Signs & Symtpoms of Alcohol Withdrawal
What Are the Withdrawal Symptoms of Alcohol?
Many patients who come to Castle Craig may experience severe withdrawal symptoms as a result of their alcohol addiction. To avoid any dangerous side effects, we have a complete medical team on standby to help manage symptoms and keep patients safe.
Withdrawal from alcohol can manifest in two ways, with patients experiencing both psychological withdrawal symptoms and physical withdrawal symptoms.
If you drink a lot of alcohol – and this could be a little every day ‘to wind down’ or lengthy binges at the weekend ‘to let off steam’ – you may find it difficult to stop or cut back. This is because when you do, you feel physically unwell and mentally very low. These feelings are alcohol withdrawal symptoms and while the easiest way to get rid of them is to have another drink, the best thing you can do is seek treatment for alcohol dependence.
Reliance on alcohol doesn’t mean you’re rolling around in the gutter stinking of booze. You may have a high-powered job, only drink the best wines, never get drunk and avoid hangovers, but you may still have an alcohol addiction and when you stop, it is likely that you will experience withdrawal symptoms.
You are here because you think you may have a problem with alcohol abuse and you want to do something about it. Congratulations on taking the first step. We are here to offer a helping hand and support you. Here we explain what to expect when you stop drinking alcohol, how to manage alcohol withdrawal symptoms and how to rid yourself of your addiction forever.
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What is Alcohol Withdrawal?
Alcohol withdrawal is the body and brain’s reaction to the cessation of alcohol. Withdrawal symptoms can start six hours from your last drink depending on your alcohol use, how abruptly you stopped drinking, your history of drinking and your personal health.
Half of all people with an alcohol use disorder will experience withdrawal symptoms and a minority of these will require hospitalisation. Symptoms range from mild to severe and can even be life-threatening.
Common symptoms of alcohol withdrawal can include:
- The shakes (also known as delirium tremens or the DTs)
- Sweating
- Nervousness
- Irritability
- Confusion
- Racing heart rate
- Rapid breathing
- Nausea
- Vomiting
- Depression
- Difficulty sleeping
- Loss of appetite
- Altered vision and hearing
For those with mild or moderate withdrawal symptoms, they can sometimes be self-managed and last up to a week. For people who have had a longer relationship with alcohol abuse, withdrawal symptoms can be acute, dangerous and last for four weeks or longer.
Not only will you feel uncomfortable while you’re experiencing alcohol withdrawal symptoms, but you will also be craving another drink to make you feel ‘normal’.
What Causes Alcohol Withdrawal Symptoms?
You might think you need alcohol to be the life and soul of the party, but while you’re feeling more chatty and less inhibited, the alcohol is actually having a depressive effect on you. It is slowing your brain down, destroying brain cells and affecting your ability to think clearly.
You may turn to alcohol because it makes you feel relaxed and happy. This is because when you drink, the brain releases more of the hormone dopamine, which is linked with pleasure. It also activates the brain’s gamma-aminobutyric acid (GABA) receptors which make you feel chilled.
However, excessive alcohol consumption can result in the reduction of GABA receptors which means that when you stop drinking, you feel less relaxed, more stressed and think that the only thing that will calm you down is a drink.
Alcohol also affects the central nervous system, the network of nerve cells which provides us with our basic physical and mental functions. Slurred speech, poor memory, delayed reflexes and poor coordination are all common side effects of excessive alcohol consumption.
If you regularly flood your body with booze, your brain adapts to this so you can function all the time with this drug in your system. It tries to overcome the sedative effect of alcohol and increases nerve activity to keep you more awake. If you stop drinking, your brain stays on high alert and the withdrawal symptoms start.
All withdrawal symptoms are unpleasant, which is why many people with alcohol addiction often develop withdrawal-related anxiety which makes them prone to relapse. Even though you know the alcohol is destroying your life, the symptoms can be difficult to cope with and the easiest way out is to reach for a drink.
What are the Severe Symptoms of Alcohol Withdrawal?
Withdrawal symptoms and their severity will differ between people depending on how long they’ve been drinking and how much they’ve been drinking. Age and underlying physical and mental health conditions also play a part, as do genetics.
Severe alcohol withdrawal symptoms can include:
- Hallucinations
- Epileptic seizures
- Chronic nerve damage (especially in the feet which can lead to poor balance and falls)
- Delirium
- Dehydration
- Coma
- Death
No one likes to think they have an addiction of any kind. People often minimise their drinking behaviour to themselves or others. It’s easy to say you only have one glass of wine a day, but if that glass is the size of a fish bowl, it could indicate a reliance on alcohol. (Drinking every day, no matter how little, is also a sign of alcohol addiction).
In many cases, people with alcohol dependence are only treated when one or more of these symptoms lands them in hospital. These people, who at this point may be endangering their life, frequently require treatment in intensive care units. In rare cases, severe alcohol withdrawal symptoms can be fatal.
