Alcohol withdrawal symptoms happen when someone who has been drinking heavily or for a long time suddenly stops or cuts back.
These symptoms may show up as mild anxiety, poor sleep, or restlessness, but in more serious cases they can lead to seizures or even life-threatening delirium tremens (DTs).
Recovery becomes safer and more effective when you understand what to expect and when to get help.
As a holistic recovery coach, I’ve worked with many individuals who underestimated alcohol withdrawal and tried to quit on their own.
Knowing the signs, the timeline, and available treatments makes all the difference in avoiding complications.
In this article, we’ll explore the symptoms of alcohol withdrawal, why they happen, how long they last, and what treatments can support a safe recovery.
What Is Alcohol Withdrawal
Alcohol withdrawal refers to the physical and psychological effects that occur after suddenly reducing or stopping alcohol use. Because alcohol is a depressant, long-term drinking forces the brain to adapt by increasing stimulating chemicals to balance its effects.
When alcohol is removed, the brain is left overstimulated, which leads to the uncomfortable and sometimes dangerous symptoms of withdrawal.
Symptoms of Alcohol Withdrawal
Not everyone will experience the same intensity of alcohol withdrawal symptoms. The severity depends on factors like:
- How much alcohol you drank
- How often you drank
- How long you’ve been drinking
Psychological symptoms:
- Anxiety or nervousness
- Irritability or restlessness
- Depression or mood swings
- Difficulty concentrating
- Bad dreams or insomnia
- Fatigue and low motivation
Physical symptoms:
- Headaches
- Nausea and vomiting
- Sweating (especially palms and face)
- Clammy skin
- Rapid heart rate or palpitations
- Shakiness or hand tremors
- High blood pressure
- Loss of appetite
In mild cases, these symptoms may feel like an intense hangover. In more severe cases, they can become life-threatening without treatment.
Causes of Alcohol Withdrawal
Alcohol changes how the brain communicates. Long-term drinking teaches the brain to depend on alcohol’s calming effect. To compensate, the brain produces more stimulating chemicals like dopamine and glutamate.
When drinking stops, the brain keeps producing these chemicals at a high rate, leaving the nervous system overstimulated. This imbalance explains why withdrawal symptoms include anxiety, tremors, and even seizures.
Timeline of Alcohol Withdrawal
The timing of alcohol withdrawal symptoms varies, but it often follows this pattern:
Stage 1: Mild withdrawal (6–12 hours after last drink)
- Headache
- Heart palpitations
- Shakiness
- Insomnia
- Mild anxiety
- Upset stomach
Stage 2: Moderate withdrawal (12–24 hours)
- Excessive sweating
- Fast heart rate
- Confusion
- Mild fever
- Elevated blood pressure
- Moderate anxiety
Stage 3: Severe withdrawal (24–72 hours)
- Severe anxiety or panic
- Hallucinations (seeing or hearing things that aren’t there)
- Intense tremors
- Seizures
- Risk of delirium tremens (DTs)
Complicated withdrawal (48–72 hours and beyond)
Delirium tremens is the most severe form of alcohol withdrawal. Symptoms include:
- Severe confusion and agitation
- Dangerous blood pressure changes
- Hallucinations
- Seizures
- Irregular heartbeat
- High fever
- Extreme sensitivity to light or sound
Delirium tremens can be fatal without emergency treatment. If you or someone you love shows signs of DTs, seek immediate medical care.
How Long Do Alcohol Withdrawal Symptoms Last
For most people, alcohol withdrawal begins within hours of the last drink and peaks between 24 and 72 hours. Many symptoms improve within five to seven days, but some effects — like sleep problems, fatigue, and mood swings — may linger for weeks or months.
Because withdrawal varies from person to person, it’s important not to assume your experience will be mild. Always consult a healthcare professional before attempting to quit alcohol.
Treatment for Alcohol Withdrawal
Alcohol withdrawal can be managed safely with the right care. Treatment depends on the severity of symptoms.
Outpatient treatment
For mild withdrawal, doctors may recommend outpatient care, where you stay at home but check in regularly for monitoring. You’ll need someone with you to ensure safety.
Inpatient treatment
For moderate to severe withdrawal, inpatient treatment is often necessary. In a hospital or rehab center, medical staff can monitor vital signs, provide IV fluids, and prevent serious complications.
Medications
Doctors may prescribe medications such as:
- Benzodiazepines (Librium, Ativan) to reduce anxiety and prevent seizures
- Vitamins (thiamine, folic acid) to address nutritional deficiencies
- Other medications to stabilize mood, sleep, or blood pressure
Counseling and support
Treatment doesn’t end when withdrawal is over. Counseling and support groups help you stay sober, deal with underlying issues, and build long-term recovery.
When to Seek Help
Alcohol withdrawal can be dangerous, and in some cases, life-threatening. Seek immediate help if you notice:
- Seizures
- Severe confusion
- Hallucinations
- Irregular heartbeat
- High fever
If you’re planning to quit drinking after heavy use, consult a doctor first. Don’t try to detox alone.
You can also call the SAMHSA National Helpline (1-800-662-HELP) for free, confidential support and treatment referrals in the U.S.
Final Thoughts
Alcohol withdrawal symptoms are your body’s way of adjusting after long-term drinking, but they can range from uncomfortable to life-threatening. Knowing the signs, timeline, and treatment options helps you prepare for a safer recovery.
If you or a loved one is struggling with alcohol withdrawal, reach out for medical support — you don’t have to face it alone. With the right care and ongoing support, recovery is possible and life can feel balanced again.
