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Learn There Alcohol Withdrawal and Detox Symptoms

Mina Draskovic, B.Psy., reviewed this content for accuracy on 7/31/23


Breaking free from alcohol addiction is a courageous journey, but the path to sobriety is not without challenges.

Alcohol withdrawal and detox symptoms can be daunting, but understanding and managing them are crucial steps towards a healthier, brighter future.

Table of Contents

We shed light on the complexities of alcohol withdrawal and offer guidance to help you or your loved one navigate this transformative process with strength and support. Contact our alcohol addiction treatment center, and let’s embark on this empowering quest together!

Introduction to Alcohol Withdrawal

Alcohol withdrawal refers to the set of physical and psychological symptoms that happen when a heavy drinker suddenly stops or significantly reduces their alcohol intake after drinking on a regular basis.

These symptoms can range from mild to severe and may include tremors, anxiety, sweating, nausea, hallucinations, and even seizures.

The severity of alcohol withdrawal differs based on the person’s drinking patterns and overall health, but this condition can be dangerous and generally requires medical attention and support to manage and reduce the severity of symptoms.

What Happens to Your Body When You Stop Drinking?

Prolonged alcohol use leads to the development of tolerance and physical dependence, which may result from compensatory functional changes by downregulation of GABA receptors and increased expression of NMDA receptors with production of more glutamate to maintain central nervous system (CNS) transmitter homeostasis. (Jesse, et al.)

Long-term alcohol use causes changes to neurotransmitters in the brain. Specifically, it decreases GABA receptors, which inhibit brain activity, and increases NMDA receptors, which stimulate the brain.

This compensates for alcohol’s depressive effects. But when alcohol is removed, the downregulated GABA system can’t inhibit brain activity enough. The upregulated NMDA system then over-excites the brain.

This hyperexcitability generates the uncomfortable symptoms of alcohol withdrawal, like tremors, seizures, agitation, and delirium tremens.

In essence, the brain has become dependent on alcohol to maintain balance. When alcohol is withdrawn, the unbalanced neurotransmitter systems cause the body to react with withdrawal symptoms. Supportive care helps stabilize the brain during this transition.

How Long Does it Take to Reset Your Body from Alcohol?

The time it takes to reset the body from alcohol depends on your drinking history, body composition, metabolism, overall health, and other factors.

For moderate drinkers, it may take a few days to a week for the body to recover. However, for heavy and long-term drinkers, the process can be more challenging, with severe symptoms usually peaking within the first 48 to 72 hours after quitting.

Complete recovery may take weeks or even months as the body gradually heals and returns to a healthier state. Heavy drinkers should seek medical supervision during this process to manage potential complications and ensure a safe recovery.

What Are the Most Common Alcohol Withdrawal Symptoms?

Alcohol withdrawal symptoms can happen when someone abruptly stops or significantly reduces their alcohol intake after a period of drinking heavily or chronic alcohol intake. These symptoms arise because the brain has adapted to the constant presence of alcohol.

The severity of symptoms of withdrawal from alcohol depend on how long the person has been drinking, how much alcohol they consume on a daily basis, and their overall health at the time of stopping alcohol consumption.

Physical Symptoms of Alcohol Withdrawal

When patients with alcohol abuse and alcoholism stop drinking alcohol, they can experience a variety of physical symptoms as their central nervous system reacts to the lack of alcohol.

These symptoms result from overactivity of the autonomic nervous system and can range in severity from mild to severe. Common physical symptoms of alcohol withdrawal include:

  • Increased heart rate and blood pressure
  • Sweating
  • Hand tremors
  • Insomnia and other sleep disturbances
  • Nausea and vomiting
  • Headaches
  • Tactile, auditory, or visual distortions

Psychological Symptoms of Alcohol Withdrawal

Patients undergoing alcohol withdrawal frequently have psychological symptoms as their central nervous system attempts to compensate for the sudden deficit of alcohol. These psychological symptoms can range from mild anxiety and irritability to potentially dangerous withdrawal seizures and delirium tremens. Common psychological symptoms of alcohol withdrawal include:

  • Anxiety and nervousness
  • Irritability and mood swings
  • Emotional instability
  • Depression
  • Poor concentration and memory
  • Withdrawal seizures
  • Delirium tremens with disorientation, confusion, hallucinations

Alcohol Withdrawal Timeline

Here’s the timeline of alcohol withdrawal symptoms in the first 72 hours after you stop alcohol abuse:

6-12 Hours After Last Drink

Early withdrawal symptoms such as headache, anxiety, irritability, restlessness, nausea, vomiting, and tachycardia may appear within 6 to 12 hours of the last drink as blood alcohol levels start to decline.

