Alcohol withdrawal often happens when you have been drinking alcohol for a long time and suddenly stop or cut back on drinking. Alcohol is a depressant, which means it slows down the functions of your brain. That is what makes you feel relaxed after drinking.

If you drink regularly, your brain will get used to the relaxing effects. But your brain cannot stay relaxed all the time. So, it will exert more effort in keeping you conscious and alert. When you reduce drinking or stop entirely, the brain stays hyperactive. Without alcohol to calm it down, you will experience withdrawal symptoms.

Symptoms of withdrawal range from mild to potentially life-threatening. For this reason, withdrawal should not be taken lightly.

What are the symptoms of alcohol withdrawal?

The symptoms vary between individuals. What withdrawal symptoms you will get depends on how long you have been drinking, how frequently you drink, and how much you drink each time. If you have other health conditions, they may cause more uncomfortable withdrawal symptoms to develop.

Withdrawal symptoms may start to show up as early as 6 hours from your last drink. In this stage of withdrawal, you may experience:

• Headaches
• Shaky hands
• Upset stomach
• Anxiety
• Insomnia
• Heart palpitations

The most intense symptoms appear 24 to 72 hours after your last drink. These may include all of the symptoms above in addition to:

• High blood pressure
• High body temperature
• Fast breathing
• Fast heartbeat

You will continue experiencing these symptoms until a week after your last drink. After that, withdrawal symptoms will begin to die down.

In about five percent of alcohol withdrawal cases, patients progress into a potentially fatal form of withdrawal called delirium tremens. It is characterized by these symptoms:

• Seizures
• Disorientation
• Visual, auditory, or tactile hallucinations
• Sudden, severe confusion (delirium)
• Agitation
• Irritability
• Sensitivity to touch, light, and sound
• Fatigue
• Body tremors
• Deep sleep that lasts for a day or longer
• Chest pain
• Stomach pain
• Fever

You are more vulnerable to delirium tremens if you have a history of alcohol withdrawal or have been drinking alcohol for 10 years or more. If your drinking habits are new, you can still be at risk of delirium tremens if you drink this much every day for several months:

• 4 to 5 pints of wine
• 7 to 8 pints of beer
• 1 pint of hard liquor

Delirium tremens is a medical emergency. If you or someone you know is experiencing its symptoms, call 911 right away.

Preventing the onset of withdrawal symptoms

Is there a way to enjoy drinking alcohol while avoiding its withdrawal symptoms? Fortunately, there are. The best way is to drink only small amounts of alcohol, and by not drinking too frequently.

As a guide, the Dietary Guidelines for Americans states that men should avoid taking more than 2 drinks a day, while women should take no more than 1 drink per day. If you stay within these limits, you are drinking moderately, and you should be safe from withdrawal symptoms.

One drink is defined as any amount of an alcoholic beverage containing about 0.6 ounces of pure alcohol. That is:

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

If you can limit your drinking to once a week or a few times a month, that’s even better. Just avoid binge drinking, as you will become more vulnerable to withdrawal symptoms. Always make it a habit to stick to moderate drinking.

How do I avoid withdrawal symptoms if I want to quit drinking?

If you have been drinking heavily for a long time and want to quit, seek professional help first. Quitting on your own will likely not succeed. The discomfort from withdrawal symptoms may compel you to go back to drinking just to make the symptoms go away.

Safely quitting alcohol involves a process called medically-assisted detox. Here, medical professionals will watch over you during the entirety of detox. They will make sure the process is as tolerable for you as possible. They will also help you manage any withdrawal symptoms that may show up. They may give you medications for this purpose.

Medications given when detoxing from alcohol

Commonly, doctors may give you benzodiazepines to help with alcohol detox. These medications relieve many withdrawal symptoms like anxiety, shaking, insomnia, and restlessness. Benzodiazepines are central nervous system depressants, so they calm down any alcohol-induced hyperactivity in your brain. They also are crucial in preventing seizures, which are leading causes of death in cases of alcohol withdrawal.

Typically, these benzodiazepines are prescribed in alcohol detox:

• Diazepam (Valium)
• Chlordiazepoxide (Librium)
• Lorazepam (Ativan)

Benzodiazepines are potent medications, and they can be abused. Doctors will closely monitor you when taking these medications to prevent misuse. Also, you will only take them for a short time to avoid getting addicted.

In some cases, benzodiazepines need to be supplemented with anticonvulsants to make sure that you do not get any seizures. Anticonvulsants are especially needed if you have delirium tremens.

Behavioral therapies

Alcohol does not only affect the physical brain. It also influences your thoughts and behaviors. To address these, you need to go through behavioral therapies to correct your thought patterns. Eventually, you will no longer want to drink alcohol.

Behavioral therapies like CBT (Cognitive Behavioral Therapy) teach you the skills you need to overcome situations that trigger cravings for alcohol. If drinking is your coping mechanism against stress, you will learn new methods to cope with stress. That way, you can stay away from addictive substances and manage stress effectively.

Other therapies may involve your friends and family to help you in your journey to recovery. They can be your main support system, encouraging you to adopt a sober lifestyle.

Where to get help

Talk to your doctor or a mental health professional to find out the best treatments for you. There is no one-size-fits all treatment. It depends on your particular needs.