Heavy alcohol drinkers who quit drinking may experience unpleasant symptoms known as alcohol withdrawal syndrome (AWS).

AWS symptoms can range from mild to severe, depending on the person and their level of alcohol abuse. Severe symptoms can be dangerous and even fatal if left untreated. However, with proper medical care and support, you can overcome alcohol withdrawal and detox to start your recovery journey.

What is Alcohol Withdrawal Syndrome?

Alcohol withdrawal syndrome refers to a set of physical and mental symptoms that happen when you stop or reduce your alcohol use after a period of prolonged or heavy drinking.

Alcohol acts as a central nervous system depressant that slows down the activity of brain cells and neurotransmitters (chemical messengers) that regulate mood, cognition, memory, sleep, pain, and other functions.

Over time, your body adapts to its presence, so when you suddenly stop or cut back, your brain is forced to adjust to the lack of alcohol, leading to withdrawal symptoms.

Overview of Alcohol Use Disorder (AUD)

Alcohol use disorder (AUD) is a medical condition that refers to problematic alcohol use patterns that cause significant impairment or distress.

Alcoholism involves losing control, preoccupation, and continued consumption despite negative outcomes. Alcohol use disorder puts you at risk of developing withdrawal symptoms if you try to quit drinking abruptly or without medical supervision.

Signs and Symptoms of Alcohol Withdrawal

Some people may experience mild symptoms that may be managed at home with self-care and support from family members or friends. Common mild symptoms include:

• Anxiety
• Nausea and vomiting
• Shaking or tremors
• Sweating
• Headache
• Irritability
• Mood swings
• Difficulty sleeping or nightmares
• Loss of appetite
• Rapid heart rate
• High blood pressure

Severe Withdrawal Symptoms

Meanwhile, others may have more severe symptoms that can be life-threatening and require medical attention, such as:

• Seizures
• Delirium tremens (DTs)
• Hallucinations
• Psychosis

If you, or someone you know, experience alcohol withdrawal symptoms listed above, seek medical care immediately. Do not try to treat them at home or by yourself. Go to a hospital or an alcohol detox center to receive medical supervision and treatment.

The Spectrum of Alcohol Withdrawal Symptoms

Not everyone undergoing alcohol withdrawal syndrome has the same symptoms or intensity.

Withdrawal progression can be categorized into three stages:

1. Mild withdrawal: Starts 6 to 12 hours after the last drink, lasts around 24 hours, and often causes anxiety, restlessness, and physical discomfort.
2. Moderate withdrawal: Begins 12 to 24 hours after the last drink, and lasts 2 to 3 days, intensifying symptoms and potentially adding confusion and mood swings.
3. Severe withdrawal: Initiates 48 to 72 hours after the last drink, lasting up to a week or more. Severe symptoms like seizures, DTs, hallucinations, and psychosis might emerge, requiring immediate medical intervention.

Post-Acute Withdrawal Syndrome (PAWS)

PAWS is a longer-lasting form of AWS, leading to persistent psychological symptoms like:

• Anxiety
• Depression
• Fatigue
• Insomnia
• Memory problems
• Difficulty concentrating
• Alcohol cravings
• Low self-esteem
• Social isolation
• Increased body temperature

PAWS is treatable through counseling, medication, support groups, and lifestyle changes.

Alcohol Cravings and the Desire to Drink

Cravings are intense urges or impulses to drink alcohol triggered by various factors, such as stress, emotions, memories, people, places, or situations. They can make you feel like you need alcohol to function or feel better.

However, cravings are not commands. You do not have to act on them or give in to them.

Some strategies to cope with or reduce alcohol cravings include:

• Seeking support
• Avoiding situations or people that remind you of drinking
• Distracting yourself with healthy activities
• Reminding yourself why you should stop drinking
• Using medication or supplements to reduce cravings or ease withdrawal symptoms (under medical supervision)

Causes and Risk Factors of Alcohol Withdrawal

AWS stems from physical alcohol dependence, where the brain adapts to the alcohol’s presence and requires it for normal functioning.

Symptom severity varies based on:

• Amount and frequency of alcohol consumption
• Duration of alcohol dependence
• Existence of co-occurring medical or mental health issues
• Drug abuse or use of other medications
• Age, gender, genetics, and metabolism of the individual

Population at Risk

While anyone regularly consuming alcohol is susceptible to physical dependence and withdrawal symptoms, certain groups face higher risks.

