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Alcohol Withdrawal Syndrome

Medically Reviewed by: Charley Allen

Table of Contents

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.

What is Alcohol Withdrawal Syndrome Design for Recovery

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.

Severe Withdrawal Symptoms Design for Recovery

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.

Post Acute Withdrawal Design for Recovery

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.

Population at Risk Design for Recovery

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


Timeline and Progression of Alcohol Withdrawal Design for Recovery

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.


Treatment Options for Alcohol Withdrawal Design for Recovery

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.


Factors Influencing Design for Recovery

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

Alcohol withdrawal symptoms usually start within 6 to 12 hours of alcohol detox and can last a few days. For most people, alcohol withdrawals subside after 72 hours, but symptoms can continue for several weeks in some people.

You should seek medical attention for severe withdrawal symptoms. People with severe alcohol withdrawal may need to be hospitalized and monitored closely for signs of complications during the alcohol detox process.

They may also need to receive intravenous fluids, medications, vitamins, and other treatments to prevent withdrawal seizures, delirium tremens, and other life-threatening symptoms.

Family therapy can be an essential component of substance abuse treatment. It involves involving family members in the recovery journey, improving communication, and providing a supportive environment for the person undergoing alcohol detox.

Alcohol withdrawal can be fatal, especially if you try to go through it alone. It’s important to get medical care immediately if you notice any symptoms related to alcohol withdrawal.

Heavy and prolonged drinking can lead to brain damage, including the development of brain lesions. These lesions can contribute to cognitive impairments and other neurological problems.

The speed and extent of recovery depend on several factors, such as the amount and duration of alcohol use, co-occurring conditions, and the level of support and treatment received.

The most severe withdrawal symptom associated with alcoholism is delirium tremens (DTs), a state of confusion, agitation, and hallucinations that can be fatal if not treated.

DTs generally occur within 48 to 72 hours of the detox process. They can cause withdrawal seizures, high fever, irregular heartbeat, low blood pressure, dehydration, and brain damage, leading to coma and death.

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides Treatment Improvement Protocols (TIPs) that offer guidelines for the clinical management of substance use disorders, including alcohol detox and treatment.

Banerjee, Niladri. “Neurotransmitters in Alcoholism: A Review of Neurobiological and Genetic Studies.” Indian Journal of Human Genetics, vol. 20, no. 1, CLOCKSS Archive, 2014, p. 20. Crossref ,

Newman, Richard K., et al. “Alcohol Withdrawal – StatPearls – NCBI Bookshelf.” Alcohol Withdrawal – StatPearls – NCBI Bookshelf, 29 Aug. 2022, Bahji, Anees, et al. “Management of Post-Acute Alcohol Withdrawal: A Mixed-Studies Scoping Review.” Journal of Studies on Alcohol and Drugs, vol. 83, no. 4, Alcohol Research Documentation, Inc., July 2022, pp. 470–79. Crossref, Saitz, Richard. “Introduction to Alcohol Withdrawal.” PubMed Central (PMC), Sinha, Rajita. “Chronic Stress, Drug Use, and Vulnerability to Addiction.” Annals of the New York Academy of Sciences, vol. 1141, no. 1, Wiley, Oct. 2008, pp. 105–30. Crossref,


Edited by: David Beasley

David Beasley - Design for Recovery

David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen

Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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