When you’ve been drinking heavily for a long time, your body gets used to having alcohol around. Alcohol withdrawal is the challenging, and sometimes dangerous, process your body goes through when you suddenly stop or cut back. Think of it as your central nervous system, which has adapted to the constant presence of a depressant (alcohol), suddenly finding itself without it. As a result, it becomes overactive and dysregulated, leading to a range of uncomfortable physical and psychological symptoms. This collection of symptoms is known as alcohol withdrawal syndrome.
This isn’t something that happens to everyone, but it’s more common than you might think. It affects about 50% of people with an alcohol use disorder who stop or significantly decrease their alcohol intake. Alcohol withdrawal symptoms can range from mild anxiety and shakiness to severe complications that require medical attention. Understanding what’s happening in your body is the first step toward navigating this process safely and getting the support you deserve.
What causes alcohol withdrawal symptoms?
To understand what causes alcohol withdrawal, it helps to think of your brain’s chemistry like a set of scales. Alcohol acts as a depressant, which means it slows down your brain function. It does this by interacting with two key neurotransmitters: GABA and glutamate.
Imagine GABA as your brain’s “brake pedal.” It calms things down and makes you feel relaxed. Alcohol enhances the effects of GABA, pushing the brake pedal harder. At the same time, it suppresses glutamate, which you can think of as the “gas pedal” that keeps your brain alert and active. When you drink regularly, your brain tries to counteract this constant breaking by becoming less sensitive to GABA and more sensitive to glutamate. It essentially recalibrates the scales to function in the presence of alcohol, leading to dependence.
When you suddenly stop drinking, the alcohol is no longer there to press the brake. However, your brain’s adaptations are still in place. The brake (GABA) is weak, and the gas pedal (glutamate) is floored. This creates a state of hyperexcitability, causing the classic symptoms of withdrawal, anxiety, tremors, a racing heart, and in severe cases, seizures. Your brain is essentially in overdrive, and it takes time for it to readjust and find its balance again.
Alcohol withdrawal symptoms
When you stop drinking, the symptoms of alcohol withdrawal can show up in many ways, ranging from mildly uncomfortable to dangerously severe. Knowing what to look for can help you understand what’s happening and when to seek help. We can group these symptoms into two main categories: those that are mild to moderate and those that signal a more complicated, severe situation.
Mild to moderate alcohol withdrawal treatment
These early symptoms are often the first sign that your body is adjusting to the absence of alcohol. While they are very uncomfortable, they are typically not life-threatening on their own. For many, these symptoms can be managed with supportive care. Common mild to moderate symptoms include:
- Anxiety. A persistent feeling of worry or nervousness is one of the most common early signs.
- Insomnia. You might find it incredibly difficult to fall asleep or stay asleep, even if you feel exhausted.
- Headache. A dull, persistent headache is a frequent complaint.
- Stomach upset/nausea. Your digestive system can feel unsettled, leading to nausea or vomiting.
- Heart palpitations. You might notice your heart beating faster or irregularly.
- Shakiness (tremors). Often called “the shakes,” these involuntary tremors usually affect the hands.
Severe or complicated alcohol withdrawal treatment
The presence of any of the following symptoms indicates a serious and potentially life-threatening situation that requires immediate medical treatment. These are not symptoms you should ever try to manage on your own. If you or a loved one experiences any of these, it is a medical emergency.
- Hallucinations. You may see, hear, or feel things that are not there. These can be frightening and disorienting.
- Seizures. These are uncontrolled electrical disturbances in the brain that can cause convulsions and loss of consciousness.
- Severe confusion/disorientation. A state of profound confusion, where you might not know who you are, where you are, or what time it is.
You can overcome addiction. Reach out to discover:
Alcohol withdrawal symptom timeline
Navigating the alcohol withdrawal timeline can feel overwhelming, but knowing what to expect can help reduce some of the anxiety. While everyone’s experience is different, symptoms tend to follow a general pattern. Here’s a look at how things typically unfold:
- Stage 1 (6-12 hours). Mild symptoms usually begin within the first 12 hours after your last drink. This is when you might start to feel anxiety, insomnia, nausea, and tremors.
- Stage 2 (12-24 hours). In this window, symptoms can intensify. For some, this is when alcoholic hallucinations may start to occur.
- Stage 3 (24-48 hours). The risk of seizures is highest during this period. Research shows that more than 90% of acute symptomatic seizures happen within 48 hours of stopping heavy drinking.
