What Are the Common Signs of Alcohol Withdrawal?

Every year, three million people die as a result of alcohol abuse. Even if alcohol addiction doesn’t turn fatal, it can rob you of your life in other ways. If you’ve struggled with alcoholism, you’re aware of how it can control every waking moment.

If you’ve decided to quit alcohol, congratulations. It’s a huge step and the first on your way to living a life free of addiction. But, quitting alcohol isn’t easy and alcohol withdrawal can be a difficult and harrowing process.

To help you get through it, we put together this guide to the signs of alcohol withdrawal. Read on to learn all about the process!

What Happens During Withdrawal?

Withdrawal occurs after long periods of consistent or heavy drinking. The body becomes physically dependent on alcohol and soon requires a drink to function. It’s similar to how if you drink coffee every day, you might get a headache if you skip a day.

Alcohol addiction is more complex than caffeine addiction, however. Alcohol is a depressant and modifies how your central nervous system operates.

Studies have found that alcohol stimulates your brain to increase its production of the neurotransmitter GABA. It also inhibits the production of the neurotransmitter glutamate.

GABA induces a feeling of euphoria, while glutamate makes you feel excitable. This is why heavy amounts of drinking can make you feel a calm sense of euphoria. To compensate, your brain stops producing GABA and produces more glutamate when you’re not intoxicated.

Your brain, therefore, depends on alcohol to regulate its neurotransmitters. When you quit alcohol cold-turkey, your neurotransmitters are entirely unbalanced and this leads to the intense symptoms of withdrawal.

Timeline of Alcohol Withdrawal

Your history of alcohol use will dictate the severity and duration of your withdrawal. Generally, alcohol withdrawal occurs in three stages: mild, severe, and delirium.

First Stage

Mild alcohol withdrawal signs can begin as soon as 6 hours after your last drink. Symptoms are generally uncomfortable, but still within your control.

You might experience:

In addition, cravings for alcohol will begin to ramp up in intensity. In most cases, withdrawal doesn’t progress further than this stage.

Second Stage

For severe addictions, severe withdrawal symptoms will follow the mild symptoms. Generally, these symptoms begin about 48 hours after your last drink. The symptoms are at their worst between 24 hours and 72 hours.

These severe symptoms include:

  • Extreme agitation
  • Fever
  • Seizures
  • Hallucinations
  • Racing heart
  • Rapid breathing

These symptoms can be life-threatening. If you experience any of them, it is a medical emergency. Call 911 or go to an emergency room immediately.

Third Stage

Although reaching the second stage of withdrawal is rare, 50% of people who experience seizures also experience the third stage of withdrawal. The third stage is characterized by delirium tremens or DTs.

Symptoms of DTs include:

  • Aggression
  • Agitation
  • Extreme confusion
  • Shaking
  • Sweating
  • Tachycardia
  • Vomiting
  • Hallucinations
  • Seizures
  • Impaired consciousness

If you experienced the second stage of withdrawal, you should already be under medical care. However, if you aren’t and you experience any of these symptoms, seek medical help immediately.

Post-Acute Withdrawal Syndrome

After the severe physical symptoms of alcohol withdrawal have passed, post-acute withdrawal syndrome (PAWS) sets in. PAWS encompasses the residual impairments that linger for months, or even years, after an addiction.

PAWS can include some mood swings, anxiety, and insomnia that result from unbalanced neurotransmitters. In addition, other symptoms include:

  • Difficulty maintaining relationships
  • Cravings for substances
  • Increased stress
  • Depression
  • Apathy

During an addiction, alcohol creeps into every aspect of your life. You can find yourself living for the next chance to have a drink. When alcohol is removed from your life, it leaves a void.

This is especially true if you relied on alcohol to handle stress, anxiety, or other mental health issues. When you remove this coping mechanism, you’re vulnerable to the same stressors as you were before in addition to intense cravings. This results in PAWS.

Coping With PAWS

Quitting alcohol is just the first step. In the wake of an addiction, you have to find new ways to cope and handle the stress of life. Without ongoing treatment for alcoholism, you’re vulnerable to a relapse.

For instance, if all your friends go to the bar every weekend, how do you cope with being the only sober friend? Do you wait in your apartment alone, or do you come to the bar and have a seltzer? Without some form of treatment or support, it’s only a matter of time until you stop by for “just one drink.”

For that reason, regular ongoing therapy is the best way to manage your sobriety. You’ll learn how to cope with stress, anxiety, depression, and being sober in a world that runs on alcohol. One-on-one coaching with a mentor who’s experienced it all first hand is the single best way to manage the residual mental symptoms of withdrawal.

Understanding the Signs of Alcohol Withdrawal

If you’ve decided to kick an alcohol addiction, you’ve come to the right place. Treatment for alcoholism doesn’t end as soon as you put down the glass. It’s an ongoing process where you learn how to stop drinking, and how to live a life without the crutch of alcohol.

Craig Beck at Stop Drinking Expert has been through it all. He’s experienced all the signs of alcohol withdrawal and the struggles of staying sober. There’s no one better to help guide you on your sobriety journey.

Take the first step, and reach out today!

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  1. I've had to many relapse events and I've difficulty putting much time together in my attempts to stop drinking. That said I'm trying again. Besides some anxiety, restlessness and minor hand shaking I feel stable. I'm afraid that I will fail again and sort of lost hope. I'm 61YO, retired from a good career but had a drinking problem that continually got worse over a span of 30 years. It got particularly worse after having bariatric surgery in 2014 where I lost close to 90lbs. I've since regained almost half that weight due to excessive drinking.

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