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Editorial Policy | Research Policy
Alcohol is one of the most frequently used and misused substances in the U.S. Approximately 15.1 million adults have alcohol use disorder, and every year 88,000 preventable deaths are linked to alcohol. Alcohol withdrawal symptoms are profoundly uncomfortable and can be dangerous and even lethal.
For all but the mildest cases of alcohol use disorders, a medical detox and acute withdrawal should be supervised by medical professionals who can provide pharmacological therapies to reduce the severity of symptoms and intervene in the case of complications.
Alcohol withdrawal is a set of symptoms that develop when you stop using alcohol after dependence has developed. Alcohol stimulates certain receptors in the brain. Prolonged stimulation of these receptors causes the brain to adjust their sensitivity, recalibrating them to adapt to the presence of alcohol. When you suddenly stop drinking, these receptors are not sensitive enough to function as they should. Withdrawal symptoms happen until the brain can rebalance these receptors to adjust for the absence of alcohol.
Symptoms of alcohol withdrawal generally occur about six hours after the last drink and include anxiety, tremors, sweating, nausea and insomnia. The peak of symptom severity is typically between 24–48 hours, and symptoms usually subside within a few days. Symptom severity depends on the degree of alcohol use; chronic, heavy alcohol use is associated with substantially more debilitating symptoms.
More serious symptoms that are apparent within 24 hours of the last drink and persist for up to a week may include:
Although relatively rare, the most serious cases of alcohol withdrawal include potentially life-threatening delirium tremens, seizures and heart attacks.
If these symptoms are left untreated, mortality rates are estimated to be as high as 37%; even with treatment, approximately 4% of people suffering from the most severe symptoms will die.
Although the alcohol detox and acute withdrawal timeline can differ quite a bit between people, most mild to moderate cases will resolve within a week. More serious cases of detox and acute withdrawal may persist for two or more weeks. However, the resolution of acute withdrawal is often the beginning of an incredibly frustrating period called “post-acute withdrawal syndrome” (PAWS), which shares many symptoms of acute withdrawal.
Alcohol-related PAWS can persist for months, even years, and for the most serious alcohol use disorders, PAWS may be a lifelong condition. PAWS is associated with the same constellation of withdrawal symptoms and cravings experienced during acute withdrawal, with fluctuating levels of severity. PAWS symptoms will subside as time goes on.
Experiencing PAWS does not mean recovery has failed; in fact, experiencing PAWS indicates that recovery is progressing normally.
Withdrawing from alcohol at home can be dangerous. If problems arise, they can’t be resolved quickly. This can lead to harm before getting medical help. It’s also more uncomfortable than withdrawing at a treatment center, where symptoms can be managed effectively.
There are no shortcuts to alcohol withdrawal remedies, but knowing what to expect and what to look out for can be helpful for someone who is managing alcohol withdrawal symptoms at home.
When planning for alcohol withdrawal, setting aside time and ensuring that someone will be present with you is important. You should make sure there is no alcohol available and that you have everything you will need for the next week to a week and a half. You should always consult a medical professional before detoxing, even if you detox at home.
For anyone who intends to undergo alcohol detox and withdrawal at home, an evaluation with a medical professional is recommended before beginning. This provides a better understanding of what you can do to ensure your safety. A medical professional can also give you tips to improve your odds of success and medications that may help with some of the withdrawal symptoms that will occur.
Anyone attempting a home withdrawal should enlist the support of a trusted friend or family member who will stay with them and make sure symptoms are progressing as expected and no alarming signs have emerged. Having someone by your side for support not only keeps you safe but also provides social support and encouragement. This can be helpful as you work to resist alcohol and overcome withdrawal symptoms.
Stopping alcohol abruptly can be risky and challenging. That’s why many people opt for tapering, which means gradually reducing alcohol intake over time. Although tapering may lessen withdrawal symptoms, there’s no scientific evidence that it’s more effective than quitting suddenly. Tapering can spread out the discomfort over a longer period, resulting in moderate discomfort for a longer time instead of intense discomfort for a shorter duration.
Alcohol withdrawal can be dangerous, and you must take it seriously. For mild symptoms, you can consider treating alcohol withdrawal at home, but you should still consult with a healthcare provider before beginning.
Before starting a detox, you must understand withdrawal symptoms and when to seek help.
Mild symptoms can include:
More severe symptoms may involve:
If severe symptoms develop, it is important to stop trying to withdraw by yourself and to seek medical advice.
Before attempting to detox from alcohol at home, you should always consult a healthcare provider. They can assess the potential severity of withdrawal symptoms, give you tips to succeed and prescribe medications you can use at home.
Dehydration and malnutrition often accompany alcohol withdrawal. Drink plenty of water and consume a balanced diet in the days leading up to and during withdrawal. Foods rich in B vitamins, such as leafy greens, whole grains and dairy, can be particularly beneficial for supporting your health during alcohol withdrawal.
