Do you ever experience shaky hands after you go a few days without drinking alcohol? Maybe a pounding headache or a lingering nausea. What you’re experiencing is alcohol withdrawal.
There are many symptoms of alcohol withdrawal, ranging from harmless and unpleasant to dangerous and incredibly painful. If you have an alcohol use disorder, chances are you’ve experienced it at least once. You’re not alone – 9% of people in Kentucky had an alcohol use disorder in 2022, and they know just what it feels like.
Alcohol withdrawal can be frustrating, and even confusing. You might wonder why you’re in so much pain, and why it’s so hard to get out of the cycle of alcohol use and withdrawal. We hear those questions all the time at Altruism Counseling and are glad we can provide answers. That’s why today we’ll talk about alcohol withdrawals, how to manage them, and more.
Alcohol withdrawal is the symptoms you experience when you stop drinking. This is because your body has developed a “dependence” on alcohol, which happens when alcohol is regularly present in the system. When it’s no longer present, your body has to adjust to it not being there, leading to side effects.
The official term for alcohol withdrawal is “alcohol withdrawal syndrome,” and it requires a clinical diagnosis. This means the medical professional evaluating you will look at your drinking history and physical symptoms. They have an official tool to help diagnose you called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 includes several symptoms and criteria of alcohol withdrawal syndrome (AWS). If someone experiences two or more of the symptoms within a few hours or days of ceasing drinking, they’re likely to fall under the criteria for AWS.
Keep in mind that it’s important to see a medical professional before assuming a diagnosis. Alcohol withdrawal is different for every person and some may experience symptoms that aren’t listed in the DSM-5.
The list used by the DSM-5 includes many of the common side effects of withdrawal, such as:
There are signs of withdrawal outside of this list also. No two people will experience the same combination and severity of side effects. To help you better spot withdrawal, let’s look at some additional symptoms.
There’s also something important to take note of: delirium tremens (DTs). DTs are the most severe form of alcohol withdrawal, and while they aren’t common – they impact 3% to 5% of people dependent on alcohol – they are dangerous. The symptoms of DTs are severe confusion, extreme agitation, hallucinations, seizures, and fever. If you or someone you know is showing signs of DTs, seek medical attention as soon as possible.
Low electrolytes due to dehydration are a possibility during alcohol withdrawal, and this can cause heart problems. Withdrawal can cause some vitamin deficiencies, too. Thankfully, both of these can usually be corrected with sufficient fluids and nutrient-rich foods.
Just like the withdrawal symptoms are different from person to person, the timeline of withdrawal symptoms is too. How much you drink, how long you’ve been drinking, and your body composition will all influence when your symptoms impact you and how severe they’ll be. Generally, though, the chart below can give you an idea of what to expect.
| 6-12 hours after the last drink | Mild symptoms like nausea, headache, upset stomach, shaky hands, and anxiety might start |
| Within the first 24 hours | Some people might start to experience hallucinations |
| Within 48 hours | Symptoms are usually at their worst. Delerium tremens and seizures are most likely to appear at this time |
| 48-72 hours | Mild symptoms will probably start to taper off |
| Longer lasting symptoms | Some people might experience long-term fatigue, sleep problems, and mood complications |
If you’re managing alcohol withdrawal right now, the prospect of withdrawal lasting beyond a few days is probably scary. Rest assured that it’s rare, especially with treatment and medical detox.
Despite the physical symptoms, alcohol withdrawal all starts in your brain. Alcohol is a depressant, meaning it slows down your central nervous system. It increases a neurotransmitter that calms you down: GABA. At the same time, it limits the production of a neurotransmitter called glutamate, which makes you excited. If you drink repeatedly, your brain gets used to having more calming feelings and less excitement.
Our brain thrives on equilibrium. When alcohol is regularly present, impacting these chemicals in our body, our brains will work to balance this out. It’s also responsible for withdrawal because when alcohol isn’t in your system, the neurotransmitters don’t readjust.
You might notice withdrawal symptoms feel like the opposite of how you feel while intoxicated. That’s due to the unbalanced neurotransmitters. You’re stuck with excessive glutamate and less GABA, which causes your symptoms.
The good news is that the brain possesses a remarkable ability to heal and find balance again in time. That’s the hard part, though: it takes time, and it can be difficult to avoid alcohol and give your brain the space it needs, especially without help.
No set amount of alcohol will cause withdrawal. It varies from person to person. Withdrawal becomes more likely the more you drink and the longer you drink. Beyond that, it depends on your body composition, physical health, age, mental health, genetic makeup, and more.
The only real way to stop alcohol withdrawal symptoms is to not return to drinking. There’s no easy solution. Your brain needs that time to adjust to your unbalanced neurotransmitters and heal again. If you don’t do this, you can get stuck in a cycle of drinking, experiencing withdrawal, and drinking again to make those symptoms go away.
Don’t be too hard on yourself if you’ve tried to stop drinking and haven’t succeeded yet. If you experience alcohol withdrawal, you might have an alcohol use disorder, which is a medical condition. While some people can stop drinking by themselves, plenty of people need additional help, and everyone can benefit from treatment.
Rehab for alcoholism (alcohol use disorder) is life-changing and usually starts with medical detox. There, you’ll be monitored by medical professionals as you go through the withdrawal process. They’ll ensure you’re safe, and provide additional support along the way to make withdrawal more tolerable.
After that, you’ll move on to additional treatment. You might attend a residential program, where you stay in a facility long-term, focusing fully on recovery by going through a variety of intensive therapies. It’s also possible that an outpatient program, which requires less of a time commitment, might suit you better. All programs come with their benefits. It just depends on your unique situation.
It’s also possible that you aren’t ready for treatment. Maybe you’re just looking for ways to make alcohol withdrawal easier right now. For as much as we recommend treatment, we understand that, too. If you need to manage withdrawal at home for now, make sure you’re eating nutritious food, staying hydrated, and getting plenty of sleep. Continue taking any medications you’re prescribed, and spend time around people who support you and don’t tempt you to drink more. Keep your environment alcohol-free, try to reduce stress as much as possible, and find healthy distractions and coping mechanisms to take your mind off of withdrawal symptoms and cravings.
If you experience hallucinations, mood swings, seizures, or other intense side effects – don’t hesitate to call for medical help. You don’t need to go through this alone.
It’s true – plenty of people can quit drinking alcohol on their own, even if they do have an alcohol use disorder. You don’t have to, though. Withdrawal is so much harder to experience alone, and it’s more dangerous, too. While it’s great to have a strong support system at home, complications can arise that your loved ones won’t know how to manage. That’s why it’s a good idea to consider treatment for an alcohol use disorder, no matter your situation.
Altruism Counseling is located in Lexington, Kentucky, and focuses on counseling individuals with substance use disorders, including alcohol use disorder. We accept Medicaid, Medicare, and commercial insurance, and offer cash payment options because we never want finances to be a barrier to recovery. We’re determined to help you get to the bottom of your alcohol use disorder so you can conquer it for good, and we do that by addressing mental health concerns alongside your alcohol use. It’s easy to get lost in addiction, but we’re here to help you find yourself. Give us a call at 859-310-6505 to get started.
