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Alcohol Withdrawal and Detox

A heavy drinker who stops or cuts back use may experience withdrawal symptoms, including anxiety or seizures.

What Causes Alcohol Withdrawal?

Symptoms of withdrawal include fatigue and nausea.

Symptoms of withdrawal include fatigue and nausea.

People who drink heavily over an extended period of time develop a tolerance to alcohol. When this happens they have to drink more to feel alcohol’s effects.

Eventually, someone with a tolerance to alcohol can become dependent on it. This means they have to drink to prevent withdrawal. The symptoms of alcohol withdrawal can be intense and even deadly.

There are multiple treatments for alcohol addiction that can help users safely and comfortably quit drinking.

Alcohol Withdrawal Symptoms

Symptoms of withdrawal can be psychological and physical. How much, how often and for how long someone consumed alcohol impacts their withdrawal symptoms. People who drink often and a lot experience the most extreme withdrawal symptoms.

Common symptoms include:









Nausea and vomiting










Delirium Tremens

Delirium tremens is a severe form of alcohol withdrawal. It causes confusion, tremors and hallucinations.

Delirium tremens is most common in people who drink the equivalent of one pint of liquor every day for several months.

Delirium tremens is life-threatening. It can cause heart problems and fatal injuries from sudden seizures. Seizures may occur 12 to 48 hours after stopping drinking. Approximately 1 out of every 20 people who experience withdrawal will suffer from delirium tremens.

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Duration of Withdrawal

The first symptoms of withdrawal usually appear within the first 5 to 10 hours after the last drink. Tremors or shakes are common first signs of withdrawal. In severe cases, seizures and hallucinations follow.

Alcohol withdrawal is the worst a day or two after the last drink. Symptoms start subsiding throughout the following week.

Physical symptoms taper off sooner than psychological ones do. Long-term effects can last for months or even years after the last drink. These may include sleep disturbances or lingering depression.

Alcohol Withdrawal Timeline

First 12 hoursHeavy drinkers experience tremors a few hours after their last drink. Symptoms during the first 12 hours include sweating, irritability, rapid heartbeat, high blood pressure, nausea, vomiting and insomnia.
Days 1-2Symptoms peak 24 to 48 hours after the last drink. Symptoms are most severe and may include seizures, night terrors, hallucinations and panic attacks.
Days 3-5Ongoing feelings of nervousness, shakiness and mood swings can last up to a week after the last drink. Delirium tremens may occur during this time as well.
Days 6+After detox, some former heavy drinkers experience longer-lasting effects of withdrawal. Symptoms are mostly psychological. They may include mood swings, anxiety, irritability, changing levels of energy and trouble sleeping. These symptoms come in waves and can last for months after the last drink.

Alcohol Detox

Detox returns a heavy drinker’s system to normal after extended alcohol abuse. People who have been drinking heavily for a long time may experience intense side effects from detox.

It is important to detox from alcohol under the supervision of a medical professional. Medical detox ensures careful monitoring and supervised medication when needed.

In the cases of long-term alcohol abusers, detoxing “cold turkey” can be dangerous and even fatal.

Although rare, some of the severe side effects of alcohol detox include heart arrhythmias, seizures, kidney or liver dysfunction and hallucinations.

Medications Used in Detox

Keeping the patient’s system in balance and preventing complications is a major part of alcohol detox. Sometimes medications are necessary to do this.

Medications used during detox include drugs that prevent seizures, reduce cravings and treat co-occurring disorders.

  • Benzodiazepines reduce psychological withdrawal symptoms like anxiety. Sedation with benzos allows people to detox without the risk of seizure. While they are effective in preventing certain symptoms of alcohol withdrawal, benzos are addictive. People on these medications should be closely monitored.
  • Anticonvulsant or anti-seizure medication may be used in addition to benzodiazepines. Anticonvulsants often aren’t helpful on their own.

Treatment for Alcohol Addiction

Detox is the first step in treating an alcohol addiction. Alcohol treatment centers create healthy environments for detox and withdrawal as part of an inpatient rehabilitation program.

Outpatient detox is also an option for those with a mild alcohol addiction. Outpatient clinics provide medications and support during the withdrawal period.

After detox, ongoing therapy and support groups can help recovering alcoholics learn how to cope without alcohol.

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Sources & Author Last Edited: April 11, 2017

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). Arlington, VA: American Psychiatric Publishing, Inc.
  2. New York Times. (2013). Treatment for Alcohol Withdrawal. Retrieved on June 8, 2015 from:
  3. National Institutes of Health. MedlinePlus. (2013). Alcohol Withdrawal. Retrieved on June 8, 2015 from:
  4. Hayashida, Motoi M.D., Sc. D. An Overview of Outpatient and Inpatient Detoxification. Retrieved on June 8, 2015 from:
  5. National Institutes of Health. MedlinePlus. (2013). Delirium Tremens. Retrieved on June 8, 2015 from:
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