These include people with a history of substance abuse or addiction, those with a trauma or mental health history, people with chronic pain or medical conditions, and those lacking social support.

Timeline and Progression of Alcohol Withdrawal

Alcohol withdrawal symptoms vary in intensity, duration, and type depending on the individual and the abovementioned factors. However, there is a general timeline and progression that many people follow.

Initial Hours After Cessation:

• Anxiety
• Irritability
• Restlessness
• Insomnia
• Tremors
• Nausea
• Vomiting
• Sweating
• Headache
• Stomach upset
• Increased heart rate and blood pressure

The First Few Days:

• Agitation
• Panic attacks
• Confusion
• Hallucinations
• Delusions
• Seizures
• Delirium tremens (DTs)

Weeks and Months: The Long-term View:

• Depression
• Anxiety
• Mood swings
• Fatigue
• Insomnia
• Poor concentration
• Memory problems
• Cravings

Diagnosis of AWS

A qualified healthcare professional diagnoses AWS based on the following:

• Clinical Evaluation: Alcohol consumption history, current symptoms, medical and mental health history, and physical examination.
• Diagnostic Criteria (DSM-5): Cessation or reduction in heavy and prolonged alcohol use and specific withdrawal symptoms.
• Identifying Severe Cases: The healthcare professional assesses the severity of AWS and identifies any signs of complications or risk factors for developing severe or life-threatening symptoms.

Treatment Options for Alcohol Withdrawal

Different types of medical interventions can help ease the symptoms of AWS and prevent complications. These include:

• Medical interventions: Medications like benzodiazepines, anticonvulsants, and vitamins can mitigate withdrawal symptoms and complications. Your medical team may also prescribe specific medications to reduce alcohol cravings during alcohol detoxification.
• Psychological Support: Counseling, therapy, and peer support groups can help you cope with the alcohol detox and address the underlying causes of your alcohol abuse.
• Preventing further drinking: Having a solid support system, avoiding triggers, and employing coping strategies can prevent relapsing into alcohol addiction.
• Rehabilitation programs: Specialized facilities offer comprehensive treatment, including alcohol detox, medical treatment, therapy, skills training, and aftercare, aiding the recovery process of a recovering alcoholic.

Factors Influencing Recovery

Some factors can influence the recovery process positively or negatively. These include:

• Physical health: If you’re physically healthy, your body can treat alcohol withdrawal symptoms faster as you detox from alcohol.
• Mental health: Good mental health can help the person deal with the psychological aspects of withdrawal and substance abuse.
• Social environment: A supportive and positive social environment can help the person stay motivated and focused through substance abuse treatment. Avoid negative influences like people who drink heavily or those who pressure you to drink.
• Relapse Prevention: Relapse prevention entails recognizing and avoiding triggers, developing coping strategies for stress and cravings, and establishing a plan for potential relapses.

Prevention Strategies for AWS

• Seeking professional help. The best way to prevent AWS is to get treatment for alcohol addiction from a qualified medical professional. A medical team can assess your situation through a medical detox and recommend the most appropriate strategies, including medication, counseling, or alcohol detoxification.
• Tapering off alcohol gradually. Even if you decide to quit drinking alone, you should do so slowly and carefully, under the guidance of medical professionals or a support group. Tapering off alcohol can help your body adjust to the lower levels of alcohol and reduce the risk of severe withdrawal symptoms.
• Staying hydrated and nourished. Drink a lot of water and eat healthy food to help your body cope with the effects of withdrawal symptoms.
• Seeking support from others. A strong support network can make a big difference during the alcohol detox. Join online or in-person support groups, such as Alcoholics Anonymous, to share your experiences and learn from others who have overcome alcohol addiction.
• Practicing self-care and coping skills. Alcohol detox can also be stressful and emotionally draining, so taking care of yourself and finding healthy ways to cope with negative feelings is essential.

Embrace Sobriety with Design for Recovery

If you or a loved one are facing alcohol addiction, it’s time to take steps toward a healthier, happier life.

At Design for Recovery Sober Living Home, we can offer a nurturing environment to overcome alcohol addiction.

Become a part of our community and gain access to valuable support and tools to help you take charge of your life and start your journey toward recovery.

Step into a new chapter of wellness at Design for Recovery. Contact us today to find out how we can help you.

Frequently Asked Questions (FAQs) About AWS