Alcohol withdrawal

Facing alcohol withdrawal can feel overwhelming and frightening, especially if you don’t know what to expect. Familiarising yourself with the symptoms and getting the right support for you, will set you up for safe withdrawal and lasting recovery.

Alcohol withdrawal occurs when someone who’s been drinking heavily or regularly for a long period of time suddenly reduces or stops drinking. Alcohol slows down brain activity by increasing calming chemicals in the brain and reducing stimulating ones. Over time, the brain adjusts by producing less calming chemical and more stimulating ones, to maintain balance.

When alcohol use stops suddenly, this balance is disrupted. The brain struggles to adjust to the absence of alcohol, leading to withdrawal symptoms. 

Recognising the signs of alcohol withdrawal

Sometimes, people who are dependent on alcohol may not realise that their personal use has reached the point where not drinking causes withdrawal symptoms. Spotting these signs can be a way to gauge the seriousness of your dependency or addiction. 

The early signs of alcohol withdrawal include:

• Tremors: Uncontrollable shaking, often in the hands, caused by the nervous system's reaction to the absence of alcohol after prolonged use
• Anxiety: Intense feelings of nervousness, fear or unease that arise as the brain adjusts to functioning without alcohol
• Sweating: Excessive perspiration resulting from the body's heightened stress response during withdrawal
• Headaches: Persistent pain or pressure in the head due to dehydration, stress and chemical imbalances caused by alcohol withdrawal

Alcohol withdrawal can also cause behavioural changes. These include irritability, restlessness or trouble sleeping.

Overview of alcohol withdrawal symptoms

Alcohol withdrawal symptoms can vary widely in intensity. You may experience mild, moderate or even severe symptoms, depending on a number of factors. These factors include how frequently you drank alcohol, in what quantity and over what period of time. Other factors include your baseline physical health and any co-occurring conditions.

Mild symptoms

Mild symptoms of alcohol withdrawal include headaches, nausea, sweating, anxiety and insomnia. Symptoms may begin 6 to12 hours after your last drink and are often the first signs of withdrawal.

Moderate symptoms

Moderate symptoms of alcohol withdrawal include vomiting, confusion, elevated heart rate and increased blood pressure. Symptoms usually develop within 12 to 48 hours and indicate a heightened response by the body to the absence of alcohol.

Severe symptoms

Severe symptoms of alcohol withdrawal include seizures, hallucinations, delirium tremens (DTs) and severe confusion. These symptoms often emerge 48 to 72 hours after your last drink and can be life-threatening without immediate medical intervention.

Alcohol withdrawal timeline

Alcohol withdrawal typically progresses along a timeline, with symptoms occurring, worsening and eventually easing off within a total of around 72 hours. Breaking down the symptoms and likely timeline gives you an indication of what to expect during withdrawal from alcohol.

• 0 to 6 hours after your last drink: Initial symptoms begin to appear, including mild anxiety, headaches and nausea
• 6 to 12 hours after your last drink: Existing symptoms may worsen at this stage and new symptoms may begin, such as sweating, tremors and insomnia
• 12 to 48 hours after your last drink: You may still be experiencing existing symptoms or they may have begun to subside. More serious symptoms, such as hallucinations and seizures, may develop
• 48 to 72 hours after your last drink: The risk of DTs peaks at this stage. Symptoms can be severe and dangerous, requiring medication attention
• Beyond 72 hours after your last drink: At this stage, symptoms generally start to lessen. However, some may linger for several weeks. Ongoing symptoms, like anxiety or insomnia, may need long-term support. Medical professionals experienced in alcohol withdrawal can advise on managing these symptoms

Treatment options for alcohol withdrawal

If you think you’re experiencing alcohol withdrawal, it’s essential to understand your options and take appropriate action to ensure your safety and wellbeing.