Most people would agree that on occasion, consumption of alcohol in moderation is fine and may actually yield some health benefits. However, when consumption of alcohol becomes chronic and spirals out of control, it can really take a toll on both physical and mental health. Alcohol itself works by increasing the effects of GABA, an inhibitory neurotransmitter in the brain. Increases in GABA activity are linked to relaxation and depression of the nervous system.
Alcohol also decreases glutamate, which is an excitatory neurotransmitter – this causes our functioning to further slow while under the influence. To a certain extent, alcohol also can increase levels of dopamine – a neurotransmitter responsible for feelings of pleasure and reward. A majority of people can have a good time drinking on occasion with friends and/or family. However, some people become addicted to the psychological response that occurs when they drink.
Individuals who drink often may put themselves at risk for health problems as well as other risky situations such as drunk driving. People who drink often and utilize alcohol to the point that it negatively affects family functioning, work-related tasks, and/or their personal life are said to suffer from alcohol “abuse.” On the other hand, people who struggle with “alcoholism” are said to be physically dependent on it to the point that it is considered a chronic disease. Once an individual with alcoholism begins drinking, they are not able to stop.
The problem for most heavy drinkers is that when they try to kick their drinking habit, they experience an array of uncomfortable withdrawal symptoms. These symptoms can be very severe and in some cases, downright dangerous. If you are going through withdrawal from alcohol or are considering it, be sure to know how to properly taper as well as the possible symptoms that you may experience.
Factors that influence Alcohol withdrawal
There are many factors that will influence the difficulty of alcohol withdrawal as well as how long it lasts. Various factors that play an important role in withdrawal include: the time span over which you used alcohol, amount you typically consume, tolerance, whether you have an addiction, how quickly you withdraw, as well as other individual factors.
1. Time Span
Over how many years did you drink? Someone who has been drinking consistently every day for 10 years is likely going to have a much tougher time kicking the habit than a college kid who drank heavily for 1 year. In general, the longer and more consistently you have been drinking, the greater your tolerance is likely to be.
Additionally when you drink every day for years, it becomes ingrained almost as an innate habit that is even tougher to drop as alcohol has become part of your physiology. It is easier for your body to get used to functioning without alcohol when you only used it for a short period of time.
Long term users must gradually wean themselves down in quantity so that their body and brain can adapt to functioning with less alcohol until they have finally become sober.
2. Amount consumed / Tolerance
How much alcohol do you consume? Those who have been binge drinking daily for a year may have a very difficult time kicking the habit if they have a high tolerance. The amount of alcohol that you consume on a consistent basis will have great influence on your level of tolerance.
Obviously someone who doesn’t drink much will have a low tolerance, whereas someone who consistently consumes large quantities is likely to have a large tolerance. Individuals with higher tolerances are likely to experience more severe withdrawal symptoms when they quit.
3. Addiction / Dependency
Are you addicted to drinking alcohol? In some cases people become addicted to alcohol because it makes them feel good, takes away anxiety, lowers stress, and allows them to feel more carefree. Many people who become addicted drink so much that they develop a dependency on the alcohol for everyday functioning.
If you are addicted, withdrawal may be extremely difficult because you may constantly crave the alcohol and/or emotional component of relaxation that drinking provides. If you consider yourself an alcoholic or suffer from alcohol addiction, you may want to seek help from an addiction specialist and/or psychotherapist. Without proper help you may not make it successfully through withdrawal.
4. Cold Turkey vs. Tapering
If you have been using alcohol heavily, it is never recommended to simply quit “cold turkey.” Quitting cold turkey is widely regarded as a dangerous move for the simple fact that it can trigger seizures and other dangerous side effects. In order to avoid seizures and minimize withdrawal symptoms, it is important to gradually taper off of alcohol. Those who quit cold turkey or taper too quickly will likely experience significantly more severe withdrawal symptoms.
In order to successfully taper off of alcohol, it is best to come up with some sort of tapering protocol based on how much you currently drink (e.g. your tolerance). On average it is recommended to reduce your alcohol consumption by about 2 drinks per day until you are down to zero. So if you start at 30 drinks a day, cut down to 28 drinks your second day, 26 your third day, etc. – until you have reached zero.
Although you may be highly motivated to kick your drinking habit and function sober, it is recommended to avoid trying to taper too quickly. If you have been drinking consistently, you should not be making drastic cuts in the amount of alcohol you drink daily. People who drop from 25 drinks per day to 10 drinks then 0 drinks are going to likely end up with very debilitating withdrawal symptoms – some of which may be dangerous.
If you haven’t been drinking a lot and have only been drinking for short periods of time, you may be able to get away with a cold turkey withdrawal. With that said, you should know whether you have been drinking lightly enough to warrant a cold turkey withdrawal. If at any time you feel as though you are tapering too quickly, make adjustments and slow down the amount you cut and/or how quickly you do it.
