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Alcohol Withdrawal Signs and Symptoms

An estimated 95,000 Americans (about 68,000 men and 27,000 women) die each year from alcohol-related causes, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Addiction therapy is critical to lowering these figures.

Even though therapy is vital for your recovery and general well-being, it is not unusual to relapse after a period of sobriety, mainly owing to intense withdrawal.

Hangovers Vs. Withdrawal

There are many similarities between a hangover and alcohol withdrawal syndrome (AWS), but they are different. The primary distinction between the two disorders is the underlying reason. A hangover happens when you consume excessive alcohol in a single sitting. In contrast, alcohol withdrawal occurs when you reduce your consumption or suddenly quit drinking while suffering from alcohol use disorder.

Overindulging in alcoholic beverages may irritate the stomach lining, dehydrate the body, and trigger inflammatory reactions. When the effects of the drink wear off, this results in typical hangover symptoms such as:

  • Headaches

  • Nausea

  • Lethargy 


This is entirely different from the withdrawal symptoms of alcoholism.

Alcohol Withdrawal: What Is It?

It can harm your body and mind if you drink too much alcohol for an extended period and then stop or cut back.

Alcohol withdrawal symptoms are a very well-defined set of signs and effects that an individual with an alcohol use disorder (AUD) experiences after drastically reducing or quitting consumption after an extended period of engaging in the behavior.

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Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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Causes of Alcohol Withdrawal

Whenever you consume alcohol, you experience what specialists call a depressing effect on the system. This is because alcohol has a sedative effect on the brain and changes the way nerves carry information.

There are close relationships between GABA, a neurotransmitter that suppresses activity, and glutamates (excitatory neurotransmitters).

When you drink alcohol, the GABA (and some glutamate) receptors in your brain change, making you less anxious and sleepy. The brain reacts by reducing GABA release and increasing glutamate transmission to compensate. As long as you keep drinking alcohol, a change called "tolerance" takes hold.

After developing tolerance, you will require more significant amounts of alcohol to feel the same effect. In addition, the brain grows so acclimated to alcohol that your body can't operate effectively without it. At this point, the brain goes into overdrive when you don't drink. This may cause withdrawal symptoms a few hours after taking the last drink.

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Alcohol Withdrawal Symptoms and Signs

In the beginning, their brain does not realize that they have stopped drinking and continue overproducing the stimulating chemicals. However, when alcohol isn't in the mix, these compounds cause many withdrawal symptoms.

Symptoms usually appear after eight hours of your last drink, although they may not show up for many days afterward. After your previous drink, these symptoms peak within 24 to 72 hours, although milder ones may remain much longer in some individuals.

Phase One: Mild Symptoms

Within six hours following your last drink, you may start to feel the effects of alcohol withdrawal. The early symptoms are usually modest, although they may be painful. They may include:

  • Nausea

  • Shakes or tremors

  • Blood pressure changes

  • Anxiety

  • Insomnia and other sleep-related issues

After experiencing these signs of alcohol withdrawal, most individuals will be able to recover.

Stage Two: Seizures and Other Potentially Life-Threatening Symptoms

For most individuals, seizures and other life-threatening symptoms usually begin within two days after your last drink. Attacks can occur in up to 5% of people who experience withdrawal. The symptoms typically reach their climax about a day following the previous drink. You will probably recover if you don't have any severe symptoms (for example, seizures) after 48 hours. It is possible, however small, that you may develop them in the future. Thus, you should still consult a doctor.

Severe withdrawal symptoms that occur during stage two include:

  • Profuse sweating 

  • Agitation

  • Confusion 

  • Hallucinations: These often include tactile, olfactory, or visual distortions

  • Seizures

Stage Three: Delirium Tremens (DTs)

DTs may occur in as many as half of the people with withdrawal seizures. They begin to manifest themselves between 48 and 72 hours after you stop drinking.

As a result, the period immediately after your decision to stop drinking is the most crucial and hazardous part of the withdrawal phase. Symptoms of DTs may include:

  • Mood swings happen quickly.

  • Fever

  • Severe sweat

  • Fever or hyperthermia 

  • Extreme agitation

  • If you have a grand mal seizure, you might have muscle spasms and lose some of your mental abilities for a short time.

  • Drowsiness or exhaustion

  • Energy bursts 

  • Extreme disorientation

  • Hallucinations

  • High blood pressure

Seeking medical attention is critical, particularly if you are experiencing signs of severe DTs. It is considered a medical emergency when a patient has DTS. At a medical or rehab facility, trained medical and addiction professionals are acquainted with these issues and are equipped to give proper therapy.

Not all DTs result in death, although they may. Up to 25% of those are affected by DTs. 

Stage Four: Post-acute Withdrawal Syndrome (PAWS)

After stopping drinking, some individuals may continue to suffer PAWS symptoms for a prolonged period (weeks to months). The following symptoms characterize PAWS:

  • Low energy 

  • Anxiety

  • Dizziness 

  • Excessive irritability and emotional turbulence

  • Sleeping problems

  • Memory problems 

  • Intense cravings 

  • Delayed reflexes 

  • Chronic nauseous

A Heart Attack and Alcoholism

You may develop cardiac difficulties during alcohol withdrawal (particularly if you suffer from DTs). This is due to the way alcohol impairs your organs.

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The Bottom Line

If you're ready to take the first step toward a sober and alcohol-free life, an addiction expert can assist you on your journey. People struggling with withdrawal symptoms or self-detoxing should immediately get help from a medical professional. The person will likely die if they experience acute symptoms like delirium tremens.

Consultation with a doctor or professional therapy is the safest way to deal with alcoholism and start detoxification.

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Hangovers vs. withdrawal
What is alcohol withdrawal?
Causes of alcohol withdrawal
Symptoms and signs of alcohol wthdrawal
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