Josh Chandler | January 26, 2022

What Is Alcohol Withdrawal and Why Does it Happen?

What Is Alcohol Withdrawal?

A 2019 National Survey on Drug Use and Health (NSDUH) found that 85.6% of people ages 18 and older reported drinking alcohol at some point in their lifetime. This same study found that 14.5 million people ages 12 and older had an alcohol use disorder. Increased alcohol use and binge drinking can increase the chances of someone developing an alcohol use disorder. Individuals are at higher risk of developing other health issues like cardiovascular disease and liver disease with chronic or heavy drinking. When a person who drinks heavily decides to stop, they can develop alcohol withdrawal symptoms that could be harmful. So what is alcohol withdrawal and why does it happen?

When someone drinks alcohol heavily for weeks, months, or years, they can experience both mental and physical problems when they suddenly stop or significantly cut back on the amount. These health issues are called alcohol withdrawal, and the symptoms can range from mild to severe.

It is doubtful any individual will experience alcohol withdrawal symptoms when they only drink once in a while and then stop. It is also more likely to go through alcohol withdrawal symptoms if someone has already gone through it once before. Please keep reading to learn more about what is alcohol withdrawal and why does it happen.

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What Causes Alcohol Withdrawal?

As a depressive substance, alcohol slows down brain function and changes the way the nerves communicate back and forth. When a person is constantly drinking, the central nervous system adjusts to having alcohol all the time. This process causes the body to work hard to keep the brain awake and keep the nervous system message pathways continually moving. When there’s a sudden decrease in alcohol in the body, the brain stays in this more alert state, which causes withdrawal.

Alcohol Withdrawal Symptoms

Withdrawal from alcohol ranges from mild symptoms that can easily be managed at home to more severe ones that can even be life-threatening. Overall, symptoms will improve after about a week, but they can last much longer for some. Initial symptoms happen as early as a few hours after the last drink of alcohol. For those with mild drinking problems, these may be the only symptoms that appear. They are milder and include:

  • Tremors
  • Nausea and vomiting
  • Anxiety, feeling on edge, or restlessness
  • Headache
  • Sweating

For those with more severe alcohol dependence, symptoms can be worse and may include:

  • Hallucinations (visual, tactile, and auditory)
  • Seizures
  • Delirium tremens, or DT, is the most severe symptom of alcohol withdrawal and can be lethal.

Early treatment and prevention can significantly reduce the chances of death from DT. Includes symptoms such as:

  • Rapid heart rate and breathing
  • High blood pressure
  • Low-grade fever
  • Feeling disoriented or confused
  • Hallucinations
  • Profuse sweating
  • Stupor, a stage of near unconsciousness
  • Loss of consciousness

Certain people have a higher risk for developing delirium tremens, including older people and those who have a history of daily, heavy alcohol use, another acute illness, a history of withdrawal seizures, and liver disease.

Alcohol Withdrawal Timeline: What to Expect

Alcohol withdrawal symptoms can range from mild to severe and depends on how much and for what length of time they were consuming alcohol. When a person stops drinking or significantly cuts back, this is what they can expect the next few hours and days to look like: as early as six hours after the last sip of alcohol, a person can start with mild symptoms such as:

  • Headache
  • Nausea
  • Vomiting
  • Anxiety
  • Insomnia
  • Sweating
  • Shaky hands

After 12 to 48 hours after the last drink, more serious problems start showing, such as hallucinations and seizures. People can feel, hear, or see things that are not there. From 48 to 72 hours after the last drink, delirium tremens set in. These are the most severe symptoms during alcohol withdrawal and include vivid hallucinations and delusions, and this usually only occurs in 5% of people. Other symptoms during this time frame include:

  • Racing heart
  • High blood pressure
  • Fever
  • Confusion
  • Heavy sweating

How Medical Detox Makes Alcohol Withdrawal Easier

When excessive or chronic alcohol use leads to dependence, the withdrawal symptoms can be pretty significant when the person decides to stop drinking. Withdrawal can be severely uncomfortable and even dangerous.

For those with severe alcohol withdrawal, medical detox may be the best choice to ensure a more comfortable and safe alcohol withdrawal process. Under medical supervision, a doctor may prescribe certain medications to stop the progression or worsening of withdrawal symptoms and prevent any further complications.

With medical detox, withdrawal from long-term alcohol abuse can be far less risky by decreasing complications such as seizures. Because it makes the withdrawal more comfortable and keeps users away from easy access to alcohol, it also increases the likelihood of completing alcohol detox. 

