This article was reviewed for medical accuracy by Dr. Yonah S. Tehrani, MD. Dr. Tehrani received his medical education at Technion University and trained at Rambam Hospital and Cedars-Sinai Medical Center.
While alcohol withdrawal symptoms are often less severe than those for opioids or other drugs, they are still major roadblocks to recovery. When people experience these mild alcohol withdrawal symptoms, they often feel that they have no choice but to drink alcohol again. As people suddenly stop drinking, their bodies might “freak out” because they have become dependent on alcohol. Note that symptoms are generally more varied and more severe when the individual was drinking regularly rather than “binging.”
For people starting recovery from alcohol use disorder, alcohol withdrawal symptoms peak after 2 hours and go away within 72 hours. For this reason, fear of alcohol withdrawal should never be a reason to quit drinking. While an individual may not experience every symptom, there are a wide variety of problems that come when someone begins alcohol recovery.
Mild Alcohol Withdrawal Symptoms
While detoxing from alcohol abuse can lead to long-term health benefits, it may not feel that way at first. Common symptoms include:
- Autonomic Hyperactivity: This is an elevated heart rate. While this is not inherently dangerous (because it lasts only a short while), it can be concerning for someone entering withdrawal. The feeling is usually associated with general unease and excessive sweating.
- Hand Tremors: This is often the first symptom that people notice. This is another symptom that, while concerning, is not generally dangerous. The only danger is for patients who drive while experiencing withdrawals, which is why that is not recommended.
- Vomiting and Nausea: Ironically, a person who stops drinking alcohol might feel sick once they stop drinking. This is why it’s important to have medical supervision during detox, both to treat the nausea and to make sure the patient is hydrated. It is also a good idea to begin detox with only mild, bland foods to lower the chance of vomiting.
- Transient Illusions and Hallucinations: While less common, some people may have visual or auditory hallucinations. These can be frightening or concerning, but most people are able to tell that they are not real and wait until they vanish (usually a few minutes, at most). This stems from the brain being unsure of how to send information without alcohol in its system.
- Generalized Anxiety: Without the use of alcohol, most people with withdrawals find themselves unable to calm down. This can be caused by co-occurring substance use disorder, where a person has a mental illness and treats it with drugs or alcohol. Without alcohol, anxiety (a common mental health symptom) can return.
- Insomnia: For those starting to recover from alcohol addiction, sleeping may be difficult. Because of the symptoms above, many find it hard to fall or stay asleep.
These are the standard, mild alcohol withdrawal symptoms. While some of them can be concerning in the moment, they are not generally considered dangerous. Of course, none of them are fun to deal with alone, either. For this reason, people who are concerned about symptoms should find treatment centers to help them manage withdrawal symptoms.
This medical supervision can look like checking in to a rehab program, receiving a prescription from your doctor, or any number of preemptive treatments. While nobody should be afraid to stop drinking alcohol, it’s important to be prepared for the realities of alcohol withdrawal symptoms.
DTs (Delirium Tremens)
The above mild alcohol withdrawal symptoms are of course concerning, but usually not dangerous. In a few cases, these unsettling symptoms are a precursor to DTs (delirium tremens), a condition which may be life-threatening. Unlike the hallucinations described above, DTs do not go away in a few minutes. Because of this, they can lead people to injure themselves or others as they react to things that aren’t there. Moreover, they are more alarming than “normal” withdrawal hallucinations because they do not always go away quickly.
However, hallucinations are not the sole symptom of DTs. Other symptoms include fever, severe agitation, confusion, and seizures.
The good news is that DTs, if caught early enough, is usually not a serious condition. That said, people with symptoms of DTs should seek medical attention immediately and may require hospitalization. Common anti-DTs drugs include benzodiazepine, haloperidol, clonidine, beta blockers, and phenytoin. What medication a patient uses depends on their own medical history and their medical professional’s recommendation.
Treatment of DTs will focus on monitoring the patient’s vitals while administering sedatives and fluids until withdrawal is complete. Additionally, testing for other medical problems and treating them will prove useful in lessening DTs symptoms.
Do not be afraid to stop drinking out of fear of DTs. While it is a serious symptom, it is easily treatable and preventable when you enter a rehab program. Everyone should feel empowered to begin recovery from their alcohol addiction, and that starts with knowing withdrawal symptoms and knowing that they can be beaten.
Get the Help You Need
Many times, stopping drinking is only part of the puzzle. The underlying issues remain, and these are the areas that we help with during treatment. We know that nothing is more disheartening than relapsing after leaving rehab, so we give patients the tools to stay sober.