24-48 Hours After Last Drink

Withdrawal symptoms peak at 24 to 48 hours. This is the window where more severe symptoms like auditory and visual hallucinations, tremors, sweating, hypertension, seizures, and delirium tremens typically occur.

48-72+ Hours After Last Drink

Delirium tremens and other medical complications are most severe 48 to 72 hours after the last drink but start to subside slowly after the 72-hour mark. Some symptoms like fatigue, anxiety, and poor sleep may persist for weeks in protracted withdrawals.

The severity and time course of withdrawal can vary dramatically based on your drinking history, other medical conditions, prior withdrawals, and genetic factors. Close monitoring and supportive care are essential during the peak withdrawal period due to the potential for progression to life-threatening symptoms.

Diagnosing Alcohol Withdrawal Syndrome

Alcohol withdrawal is no fun. When your body gets used to having alcohol every day, it reacts badly if you suddenly stop drinking. This reaction is called alcohol withdrawal syndrome, or AWS.

AWS can cause symptoms like shaking, sweating, nausea, anxiety, and even seizures. The more dependent your body is on alcohol, the worse AWS gets. That’s why it’s so important to diagnose AWS correctly.

If a doctor knows you have AWS, they can give you the right medicine to help ease the symptoms and prevent dangerous complications. There are scoring systems doctors use to rate the severity of your withdrawal. This helps them decide if you need to be hospitalized for treatment or if you can safely detox at home.

The best way to avoid AWS is to slow down your drinking over time before you quit completely. But once AWS sets in, get medical care. With the right treatment, you can get through withdrawal more comfortably and safely. And you’ll be on your way toward lasting sobriety.

Withdrawal Assessment

A comprehensive assessment starts with taking a history to identify any prior episodes of alcohol withdrawal, typical drinking patterns, time of last drink, and factors that may complicate withdrawal. A physical exam assesses vital signs, fluid status, orientation, tremors, and other symptoms. Questions about substance abuse like CAGE can screen for dependence on alcohol.

In patients able to participate, structured scales like the Clinical Institute Withdrawal Assessment (CIWA-Ar) are invaluable for assessing AWS severity. It rates 10 symptoms on a scale from 0 to 7. Scores below 10 indicate mild symptoms of withdrawal, 10-20 mild to moderate, and above 20 severe withdrawal symptoms.

Alcohol Withdrawal Delirium Tremens Diagnosis

Delirium tremens is characterized by a rapid fluctuation of consciousness and change in cognition occurring over a short period of time, accompanied by severe autonomic symptoms (sweating, nausea, palpitations and tremor) and psychological symptoms (i.e. anxiety). (Mirijello, et al.)

Delirium tremens (DT) is the most severe manifestation of alcohol withdrawal syndrome, occurring 48-72 hours after the last drink. It involves delirium—a rapid onset confused state with perceptual and somatic disturbances. According to the

Delirium tremens often includes fever, hypertension, anxiety, agitation, and even hallucinations. Without treatment, it can result in injury, medical complications, or death, so catching this condition early and managing its symptoms is crucial.

Besides delirium tremens, other indicators of severe withdrawals requiring close monitoring and treatment include:

  • withdrawal seizures
  • high CIWA-Ar scores (>15)
  • abnormal vital signs
  • co-occurring illnesses
  • electrolyte disturbances
  • prior detox history
  • physical symptoms of intoxication at presentation. 

Patients at risk for progression can be identified using tools like PAWSS.

Differential Diagnosis

The symptoms of alcohol withdrawal syndrome can mimic many other health issues—infections, liver problems, head injuries, thyroid issues, drug intoxication, and mental health disorders.

That’s why doctors need to rule out other possibilities when diagnosing AWS. Tests like neuroimaging and lab work help identify other causes if the case is complex. The process of ruling out other causes is known as differential diagnosis.

Diagnosing AWS requires a high level of knowledge and discrimination. Doctors need to do structured symptom assessments and evaluate the overall risk of severe withdrawal, as ruling out disorders that imitate AWS is crucial.

The earlier AWS is recognized, the sooner treatment can begin. This improves outcomes and prevents progression to dangerous stages, which is why family physicians on the frontlines must be skilled at spotting alcohol withdrawal in patients and suggesting detox and treatment options.

How Can You Manage Alcohol Withdrawal Symptoms?

