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Alcohol Withdrawal Symptoms and How to Treat Them

Alcohol Withdrawal Symptoms and How to Treat Them
Written by Seth Fletcher on August 2, 2016
Medical editor Dr. Chintan Shah
Last update: March 7, 2024

What happens when an alcoholic stops drinking? When heavy alcohol users abruptly discontinue or drastically reduce their alcohol use, they’ll experience unpleasant and potentially dangerous symptoms. This set of symptoms is known as alcohol withdrawal syndrome, which may be mild or severe depending on the extent of alcohol use. Those symptoms can worsen over time and may be life-threatening in some cases; therefore, it’s vital to seek help immediately if you notice any of these symptoms.

Individuals who drink alcohol infrequently are unlikely to have withdrawal symptoms if they stop. Alcohol withdrawal symptoms typically begin within hours after the last drink though some individuals may not experience any for a few days. The Canadian Centre for Addictions explains all about alcohol withdrawal and how to treat them.

Key Takeaways

  • Alcohol withdrawal symptoms occur when a heavy alcohol user suddenly stops or reduces their alcohol consumption
  • Withdrawal symptoms of alcohol begin a few hours to days after the last drink
  • The symptoms can be mild, moderate, or severe depending on the frequency of alcohol use and the amount consumed
  • Alcohol withdrawal symptoms can be treated at home or a treatment facility, depending on the severity of the symptoms

What are the Common Symptoms of Alcohol Withdrawal?

The symptoms of alcohol withdrawal include two or more of the following:

  • Anxiety
  • Vomiting 
  • Headaches
  • Tremors or shakes
  • Fatigue
  • Mood swings
  • Pale skin
  • Nightmares  
  • Insomnia 
  • Irritability
  • Impaired attention 
  • Loss of appetite 

These symptoms worsen over the first few days, and milder symptoms may last for weeks. In extreme cases of alcohol withdrawal, the individual may experience delirium tremens (DT) – the most severe type of withdrawal. Symptoms of DT include:

  • Extreme confusion or agitation
  • Fever 
  • Excessive sweating 
  • Seizures
  • Visual, auditory, or tactile hallucinations
  • Increased heart rate or blood pressure
  • Rapid abnormal breathing

Delirium tremens is a medical emergency and requires immediate attention. You should seek help immediately if you or a loved one is exhibiting any of these symptoms due to alcohol withdrawal. The Canadian Centre for Addictions offers multiple treatment options for alcohol withdrawal and addiction in an environment that inspires lasting change. Call 1-855-499-9446 today to understand your options and learn the best coping strategies to overcome your alcohol addiction. 

What is Alcohol Withdrawal?

Alcohol withdrawal occurs when a heavy drinker or someone with alcohol use disorder experiences unpleasant symptoms from alcohol use cessation or reduction. Alcohol is a depressant that elicits euphoria and calmness by increasing gamma amino butyric acid (GABA) and decreasing glutamate neurotransmitters. Heavy or continued alcohol use causes the body to become dependent on this imbalance of chemicals. 

You might ask yourself - what does alcohol withdrawal feel like? Suddenly stopping or reducing alcohol intake means the body no longer receives the required amount of alcohol to trigger this neurotransmitter imbalance. This disrupts brain activity and leads to a state of hyperarousal. Consequently, the individual begins to experience the symptoms associated with withdrawal.

What are the Dangers of Excessive Drinking?

Excessive drinking is a term that covers binge drinking, heavy drinking, underage drinking, or drinking while pregnant. The dangers of excessive drinking could be short or long-term. 

Short-term dangers of excessive drinking include: 

  • Accidents and injuries from driving, falls, burns, and other reckless behaviour
  • Alcohol poisoning due to high blood alcohol levels
  • Risky sexual behaviour, such as unprotected sex, which can lead to sexually transmitted infections or unwanted pregnancy.
  • Miscarriage, stillbirth, or fetal disorders in pregnant women

Long-term dangers of excessive drinking arise from consuming alcohol over an extended period. These include: 

  • Alcohol use disorder and addiction
  • Depression, anxiety, and other mental health issues
  • Lowering of immune system function
  • Cardiovascular problems, liver disease, and digestive dysfunction 
  • Problems with memory and learning
  • Liver, throat, colon, and rectal cancer
  • Broken relationships, social problems, work-related issues, and financial difficulties 

What is Considered Excessive Drinking?