Medications Used to Treat Alcohol Withdrawal

Administering medications during detox can also reduce future episodes of severe withdrawal symptoms if the person relapses and needs to detox again. Without using medications with the first withdrawal, the individual can be at risk of seizures following repeated withdrawal events.

During medical detox, alcohol withdrawal symptom medications may be given when symptoms start and throughout the process until they subside. Over 150 medications have been explored to treat alcohol withdrawal, and there continues to be a dispute on which medications are the best approach to managing withdrawal symptoms. 

Some of the medications used for acute alcohol withdrawal syndrome are:

  • Benzodiazepines: As a class of sedative medications, they help treat panic attacks, anxiety, and certain types of seizures. Physicians often use these for more problematic withdrawal symptoms, such as reducing the risk of seizures. Frequently used benzodiazepines which are also FDA-approved, are chlordiazepoxide (Librium), clorazepate (Tranxene), oxazepam (Serax), and diazepam (Valium).
  • Anticonvulsants: Due to the high risk of seizures, physicians will sometimes also prescribe other seizure medications in addition to benzodiazepines, especially during severe alcohol withdrawal. Some of these additional anticonvulsants are gabapentin (Neurontin), valproic acid (Depakene), oxcarbazepine (Trileptal), and carbamazepine (Tegretol). These can be used along with benzodiazepines or as a replacement. One advantage of using anticonvulsants is that they are less likely to be abused than benzos, but a downside is that they do not prevent DTs or grand-mal seizures.
  • Barbiturates: This class of drugs may be used to treat alcohol withdrawal symptoms in benzodiazepine-resistant cases. In particular, they are used in emergency departments and intensive care units. One study showed that they were more effective in an emergency department setting at treating seizures and delivered a low rate of causing respiratory depression.
  • Antipsychotics: Patients with a co-occurring disorder, such as schizophrenia, may be prescribed antipsychotic medications, but they must be used with caution since they lower the seizure threshold
  • Centrally Acting Alpha-s Agonists: Antihypertensive drugs, like clonidine, have been shown to reduce adrenaline-related symptoms but do not prevent seizures. Some of the milder symptoms they can help with are high blood pressure, anxiety, irritability, sweating, and tremors.
  • Beta-Blockers: These drugs help prevent some of the same adrenaline-related symptoms but fail to prevent the development of seizures or delirium tremens.
  • Baclofen: As a skeletal muscle relaxant, it is a selective agonist of the GABA-B receptor. Studies support its use for acute alcohol withdrawal and rapidly reduces symptoms, but not for controlling severe symptoms.

During medical detox, the individual will be monitored 24/7 and may be prescribed one or more of these medications. Using medical detox can significantly increase safety during the withdrawal process, provide more support than if an individual went by it on their own, and increase chances for the person to enter alcohol rehab that will help them maintain sobriety long-term.

Alcohol Detox and Rehab at Muse in Los Angeles

If you or a loved one has battled with alcohol use disorder for an extended period and is ready to stop, the safest option is to check into a professional alcohol detox program. At Muse Treatment in Los Angeles, you will receive a medical and psychiatric assessment upon admission to help their personnel decide what type of alcohol detox is best for you, including medical detox.

Alcohol detox can be an uncomfortable and even dangerous experience, and it is better safe than sorry to do it under professional care so you understand what is alcohol withdrawal and why does it happen. We can also help you get the support and therapy to start the recovery process during your withdrawal process. After your detox program is complete, we can recommend an appropriate alcohol rehab program for you, whether inpatient or outpatient care to help you have the best chance of long-term recovery.  

Please get in touch with Muse Treatment today at (800) 426-1818 to learn more about our alcohol detox program in Los Angeles and our alcohol rehab in Los Angeles. One of our addiction specialists will be happy to answer any of your questions about what is alcohol withdrawal and why does it happen.

Alcohol Addiction,Detox,Withdrawal,
Josh Chandler
Josh Chandler
After growing up in Chicago and North Carolina, Josh chose to get help with substance use disorder and mental health in California because of the state's reputation for top-tier treatment. There, he found the treatment he needed to achieve more than five years of recovery. He's been in the drug and alcohol addiction rehab industry for four years and now serves as the Director of Admissions for Resurgence Behavioral Health. Josh remains passionate about the field because he understands that one phone call can alter the course of a person's life.

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