Understanding
Alcohol
Withdrawal

What is Alcohol Withdrawal Syndrome (AWS)?

  • Alcohol Withdrawal Syndrome (AWS) is a set of symptoms that occur when an individual who is physically dependent on alcohol suddenly stops drinking or drastically reduces their alcohol intake. This condition affects the body’s central nervous system (CNS), leading to a range of physical and psychological symptoms. The severity of AWS can vary significantly, from mild discomfort to severe, life-threatening conditions.

  • When someone with a high level of alcohol intake suddenly stops, their CNS, which has adapted to the constant presence of alcohol, goes into overdrive. This can result in symptoms such as mild anxiety, tremors, and sweating in less severe cases. However, more severe withdrawal symptoms can include hallucinations, seizures, and delirium tremens (DTs). Understanding AWS is crucial for recognizing the need for medical intervention and support during the withdrawal process.

Causes and Risk Factors

Alcohol Withdrawal Syndrome (AWS) is primarily caused by the sudden reduction or cessation of alcohol consumption in individuals who have developed a physical dependence on alcohol. Several risk factors can increase the likelihood of developing AWS, including:

  • Heavy and Prolonged Alcohol Use: Regularly consuming large amounts of alcohol over an extended period significantly increases the risk.

  • History of Previous Withdrawal Episodes: Individuals who have experienced withdrawal symptoms in the past are more likely to experience them again.

  • Co-occurring Medical or Psychiatric Conditions: Existing health issues can exacerbate the symptoms of AWS.

  • Family History of Alcoholism: Genetics can play a role in the likelihood of developing alcohol dependence and AWS.

  • Age: Older adults are more susceptible to AWS due to the cumulative effects of long-term alcohol use.

  • Use of Other Substances: Concurrent use of other substances can complicate and intensify withdrawal symptoms.


The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking as consuming four or more drinks per day for men and three or more drinks per day for women. Individuals who meet or exceed these levels of alcohol use are at a higher risk of developing AWS.

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Stats for Alcohol Addiction & Withdrawal

  • 1 in 12 people in the US are addicted to alcohol. Alcohol is the most used substance in the country. Alcohol addiction harms society and families, causes serious and fatal accidents and kills. And yet alcohol is a part of many milestones in modern life. Alcohol is served at weddings, graduations, parties and in homes all over the country.

  • More than 2/3 of the population drinks. Yet 50% of all alcohol purchased and served in the country is consumed by 10% of the population. This article covers the symptoms, timeline and best options for getting help for both alcohol addiction and the symptoms.
An infographic of alcohol and driving statistics.

Alcohol and Driving

Alcohol impairment is dangerous for all drivers but especially commuters. Every day 29-32 people in the US die from drunk driving accidents. Drunk driving crashes cost more than 44 million dollars a year. 200 billion dollars is directly attributed to drunk driving crashes including:

  • Medical

  • Insurance

  • Lost wages

  • EMS service

  • Property damage

  • Productivity


Anyone driving with a BAC or blood alcohol level above the .08 legal limit can be fined or sentenced to jail time. They can lose their license for several years. More lost productivity and wages. The average cost of drunk driving charges, jail time, insurance, attorney fees and impound is $10,000 to $15,000. More stress for someone already addicted to alcohol.

Risks of Alcohol Use Disorder

  • Someone with a long term alcohol addiction is especially dangerous. They have a hard time quitting. Seizures and tremors are common. Severe alcohol withdrawal can lead to dangerous symptoms, including withdrawal seizures. Those in recovery can develop delirium tremens. This is dangerous because they can lapse into a coma and die while trying to get clean. Withdrawal symptoms start about 8 hours after the last drink and can last several weeks.

  • Alcohol is involved in 40% of all violent crime arrests. 50% of all inmates in jail are struggling with alcohol addiction. Alcohol is a factor in more than 40% of all suicide attempts in the US every year. With the prevalence of alcohol it’s very dangerous for anyone with a substance abuse problem.
A couple of friends drunk at the bar, in need of treatment.
An infographic displaying statistics of alcohol crime related.
  • Alcohol is different than street drugs. A lot of effort is required to find a specific drug. With alcohol it’s easy to get. Because of the legality of alcohol family and friends have a harder time recognizing the alcohol addiction of a loved one. There are specific signs of alcohol addiction:
  • Cravings for alcohol

  • Irritability

  • Financial problems

  • Can’t do anything without drinking first

  • Feelings of guilt

  • Legal issues like car accidents and DUIs

  • Drinking in secret or alone

  • Injuries from alcohol impairment

  • Withdrawal symptoms like anxiety or sweating

  • Relationship problems

  • Drinking as soon as they wake up in the morning

  • Can’t control or stop drinking no matter the consequences

  • Smells of alcohol

An infographic showing the length of alcohol detox.

Alcohol and Recovery

  • Alcohol addiction is tough for someone in recovery. To stay sober they need ongoing support and maintenance plans. This is key to success. Withdrawal symptoms for long term alcohol addiction and abuse can be brutal. Mild withdrawal symptoms, which can often be managed with proper support and monitoring, are less severe and usually do not require specific medications. Unfortunately the symptoms of withdrawal can be deadly.

  • Friends and family of their loved one need to encourage them to get help from professionals. Anyone trying to recover from an alcohol addiction can have serious medical complications. Symptoms of withdrawal can last weeks or even months.

