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Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.
Tremors, uncontrollable sweating, racing heart, and hallucinations some of the symptoms of alcohol withdrawal. As your brain and body adjust to the absence of alcohol, you experience a range of unpleasant and potentially dangerous complications.
This cluster of symptoms is known as alcohol withdrawal syndrome (AWS).
When you decide to break your alcohol dependency, Ardu Recovery Center can help. Our alcohol detox can get you through the withdrawal stage, and then our comprehensive alcohol addiction treatment program provides the tools and the support you need to overcome dependency and reclaim your well-being.
Ardu has highly exceptional staff that truly love their jobs and care about the clients treating them with the utmost love and respect. After graduating from Ardu…I am still clean and sober six months later. The tools I learned at Ardu are tools I can take with me for a lifetime.
Alcohol withdrawal syndrome happens when a person who is physically dependent on alcohol suddenly stops drinking or dramatically reduces the intake. This complex condition arises because the brain has adapted to the constant presence of alcohol. In the absence of alcohol, the brain goes into overdrive, causing a reaction throughout the body.
AWS stems from a biological revolt inside the body and brain of a dependent drinker. The nervous system has been so long saturated in liquor that it starts to rebel in its absence. AWS brings unpleasant and often severe symptoms.
The symptoms of alcohol withdrawal syndrome can range from mild to moderate to severe, in which case you can experience seizures, hallucinations, and life-threatening delirium tremens. The severity depends on:
To make things easier, we’ve grouped the symptoms based on when they tend to emerge during alcohol detox.
The early signs of withdrawal mean that the alcohol is leaving the system. These mild symptoms are uncomfortable but generally not severe or dangerous.
In the early withdrawal stage, you may experience:
These moderate withdrawal symptoms peak during the middle stage of withdrawal and often require close medical monitoring and management. These include:
The last stage of withdrawal syndrome is also the most hazardous and often involves extended delirium. You may need urgent medical intervention (such as from a medical detox facility) to avoid life-threatening seizures, arrhythmias, and organ failure.
The following symptoms gradually abate with treatment over 5-7 days:
Delirium tremens starts about three days after the beginning of detox and can last upwards of a week or more, depending on the severity of withdrawal effects.
With the worst of the withdrawal symptoms behind you on day eight, you’ll need ongoing care. Our qualified rehab facility can help you adjust to life without alcohol and fight cravings with cognitive behavioral therapy, group therapy, and other modalities.
The more dependent your body is on alcohol, the worse AWS gets. That’s why it’s so important to diagnose this condition correctly. Our detox center can help you through severe alcohol withdrawal, including delirium tremens. Once you’re detoxed, we can help you combat the long-term effects of alcohol addiction and get your life back.
Regular alcohol consumption throws your brain and entire body out of homeostasis. Then, when you quit booze, critical bodily processes lose their equilibrium even more, spiraling into dysfunction and distress.
While the liver, heart, and other organs are taxed during withdrawal, they are simply responding to distress signals arising from the central nervous system (read about the effects of booze on the CNS).
Let’s explain how the brain and other vital body parts react when you stop drinking.
Heavy drinking can do a serious number on your brain. When you stop drinking, your brain has a chance to (at least partially) recover.
Here are some of the ways alcohol affects your brain:
Let’s explore these effects in more detail.
The alcohol withdrawal syndrome is a well‐known condition occurring after intentional or unintentional abrupt cessation of heavy/constant drinking in patients suffering from alcohol use disorders (AUDs). AUDs are common in neurological departments with patients admitted for coma, epileptic seizures, dementia, polyneuropathy, and gait disturbances. (Jesse, et. al.)
Alcohol acts on neurotransmitters like GABA, glutamate, dopamine, serotonin, and norepinephrine. Neurotransmitters are the brain’s chemical messengers that send and receive signals between neurons. Our thoughts, emotions, behaviors, and physiological processes rely on this delicate neurochemical signaling system.
GABA (gamma-aminobutyric acid) is the major inhibitory neurotransmitter in the central nervous center. GABA has particular binding sites available for ethanol, thus increasing the inhibition of the central nervous system when present. Chronic ethanol exposure to GABA creates constant inhibition or depressant effects on the brain. (Newman, et. al.)
Newman, et. al. also reveal that alcohol acts on another neurotransmitter to counter the decreasing GABA inhibition.
Ethanol also binds to glutamate, which is one of the excitatory amino acids in the central nervous system. When it binds to glutamate, it inhibits the excitation of the central nervous system, thus worsening the depression of the brain.
Once the alcohol is gone, there’s too much glutamate excitation and not enough GABA inhibition. As a result, the brain enters a hyper-excited state of neuronal overactivity and miscommunication between critical brain regions.
This “neuronal hyper-excitation” underlies every alcohol withdrawal symptom:
This means that, by removing alcohol from your system—which is the right choice—your alcohol-adapted brain turns against you. However, wonderful things happen to your brain when you stop drinking. You just need to give your brain the chance and time to recover from alcohol’s toxic effects.