Over-the-counter medications can help with some withdrawal symptoms like nausea, headaches and anxiety. You should always follow instructions provided by a healthcare professional or that come with the medicine when taking these meds.
Make your environment as calm and quiet as possible. This will help manage anxiety and insomnia that often come with alcohol withdrawal. This can also help you minimize the stress and discomfort that can accompany withdrawal.
Meditation and mindfulness can help manage the psychological symptoms of withdrawal, like anxiety and restlessness. Techniques like yoga, deep breathing exercises and guided meditation can be beneficial during alcohol withdrawal.
You might not be able to exercise during all of the withdrawal, but if you’re up to it, light exercise can help by releasing endorphins. These feel-good hormones help to boost your mood and make withdrawal symptoms more tolerable.
Social support is vital during alcohol withdrawal. Let your friends or family know about your decision so they can offer emotional support. Having someone provide support and care can also help if your withdrawal becomes so severe that you need someone to help you seek medical care.
Consider starting therapy or counseling during withdrawal. A professional counselor or therapist can provide techniques to manage withdrawal symptoms, especially those related to your emotions. A counselor can also help you make a plan to maintain sobriety once you are done with withdrawal.
Alcohol withdrawal can be dangerous, even life-threatening. If symptoms worsen, seek medical help immediately. You should not delay seeking help to try finishing withdrawal at home and should be ready to get immediate medical attention when things worsen.
Dangers associated with alcohol detox and withdrawal generally stem from substantially altered brain chemistry caused by chronic alcohol misuse. In severe cases, a condition called delirium tremens (DTs) will occur. The risk of this is somewhat low for people detoxing for the first time but still high enough to be a significant concern. If delirium tremens develop, it carries a 37% chance of dying if untreated.
Alcohol particularly affects two neurotransmitters, GABA and NMDA, which are responsible for cooperatively maintaining appropriate levels of brain activity: GABA inhibits activity, and NMDA potentiates activity.
Chronic, heavy alcohol use increases GABA signaling and reduces NMDA signaling, resulting in a persistent reduction in brain activity for as long as alcohol is present. The brain compensates for this suppressed activity level by becoming hyperactive to offset it and achieve a more normal level of function.
When alcohol use is stopped suddenly, the suppressive effect of alcohol on the brain is suddenly gone, but the hyperactivity that the brain used to compensate for takes a while to return to normal. This hyperactive state is the cause of withdrawal symptoms. In severe cases, potentially lethal seizures and heart attacks can occur.
Another dangerous consequence of severe alcohol withdrawal is delirium tremens (DTs). DTs affect 3–5% of people experiencing withdrawal and, in addition to the more common withdrawal symptoms, can include:
DTs generally manifest about three days after withdrawal begins and persist for two to three days. In some cases, DTs may persist for seven to eight days. DTs are an extremely dangerous complication that is a medical emergency; by some estimates, the mortality rate of untreated DTs is as high as 37%.
Anyone considering alcohol detox and withdrawal at home is urged to consult a medical professional before beginning the process. Even mild withdrawal is not without risk.
Recovering from alcohol use disorder is difficult, especially when done alone. The Recovery Village at Palmer Lake offers full-service rehab programs tailored to the needs of our patients. Our team of experts will address each aspect of your recovery and help you get on the road to lifelong recovery. Contact a Recovery Advocate today.
Because alcohol withdrawal can be dangerous – and even kill you – make sure you have medical advice from your doctor or a rehab facility when you decide to stop drinking.
There are many misconceptions about alcoholism that make it sound like an alcoholic is an easy person to spot, however, many alcoholics function effectively and lead relatively normal lives.
An alcohol abuse problem can include binge drinking, having negative consequences such as hangovers with your drinking but continuing anyway, and drinking despite the desire to stop.
In a recent study by The Recovery Village, 44% of respondents reported abusing alcohol in an attempt to ease uncomfortable feelings that stem from underlying anxiety.
Drinking more than three drinks in a single sitting will temporarily cause your blood pressure to rise, but extended binge drinking or regular alcohol consumption can cause a permanent increase in blood pressure.
Rahman, Abdul & Paul, Manju. “Delirium Tremens.” STATPearls, August 22, 2022. Accessed June 22, 2023.
National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” August 2018. Accessed June 22, 2023.
Bayard, Max, et al. “Alcohol Withdrawal Syndrome.” American Family Physician, March 2004. Accessed June 22, 2023.
Schuckit, Marc A. “Recognition and Management of Withdrawal[…]m (Delirium Tremens).” The New England Journal of Medicine, November 2014. Accessed June 22, 2023.
Gupta, Mohit; Gokarakonda, Srinivasa B.; Attia, Fibi N. “Withdrawal Syndromes.” StatPearls, April 29, 2023. Accessed July 14, 2023.
The Recovery Village at Palmer Lake aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.
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