While drinking in moderation can be safe and even have some health benefits, heavy alcohol use can increase the risk of an alcohol use disorder, which is the clinical term for an alcohol addiction. The National Institute on Alcohol Abuse and Alcoholism describes heavy alcohol use as over four drinks in a given day for men and over three drinks in a day for women.
Those who have been heavily abusing alcohol may develop an addiction and experience withdrawal symptoms if they stop drinking. Withdrawal occurs because, over time, the body adapts to the presence of alcohol and does not function the same without it. When a person is unable to function normally in the absence of alcohol, this is called alcohol dependence.
Alcohol Withdrawal Symptoms
When a person who is dependent upon alcohol stops drinking, uncomfortable withdrawal symptoms can appear. Some common symptoms of alcohol withdrawal are discussed below.
Seizures
While there are a variety of symptoms of alcohol withdrawal, some of which are mild, a more severe symptom of alcohol withdrawal is the occurrence of seizures. According to a 2013 report in the Industrial Psychiatry Journal, alcohol withdrawal seizures can occur 6 to 48 hours after a person stops drinking. These seizures are typically tonic-clonic seizures. It is possible to have as many as six withdrawal seizures over the course of six hours. If left untreated, alcohol withdrawal seizures can progress to a potentially fatal condition called delirium tremens.
Delirium
As previously indicated, alcohol withdrawal seizures can be a risk factor for delirium tremens, which can be life-threatening. This condition involves other symptoms, such as tremor, sweating, elevated heart rate, disorientation, agitation, and hallucinations. It typically begins two to three days after a person stops drinking. According to the report in the Indian Psychiatry Journal, this condition is fatal in about 8 percent of cases.
People are at risk of developing delirium tremens if they have a history of the condition, have experienced alcohol withdrawal seizures, or have co-occurring health problems. Other factors, such as brain lesions, older age, dehydration, and low platelet count can also increase the risk of delirium tremens. In addition, someone who has a high blood alcohol content but still demonstrates severe withdrawal symptoms is at a higher risk. Those who have risk factors and display serious symptoms like seizures and confusion are in need of emergency medical treatment for alcohol withdrawal.
Headaches
Alcohol withdrawal headaches are among the more mild side effects of alcohol withdrawal. Headaches are considered an earlier alcohol withdrawal symptom, and they typically begin 6 hours after a person’s last drink and persist for a day or two.
Anxiety
Anxiety is also among the milder symptoms of alcohol withdrawal. It typically starts six hours after a person stops drinking and ceases within a day or two. According to a 2014 report in Alcohol and Alcoholism, anxiety is actually one of the key symptoms of alcohol withdrawal.
Hallucinations
While hallucinations can occur during delirium tremens, they are also a general symptom of alcohol withdrawal. According to a 2015 report in the professional journal Drugs, about a quarter of patients who undergo alcohol withdrawal will experience hallucinations, which can involve hearing, seeing, or feeling things that are not actually real. These hallucinations can cause agitation, but patients recognize that they are not real. A person who experiences alcohol withdrawal hallucinations without delirium tremens will remain coherent, whereas someone suffering from delirium tremens will appear disoriented.
Fever
Some people who undergo mild alcohol withdrawal may experience a fever, as hyperthermia, or elevated body temperature, is possible when a person stops drinking. According to the report in Drugs, elevated body temperature begins about 6 to 12 hours after a person’s last alcoholic drink. While withdrawal fevers can be a form of mild withdrawal that diminishes on its own, in some cases, they can be a sign of a more serious problem, including delirium tremens. This condition can also cause an elevated body temperature, so patients who have fever along with other serious symptoms, such as seizures and disorientation, should seek immediate treatment.
Sweating
Alcohol withdrawal can cause an elevated body temperature, and along with this comes sweating. Like withdrawal fevers, alcohol withdrawal sweats are considered a mild withdrawal symptom, and they appear 6-12 hours after the last drink. The clinical term for excessive sweating is diaphoresis.
Night Sweats
Given the fact that alcohol withdrawal can cause excessive sweating, it is also possible that sweats will continue into the night. Sweating can begin as few as six hours after a person stops drinking, so if someone has been drinking heavily, he or she may go into withdrawal while sleeping. For instance, a person may spend most of the evening drinking, consume the last alcoholic beverage at 10 p.m., and wake up with night sweats at 4 a.m. as the body begins to withdraw.