Age plays a factor. More people under 30 who abuse alcohol have few or no withdrawal symptoms compared to those over 30. However, symptoms are no worse in the over 60s, which means advanced age should be no barrier to giving up alcohol and getting sober. Never think you are ‘too old’ to come clean. It won’t be any harder for you than it will for someone half your age.
The good news is all alcohol withdrawal symptoms, no matter how severe, can be managed with the right treatment and support.
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How Much Alcohol Do I Need to Drink to Experience Withdrawal Symptoms?
There is no exact science here as everyone is affected by alcohol differently. Even when it comes to experiencing hangovers, some people feel like the walking dead after one or two drinks while others appear to shake them off no matter how much they imbibe.
Nevertheless, alcohol abuse will often result in physical dependence on drink. As the brain and central nervous system have adjusted to the amount of alcohol introduced to the body, stopping suddenly or cutting down severely means they have to adjust again, immediately. And this can result in alcohol withdrawal symptoms.
A regular intake of alcohol doesn’t have to be particularly long-term for withdrawal symptoms to be present. The amount you drink can be just as important. A study found that men who drank almost 30 drinks per day for just three months experienced withdrawal symptoms. Then men that drank the most had the most severe symptoms with hallucinations, seizures and delirium tremens (DTs or the shakes).
As well as the physical withdrawal symptoms, people with an alcohol use disorder may fear going sober will affect the way they spend their time and their money, they worry it will impact negatively their relationships, their friendship groups and how they find their joy in life. It is a common misconception among regular drinkers that stopping alcohol causes more problems than continuing. This is where professional treatment comes into play. It can arm you with strategies on how to live a full and rewarding life in the absence of alcohol.
How Long Do Alcohol Withdrawal Symptoms Last?
Once you’ve made the decision to stop drinking, your body starts its detox which means it is cleaning the alcohol from your system. Withdrawal symptoms can start within hours and while your first thought might be to reach for a drink, you’ll be doing yourself and your loved ones a huge favour if you don’t.
Fortunately, in the vast majority of cases, withdrawal symptoms do not last for very long and there is treatment available to help. Here’s what you can expect:
Six to 12 hours: You may start to feel mild symptoms such as headache, anxiety, nausea and shaky hands. You will crave a drink to ‘steady your nerves’.
12 to 24 hours: Some people may experience visual and aural disturbances, which means they see and hear things that aren’t there. You may also have tactile hallucinations which means it feels as though something is touching your body, such as bugs crawling over your skin.
One to three days: In mild cases, symptoms peak during this period and then taper off. In around 10% of cases, the symptoms can get worse, resulting in fever and excessive sweating. More than 90% of seizures happen 24 to 48 hours after the last drink and the DTs may kick in 48 hours onwards.
Three to seven days: Chronic delirium tremens can result in aggression, dehydration, rapid heart rate, high blood pressure and reduced blood flow to the brain. This often leads to excessive fatigue and lengthy sleep.
Seven days onwards: Psychiatric problems associated with withdrawal, including anxiety, depression and insomnia can last long after the acute withdrawal symptoms have subsided. These can lead to relapses days, months and years after withdrawal, which is why professional long-term treatment for alcohol addiction is so important.
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Post-Acute Withdrawal Syndrome (PAWS)
Although in the majority of cases, symptoms of alcohol withdrawal subside after one or two weeks, the after-effect of long-term and intense alcohol abuse can carry on indefinitely, possibly for a lifetime. These tend to be psychological, such as depression, anxiety and an inability to experience pleasure from life when alcohol isn’t involved.
The chance of relapse is highest in this stage with more than three-quarters of people with an alcohol addiction relapsing within a year of starting alcohol withdrawal. This is often due to the intense craving for a drink, inability to cope with triggers that previously motivated them to drink (such as arguing with a partner or having a bad day at work) and failure to continue with ongoing professional treatment.
Relapsing, returning to alcohol addiction, getting clean and experiencing withdrawal symptoms impact the brain long-term, affecting memory, concentration and decision-making.
PAWS symptoms may leave and return, ebbing and flowing as you continue with your recovery. It’s important that you realise they may come back and are prepared for that with treatment in place and support.
The most common PAWS symptoms are:
- Anxiety
- Confusion and foggy thoughts
- Disturbed sleep
- Mood swings
- Depression
- Irritability
- Fatigue
- Intense cravings for more alcohol
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Can Medication Help Relieve Symptoms of Alcohol Withdrawal?
Quitting drinking suddenly – i.e. going ‘cold turkey’ – can be dangerous for some people as the alcohol withdrawal symptoms are too severe and they simply can’t cope.
Some medications can help bridge the gap between alcohol addiction and being sober. Benzodiazepines (or ‘benzos’), such as diazepam (better known as Valium) are seen as the gold standard medicines for alcohol withdrawal symptoms. They reduce the effects of many symptoms including anxiety, insomnia, headaches, pain and seizures.