5. Individual Factors
Individual factors play an important role in determining how successful someone is with their withdrawal as well as how a person copes with symptoms. Having healthy habits, good social support, and a productive environment can go a long way in helping a person make it through withdrawal. Without adequate support and proper environment, withdrawal symptoms can be more distracting and tougher to deal with.
- Physiology: Everyone is unique and will react differently to the process of withdrawal. Some people are more psychologically resilient and less sensitive to withdrawals than others. Your nervous system and the way your individual body responds to the withdrawal may be different than that of someone else.
- Habits: Do you have supportive habits to help you through withdrawal? Or do you have other addictions and bad habits that are tough to break. Individuals that are caught up in a string of bad habits may have a tough time quitting alcohol and dealing with symptoms. For example, someone who has healthy dietary, exercise, and sleep habits may experience quicker recovery than others.
- Environment: Your environment can play a role in determining the difficulty of withdrawal. If you live in a safe, positive environment, it is thought that withdrawal will be easier to handle. People that live in a rougher environment are going to likely face greater difficulty in withdrawal. If lots of other people around you in your environment drink, it may be tougher to quit and you may get less support.
- Social Support: Do you have good social support? People with a more supportive social network may have an easier time getting through difficult withdrawal symptoms. If you have someone around to talk to who will support you when you are experiencing difficult withdrawal effects, it may help you with coping as opposed to someone without good social support.
- Other drugs: Are you using any other drugs? In some cases other drugs may make the withdrawal process easier. If you are working with your doctor and have been prescribed medications to help ease the symptoms of alcohol withdrawal, they may actually help. On the other hand, if you are using illicit drugs to deal with alcohol withdrawal, you are essentially just shifting the addiction to a new substance.
- Personality: Do you have a naturally addictive personality? People who have addictive personalities may have a tougher time making it through alcohol withdrawal. Individuals who have more carefree non-addictive personalities will likely have an easier time making it through withdrawal.
- Coping mechanism: Many people use alcohol as a coping mechanism for stressors and/or to deal with life. People that are using alcohol to make it through a rough time in life may have a tougher time quitting because they are essentially using it as a drug to mask a deeper underlying issue. If you are using it as a crutch or coping mechanism, it is advised to seek some sort of therapy to help address other problems.
Alcohol Withdrawal Symptoms: List of Possibilities
Below is a list of possible symptoms that you may experience upon withdrawing from alcohol. Understand that you may not experience every symptom listed below and the severity of these symptoms is largely based on individual circumstances. One person may experience nearly every symptom listed below, while another may have a relatively mild withdrawal and only have to deal with a few symptoms.
- Agitation: Many people feel agitated during the first few weeks of withdrawal. The agitation may last much longer than a few weeks in some cases. Do your best to manage this feeling by getting some light exercise and/or practicing relaxation exercises.
- Anger: Many individuals experience anger to the point of rage during withdrawal from alcohol. This anger is typically a result of our inability to relax and in part due to the fact that the brain is sensitive during withdrawal. Neurotransmitter levels have not recovered to baseline and this may make you more prone to anger outbursts.
- Anxiety: The amount of anxiety people experience from alcohol withdrawal can be extreme. This may be due to changes in neurotransmitter levels (specifically GABA) as a result of extensive alcohol use. Additionally consistent alcohol abuse can diminish our natural ability to relax because the brain has become reliant on the alcohol to induce relaxation. Over time, your brain and nervous system will recover, but be prepared to deal with some anxiety during withdrawal.
- Appetite loss: A large percentage of people will notice that their appetite changes during alcohol withdrawal. If you notice that you are lacking appetite, understand that it’s merely a withdrawal symptom. Over time as your body resets itself, your appetite should come back.
- Blood pressure increases: In some cases people experience hypertension (high blood pressure) when they stop consuming alcohol. If you know that your blood pressure could be problematic, consult a doctor and discuss what can be done to manage this symptom. They may suggest taking something like Clonidine – which can help control blood pressure and may take an edge off of other symptoms.
- Confusion: You may experience severe confusion when you initially stop drinking alcohol. This confusion is in part due to neurotransmitter changes, but also due to the array of other psychological symptoms such as poor concentration and memory functioning during withdrawal.
- Concentration problems: It is very common to experience foggy thinking and lack of concentration when you withdraw from alcohol. It may seem impossible to focus on schoolwork and/or job-related tasks. Do your best to tough out the lack of concentration and do what you can to get through each day. The brain will eventually recover and you’ll be able to concentrate again – it just may take some time.
- Cravings: Although many people that quit drinking alcohol are mentally determined to do so, it can be difficult to deal with cravings that arise during withdrawal. Some people experience such extreme cravings that they have a difficult time gradually tapering off of alcohol and or becoming fully sober. Do your best to deal with any cravings by getting rid of all excess alcohol once you have fully tapered yourself down.