Detoxification is the process of weaning a person from a psychoactive substance in a safe and effective manner by gradually tapering the dependence producing substance or by substituting it with a cross-tolerant pharmacological agent and tapering it. This process minimizes the withdrawal symptoms, prevents complications and hastens the process of abstinence from the substance in a more humane way. (Kattimani, et al.)

Alcohol withdrawal symptoms treatment can range from mild to life-threatening. Seeking medical treatments for alcohol withdrawal and detox is strongly advised, as alcohol withdrawal can lead to seizures, delirium tremens, and even death in severe cases.

At Ardu, you can choose medical treatment of alcohol withdrawal, holistic detox, or a combination of the two alcohol detox methods.

Medical Detox

Medical detox provides pharmacological treatment to safely manage alcohol withdrawal symptoms and prevent dangerous complications. Under medical supervision, the management of alcohol withdrawal is done with medications such as benzodiazepines, anticonvulsants, antipsychotics, pain management medications, and barbiturates to relieve symptoms and prevent complications like anxiety, tremors, seizures, hallucinations, and delirium.

The medications help by acting on neurotransmitters like GABA and glutamate that are dysregulated during alcohol detox. The doses are determined and tapered based on the severity of alcohol dependence and withdrawal symptoms. In addition to medications, medical detox at Ardu provides fluids, nutrition, vitamin supplements, and around-the-clock monitoring and supportive care to ensure your comfort and safety during alcohol detoxification.

Holistic Detox

Holistic detox focuses on treating alcohol withdrawal symptoms without medication. It uses natural therapies like nutritional therapy, meditation, acupuncture, massage therapy, nutritional supplements, and herbal remedies.

A healthy, alcohol-free diet along with therapies like acupuncture and exercise therapy help manage anxiety, insomnia, muscle cramps and other withdrawal symptoms. Meditation and psychotherapy provide mental support.

Medical supervision is still required in holistic detox to monitor withdrawal symptoms and vitals. Holistic detox is suitable for those with mild to moderate alcohol dependence, as severe withdrawal requiring medication is hard to manage with holistic detox alone.

What Comes After Alcohol Detox?

Completing alcohol detox is an important first step, but it’s just the beginning of your recovery journey. Here at Ardu, our doors remain open for you after detox. You can continue treatment with us through our welcoming inpatient facilities or our flexible outpatient therapy sessions.

We know recovering from alcohol addiction is a lifelong process. Our goal is to support you each step of the way with compassion and evidence-based care. Detox marks a pivotal moment to build on. Now you can start creating healthy new routines and gaining skills to maintain sobriety. With your courage and our help, a flourishing recovery is within reach. Together, we’ll find the treatment options after detox that fit your needs and empower your growth.

We offer multiple forms of individual therapy, including motivational interviewing, cognitive-behavioral therapy, and family therapy, as well as group therapy options and dual diagnosis treatment for those with a co-occurring mental health disorder.

Inpatient Treatment

Inpatient alcohol addiction treatment involves staying at a residential treatment facility 24/7 for one to three months while undergoing intensive therapy and medical management of withdrawal and addiction.

Following detoxification, patients at Ardu’s addiction treatment center participate in behavioral therapies including cognitive behavioral therapy, motivational interviewing, and 12-step facilitation, such as Alcoholics Anonymous, to identify root causes of addiction and build coping skills. Counseling, group therapy, meditation, art therapy and other programs provide support during your treatment..

After residential treatment, patients can attend outpatient programs and support groups for ongoing recovery. Patient education on relapse prevention and planning for post-discharge care start from day one at our residential treatment facilities, ensuring successful, lasting sobriety.

Outpatient Treatment

Patients may be candidates for outpatient treatment if they have only mild to moderate symptoms, no significant concurrent drug use, and little alcohol craving. If patients have risk factors for severe withdrawal then inpatient management should be strongly considered. (Perry, et al.)

Outpatient addiction treatment at Ardu offers flexible and effective solutions for people seeking recovery from alcoholism while maintaining their daily routines, such as partial hospitalization programming and intensive outpatient treatment.

Our experienced team of addiction specialists provides counseling, group therapy, and experiential treatments to help clients overcome alcohol use disorder. With our support, you can achieve sobriety and build a strong foundation for long-term recovery while still taking on home and work responsibilities.

What Is Dual Diagnosis Treatment for Alcoholism?

Dual diagnosis refers to the co-occurrence of alcohol use disorders alongside other mental disorders, such as mood or anxiety disorders.