Other medications include acamprosate (sold as Campral), and disulfiram (sold as Antabuse), both of which reduce cravings.
All these drugs are prescription-only and need to be taken as part of a controlled treatment plan. They can make you drowsy, so they need to be taken carefully and not when you’re driving. They can also be addictive which means you need medical supervision while taking them.
The dosage depends on the level of your addiction and the severity of withdrawal symptoms. In some cases, it will be reduced over time until you can manage without them. It can be dangerous to take these drugs while continuing with alcohol as the side effects are particularly unpleasant.
Castle Craig offers medically managed detox programmes for alcohol addiction, our team of doctors and nurses will make sure that you are safe and comfortable during your detox. Find out more about our alcohol detox programme.
Is it Safe to Detox from Alcohol at Home Without Medical Supervision?
In a word, no. The severity of withdrawal symptoms can make you a danger to yourself and those around you. A low mood and feelings of depression could spiral into thoughts of self-harming or suicide. Irritability could turn into aggression or even violence to others, and seizures and delirium tremens suffered alone can be frightening and possibly life-threatening.
It is important that you don’t deal with your alcohol addiction alone. There are many places for you to get help, including your GP, who can signpost you to the appropriate help such as a professional inpatient alcohol rehab like Castle Craig.
Alcohol abuse may have had a damaging effect on your life, work and relationships. If you have particular needs, such as a safe place to live or help with drug addiction, there are organisations that can help you. You can find a list here.
If you share your home with a person with alcohol addiction and you have decided to get clean but they haven’t, it will be very difficult, if not impossible, for you to do so. The presence of alcohol, coupled with pressure to join them in a drink, may be hard to resist. If this is your situation, see if you can find another place to stay so you can stay focused and not be distracted.
What Can I Expect from Rehab for Alcohol Addiction?
The best and safest way to manage alcohol withdrawal symptoms and beat cravings is at a rehab centre such as Castle Craig. Here you will find experts in alcohol addiction who can provide medical support through our alcohol detox programme, as well as other evidence-based treatments, such as counselling and talking therapies.
Just as everyone’s relationship with alcohol is different, so is their treatment plan. You will receive help tailormade to your needs and circumstances.
Counselling can provide you with strategies to deal with cravings and the triggers that previously sent you reaching for the bottle. You will also meet like-minded people who have struggled with an overcome addiction. They know exactly what you are going through and can advise, support and inspire you.
Castle Craig offers inpatient or residential treatment that lasts 4 weeks minimum. However, you can also attend outpatient rehab through our sister clinic CATCH Recovery.
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Outpatient Rehab for Alcohol Addiction
Outpatient rehab, during which you attend the centre at arranged times, for treatment and therapy, is best suited for those whose alcohol withdrawal symptoms are mild to moderate.
Although it means you can continue with your family and work responsibilities, you will be exposed to many triggers in your normal life and be more susceptible to relapsing. It is important that you have a safe environment in which to detox and a strong support network.
Outpatient rehab is not appropriate if you have potentially life-threatening alcohol withdrawal symptoms, such as seizures or delirium tremens, or suicidal thoughts. In this case, you will need round-the-clock care to ensure you remain safe.
Inpatient Rehab for Alcohol Addiction
The safest way to manage withdrawal symptoms and free yourself from alcohol addiction for good is to move into a residential rehab centre where you live in comfort as if you were in a hotel and have medical and emotional support on tap 24/7.
Those who complete the inpatient stay have a reduced chance of relapsing. But support doesn’t end when you leave. It continues for as long as you require – possibly a lifetime.
How Can Castle Craig Help?
How Do I Pay For Rehab?
One concern we sometimes hear from people is how they will fund their rehab treatment. The cost of rehab varies depending on what kind of accommodation you choose. You can pay for treatment at Castle Craig privately, or through medical insurance, and some people receive funding through the NHS.
How Long Is the Rehab Programme?
Residential rehab treatment starts at four weeks and can go up to 12+ weeks. Research shows us that the longer you stay in rehab and are part of the residential therapy programme, the longer the likelihood of continued abstinence and stable recovery.
Who Will I Speak to When I Call?
When you call you will reach our Help Centre team who will give you all the information you need to help you decide whether to choose treatment at Castle Craig. Once you have decided that you would like to have a free screening assessment you will be put in touch with our admissions case managers who will guide you through the admissions process.
What Happens at the End of My Treatment?
Castle Craig thoroughly prepares patients before departure by creating a personalised continuing care plan which is formulated following discussions with the medical and therapeutic team. We offer an online continuing care programme which runs for 24 weeks after leaving treatment, in order to ensure a smooth transition back into your everyday life. Patients leaving treatment automatically join our Recovery Club where they can stay connected via our annual reunion, events, online workshops and recovery newsletters.