- Stage 4 (48-72 hours). This is when the risk for delirium tremens (DTs), the most severe form of withdrawal, begins. DTs are a medical emergency characterized by severe confusion, agitation, fever, and hallucinations.
So, how long does alcohol withdrawal last? The most intense, acute symptoms typically peak within 72 hours and begin to subside within 5-7 days. However, it’s important to remember that some psychological symptoms, like anxiety, depression, and sleep disturbances, can linger for weeks or even months as your brain continues to heal. The journey to feeling like yourself again is a process, and the timeline for recovery from alcoholism extends beyond the acute withdrawal phase.
Alcohol withdrawal complications
While many people experience milder symptoms, alcohol withdrawal can lead to serious medical complications that require immediate attention. The two most significant risks are seizures and a condition called delirium tremens (DTs). These complications are why medical supervision during detox is so critical. While alcohol withdrawal is common, delirium tremens only occurs in about 5% of people going through it. However, it is incredibly dangerous; about 5% to 10% of people with this complication die from it, which underscores the importance of professional medical care.
Delerium tremens (DTs)
Delirium tremens is the most severe form of alcohol withdrawal and is considered a medical emergency. It involves a sudden and severe shift in your mental and nervous system functions. The symptoms are intense and can be frightening for both the person experiencing them and those around them. Key symptoms of DTs include severe disorientation and confusion, extreme agitation, high fever, heavy sweating, and vivid hallucinations that can be both visual and tactile (like feeling things crawling on your skin). The mortality rate associated with untreated DTs is high, making it absolutely essential to seek emergency medical help if these symptoms appear.
WE ARE AVAILABLE 24/7
Request a call for answers and help.
If you or someone you care about is struggling with addiction or mental health problems, request a call to speak with a knowledgeable treatment specialist. Our team is here to help you understand your options for care. There is no cost or obligation to enter treatment by requesting a call.
"*" indicates required fields
What is the treatment for alcohol withdrawal?
The primary goals of treatment for alcohol withdrawal are to manage your symptoms safely, prevent serious complications like seizures, and help you transition into long-term recovery. The right approach depends entirely on the severity of your symptoms.
For severe withdrawal, inpatient medical detox is the standard of care. This provides 24/7 medical supervision in a safe, controlled environment. Medications, most commonly benzodiazepines, are often used to calm the overactive nervous system, reduce the risk of seizures, and prevent the progression to delirium tremens. This level of care ensures your safety during the most critical phase of withdrawal. Deciding between inpatient vs. residential treatment often depends on the intensity of medical supervision required.
For those with mild to moderate symptoms, supportive outpatient treatment can be a very effective alternative. This approach allows you to recover from the comfort of your home while receiving regular monitoring, nutritional guidance to replenish your body, and compassionate therapy to start addressing the root causes of your drinking. At Red Ribbon Recovery Indiana, we can help you determine the appropriate level of care for your unique situation. You don’t have to make this decision alone. A confidential call can help you understand your options and take the first step toward a safer path forward.
When to contact a medical professional
It’s crucial to know when alcohol withdrawal symptoms have crossed the line from uncomfortable to dangerous. Attempting to detox at home without supervision is never recommended, especially if you have a history of heavy, long-term drinking, as this is when the risk of severe complications is highest. If you or someone you know experiences any of the following, please call 911 or go to the nearest emergency room immediately:
- Seizures or convulsions
- Loss of consciousness
- Severe confusion or disorientation (not knowing who or where you are)
- Hallucinations (seeing, hearing, or feeling things that are not there)
- High fever
- Chest pain or severe, rapid heartbeat
These symptoms are signs of a medical emergency that require immediate professional care. Please do not wait to see if they get better on their own. You can also contact us for guidance on how to proceed safely.
Free Insurance Check
Our rehab center accepts most insurance plans.
Check if your insurance will cover the cost of treatment by filling out our confidential insurance form. We accept most insurance plans.
Finding support for alcohol recovery in Indiana
Getting through the acute phase of withdrawal is a monumental first step, but the journey to lasting recovery continues from there. This is where building a strong foundation of support becomes so important. At Red Ribbon Recovery Indiana, we are here to be your compassionate partner on this path. We understand that true healing involves more than just stopping drinking; it’s about addressing the underlying reasons why alcohol became a problem in the first place. If you’re ready to take the next step, our admissions team can help guide you through the process with care and understanding.
Don't go through alcohol withdrawal symptoms alone
Navigating alcohol withdrawal is undoubtedly one of the toughest challenges anyone can face, but it’s important to hold onto this truth: it is a treatable medical condition, and you can get through it safely with the right support. Understanding the symptoms, the timeline, and when to ask for help are powerful first steps toward taking back control of your health and your future.