- Crying spells: The depression that people experience during alcohol withdrawal can be debilitating. This may lead people to feel hopeless and inevitably breakdown and cry. If you find yourself crying often during withdrawal, just know that you will eventually experience emotional recovery.
- Delirium tremens: People experience major fluctuations in nervous system functioning during alcohol withdrawal. This is a more common symptom in people who drink large amounts of alcohol every single day for months. It also is more likely to affect individuals who have had an alcohol habit for many years. Essentially this is a psychotic state in which an alcoholic experiences tremors (shakes), anxiety, feels disoriented, and can possibly hallucinate.
- Depression: Do you feel severely depressed now that you have stopped drinking? This is relatively normal and is in part due to neurotransmitter changes in the brain. As your brainwave functioning and neurotransmitters reestablish homeostasis, your mood should lift. Keep in mind that you may feel depressed for awhile, most people don’t recover overnight.
- Depersonalization: If you feel unlike your natural self and/or almost like a zombie, just know that this is another possible withdrawal symptom. This is caused by changes in brain functioning and can actually be exacerbated by anxiety. Do your best to keep the faith that you will eventually feel normal again because you will.
- Dilated pupils: You may notice that your pupils become enlarged and dilated when you withdraw. While drinking, most people experience pupil constriction due to the depressant effect it has on the nervous system. When you come off of alcohol your nervous system elicits the opposite response and pupils dilate.
- Dizziness: A very common symptom to experience during withdrawal is that of dizziness. You may feel dizzy to the point of vertigo and/or feel as if you have a difficult time maintaining balance. The dizziness can be uncomfortable, but it will eventually lessen and eventually stop over time.
- Fatigue: Don’t be surprised if you feel so tired that you cannot get out of bed in the morning. If you have been using alcohol for a long time, you may feel weak and tired. Your body and brain are likely completely drained of energy and will need some rest to function soberly.
- Fever: Some individuals experience spikes in body temperature when they stop drinking and become sick. Most people that get fevers will only have “low grade” fevers, but it is possible to run higher fevers as well.
- Hallucinations: Some people actually experience psychotic symptoms when they withdraw from alcohol. This can include hallucinations, which are regarded as seeing and/or hearing things that aren’t based in reality. Most people do not hallucinate when they stop drinking, but it is possible for more chronic, long-term alcoholics.
- Headache: Another very obvious symptom that people experience is that of headaches. Even short-term drinkers experience various degrees of headaches when they stop drinking. You may experience light headaches and/or something more severe like a migraine. These will eventually go away with proper rest as time passes.
- Heart palpitations: The symptom of palpitations can be somewhat alarming to a person who has never experienced them before. These are basically feelings that your heart is pounding especially loudly and/or racing. If you react to these with anxiety and panic, they will likely become more severe. As your anxiety subsides and your body relaxes again, these will diminish.
- Insomnia: Some people drink alcohol because it depresses the nervous system and helps them fall asleep. During withdrawal not only are many people anxious, they experience significant changes in sleep patterns – which can inevitably lead to insomnia. Just know that it is very normal to experience insomnia when you withdraw. Your sleep pattern should correct itself over time.
- Irritability: Withdrawal from alcohol can lead to irritability as a result of changes in GABA functioning. When you have adequate GABA, you are able to keep calm and don’t get bothered by minor things. Insufficient GABA can lead a person to feel irritable and unable to stay calm.
- Itching: Some people have reported that they experience intensely itchy skin during withdrawal. The itch can feel almost like a rash in regards to severity and/or like bugs crawling all over the skin. The cause of this isn’t fully understood but one theory suggests that it’s the result of the central nervous system reactivating itself via nerve endings after being numbed by the alcohol for an extended period.
- Joint pain: Do you feel pain in your joints now that you are going through withdrawal? This is especially common and largely due to the fact that alcohol can numb any sensations of pain. Additionally your body may have been in a drunken stupor for such a long time that reactivation of joint functioning causes some minor aches.
- Mood swings: Most people can expect some sort of mood swings during their withdrawal. One minute you may feel deeply depressed and hopeless, the next you may be optimistic about the withdrawal process. Understand that changes in mood such as feelings of anger, sadness, apathy, anxiety, etc. will all gradually stabilize.
- Muscle weakness: A lot of people who drink consistently don’t get adequate exercise. Heavy drinking and minimal exercise is a recipe for muscle weakness. Your muscles may have actually become weaker due to lack of exercise and stagnation during the period in which you drank heavily. The weakness is also in part due to your body adapting to the detoxification process.
- Nausea: If you feel really nauseated during the first few weeks of withdrawal, this is pretty normal. The nausea may become intense at times and lead to vomiting. It may be difficult to work through this symptom, but eventually you will recover.
