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Withdrawal From Alcohol

People who drink alcohol heavily for weeks, months, and even years will experience moderate to severe mental and physical symptoms when they stop drinking. These symptoms paired with quitting drinking are what define alcohol withdrawal.

People who drink moderately or those who enjoy a glass of wine at celebrations are unlikely to experience any withdrawal symptoms when they stop drinking. However, it doesn’t take very long to develop a dependence on alcohol after heavy, frequent drinking.

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Alcohol is a central nervous system depressant. This means it slows down brain function and alters the ways in which nerve cells in the brain communicate. As time goes on and the system is fed more and more alcohol, the central nervous system adjusts to having excess alcohol. As a result, the brain and body begin to work overtime to continue processing alcohol and keep up with the flood of dopamine and serotonin in the brain. At the same time, chronic drinking causes an excess of gamma-aminobutyric acid (GABA) in the brain – a neurotransmitter that regulates mood, well-being, and much more. Without GABA, painful withdrawal symptoms endure until the brain can once again develop this neurotransmitter naturally. The brain and body eventually get used to working overtime – until a person suddenly stops drinking. When a person who is dependent on alcohol suddenly lets the alcohol levels in their body drop, the body enters a state of shock where it is still in an overactive state but does not have alcohol to process. This is when withdrawal symptoms occur.

Factors That Influence he Severity and Duration of Alcohol Withdrawal

Every individual is different and may have a different experience during detox. This is because there are many individual factors that dictate how serious symptoms become and how long they last. Some of these influential factors include:

  • How long a person has been drinking – the longer someone is addicted to alcohol, the longer their withdrawal symptoms will last and the more severe they will be.
  • How frequently a person drinks – people who drink several times a day may have longer-lasting and more severe withdrawal symptoms than people who only drink in the evening.
  • The quantity of alcohol last consumed – people who drink beverages with higher alcohol content or those who consume large volumes of alcohol may have more severe symptoms. Age, weight, and metabolism – younger people and people with low BMIs tend to have less severe symptoms. However, the older a person gets, the slower their metabolism becomes. The slower the metabolic rate, the longer it will take to detox from alcohol.
  • Liver and kidney function – the kidney and liver are responsible for processing and metabolizing alcohol. If these organs are impaired or not functioning properly, withdrawal may take longer.

Another factor that can influence alcohol withdrawal is whether or not the person has detoxed from alcohol before. People who have already gone through withdrawal, returned to drinking, and try to detox again may be prone to more severe symptoms than first-timers.

Alcohol Withdrawal Symptoms

The symptoms of alcohol withdrawal range from mild to severe depending on the various above-listed factors. However, some of the early or more mild symptoms that are commonly experienced during alcohol withdrawal include:

  • Shaky hands
  • Tremors
  • Headache
  • Anxiety
  • Nausea
  • Vomiting
  • Insomnia
  • Sweating
  • Hyper-alert state
  • Nightmares
  • Irritability
  • High blood pressure

While these symptoms may not sound so bad, others are potentially fatal. Other more serious withdrawal symptoms that can occur after the first 1-2 days include seizures and hallucinations.


Delirium tremens, more commonly referred to as DTs, may occur 2-3 days after a person takes their last drink. DTs are not to be confused with regular alcohol withdrawal seizures or hallucinations. Instead, they are far more serious and only occur in 5-10% of patients with alcohol use disorder. DTs are the most severe symptoms that involve vivid hallucinations and intense delusions. Other symptoms include:

  • Confusion
  • Disorientation
  • Stupor
  • Loss of consciousness
  • Angry behavior
  • Irrational beliefs
  • Racing heartbeat
  • High blood pressure
  • Sleep disturbances
  • Fever
  • Sweating
  • Visual, tactile, or auditory hallucinations

Without medical treatment, DTs can be deadly. And, even though they only occur within a small percentage of patients, it is never worth the risk. Instead, the safest way to detox from alcohol is to do so at an alcohol detox center in Massachusetts.

Alcohol Withdrawal Timeline

Most people see their symptoms begin to improve after five days, however, some heavy, chronic drinkers may experience symptoms for up to three weeks. Although the exact alcohol withdrawal timeline varies from one person to the next, here is an estimate of what is to be expected during the first few days of alcohol detox. Alcohol withdrawal can be divided up into 3 stages: mild, moderate, and severe.

  • Stage 1: mild – these symptoms can begin as quickly as 6 hours after the last drink. Symptoms may include headache, anxiety, tremors, stomach problems, and heart palpitations.
  • Stage 2: moderate – moderate symptoms may begin 12-24 hours after a person’s last drink and may include high blood pressure, confusion, rapid breathing, hyperthermia, and alcohol cravings.
  • Stage 3: severe – not all patients will reach the severe stage, however, those that do require medical care. These symptoms can occur 24-36 hours after stopping drinking and include seizures, hallucinations, disorientation, and stupor.

Most patients see their symptoms peak somewhere between 24-72 hours after their last drink. In general, seizure risk is highest 48 hours after the last drink. Some patients may experience post-acute withdrawal syndrome (PAWS) where they suffer lingering symptoms of withdrawal. These persistent symptoms can be difficult to cope with without a treatment program, especially because they can last for months. Examples of PAWS include:

  • Mood swings
  • Fatigue
  • Sleep disturbances
  • Depression
  • Anxiety
  • Alcohol cravings

DespIte how difficult and long-lasting alcohol withdrawal can be, alcohol detox centers in Massachusetts have the medications and expert knowledge needed to keep patients safe and comfortable as they sober up.

Treatment for Alcohol Withdrawal

The exact treatment for alcohol withdrawal syndrome depends on how severe a person’s symptoms are. Most need inpatient detoxification with 24/7 monitoring and supervision. Around-the-clock care can help prevent potentially dangerous complications, like seizures or DTs. Alcohol withdrawal symptoms are generally treated with benzodiazepines. Benzodiazepines are used to treat anxiety disorders and seizures and they work by increasing the reuptake of GABA in the brain. As a result, they are helpful in reducing alcohol withdrawal symptoms and preventing seizures. Benzodiazepines that are commonly prescribed for alcohol detox include:

  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Xanax (alprazolam)
  • Valium (diazepam)

Other medications, vitamins, and supplements may be given to help boost the immune system that has been depleted as a result of alcohol abuse. Patients may be slowly weaned off of these medications as their symptoms begin to subside. Alcohol detox centers in Massachusetts also offer therapeutic services and supportive care to help patients deal with the emotional and mental aspects of alcoholism and alcohol withdrawal. And, throughout the detox process, doctors and nurses are prepared to intervene in case an emergency situation strikes.

Start Alcohol Detox in Massachusetts Today

Treating the symptoms of alcohol withdrawal isn’t going to cure addiction, but it will get a person ready to begin treatment by stabilizing their mind and body. At Elevate Recovery Center, we use only evidence-based treatment methods to help our patients stay safe and comfortable as they detox. To learn more about our treatment programs or to find help for alcohol withdrawal, pick up the phone and call us today.


Valerie Tecci, Program Director

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We believe everyone struggling with substance use disorder deserves the treatment they need. Our team is here to help you every step of the way.

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