The liver gets hit hard by alcohol abuse, but ironically it also gets thrown for a loop when booze disappears during withdrawal.
The liver is something of a rockstar among the organs. It is responsible for filtering toxins from the blood and so many more vital functions that basically keep you up and running. When alcohol floods the system daily, the liver works overtime trying to metabolize it.
So when drinking suddenly stops, the liver is still primed and ready with extra metabolic capacity. But there’s no alcohol coming in. This can lead to rapid rises in liver enzymes as the organ readjusts.
The liver suffers significant short-term duress during withdrawal. Here’s what happens to your liver when you stop drinking:
The best thing you can do for your liver is to quit alcohol. With the right help, you can regain control and heal from alcoholism’s adverse effects. Contact Ardu and start your recovery.
Think your stomach had it bad while you were drinking? The pain can get even worse when you try to get clean. That’s because your digestive system got used to operating with alcohol constantly suppressing nerves and damaging tissue.
So when you stop drinking, the stomach and intestines essentially revolt, stirring up inflammation, dysfunction, and distress from mouth to colon. The gastrointestinal system faces significant disruption when you remove alcohol after heavy, prolonged use.
Your stomach and intestines demand the return of toxins to quell their uprising. If you pull through these arduous stages of alcohol recovery, you get closer to feeling healthy and vibrant again, no longer chained to the cycle of alcohol dependence.
The kidneys suffer toxic effects from alcohol and secondary impacts during withdrawal. When you quit drinking, here’s what can happen to your kidneys:
While kidneys can recover after alcohol abstinence, withdrawal puts them through the wringer. Take the strain off this vital organ and make sure kidneys are properly hydrated and nourished.
Do you want to put a stop to the damage alcohol is doing to your body? Seek the help of our compassionate, skilled professionals at our drug and alcohol rehab center. We will support you through medically supervised alcohol detox and provide therapeutic treatment to start your journey toward healing and long-term sobriety.
Alcohol withdrawal syndrome can in fact contribute to the vicious cycle of alcohol addiction by driving someone back to drinking to make the symptoms stop. AWS can potentially exacerbate cross-addictive tendencies as well, as the addict looks for a new addiction to distract them.
A 2008 study on alcohol dependence, withdrawal, and relapse suggests that alcohol withdrawal syndrome can often perpetuate addiction.
Although many physical signs and symptoms of withdrawal typically abate within a few days, symptoms associated with psychological distress and dysphoria may linger for protracted periods of time. The persistence of these symptoms (e.g., anxiety, negative affect, altered reward set point manifesting as dysphoria and/or anhedonia) may constitute a significant motivational factor that leads to relapse to heavy drinking.
Withdrawal-related anxiety and sensitivity to stress cues can increase the risk of relapse in alcoholics. Animal models showed similar hypersensitivity during withdrawal, confirming that dependence enhances susceptibility to relapse triggers.
Then there are the distressing physical and psychological symptoms that provide strong motivation to resume drinking in order to quickly alleviate the discomfort. The looming possibility of repeated agonizing withdrawals can drive continued excessive drinking despite negative consequences. That’s why relapse is considered a natural part of every addiction.
Each symptom of withdrawal on its own can make you curse the day you took up the bottle. But when those symptoms converge and attack all at once, you’ll know that alcohol withdrawal syndrome has taken hold.
You may have heard the terms “alcohol withdrawal” and “alcohol withdrawal syndrome” used interchangeably. While withdrawal symptoms refer to individual effects such as tremors, anxiety, or sweating, alcohol withdrawal syndrome represents the full cluster of severe symptoms that accompany withdrawal.
Specifically, AWS goes beyond a few unpleasant symptoms to a dangerous complex of uncontrolled central nervous system and bodily reactions.
Here are the key ways AWS is more complex and dangerous than individual symptoms of withdrawal:
With alcohol abstinence, proper nutrition, and therapeutic support, you can overcome alcohol syndrome.
There is no medical “cure” for alcohol withdrawal syndrome, other than staying the course with your sobriety and letting the symptoms run their course under proper medical supervision.
Here are some ways to mitigate the effects of AWS:
Doctors recommend combining medical and psychotherapeutic interventions that allow you to pass through the acute alcohol withdrawal phase safely.
If you need help, our alcohol detox program can help you get over the withdrawal stage, and our alcohol rehab can help you rewire your patterns, body, and brain for an addiction-free life.
How much booze until those first symptoms kick in? Unfortunately, there’s no magic number. In general, consuming more than 3–4 drinks daily over months to years often results in physical alcohol dependence and subsequent withdrawal upon quitting. Some people can drink heavily for years with no withdrawal effects. Others get hooked after just a few months of moderate use.
Your unique biology and drinking habits interact in complex ways. Many factors influence a person’s susceptibility to booze.
