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What to Expect from Alcohol Withdrawal

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Updated September 19, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Many people drink too much every once in a while, and many also drink too much a lot of the time. While it is a great idea to quit drinking, you should also think through whether you might experience alcohol withdrawal symptoms, and how to manage them, before quitting cold turkey. Depending on how much you have been drinking and for how long, alcohol withdrawal symptoms can be severe and even life-threatening, so talk to your doctor for individual advice. This article is intended to help you to understand what could happen when you quit drinking, and is not a substitute for medical advice.

If you have been drinking heavily for a while, whether as a regular pattern, in binges, or if you have become addicted, you may want to know what to expect if you stop drinking and go into alcohol withdrawal.

For those who have become addicted to alcohol, you are likely to experience some withdrawal symptoms when you quit, but withdrawal can also happen after periodic heavy drinking. The initial hangover can vary in time and intensity, and can last for hours, but you will usually start to feel better within a day. In contrast, alcohol withdrawal worsens over the first few hours and days, and lasts from days to a week or more. Some drinkers experience weeks or months of withdrawal symptoms, known as post acute withdrawal syndrome (PAWS).

The exact experience of alcohol withdrawal varies from person to person, and the severity depends an a whole host of factors, but there are certain common features, which are outlined here.

Alcohol Cravings

Most people who are withdrawing from alcohol experience a strong desire to drink more. This is known as experiencing cravings, and cravings are common among people withdrawing from many addictive substances. Part of the craving is driven by the wish to reduce the symptoms of alcohol withdrawal, and part of it is the desire to re-experience the pleasure of the alcohol intoxication.

Mood Changes

Withdrawing from alcohol takes it toll on your mood. One way of thinking about withdrawal is that it is like having to pay back a loan. You get an advance on some good feelings while you are drunk, but then you are saddled with a debt of those same feelings during the withdrawal phase. This is called a rebound effect, and is part of your body’s way of maintaining homeostasis. Once you have paid off the "debt," you can feel good again naturally.

Many people drink to feel relaxed and happy. So when you withdraw from alcohol, you can expect to feel anxious and miserable, simply because your body is adjusting to the relaxant and mood elevating effects of alcohol not being there.

Another reason that withdrawal feels so bad is because many people drink to cover up negative feelings, like grief, anxiety, and frustration. Without the numbing effect of alcohol, and without having dealt with the underlying cause of those negative feelings, you can feel overwhelmed emotionally, just when you are at your weakest. For this reason, it makes sense to go through withdrawal in a supportive atmosphere, where negative feelings won't be provoked. It can be done at home, but this is only a good idea if your family or other people at home are going to be kind, sensitive and supportive during the process, so talk it over with them beforehand. And it is still a good idea to talk it over with your doctor, so they can give you medication that may prevent the most risky symptoms from happening.

Sleep Problems

Despite the tiredness you are probably feeling, alcohol withdrawal often causes insomnia (having trouble getting to sleep or staying asleep).

Nausea or Vomiting

Vomiting, or feeling as if you are going to vomit (nausea) is a recognized aspect of alcohol withdrawal. You probably won't feel like going out and about anyway, but wherever you are, make sure you have a bathroom close by.

Physical Agitation

People going through alcohol withdrawal often feel physically agitated. This is exacerbated by an increase in heart rate and sweating. You might also get physical tremors and notice your hands shaking. Obviously, this will make you feel unwell, but it is important to recognize these withdrawal symptoms for what they are, and not just the symptoms of a cold or flu. If you experience these symptoms and have not received treatment for alcohol withdrawal, see your doctor or go to the emergency room of your nearest hospital. Medication can prevent some of the more serious withdrawal symptoms, such as hallucinations and seizures.

Hallucinations

Hallucinations, which can occur on their own or be part of the severe withdrawal syndrome of delirium tremens (DT), are among the more severe symptoms of alcohol withdrawal — but not everyone who goes through withdrawal will experience them. Hallucinations involve seeing, hearing or feeling things that are not there, and can be quite unpleasant. Some people who experience hallucinations find them frightening and think they are going crazy. If fact, while some people can develop substance-induced psychosis as a result of using alcohol or other drugs, in most cases, the hallucinations stop after treatment or after the withdrawal has run its course. It's better to see a doctor and get medication than to try and cope on your own, as this can also prevent one of the potentially most dangerous alcohol withdrawal symptom: seizures.

Seizures

While seizures are uncommon, they are a normal symptoms of alcohol withdrawal, and you should always prepare for and avoid the risk of seizures by getting appropriate medical attention. Seizures during alcohol withdrawal can be life-threatening, so call 911 if think you think someone going through alcohol withdrawal is having a seizure.

Sources:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fifth Edition DSM-5. American Psychiatric Association. 2013.

Justice Institute of British Columbia. Substance Use/Misuse Certificate Program. Victoria, BC. 2001.

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