Alcohol Withdrawal Symptoms

Published by John Gillen | Last updated: 19th December 2023 | All Sources


Clinically Reviewed by Dr. Olalekan Otulana (Advanced Practitioner)

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All information on this page has been reviewed and verified by a certified addiction professional.
Last Reviewed: 19th December 2023

If you suspect that yourself or a loved one is suffering from alcoholism and you are reading this message, then there’s a good chance you may wish to take action to improve the situation by attending a drug rehab.

If so, you need to gain some basic knowledge of ‘alcohol withdrawal syndrome’, a term you or your loved one are soon to become acquainted with.


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Alcohol Withdrawal Syndrome

Alcohol withdrawal syndrome is an umbrella term for a family of symptoms an alcoholic endures when you suddenly cease to drink alcohol.

Alcohol withdrawal symptoms vary, and each person tends to experience a different set of symptoms depending on how long drinking has persisted in the period leading up to detoxification. Symptoms also vary according to the quantity of alcohol consumed.

As a rule of thumb, the longer one has consumed alcohol and the higher the quantity of consumption the more severe the symptoms will be (sounds obvious!). At the top end of the spectrum, a sufferer can expect life-threatening symptoms roughly 48 hours into alcohol cessation.

Professional observation thus becomes essential. Withdrawal for a chronic alcoholic can be far more dangerous than withdrawal from harmful drugs such as heroin or crack-cocaine. These are the most common alcohol withdrawal symptoms. It is hard to avoid these symptoms, especially after prolonged alcohol consumption.


Physical symptoms of Alcohol Withdrawal:

  • Hand tremors
  • Visual hallucinations
  • Sweating
  • Nausea and vomiting
  • Minor to moderate seizures (in serious cases)
  • Psychological Symptoms
  • Anxiety
  • Depression
  • Irritability
  • Restlessness
  • Insomnia


The Alcohol Withdrawal Timeline

The journey through the spectrum of withdrawal symptoms or alcohol abuse begins as early as two hours after drinking, peaking in severity roughly two to three days after the cessation.

Symptoms can last for up to a year after cessation, although this tends to be limited to temptation. The spectrum of symptoms changes, depending on the amount of time that has passed since you last consumed an alcoholic beverage, something we shall detail below.


12 hours no alcohol

Usually, within the first five hours of cessation, the addict will suffer irritable symptoms such as becoming anxious and experiencing the classic ‘shakes’. Vomiting and headaches may also be experienced. This is the stage when most addicts give in and start to drink again. The cycle of addiction has the addict in its grip.


12 to 24 hours after quitting alcohol

Symptoms tend to progressively get worse as time goes on. Symptoms begin to manifest themselves in the form of tremors and mild hallucinations which are distinguishable from reality. The more chronic the addiction, the more severe the symptoms will be.


24 to 48 hours after stopping drinking

Symptoms normally peak 24 to 48 hours in. Tremors can morph into full-on seizures and the probability of death becomes a legitimate concern, especially for the chronic alcoholic. Hallucination can get more vivid and can be indistinguishable from reality, a condition known as ‘Alcoholic Hallucinosis’.


48 to 96 hours no alcohol

Within 48 hours the sufferer tends to begin to get better. However, for the chronic alcoholic, symptoms can get progressively worse, potentially suffering from a disease known as Delirium Tremens (DT).

DT manifests itself in the form of an increased heartbeat and rapid fever, and a stroke can occur, even death. Unlike any prior hallucinations, hallucinations can be confused with reality, such hallucinations tend to be both visual and auditory in nature.

Survivors who suffered from harsh withdrawal symptoms recount hearing threatening voices and visions of moving objects such as insects crawling around in their bed. Blood pressure also increases to dangerous levels.

DT is a medical emergency requiring 24-hour medical observation. DT occurs in roughly 1 in 20 of sufferers. Chlordiazepoxide, vitamins and several other drugs are usually prescribed to aid the detox process and prevent DT from manifesting.


96 hours+ after cessation

Life-threatening symptoms all but fade after 98 hours of cessation. The ‘acute’ stage of withdrawal has ended but a protracted period of symptoms can last up to one year of cessation. This set of symptoms are known as ‘non-acute withdrawal syndrome’ and can manifest in the form of an ever-present urge to return to drinking and a more insidious syndrome known as ‘anhedonia’ whereby one’s ability to feel pleasure is suppressed. Insomnia is also a common occurrence at this stage.


Alcohol Withdrawal Symptoms Timeline Infographic

Alcohol Withdrawal Symptoms Timeline

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The Science Behind Alcohol Withdrawal Symptoms

If you have taken the time to read the above, you may be eager to learn why the brain and body behave as they do to cause alcohol withdrawal syndrome. When the prolonged intake of alcohol has occurred, the brain’s transmitters go into overdrive.

A chemical is known as GABA, which makes you feel calm and relaxed, increases, and depletes. More alcohol is needed to get this ‘kick’. You build up a ‘tolerance’ and more and more alcohol is needed.

Chronic alcohol intake also suppresses Glutamate which is a substance in the body that produces the feeling of excitement. The glutamate system goes into overdrive to maintain normal levels of the glutamate substance.

When alcohol is withdrawn, the system continues in overdrive, leading to a state of hyper-excitability – or ‘neuropsychiatric‘ excitability. The brain acts rather like a runaway train.


Our Approach To Treatment

Here at Cassiobury Court London, our alcohol rehab centre, you shall receive 24-hour medical observation from our knowledgeable medical staff who specialise in rehabilitating alcoholics. Medication such as Chlordiazepoxide may be offered during an alcohol detox depending on the level of severity of withdrawal symptoms. Willpower is the essential and the residential treatment we offer means temptation is minimised.

We additionally provide education and coping strategies that aid the overall process which is especially helpful for long-term relapse prevention. You will also be given plenty of nutritious meals and a range of supplements to ease this difficult process of withdrawal.

In addition to detox from alcohol, our dedicated team also provide various psychological and well-being therapies such as cognitive behavioural therapy, stress management, relapse prevention, counselling, art therapy, relaxation and sleep management, fitness therapy, and low-level laser therapy.

John Gillen

John Gillen - Author Last updated: 19th December 2023

John Gillen is a leading addiction treatment expert with over 15 years of experience providing evidence-based treatment methods for individuals throughout the UK. John also co-authors the book, The Secret Disease of Addiction, which delves into how the addictive mind works and what treatment techniques work best.

Dr. Olalekan Otulana (Advanced Practitioner)

Dr. Olalekan Otulana (Advanced Practitioner) - Medical Reviewer - Last Reviewed: 19th December 2023

Dr. Olalekan Otulana MBChB, DRCOG, MRCGP, DFSRH, FRSPH, MBA (Cantab)

 Dr Otulana is a highly experienced GP and Addiction Physician. He has a specialist interest in Substance Misuse Management and he has a wide range of experience in the assessment, management (including detoxification) and residential rehabilitation of clients with various drug and substance addiction problems.  His main aim is to comprehensively assess patients with addiction problems and determine their treatment needs for medical detoxification treatments and psychological interventions. He is also experienced in managing patients who require dual drug and alcohol detoxification treatments.

A strong healthcare services professional with a Master of Business Administration (M.B.A.) degree from Cambridge University Judge Business School.