We offer medical detox and multiple addiction treatment options in our
luxury treatment centres in Port Hope, Cobourg, and Ottawa.
Alcohol Withdrawal Symptoms and What You Need to Know
Your body adapts to alcohol over time. Stop drinking suddenly after months or years of heavy use, and it rebels. Hard. What starts as shaky hands and racing thoughts can escalate into seizures, hallucinations, and even death. That's not meant to scare you away from quitting. It's meant to prepare you for what alcohol withdrawal symptoms actually look like and why getting proper support matters so much.
Key Takeaways
- Your brain chemistry shifts when you drink heavily for extended periods, and stopping abruptly throws everything into overdrive
- Three stages exist, each more intense than the last, ranging from anxiety and tremors to life-threatening delirium tremens
- Physical symptoms hit first, usually within 6-12 hours, bringing tremors, sweating, and that awful sense that something terrible is about to happen
- The danger window spans 24-72 hours when seizures and severe complications peak
- Medical supervision saves lives since severe withdrawal carries mortality rates of 5-15% even with treatment, and up to 37% without it
What Is Alcohol Withdrawal?
Here's what happens inside your brain. Alcohol acts as a depressant, boosting GABA (your brain's calming chemical) while suppressing glutamate (the excitatory one). Drink enough for long enough, and your brain recalibrates. It dials down GABA receptors and cranks up glutamate receptors to compensate for the constant sedation.
Then you stop drinking.
Suddenly your brain finds itself in a hyperexcitable state with too little inhibition and way too much stimulation. That neurochemical chaos produces the characteristic signs of alcohol withdrawal that affect your entire body. Your heart races. Your hands shake. Your mind won't quiet down. Sleep disappears.
Severity depends on how much you've been drinking and for how long. Someone knocking back a bottle of vodka daily for three years faces dramatically different risks than a weekend binge drinker. Previous withdrawals matter too. Each one tends to get worse than the last through something called kindling — a sensitization phenomenon where your nervous system grows increasingly reactive with each withdrawal attempt.
Who Faces the Highest Risk?
Certain characteristics push you toward the dangerous end of the spectrum. Previous delirium tremens or withdrawal seizures predict recurrence more strongly than anything else. That kindling effect makes each withdrawal worse. The longer your history of alcohol dependence, the higher your risk climbs.
| Risk Factor | Why It Matters |
| Previous delirium tremens or seizures | Strongest predictor of recurrence; kindling sensitizes your brain |
| Daily consumption of 8+ drinks for years | Higher baseline dependence means more severe neurochemical rebound |
| Concurrent benzodiazepine or barbiturate use | Creates complicated, potentially dangerous withdrawal patterns |
| Liver disease | Interferes with medication metabolism during treatment |
| Heart conditions | Blood pressure swings become more threatening |
| Age over 65 | Slower metabolism, higher fall risk, more complications |
| Multiple previous withdrawal attempts | Each episode lowers seizure threshold |
| Co-occurring mental health conditions | Depression and anxiety intensify during withdrawal |
Nutritional deficits create additional hazards. Heavy drinkers often run low on thiamine (vitamin B1), which can trigger Wernicke-Korsakoff syndrome and cause permanent brain damage if not caught quickly.
Stages of Alcohol Withdrawal
The stages of alcohol withdrawal follow a fairly predictable timeline, though your experience will depend on your drinking history, overall health, and genetics. Doctors break it into distinct phases based on timing and symptom severity.
Mild Withdrawal (6-24 Hours)
Within six to twelve hours after your last drink, the first signs of alcohol withdrawal creep in. Anxiety dominates this phase. Not regular nervousness. A deep, unsettling sense that something bad is coming. You can't pinpoint what. You just know it's there.
Your hands develop a fine tremor. Maybe your whole body does. Night sweats soak your sheets. Nausea comes in waves, sometimes bringing vomiting along for the ride. Your heart beats faster than it should, even when you're lying still.
Sleep? Forget it. You'll lie awake for hours, thoughts racing through worst-case scenarios. If you do drift off, vivid nightmares jolt you back awake. The next day brings brain fog, irritability, and difficulty focusing on anything.
The good news? Most people at this point remain physically stable. Vital signs stay within normal range. You're uncomfortable, not in danger. Yet.
Moderate Withdrawal (24-48 Hours)
Things ramp up considerably during this phase. That anxiety from the mild phase escalates into full-blown agitation. You can't sit still. Can't get comfortable. Every sensation feels amplified.
Tremors grow visible from across the room. Blood pressure climbs. Pulse races. Body temperature rises. You're sweating through everything you wear, losing fluids and electrolytes faster than you can replace them. Nausea, vomiting, and diarrhea make dehydration worse.
Strange perceptual changes might appear. Lights seem too bright, sounds too loud. The room feels somehow off, though you can't explain exactly how. Some people report visual disturbances at the edges of their vision. Auditory, visual, and tactile hallucinations can begin during this window.
This phase demands medical attention. Not everyone progresses to severe withdrawal, but there's no way to predict who will. Getting evaluated now could prevent a crisis later.