According to The American Psychiatric Association, this comorbidity is relatively common and has important implications for treatment planning. Identifying these co-occurring conditions can facilitate integrated care, addressing both the alcoholism and the associated psychiatric symptoms.

The relationship between alcohol use and psychiatric symptoms is complex and can go both ways. Alcohol can worsen certain symptoms of depression and other mood disorders. Conversely, it can reduce symptoms of anxiety or psychosis, which contribute to ongoing alcohol abuse in people with these conditions.

At Ardu, we can help you understand whether you’re using alcohol to cope with a mental health condition. If you’re at risk for self-harm, suicide, or aggressive behaviors, we’ll provide a safe environment. Contact our dual diagnosis treatment center for help. Our dual diagnosis services include:

Start Your Sobriety Journey with Ardu Detox Center

We are here for you every step of the way on your journey to recovery from alcohol addiction. Our caring and experienced team of professionals will support you with the tools you need to overcome alcohol withdrawal and detox symptoms.

You don’t have to face this challenge alone; we’ll walk beside you, offering compassionate care and treatments to ensure your safety and success. Take the brave step towards a new life today, and let’s triumph over alcohol addiction together and embrace a future filled with hope, healing, and happiness. 

FAQ on Alcohol Withdrawals and Detox

What to expect after a detox?

After alcohol detox, it is normal to experience some post-acute withdrawal symptoms like mood swings, anxiety, impaired concentration, fatigue and sleep disturbances. These typically improve within weeks to months with support. Maintaining sobriety requires building a recovery plan through counseling, support groups, lifestyle changes.

Does your liver repair itself when you stop drinking?

The liver has an amazing ability to regenerate and repair itself when alcohol intake stops. Light drinkers may see liver enzymes normalize quickly. Heavy drinkers often take several months to over a year for the liver to show complete healing, if there is no permanent scarring.

What is considered heavy drinking?

For men, heavy drinking is defined as more than 4 drinks on any day or more than 14 drinks per week. For women, heavy drinking is more than 3 drinks on any day or more than 7 drinks per week.

What happens to your face when you stop drinking?

Changes in facial appearance after quitting heavy drinking include less puffiness and bloating, improved skin tone, smaller pores, a more even skin tone, brighter eyes, improved sleep leading to fewer bags under the eyes. Overall the face looks healthier, as it is a reflection of the overall health improvement that happens once you stop drinking.

What happens 3 weeks after quitting drinking?

After three weeks of sobriety, improved sleep and nutrition will lead to more energy, better concentration and memory. Anxiety, mood swings and cravings tend to reduce and liver enzymes start improving. All-in-all, after just three weeks of being sober, you will look better, feel better, and your body will start repairing itself from the damage caused by alcohol abuse.

How long does it take to lose my alcohol belly?

It can take two to six months of sobriety along with a healthy diet and exercise for an alcoholic belly to go away completely, but within weeks there will be less bloating and a noticeable slimming of the abdomen.

Can alcohol use affect psoriatic arthritis?

Yes, alcohol use can potentially affect psoriatic arthritis. Excessive alcohol consumption can exacerbate inflammation in the body, which can worsen psoriatic arthritis symptoms and lead to other alcohol health complications.

Alcohol can also interact with certain medications used to manage the condition, reducing their effectiveness and potentially causing adverse effects. Therefore, people with psoriatic arthritis should limit their alcohol intake and consult their healthcare provider to minimize potential complications.


  1. Jesse, S. (2016). Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurologica Scandinavica, 135(1), 4–16. https://doi.org/10.1111/ane.12671
  2. Mirijello, A. (2015). Identification and management of alcohol withdrawal syndrome. Drugs, 75(4), 353–365. https://doi.org/10.1007/s40265-015-0358-1
  3. Kattimani, S. (2013). Clinical management of alcohol withdrawal: A systematic review. Industrial psychiatry journal, 22(2), 100–108. https://doi.org/10.4103/0972-6748.132914
  4. Perry E. C. (2014). Inpatient management of acute alcohol withdrawal syndrome. CNS drugs, 28(5), 401–410. https://doi.org/10.1007/s40263-014-0163-5
  5. Reus, V. I. (2018) The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. https://doi.org/10.1176/appi.books.9781615371969

Further Reading

Can Alcohol Affect Birth Control?

What Is the Effect of Alcohol on the Kidneys?

How to Identify Alcohol Poisoning

Alcohol Abuse Statistics in the United States

What Are the Signs of Alcoholism?

Is Alcohol a Drug?