Binge drinking is the most common form of excessive drinking and is defined as consuming five or more drinks on a single occasion for men and four or more drinks on a single occasion for women. Up to 15 or more drinks per week will be considered excessive, heavy drinking for men, while for women, having eight or more drinks per week is considered excessive. 

Alcohol Withdrawal Stages and Symptoms Severity

Alcohol withdrawal stages and symptoms severity depend on factors like the amount of alcohol consumed, frequency of drinking, use of other substances, and presence of other health conditions. 

The stages of alcohol withdrawal and symptom severity include the following: 

  • Stage One (Mild)

Symptoms of this stage include headache, anxiety, insomnia, tremors, gastrointestinal disturbances, and heart palpitations.

  • Stage Two (Moderate)

Stage two symptoms may include stage one symptoms and confusion, mild hyperthermia, rapid abnormal breathing, and elevated blood pressure or heart rate. 

  • Stage Three (Severe)

Stage three symptoms include hallucinations, seizures, disorientation, impaired attention, and stage two symptoms. 

Risk Factors for Alcohol Withdrawal

Most people who abuse alcohol or have an alcohol use disorder will experience mild to moderate withdrawal symptoms if they abruptly stop or reduce alcohol use. Consuming large amounts of alcohol frequently also increases alcohol withdrawal risk. Severe alcohol withdrawal symptoms are relatively rare, but the following factors may put an individual at risk:

  • Diminished liver function
  • Dehydration or electrolyte imbalances
  • History of delirium tremens or alcohol withdrawal seizures
  • Brain lesions
  • Heavy daily alcohol use
  • Co-occurring health problems

Alcohol Withdrawal Timeline

The timeline of alcohol withdrawal depends on individual factors like drinking frequency, amount of alcohol used, pre-existing health conditions, and presence of other intoxicating substances. 

Alcohol withdrawal symptoms generally follow this timeline after the last drink:

  • Six to 12 hours

Early symptoms include slight tremors, sweating, increased heart rate, nausea, and vomiting. 

  • 12 to 24 hours

The individual may experience visual, auditory, and tactile hallucinations within this time frame.

  • 24 to 48 hours

Existing symptoms will have peaked and begun to resolve, even though some may persist for longer. Seizures may occur during this period for those who have them. 

  • 48 to 72 hours

In extreme cases, the individual may experience delirium tremens and require emergency medical attention.  

Alcohol Withdrawal Diagnosis

A health professional will diagnose withdrawal from alcohol by reviewing your medical history, asking about symptoms and performing a physical examination. They may also carry out blood and urine tests, and a toxicology screening, to determine how much alcohol is in your system. 

Your doctor will look out for physical signs of alcohol withdrawal, such as:

  • Shaky hands
  • Abnormal heart rhythms
  • Dehydration
  • Fever 

They may also ask questions to test the individual’s ability to think clearly, such as:

  • Where are we?
  • Who am I?
  • What day is it?
  • Do you feel sick to your stomach?

Alcohol Withdrawal Treatment

The approach to alcohol withdrawal treatment depends on the severity of the symptoms. People with mild alcohol withdrawal symptoms may be treated at home if they have someone around to observe and ensure the symptoms don’t worsen. Those with moderate to severe symptoms will have to spend time in a hospital or treatment centre for close observation and monitoring. 

The goal of alcohol withdrawal treatment is to manage symptoms and get the individual to stop drinking as safely as possible. However, the best approach to alcohol withdrawal treatment is a long-term plan to help the individual achieve alcohol abstinence. 

Alcohol withdrawal treatment options include: 

Home Care

If you have a mild case of alcohol withdrawal, you may be able to remain at home while you recover if your home environment supports sobriety. A loved one or friend will stay with you to monitor your progress or call for help if the situation worsens. They will also ensure you attend scheduled medical appointments or counselling sessions.  

Medical Detox

Medical detox is typically the first stage in treating moderate to severe cases of withdrawal. It helps rid the body of alcohol and other toxic substances safely. Alcohol detox only removes it from the system but does not resolve the thought patterns and behaviours fueling alcohol use.

Residential or Inpatient Care

Residential or inpatient care involves living at a treatment facility where a team of professionals provides round-the-clock monitoring till the individual becomes stable. It may also involve group or individual therapy and other forms of treatment designed to aid recovery.