Severe Withdrawal and Delirium Tremens (48-72+ Hours)
Severe alcohol withdrawal is a genuine medical emergency. Only about 3-5% of people experiencing withdrawal reach this point, but among those who do, mortality rates without treatment historically ran between 15-37%. Modern intensive care has improved those numbers to around 1-5% with proper treatment. Still, delirium tremens kills.
Confusion sets in deeply. You lose track of where you are. Who people are. What day it is. Time stops making sense. Family members visiting look like strangers.
Hallucinations turn terrifyingly real. Visual ones dominate. Insects crawling on your skin. Shadowy figures in corners. Threatening shapes that trigger genuine panic. Some people hear voices or feel things touching them that aren't there. Your brain can't distinguish these experiences from reality.
Meanwhile, your autonomic nervous system goes haywire. Heart rate swings wildly between dangerously fast and concerningly slow. Blood pressure spikes, then crashes. Temperature climbs toward fever. Tremors may progress into full seizures. Without IV fluids, benzodiazepines, and constant monitoring, this phase can prove fatal.
Warning signs requiring immediate emergency care:
- Fever above 38°C (100.4°F)
- Severe confusion or disorientation
- Hallucinations (visual, auditory, or tactile)
- Seizures or convulsions
- Extreme agitation or combativeness
- Racing or irregular heartbeat
- Profuse sweating with pale, clammy skin
If you experience any of these symptoms, call 911 immediately. Do not attempt to manage severe withdrawal at home.
How Is Alcohol Withdrawal Treated?
Professional treatment turns withdrawal from potentially deadly to manageable. The approach depends on your symptom severity, medical history, and risk factors.
Medical Detoxification
Benzodiazepines remain the gold standard treatment for alcohol withdrawal. Medications like diazepam, lorazepam, and chlordiazepoxide work on the same GABA receptors as alcohol, easing symptoms while preventing dangerous complications. Doctors typically use symptom-triggered dosing based on standardized assessment scales, adjusting medication levels as your condition changes.
Beyond benzodiazepines, treatment teams address the nutritional deficiencies common in heavy drinkers. Thiamine supplementation prevents Wernicke encephalopathy. IV fluids correct dehydration and electrolyte imbalances. Monitoring catches blood pressure swings, heart rhythm changes, and fever before they become emergencies.
What Our Luxury Rehab Offers
At the Canadian Centre for Addictions, our facilities in Port Hope (Hillcrest Mansion) and Cobourg (Woodlawn Inn) provide medically supervised detox in a setting that feels nothing like a hospital. Private rooms with lake views. Chef-prepared meals. Round-the-clock nursing care. The medical support you need wrapped in an environment designed for healing.
Our approach combines several elements that research shows improve outcomes:
- 24/7 medical monitoring during the acute withdrawal phase
- Individual counselling to address what drove the drinking in the first place
- Group therapy connecting you with others who understand
- Family programming to repair relationships damaged by alcohol
- Lifetime aftercare because recovery doesn't end when you leave
We maintain a 95.6% success rate — not because withdrawal is easy, but because we address addiction as the medical condition it is. Detox alone doesn't cure alcohol dependence. Your brain needs time to heal, and you'll need strategies for staying sober long after the physical symptoms fade.
Ready to talk about your situation? Call us at 1-855-499-9446. The conversation is free and confidential.
When to Seek Help for Alcohol Addiction
If you experience withdrawal symptoms when you try cutting back, you've developed alcohol dependence. That's not a moral judgement. It's a medical reality that requires medical attention.
Some symptoms demand emergency care. Fever. Severe confusion. Hallucinations. Seizures. Any of these mean calling 911, not waiting to see if things improve. Anyone who's experienced severe withdrawal before shouldn't attempt detox without medical supervision. Ever.
Beyond the immediate safety concerns, professional treatment addresses the addiction itself. Medication for Alcohol Withdrawal can ease symptoms and reduce cravings while therapy helps you understand the patterns that led here.
Recovery happens. People do this every day.
FAQ
By day four, alcohol withdrawal symptoms usually fade for most people. Your body's rehydrated. Energy trickles back. Sleep improves, though it might take another week or two to fully normalize. Some anxiety may linger, but each day gets a little easier. Protracted withdrawal can extend certain symptoms for weeks in heavy, long-term drinkers.
Days two and three typically bring the worst of it. Alcohol withdrawal symptoms peak during this window, combining intense cravings with physical misery and psychological distress. Push through, and day four feels noticeably better. Most people describe steady improvement from there.
Some people experience formication, the sensation of insects crawling under their skin. Others report autoscopy, actually seeing themselves from outside their body. Status epilepticus, or continuous seizure activity, remains rare but demands immediate intervention. Alcohol-related psychosis can also develop in approximately 3% of those with alcohol dependence.
Not during acute withdrawal. Benzodiazepines remain the gold standard for managing withdrawal safely. Antidepressants might enter the picture later if depression or anxiety persists once withdrawal resolves. Many heavy drinkers have underlying mood disorders that surface once alcohol stops masking them.
Canadian guidelines draw the line at more than ten standard drinks weekly for women or fifteen for men. Daily limits matter too. No more than three drinks on any given day for women, four for men. Binge drinking counts as heavy drinking too, regardless of your weekly total.