Deciding to stop drinking is the beginning of a hopeful new chapter. If you’re ready to start your journey to recovery and want help with alcohol withdrawal symptoms, our compassionate team at Red Ribbon Recovery Indiana is here to help. You can call us at (317) 707-9848 to talk about your options or contact us today to find out more. Taking that first step is the most important one you’ll ever make.
We are here to help you or a loved one find addiction treatment near you.
Admitting you have a substance abuse problem and asking for help is not always easy. If you or a loved one are struggling with drug addiction, alcohol addiction or another substance use disorder, help is available. Call SAMHSA’s National Helpline at (317) 707-9848 to learn about resources in your area or reach out to our team for personalized treatment.
Frequently Asked Questions About Detox
How is alcohol withdrawal diagnosed?
A doctor or other medical professional typically diagnoses alcohol withdrawal through a conversation about your symptoms and your history with alcohol. There isn’t a single blood test or scan for it; the diagnosis relies on a clinical assessment of what you’re experiencing physically and emotionally.
They will likely perform a physical exam and ask questions about how much and how often you drink. This helps them understand the severity of the situation and rule out other health conditions that might cause similar symptoms.
Can I prevent alcohol withdrawal?
The only way to completely prevent alcohol withdrawal is to avoid developing a physical dependence on alcohol. If you already drink heavily and have become dependent, you can’t stop the withdrawal process from happening if you quit, but you can make it much safer.
Quitting “cold turkey” on your own carries serious risks. The best way to manage withdrawal is by working with a doctor who can help you taper off alcohol slowly or guide you through a medical detox. This approach helps minimize dangerous symptoms and manage your health safely.
What are the risk factors for alcohol withdrawal?
The biggest risk factor for alcohol withdrawal is a history of long-term, heavy drinking, which can lead to physical dependence. If you’ve gone through withdrawal before, you’re more likely to experience it again, and it may be more severe.
Other factors that can increase the risk include having co-occurring mental or physical health conditions, your age, and your overall nutritional health. Each person’s situation is unique, so these factors can affect individuals differently.
What is the prognosis for someone with alcohol withdrawal?
With professional medical care, the prognosis for getting through alcohol withdrawal safely is very good. Most of the acute physical symptoms usually improve within five to seven days. Supportive treatment helps manage discomfort and prevents severe complications like seizures.
The long-term outlook for recovery is even better when detox is followed by ongoing support, such as therapy or counseling. This continuing care addresses the root causes of the alcohol use disorder, building a strong foundation for lasting health and sobriety.
How much do I have to drink to experience withdrawal?
There is no magic number of drinks that causes withdrawal, because it depends on your individual body and circumstances. Withdrawal is a sign of physical dependence, which usually develops from consistent, heavy drinking over a period of weeks, months, or years.
Factors like your metabolism, genetics, overall health, and whether you have other medical conditions all play a part. It’s less about a specific quantity of alcohol and more about how your brain and body have adapted to its constant presence.
Reviews
Sources
- Kattimani, S., & Jain, N. (2010). Blood alcohol levels in patients with alcoholic liver disease. Prevalence, Trends, and Incidence of Alcohol Withdrawal Symptoms. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC6761821/
- Maldonado, J. R. (2023). Alcohol Withdrawal Syndrome. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441882/
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2025). Home | SAMHSA. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov
- Kattimani, S., & Jain, N. (2010). Blood alcohol levels in patients with alcoholic liver disease. NEUROCHEMICAL MECHANISMS OF ALCOHOL WITHDRAWAL. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC6943828/
About the content
Written by: Carli Simmonds. Carli Simmonds holds a Master of Arts in Community Health Psychology from Northeastern University. From a young age, she witnessed the challenges her community faced with substance abuse, addiction, and mental health challenges, inspiring her dedication to the field.
Medical reviewed by: Jodi Tarantino, LICSW. Jodi Tarantino is an experienced, licensed Independent Clinical Social Worker (LICSW) and Program Director with over 20 years of experience in Behavioral Healthcare. Also reviewed by the RRR Editorial team.
Red Ribbon Recovery is committed to delivering transparent, up-to-date, and medically accurate information. All content is carefully written and reviewed by experienced professionals to ensure clarity and reliability. During the editorial and medical review process, our team fact-checks information using reputable sources. Our goal is to create content that is informative, easy to understand and helpful to our visitors.
