?

When someone drinks alcohol, it affects the central nervous system. The CNS includes the brain and spinal cord, and alcohol has a depressant effect on it. That’s why when someone’s intoxicated they may seem drowsy, may pass out or may have a lack of coordination.

Alcohol, in addition to being a depressant, affects certain brain neurotransmitters like GABA. That’s why people who drink may feel pleasant.

Over time, the central nervous system starts to become used to the effects of alcohol on GABA and other neurotransmitters. With repeated alcohol exposure, dependence forms. That dependence means without alcohol, the brain and body wouldn’t be able to function normally, at least in the new sense.

When someone’s dependent on alcohol, and they attempt to cut down on their drinking or stop drinking altogether, they may go through alcohol withdrawal.

Alcohol withdrawal includes a set of symptoms that occur as your brain and body try to adjust without the effects of alcohol.

Symptoms of alcohol withdrawal can be mild, moderate or severe. It’s estimated that around 50 percent of people who are addicted to alcohol will experience withdrawal symptoms if they stop suddenly.

Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms can vary from person-to-person, but often include:

  • Anxiety
  • Shaky hands
  • Nausea
  • Vomiting
  • Insomnia
  • Sweating
  • Headache

More severe alcohol withdrawal symptoms can occur as well. Some of the most serious alcohol withdrawal symptoms can include hallucinations and seizures. There is also a condition called delirium tremens or DTs.

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Delirium Tremens and Alcohol Withdrawal

Delirium tremens can occur when someone has something called alcohol withdrawal delirium or AWD. This is the most severe type of alcohol withdrawal. Only around 3 to 5 percent of people who go through alcohol withdrawal will experience severe AWD symptoms. AWD only occurs in people with a long-term and significant history of alcohol use.

Heavy drinkers may develop AWD symptoms not only if they stop drinking suddenly or reduce their intake too rapidly, but also if they are sick, have an infection or have a head injury.

Symptoms of AWD usually take around three days to appear after someone has their last drink and in some cases, these symptoms may take a week or more to occur. Symptoms include:

  • Agitation
  • Irritability
  • Anxiety
  • Chest pain
  • Delirium which is characterized as a disturbed mind state
  • Delusions which means believing things that aren’t true
  • Excessive sweating
  • Excitement
  • Problems with involuntary eye and muscle movement
  • Confusion
  • Fatigue
  • Hallucinations
  • Increased heart rate
  • Fear
  • Fever
  • Nightmares
  • Seizures
  • Light, sound or touch sensitivity
  • Rapid changes in mood

Timeline for Alcohol Withdrawal Symptoms

Everyone is going to be somewhat different in their alcohol withdrawal timeline, but you can reasonably expect it to look something like this:

Stage One

Stage of alcohol withdrawal usually occurs anywhere from 6 to 12 hours after someone takes their last drink. The minor symptoms of withdrawal will occur during this stage.

Early alcohol withdrawal symptoms might include anxiety, insomnia, nausea, and loss of appetite. Also possible are sweating, headache, and changes in heart rate.

Stage Two

Stage two of alcohol withdrawal occurs anywhere from 12 to 24 hours after someone has their last drink of alcohol. This is when hallucinations may occur. There are tactile hallucinations which means someone feels things such as itching or burning that’s not really happening.

Auditory and visual hallucinations are possible also.

Stage Three

Stage three of alcohol withdrawal will usually occur 24 to 48 hours after the last drink. This is the phase when people may experience seizures as a symptom of alcohol withdrawal.

Stage Four

Stage four begins 48 to 72 hours after the last drink of alcohol, and this is when the most severe AWD symptoms might occur. For most people who go through the symptoms of alcohol withdrawal, they will start to subside within five to seven days.

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Complications Related to Alcohol Withdrawal

Alcohol withdrawal can be severe, and if someone goes through it and particularly if they have alcohol withdrawal delirium, long-term complications may occur.

For example, alcoholic liver disease may be an issue requiring treatment. Alcoholic liver disease causes scarring and cirrhosis of the liver.

If someone has alcoholic liver disease, they may need antibiotics and treatments to remove the build-up of fluid in their abdomen. If alcoholic liver disease isn’t treated, it can cause kidney failure and liver disease.

Alcoholic cardiomyopathy can occur as the result of alcohol withdrawal as well. This refers to a situation where someone could experience heart failure.

How to Safely Detox from Alcohol

People often wonder what the safest way to detox from alcohol is, and the answer is that it should only be done under medical supervision. If you’re someone who regularly uses alcohol and you want to stop, speak to a medical professional.

For many longer-term users of alcohol, the best course of action is to go to a professional alcohol detox program.

What to Expect From an Alcohol Detox

An alcohol detox is a program where people can go to receive medical care and treatment as they go through alcohol withdrawal.

An alcohol detox is not an addiction treatment program, but it is a necessary first step to treat for someone who’s dependent on alcohol.

People who may need a professional alcohol detox include anyone who requires alcohol to feel normal. For example, if you start to have shakes when you don’t have a drink, you likely require a professional alcohol detox. If you were to stop cold turkey, it could be serious or deadly.

During an alcohol detox, you can expect that you will be provided with any necessary prescription or over-the-counter medicines to treat physical symptoms as well as mental symptoms of alcohol withdrawal.

Typically, what you can expect to happen during an alcohol detox program includes:

  • Alcohol detoxing will usually begin with an intake exam. During an intake exam, you will work with the team of the detox facility including medical professionals and go over your medical history as well as your drinking history. This will be a time when blood tests are done, as well as other diagnostic mental and physical health tests.
  • During the actual detox program, you may receive certain medications for symptoms on an as-needed basis.
  • A medical team will monitor you throughout the entire alcohol detox protocol to ensure that you are stable physically and mentally. You will regularly have your vitals checked as well.
  • Once you complete the alcohol detox process, you can begin the next steps of going to addiction treatment.


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Tips on How to Choose an Alcohol Detox

Choosing an alcohol detox can be a difficult decision. First and foremost, you will need to decide between an inpatient or outpatient alcohol detox.

An inpatient detox program can occur in a standalone detox facility, at a hospital or it can be part of a rehab facility. With inpatient detox, there is the advantage of 24/7 support, monitoring, and help when needed.

An outpatient detox program does provide treatment primarily during the day hours, but then you can return home in the evenings.

Inpatient alcohol detox is going to have more services and more comprehensive treatment, but it’s also the more expensive option so things like costs and insurance coverage should be considered.

Outpatient alcohol detox may be an option if you are likely to experience mild or moderate alcohol withdrawal. Someone might also consider outpatient alcohol detox if they have a safe and stable home environment, and their underlying mental and physical health are generally good. Someone with a long history of excessive alcohol use probably wouldn’t be a good fit for outpatient detox, however.

Insurance coverage can be a big consideration when choosing not only an alcohol detox but a rehab program as well. You should speak with your health insurance provider about any copays or costs you will have to pay out-of-pocket, what’s covered by your plan regarding detox and rehab, and how the insurance company determines what will be covered.

Alcohol detoxing can be a serious situation and in some cases, it requires constant medical care or even emergency medical attention. Contact Amethyst Recovery for more information about alcohol and what to expect from an alcohol detox.


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