Alcohol withdrawal
Detoxification - alcohol; Detox - alcoholAlcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking alcohol.
Causes
Alcohol withdrawal occurs most often in adults. But, it may also occur in teenagers or children.
The more you drink regularly, the more likely you are to develop alcohol withdrawal symptoms when you stop drinking.
You may have more severe withdrawal symptoms if you have certain other medical problems.
Symptoms
Alcohol withdrawal symptoms usually occur within 8 hours after the last drink, but can occur days later. Symptoms usually peak by 24 to 72 hours, but may go on for weeks.
Common symptoms include:
- Anxiety or nervousness
Anxiety
Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...
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Depression
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...
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Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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- Jumpiness or shakiness
- Mood swings
- Nightmares
- Not thinking clearly
Other symptoms may include:
- Sweating, clammy skin
Sweating
Sweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...
Read Article Now Book Mark Article - Enlarged (dilated) pupils
- Headache
Headache
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
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- Loss of appetite
Loss of appetite
A decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.
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- Pallor
Pallor
Paleness is an abnormal loss of color from normal skin or mucous membranes.
Read Article Now Book Mark Article - Rapid heart rate
Rapid heart rate
A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.
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- Tremor of the hands or other body parts
A severe form of alcohol withdrawal called delirium tremens can cause:
Delirium tremens
Delirium tremens is a severe form of alcohol withdrawal. It involves sudden and severe mental or nervous system changes.
Read Article Now Book Mark Article- Agitation
Agitation
Agitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.
Read Article Now Book Mark Article - Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
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- Seizures
Seizures
A seizure is the physical changes in behavior that occurs during an episode of abnormal electrical activity in the brain. The term "seizure" is often...
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Exams and Tests
Your health care provider will perform a physical exam. This may reveal:
- Abnormal eye movements
- Abnormal heart rhythms
- Dehydration (not enough fluids in the body)
- Fever
- Rapid breathing
- Rapid heart rate
- Shaky hands
Blood and urine tests, including a toxicology screen, may be done.
Toxicology screen
A toxicology screen refers to various tests that determine the type and approximate amount of legal and illegal drugs a person has taken.
Read Article Now Book Mark ArticleTreatment
The goal of treatment includes:
- Reducing withdrawal symptoms
- Preventing complications of alcohol use
- Therapy to get you to stop drinking (abstinence)
INPATIENT TREATMENT
People with moderate-to-severe symptoms of alcohol withdrawal may need inpatient treatment at a hospital or other facility that treats alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens.
Treatment may include:
- Monitoring of blood pressure, body temperature, heart rate, and blood levels of different chemicals in the body
- Fluids or medicines given through a vein (by IV)
- Sedation using medicines until withdrawal is complete
OUTPATIENT TREATMENT
If you have mild-to-moderate alcohol withdrawal symptoms, you can often be treated in an outpatient setting. During this process, you will need someone who can stay with and keep an eye on you. You will likely need to make daily visits to your provider until you are stable.
Treatment usually includes:
- Sedative drugs to help ease withdrawal symptoms
- Blood tests
- Patient and family counseling to discuss the long-term issue of alcoholism
Alcoholism
Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...
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It is important to go to a living situation that helps support you in staying sober. Some areas have housing options that provide a supportive environment for those trying to stay sober.
Permanent and life-long abstinence from alcohol is the best treatment for those who have gone through alcohol withdrawal.
Support Groups
The following organizations are good resources for information on alcoholism:
- Alcoholics Anonymous -- www.aa.org
- Al-Anon Family Groups/Al-Anon/Alateen -- al-anon.org
- National Institute on Alcohol Abuse and Alcoholism -- www.niaaa.nih.gov
- Substance Abuse and Mental Health Services Administration -- www.samhsa.gov/atod/alcohol
Outlook (Prognosis)
How well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.
Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver, heart, and nervous system disease.
Most people who go through alcohol withdrawal make a full recovery. But, death is possible, especially if delirium tremens occurs.
When to Contact a Medical Professional
Alcohol withdrawal is a serious condition that may rapidly become life threatening.
Call your provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Call for an appointment with your provider if symptoms persist after treatment.
Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur.
If you go to the hospital for another reason, tell the providers if you've been drinking heavily so they can monitor you for symptoms of alcohol withdrawal.
Prevention
Reduce or avoid alcohol. If you have a drinking problem, you should stop alcohol completely. Total and lifelong avoidance of alcohol (abstinence) is the safest approach.
Stop alcohol completely
This article describes how to determine if you have a problem with alcohol use and offers advice on how to decide to quit drinking.
Read Article Now Book Mark ArticleReferences
Finnell JT. Alcohol-related disease. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 142.
Kelly JF, Renner JA. Alcohol-related disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 26.
Mirijello A, D'Angelo C, Ferrulli A, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-365. PMID: 25666543 pubmed.ncbi.nlm.nih.gov/25666543/.
O'Connor PG. Alcohol use disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 30.
Review Date: 1/17/2021
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.