Medications may also be administered to reduce the effects of alcohol withdrawal or prevent further complications. Some drug classes prescribed for alcohol withdrawal symptoms include benzodiazepine, anticonvulsants, antipsychotics, and beta blockers. 

The Canadian Centre for Addictions offers sophisticated treatment for alcohol withdrawal symptoms in a serene environment. We have a team of experts at our alcohol rehab Toronto facilities that help people understand their addictions and the healthier coping strategies available. 

Can You Prevent Alcohol Withdrawal Symptoms?

The only way to prevent alcohol withdrawal symptoms is by treating the underlying cause, which is alcohol dependence or addiction. Treating alcohol withdrawal is only a short-term solution, as withdrawal symptoms will return if you relapse and try to quit again. Contact the Canadian Centre for Addictions to learn about available treatment options to help you or a loved one overcome alcohol dependence and addiction. 

When to Seek Medical Advice

It’s vital to seek medical advice for alcohol use if you notice that you can no longer regulate the amount of alcohol you consume. If you also spend time recovering from the effects of alcohol use, you may need to contact a professional. It’s also time to seek medical help if your alcohol use is beginning to affect your work, academics, or relationships. Contact CCFA today to learn about available treatment programs for you or a loved one. 

Treatment at Home vs. Detox Centre

Depending on the severity of the situation or personal preference, you can decide to treat alcohol withdrawal symptoms at home or a detox centre. Treatment at home offers privacy and the comfort of a familiar environment, but you may not have access to professional treatment if complications arise. One should always be wary of the possible side effects of alcohol withdrawal, such as severe cravings, anxiety and mood swings, thus assessing whether they would require being monitored and treated by a professional.

Treatment at home is also cheaper, you’ll spend less than you would at a detox centre, but the tradeoff is that you will likely relapse without professional monitoring or guidance. You should only opt for home treatment if your withdrawal symptoms are mild and you have a reliable support structure. If you don’t, a detox centre is the right place for your withdrawal treatment.


Alcohol withdrawal symptoms are unpleasant and can be life-threatening, but most people fully recover after treatment. However, it is necessary to address the underlying thought patterns and behaviours that led to alcohol abuse in the first place. Otherwise, alcohol abuse will continue, and you will trigger a cycle of alcohol use, cessation, and withdrawal symptoms treatment. 

Continued drinking can also cause organ damage and several health complications making a recovery more difficult. Fortunately, you can employ any of the available treatment programs to help you or your loved one stop alcohol use and get on the path to lasting sobriety. 

Frequently Asked Questions

What happens after four days of not drinking?

After four days of not drinking, the alcohol will have left your system, and your body will begin to return to normal. You will feel more hydrated and less tired as symptoms begin to wane. You may also experience mild to severe cravings after four days, but taking things one day at a time can help make the situation more manageable.

What is the hardest day of sobriety?

The hardest day of sobriety is usually the first day when withdrawal symptoms are severe,  and the risk of relapse is high. However, after day one, the body starts to detoxify and withdrawal symptoms begin to subside.

What are rare withdrawal symptoms?

Rare withdrawal symptoms are severe symptoms of withdrawal that occur during delirium tremens and include:
- Extreme confusion or agitation
- Fever 
- Excessive sweating 
- Seizures
- Visual, auditory, or tactile hallucinations
- Increased heart rate or blood pressure
- Rapid abnormal breathing

Do antidepressants help with withdrawal symptoms?

Yes. Alcohol has depressant effects on the nervous system, so antidepressants may be prescribed during detox. Antidepressants are also used as mood stabilizers to help people with co-occurring mental health disorders like anxiety or depression during withdrawal. Trazodone and Imipramine are examples of antidepressants used in alcohol withdrawal treatment.  

Who is considered a heavy drinker?

A person is considered a heavy drinker if they consume five or more drinks on a single occasion or 15 drinks or more per week for males, and four or more drinks on a single occasion or eight or more drinks per week for females.

Certified Addiction Counsellor

Seth brings many years of professional experience working the front lines of addiction in both the government and privatized sectors.

Dr. Chintan is a Board Certified Family Physician with an interest in holistic and preventative care as well as healthcare systems. Credentialed Physician with both American & Canadian Board of Family Medicine. Adjunct Professor in the Department of Family Medicine at the Schulich School of Medicine & Dentistry. Telemedicine clinician.

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