What Does Alcohol Withdrawal Feel Like?

When you have been drinking alcohol heavily for a time, you are vulnerable to developing withdrawal symptoms. When you cut back on drinking or try to stop altogether, alcohol withdrawal will hinder your efforts. The symptoms are often uncomfortable, and they can compel you to drink again just to make them go away.

Drinking moderately does not put you at risk of developing withdrawal. But drinking heavily puts you at much greater risk.

Read on to find out in more detail what alcohol withdrawal feels like.

What are the symptoms of alcohol withdrawal?

Many people have reported withdrawal to feel like a case of the flu. The symptoms vary, and they range from mild to severe. A few of the severe symptoms are potentially fatal.

A number of typical mild withdrawal symptoms are:

• Tremors
• Anxiety
• Changes in mood
• Problems with sleep
• Upset stomach
• Headaches
• Fatigue
• Sweating
• Jumpiness
• Loss of appetite
• Dilated pupils

Most individuals experiencing withdrawal from alcohol only experience these symptoms. But in around 10 percent of cases, withdrawal can progress into more severe symptoms, such as:

• Fast breathing
• Fever
• Profuse sweating
• Confusion
• Hallucinations
• Seizures

Seizures, in particular, can become life-threatening. If you experience any of these symptoms, call for medical help immediately.

Withdrawal timeline

Usually, alcohol withdrawal occurs in three stages. Symptoms begin to show up about 6 hours after your last drink. Withdrawal can continue for up to a week; after that, they begin to die down.

In the first stage, you will experience only mild symptoms. These can be uncomfortable, but they are not fatal. These symptoms include:

• Tremors (shaking)
• Changes in blood pressure
• Anxiety
• Nausea
• Insomnia

For most people, these symptoms are the only ones they will experience before recovering from withdrawal. In some cases, though, symptoms will progress to the second stage.

The second stage of withdrawal may happen within 48 hours after your last drink. Symptoms also peak at this stage, occurring between 24 and 72 hours after your last drink. Second stage symptoms include seizures and other serious conditions.

More than 5 percent of people with alcohol withdrawal go through the second stage. Many of them also experience seizures.

The third and final stage of withdrawal is characterized by delirium tremens. This condition is potentially fatal, and it occurs in about 50 percent of people who develop withdrawal seizures. Delirium tremens can manifest between 48 and 72 hours after the last drink. Symptoms of this condition include:

• Bursts of energy
• Confusion
• Auditory and visual hallucinations
• Excessive sweating
• Increased body temperature
• Tonic-clonic seizures (characterized by muscle spasms and sudden loss of consciousness)
• Agitation
• Fatigue
• Sleepiness

Close to 25 percent of individuals who get delirium tremens die from it. But if they get medical care, the number goes down to just 1 percent. For that reason, you need to treat delirium tremens as a medical emergency. Call for medical help immediately if you or someone you know is experiencing this condition.

In some cases, there may be a fourth stage of withdrawal. This is known as post-acute withdrawal syndrome or PAWS. Symptoms of PAWS include trouble sleeping and constant changes in your mood. These may persist for weeks to months.

What causes the withdrawal symptoms?

Withdrawal is a side effect of alcohol on the brain. Alcohol is a central nervous system depressant; in other words, it slows down activity in your brain. In particular, alcohol causes your brain to produce more GABA (gamma-aminobutyric acid) and less glutamate. GABA is a molecule in your brain that makes you feel calm and relaxed, while glutamate makes you feel excited.

When you’ve been drinking for a while now, your brain gets used to this effect of alcohol. To keep you alert, the brain compensates for this effect. It starts making less GABA and more glutamate. That way, the brain is more excited and alert even when there is alcohol in your system.

If you suddenly stop drinking or cut down on it, your brain is still in that excited state. That is what causes withdrawal symptoms like anxiety, shaking, and jumpiness.

Is there a way to drink alcohol without risking withdrawal?

The best way to avoid withdrawal is to abstain from drinking. With no alcohol in your system, your brain chemistry will not be altered.

But if you really can’t help it, practice moderate drinking. Based on guidelines from the Centers for Disease Control and Prevention (CDC), moderate drinking is defined as:

• Consuming no more than 15 drinks per week for men
• Consuming no more than 8 drinks per week for women

One drink is equivalent to the following:

• 12 ounces of beer at 5% alcohol
• 5 ounces of wine at 12% alcohol
• 5 ounces (1 shot) of distilled spirits (gin, rum, whiskey, etc.) at 40% alcohol

If you are within these limits, you are not likely to suffer from withdrawal when you stop drinking.

How is withdrawal treated?

First, a healthcare professional will diagnose your condition using a tool called CIWA-Ar, or the Clinical Institute Withdrawal Assessment for Alcohol. Your answers to the questions in the CIWA-Ar will determine how severe your withdrawal is. Your healthcare professional may also conduct a physical exam, checking for signs like irregular heart rate, fever, or dehydration.

Withdrawal is usually helped through medically-assisted detox. Here, medical professionals will keep watch while you slowly get rid of alcohol from your system. They may give you medications to help ease withdrawal symptoms and prevent any alcohol cravings. If you encounter any health problems during the detox process, doctors will be ready to help at a moment’s notice.

After detox, you may need to go through a number of behavioral therapies. These address the mental components of alcohol abuse. Therapies here include:

• Cognitive behavioral therapy (CBT)
• Family therapy
• Motivational enhancement therapy
• Participating in support groups

The goal of these therapies is to equip you with healthy coping mechanisms that do not involve addictive substances like alcohol. They will also give you the skills you need to overcome alcohol cravings and avoid anything that triggers you to drink.

Soon enough, you will be able to live a sober life once again.