One thing is certain—the more heavily and frequently you consume over time, the higher the risks. Cutting back or quitting altogether is the surest way to steer clear of the risk of developing AWS.
Alcohol withdrawal symptoms can range from mild to life-threatening, but you don’t have to face this challenge alone. We offer compassionate care and treatment to ensure your safety and success.
At Ardu, you can choose medical detox, holistic detox, or a combination of the two approaches.
We know recovering from alcohol addiction is a lifelong process. Our goal is to support you each step of the way with compassion and evidence-based care. You can continue treatment with us through our welcoming inpatient care facilities or our flexible outpatient therapy sessions.
We offer multiple forms of individual therapy, including motivational interviewing, cognitive-behavioral therapy, and family therapy, as well as group therapy options and dual diagnosis treatment for those with a co-occurring mental health disorder.
You can also choose to stay at our residential treatment facility 24/7 for one to three months while undergoing intensive therapy and medical management of withdrawal and addiction. We provide counseling, group therapy, art therapy, and other programs during your stay.
If you’re looking for more flexible arrangements, our outpatient addiction treatment allows you to maintain your daily routines to help you overcome alcohol use disorder. With our support, you can achieve sobriety and build a strong foundation for long-term recovery while still taking on home and work responsibilities.
Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.
Alcohol use disorder (AUD) is a chronic yet treatable brain disease characterized by an inability to control alcohol use despite negative consequences. While it may not be “cured” in the traditional sense, it can be effectively managed and treated.
Treatment for AUD typically involves a combination of behavioral therapies, counseling, and medications. The goal is to help the person with alcohol addiction reduce or stop their consumption, manage alcohol cravings, and address underlying factors contributing to the abuse.
Recovery from AUD varies from person to person, and it’s an ongoing process. Some people achieve long-term abstinence, while others may learn to moderate their alcohol intake.
The term “Type 1 alcoholic,” while not a formal medical classification, is often used to describe people with severe alcohol addiction. These individuals often display compulsive drinking behavior, a high tolerance for alcohol, and significant life disruptions due to their addiction. The so-called type 1 alcoholics also tend to experience more severe withdrawal symptoms.
However, addiction is a complex issue, and attempting to categorize individuals into types oversimplifies the reality of AUD. Alcohol addiction exists on a spectrum, and there are no universally accepted “types” of alcoholics. Each person’s experience with alcohol use disorder is unique and may require personalized treatment.
The life expectancy of a recovering alcoholic depends on several factors, including the severity of their alcohol use disorder, their overall health, and their commitment to recovery. Generally, once an individual stops drinking and seeks treatment, their life expectancy can improve.
Alcohol abuse can lead to a wide range of health issues, such as liver disease and liver cirrhosis, cardiovascular problems, and increased risk of accidents and injuries. The extent of recovery depends on the damage done during the period of heavy drinking.
Severe withdrawal syndrome in alcoholics is typically referred to as “Delirium tremens” (DT). It’s a life-threatening condition that can occur when individuals with severe alcohol addiction suddenly stop drinking. DT is characterized by a combination of severe symptoms, including hallucinations, confusion, severe agitation, tremors, and potentially life-threatening autonomic nervous system disturbances.
DT is a medical emergency and requires immediate hospitalization and intensive medical care. Without proper treatment, it can lead to seizures, respiratory failure, and even death.
Withdrawal behavior encompasses a broad spectrum of physical and psychological symptoms.
Physically, individuals experiencing withdrawal from substances like alcohol or drugs may encounter symptoms such as tremors, sweating, increased heart rate, nausea, vomiting, and even seizures in severe cases. These physical manifestations stem from your body’s reaction to the sudden deprivation of the substance it has become dependent on. These symptoms can be both uncomfortable and, in extreme cases, life-threatening.
Psychologically, withdrawal often leads to mood disturbances, such as anxiety, depression, irritability, and intense cravings for alcohol. The psychological aspects of withdrawal can be emotionally challenging, with cravings being a powerful force compelling you to return to your addictive behaviors.
People who are in the throes of withdrawal from substances need compassion and support. Withdrawal is a vulnerable and often distressing experience. Here’s how to effectively deal with those going through withdrawal:
Everyone’s withdrawal experience is unique, and there is no one-size-fits-all approach. Offer empathy, patience, and unwavering support to help your loved one successfully navigate withdrawal and embark on their journey to recovery.
Jesse, S., Bråthen, G., Ferrara, M., Keindl, M., Tanasescu, R., Brodtkorb, E., Hillbom, M., Leone, M. A., & Ludolph, A. C. (2016). Alcohol withdrawal syndrome: Mechanisms, manifestations, and management. Acta Neurologica Scandinavica, 135(1), 4-16. https://doi.org/10.1111/ane.12671
Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. [Updated 2023 July 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/
Becker, H. C. (2008). Alcohol Dependence, Withdrawal, and Relapse. Alcohol Research & Health, 31(4), 348-361. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860472/
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