- Nightmares: A lot of people end up having to deal with nightmares, bad dreams, and crazy dreams when they stop drinking. The nightmares may be caused by poor sleep quality and the brain attempting to function sober again.
- Panic attacks: Some people experience such intense anxiety that it escalates to a panic attack. Panic attacks are caused by intense surges of uncontrollable anxiety. These are thought to be caused by disruptions with GABA neurotransmitter levels; when they drop, it’s easy for panic to set in. If you notice yourself experiencing panic, it is advised to practice relaxation techniques as they will calm the nervous system and promote desensitization to environmental triggers.
- Seizures: One of the dangers associated with rapid withdrawal or quitting alcohol “cold turkey” after extensive usage is that of seizures. If you quit cold turkey, you may not have adequate GABA in the brain to inhibit electrical activity. The electrical activity may spike, which could lead to a seizure. Seizures are more common in long-term alcoholics and/or people who have withdrawn from alcohol many times.
- Sleep disturbances: In addition to experiencing general insomnia, your entire sleep cycle may be thrown off schedule. You may be unable to sleep at night, but may feel tired during the day. Additionally you may fall asleep and not be able to stay asleep for a long period of time. For long term drinkers it may take over a month for your sleep cycle to correct itself.
- Suicidal thinking: The depression, anxiety, and panic that can set in during withdrawal can take a major psychological toll. If at any point you feel suicidal, recognize that although you feel crappy, you will eventually feel better. If you are unable to cope with this feeling, seek out a professional therapist. Typically as time passes, your emotions will stabilize and you’ll feel less depressed.
- Sweating: Most people notice heavy night sweats when they are going through detoxification from alcohol. With that said, you may also sweat profusely throughout the day. The amount you sweat should gradually lessen and normalize within a few weeks.
- Tremors: You may notice that your hands and/or other body parts constantly shake. Shaking is a symptom that many heavy drinkers experience during the tapering process and after they have had their last drink. Recognize that this symptom may be very uncomfortable, but it should subside over time.
- Vomiting: Most individuals who drink a lot can attest to feeling flu-like symptoms when they stop using alcohol. One of the symptoms that people experience is that of vomiting. Consider taking something like Pepto-Bismol to calm your stomach. Additionally make sure that you are drinking plenty of water as vomiting can lead to dehydration.
Note: While certain symptoms may be noticeable during the “tapering” process, a majority will emerge after alcohol has been fully cleared from your body. For further information about how alcohol is metabolized and the rate by which it is eliminated, read the article: “How long does alcohol stay in your system?”
Alcohol Withdrawal Symptoms: How long do they last?
There is no exact predictable timeline that can be universally followed for withdrawal from alcohol. Although many people may experience most intense symptoms within the first few days of withdrawal (the acute phase), some end up dealing with severe withdrawal symptoms for weeks and in other cases months since their last drink (post-acute phase). The severity of symptoms as well as the duration of withdrawal will largely depend on individual circumstances.
Individuals who are naturally less sensitive to withdrawal and have a supportive environment may recover at a quicker rate than people who are highly sensitive to withdrawal symptoms. Additionally someone who has been drinking heavily for years and is withdrawing may experience much more intense and longer-lasting symptoms, compared to someone who was only drinking for a couple months. It is important to understand that the withdrawal process is a highly unique and individualized based on many personal factors.
Some people may only end up experiencing intense symptoms for a few weeks and gradually improve, while others don’t notice any symptoms until they have been off of alcohol for a few weeks. Some people report pretty intense withdrawal symptoms for up to 6 weeks after their last drink, while other people end up going through protracted withdrawals that last up to 3 months. As a rule of thumb for any major withdrawal, I always recommend giving yourself 90 days before reevaluating how you feel and your symptoms.
Although it can be difficult to wait a full 3 months, a majority of people will be able to notice significant improvement after this duration of time. By waiting 90 days you have given your nervous system more time to adapt to sober functioning and you will likely be able to recognize some clear improvements in your recovery compared to the first couple weeks of withdrawal. Keep in mind that in some cases, protracted withdrawal symptoms can last up to a full year.
In the meantime, make sure that you don’t get caught up in how long the symptoms are going to last, rather take the time to focus on recovery. Take things one day at a time and if necessary, one hour at a time in the early phases of withdrawal. One tough hour may seem like a marathon, but you will survive and eventually experience full recovery. Each day try to focus on doing healthy things for yourself like eating good foods, staying hydrated, resting, getting good sleep, staying productive as possible, talking with friends, and consider some light exercise.
If you are currently dealing with alcohol withdrawal symptoms and/or have already survived alcohol withdrawal, feel free to share your experience in the comments section below. By sharing your experience, you may give someone else some encouragement and/or hope that they need in order to make it through this challenge.