Insomnia
Beyond causing night sweats, alcohol can cause insomnia, or difficulty sleeping. It is possible that uncomfortable symptoms like excessive sweating can make it difficult to sleep during alcohol withdrawal. On the other hand, insomnia itself is a common withdrawal symptom that begins 6 to 12 hours after the last drink, according to a report in American Family Physician. The results of a study in The American Journal on Addictions found that about a third of people who had been dependent upon alcohol during their lives experienced insomnia related to withdrawal.
Gastrointestinal Problems
Among the other common symptoms of alcohol withdrawal is gastrointestinal upset, per American Family Physician. This can include symptoms such as diarrhea, nausea, or stomach pain. These symptoms generally begin about 6 to 12 hours after a person stops drinking, and they are considered to be minor.
Tremor “The Shakes”
Another symptom associated with alcohol withdrawal is tremor, or “the shakes”. This may involve the hands or arms appearing shaky and unsteady. Tremor is also usually a minor withdrawal symptom, and it appears 6 to 12 hours after the last alcoholic beverage. Tremors that occur two to three days after a person stops drinking can be a sign of delirium tremens if they appear alongside seizures, agitation, and severe confusion. In this case, medical treatment is imperative.
High Blood Pressure, Chest Pain, or Palpitations
Alcohol withdrawal can result in some cardiovascular symptoms, such as chest pain or heart palpitations. According to American Family Physician, chest palpitations are a minor alcohol withdrawal symptom, and they start 6 to 12 hours after a person discontinues alcohol use. On the other hand, chest pain and high blood pressure that occurs later on may be a sign of delirium tremens, as this condition involves dangerously high blood pressure and elevated heart rate. A patient who experiences these symptoms two to three days after giving up alcohol should seek emergency treatment, especially if the symptoms are accompanied by disorientation.
Fatigue
As previously mentioned, alcohol can cause insomnia. Similarly, it might lead to fatigue. If a person is having difficulty sleeping during alcohol withdrawal, he or she may understandably feel tired during the day. As an expert from Columbia University has explained, early alcohol withdrawal can disrupt the sleep cycle, resulting in less restorative sleep and causing a person to wake up more frequently during the night. All of this can contribute to considerable fatigue. The dehydration that occurs when a person drinks heavily can also cause fatigue, so it is important to consume adequate amounts of water when withdrawing from alcohol, according to Columbia University.
Gout
People who undergo alcohol withdrawal may suffer from gout, but this condition is not necessarily a symptom of withdrawal itself, but rather a side effect of prolonged alcohol abuse. According to a 2017 study, people who are dependent upon alcohol are twice as likely to experience gout. This means that a person who undergoes alcohol withdrawal may also experience gout, since alcohol abuse and withdrawal can go hand-in-hand, just as alcohol abuse is also linked to gout.
Depression
According to a study in the German Journal of Psychiatry, depression is possible during alcohol withdrawal. Depression tends to be higher on day one of detox and then decrease by day 14. Depression and cravings for alcohol tend to go hand-in-hand, so it can be important to address depressive symptoms to prevent a relapse to alcohol abuse.
Help with Alcohol Withdrawal
Depression and a variety of other unpleasant symptoms are possible during alcohol withdrawal. These symptoms can range from mild side effects that begin within six hours of giving up drinking, to serious and potentially fatal symptoms that begin two to three days after the last alcoholic beverage. Giving up alcohol can be challenging when withdrawal creates unpleasant and potentially dangerous symptoms, so it is important to seek professional treatment when giving up alcohol after ongoing heavy drinking.
While some people may be able to undergo withdrawal at home and engage in outpatient counseling services, others may require inpatient treatment or hospitalization to treat serious alcohol withdrawal complications. Wherever you fall on the spectrum, it is necessary to seek help to give up drinking if you have developed an alcohol addiction.
Sources & Addiction Resources
- https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/
- https://academic.oup.com/alcalc/article/49/6/654/2888162
- https://link.springer.com/article/10.1007/s40265-015-0358-1
- https://www.aafp.org/afp/2004/0315/p1443.html#afp20040315p1443-t2
- https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1521-0391.2010.00035.x
- https://goaskalice.columbia.edu/answered-questions/alcohol-withdrawal-and-extreme-fatigue-0
- https://www.sciencedirect.com/science/article/pii/S1297319X16300343
- http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.536.6144&rep=rep1&type=pdf