Alcohol Withdrawal

What is Alcohol withdrawal syndrome?

Alcohol withdrawal syndrome occurs when a person suddenly stops or reduces the consumption of alcohol. It occurs in people who had been heavily dependent on alcohol for a considerable period of time. This reduction may be a deliberately planned course of action or a sudden occurrence. It is commonly seen in case of alcoholics during rehabilitation to get rid of their addiction. To put it simply, this sudden change tends to act as if the person is suffering from its deficiency like any other essential nutrient or mineral needed by the body. These reactions are seen for a specific timeline while the body tries to adapt to the absence of alcohol.


The following sequence illustrates the actions and developments that lead to alcohol withdrawal syndrome:

  1. Excessive drinking excites the nervous system and makes it dependent on alcohol while causing irritation
  2. Prolonged drinking affects the neurotransmitters (chemicals that transfer messages) in the brain
  3. Further, it intensifies the effect of GABA (a neurotransmitter that causes a feeling of relaxation) and then suppresses it over time leading to an increase in the desire for more consumption
  4. This suppresses the effect of glutamate (a neurotransmitter that causes a feeling of excitability) and makes it function under alcohol influence
  5. Finally, Neurotransmitters rebound when drinking is reduced or stopped as they are no more suppressed. It causes hyperexcitability in the brain in the form of tremors, DTs, seizures, irritability, etc.

Alcohol Withdrawal Symptoms & Signs

Signs and Symptoms of alcohol detox may vary according to the intensity of the situation, i.e. how much and how long a person has been drinking.

Minor/Mild symptoms (occurs 6–12 hours after a person stops drinking):

  • Hand tremors
  • Excessive Sweating
  • Mild anxiety
  • Nausea & Vomiting
  • Disruption in eating patterns & digestive functioning
  • Insomnia
  • Headache

Symptoms that occur under extreme conditions

  • Extreme agitation, irritation & anxiety
  • Irregular heart beat & high blood pressure
  • Alcoholic hallucinosis (includes visual, auditory & tactile hallucinations)
  • Severe tremors
  • Fever
  • Seizures


Assessment of alcohol withdrawal syndrome is made by physical examination and reviewing medical history of the individual. It may be made on the basis of symptoms discussed above. The doctor may ask the following questions to assess whether the individuals are suffering from alcohol withdrawal, such as:

  • Who am I?
  • What day is it?
  • Is there a feeling of sickness in the stomach?
  • Is there a feeling of bugs crawling under the skin?

The doctor may examine the individual with regard to the following health conditions in order to decipher whether the person is suffering from this syndrome.

  • Irregular heartbeat
  • Coronary artery disease
  • Gastrointestinal bleeding & infections
  • Liver disease
  • Pancreatitis
  • Alcohol and electrolyte levels
  • Nervous system impairment


Treatment of alcohol detox depends on the severity of the situation. People who exhibit moderate or mild symptoms are advised to stay at home for their treatment. Surrounded by caring and supportive family and friends, people tend to feel safer and they remain committed to the process of detoxification.

On the other hand people who are observed to have severe symptoms, experience withdrawal seizures. They might need medical and psychiatric help to continue with the detoxification process. The treatment ensures reduction of associated symptoms as soon as possible, promotes abstinence from alcohol and prevents occurrence of other complications.

Drugs given to patients under Benzodiazepines include:

  1. Ativan (lorazepam)
  2. Xanax (alprazoram)
  3. Klonopin (clonazepam)
  4. Valium (diazepam)

Nutrient supplements are also given to make up for the nutrients that have been lost due to excessive drinking. In addition to these, antipsychotic drugs can be taken to prevent hallucinations. Also, beta blocker can be also taken to reduce heart rate and blood pressure, while intake of phenytoin to treat seizures.


The best possible method for prevention is to avoid alcohol. In case a person feels addicted to drinking, they can opt for medical counselling to reduce their dependence on alcohol. Guidelines prescribe alcohol withdrawal syndrome to be backed by treatment for alcohol abuse to eliminate the underlying factors related to the syndrome. Persons who suffer from such an addiction can contact help groups and alcohol rehabilitation centres for the best medication.

Alcohol Detox: How long does it take?

The 1st couple of hours of alcohol withdrawal get dominated by cravings being the most visible signs. Later, the symptoms could be severe and range from hallucinations to seizures. Further, after a few days these cravings are expected to grow leading to physical discomfort. It is important to closely monitor and manage the number of seizures to control its occurrence. However, the number of seizures decreases considerably after a period of 48 hours. Although, the symptoms would keep appearing till the next 96 hours since last alcohol consumption, the timeline for complete detoxification is usually between 7 to 10 days.

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