The Timeline of Withdrawal

  • The timeline of withdrawal has three stages. Stage one, characterized by mild symptoms, starts as soon as 8 hours or less after the last drink. Stage two starts 24 hours after the last drink and lasts 72 hours. Stage three starts 72 hours after the last drink. This stage is painful, intense and where fatal complications can occur.

  • Stage three can last up to 7 days. This is when the symptoms will start to subside. If the person has been drinking for a long time or has comorbid conditions due to alcohol addiction the consequences can be lingering effects or permanent health issues or conditions. If they don’t get medical help the symptoms of withdrawal can last weeks after the last drink.

Get started today!

 
Start your recovery journey with us at Asana Recovery,  where we prioritize your well-being and provide a welcoming environment for you to heal. 

Get started today!

 

Start your recovery journey with us at Asana Recovery, 
where we prioritize your well-being and provide
a welcoming environment for you to heal.

Physical Symptoms of Withdrawal

  • In stage one of withdrawal the person can experience nausea, stomach pain and insomnia. In stage two the symptoms can be changes in heart rhythm, increased body temperature and high blood pressure. People with suspected heart problems or heart conditions need to be monitored for signs of a stroke or heart attack.

  • In stage three of withdrawal the person in recovery will usually have a fever. There’s also a risk of delirium tremens. This is a serious condition where the person develops a high fever, seizures and tremors. In some cases they will slip into a coma, go into respiratory arrest and not survive.

  • Long term issues with coordination and motor control. Hearing loss. If they experienced trauma, injury or accident due to alcohol abuse muscle and joint issues and arthritis can develop.

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Emotional and Psychological Symptoms

Alcohol withdrawal symptoms will include hallucinations, agitation, anxiety, and confusion, especially in individuals with alcohol use disorders. Long term issues with emotional regulation and memory problems can occur. Even after they’re recovered from active addiction they will struggle with occasional cravings. In most cases this will be followed by a clinical depression episode.

Support and ongoing therapy from the community and loved ones is key for someone with an alcohol addiction to stay sober and deal with long term issues in a healthy and positive way. If they don’t get help they will harm themselves or relapse.

Severe Alcohol Withdrawal


Severe alcohol withdrawal is a critical condition that demands immediate medical attention. It is characterized by intense and potentially life-threatening symptoms, including:

  • Delirium Tremens (DTs): A severe form of withdrawal that includes sudden and severe mental or nervous system changes.

  • Seizures: Uncontrolled electrical disturbances in the brain that can lead to convulsions.

  • Hallucinations: Seeing, hearing, or feeling things that are not there.

  • Coma: A state of prolonged unconsciousness.

  • Respiratory Depression: Slow and ineffective breathing that can be fatal.


Individuals with a history of heavy and prolonged alcohol use, especially those who have experienced previous withdrawal episodes, are at a higher risk of severe alcohol withdrawal. The onset of severe symptoms necessitates immediate medical intervention to prevent complications and ensure the safety of the individual. If you or someone you know is experiencing severe symptoms of alcohol withdrawal, it is crucial to seek medical help without delay.


By understanding the complexities of alcohol withdrawal syndrome and recognizing the risk factors and severe symptoms, individuals and their loved ones can better prepare for the challenges of recovery and seek the necessary medical support.

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Frequently Asked Questions

Quitting without medical supervision is not safe. Especially if the person has been drinking for a long time. If they quit cold turkey the symptoms of withdrawal will be more intense or worse. A medical detox is needed to taper off the alcohol under the care of a doctor. The doctor can also prescribe benzodiazepines to help the person taper off the alcohol.

People in recovery can taper off alcohol with the following:

  • Anti-anxiety medication

  • Sleep aids short term only

  • Benzodiazepines

  • Mood stabilizers

  • Small amounts of alcohol

Doctors in a medical detox center are on call 24/7 to help with severe withdrawal symptoms. If the person experiences a heart arrhythmia or delirium tremens they can keep them safe by addressing the issue quickly. Detoxing at home is not recommended because the person doesn’t have the supervision and medical help they need.

More alcohol or illegal drugs are not safe during detox. Detoxing at home without proper support or medical help is dangerous because the person can develop life threatening conditions, get hurt and die.


People in recovery are at high risk of having suicidal thoughts or attempting suicide due to severe depression. Family members don’t have the training or experience to handle these complications. A professional support system must be in place for all recovering alcoholics to stay safe and sober for life.

The first step for anyone addicted to alcohol is to enter a medical detox. A doctor will then assess the person for any health conditions. The person is then evaluated and treated for any underlying mental or physical issues. Replacement medications are used to help the person detox safely. Withdrawal symptoms are managed with prescription medication.

Once the worst of the withdrawal symptoms have passed the person will start working with a therapist. This is when the person will learn how to overcome the issues that led to their alcohol addiction. The therapist will develop coping mechanisms and plans to help the person stay sober when they leave the facility. The length of time the person will need to stay in the facility is determined by:

  • How long the person has been addicted

  • The person’s lifestyle

  • If the person is also addicted to other drugs

  • Any underlying mental or physical conditions


These factors will determine what type of therapy is best for each situation. Sometimes one on one therapy is all that’s needed. Other times family and group therapy is beneficial. Patients in a rehab center have access to multiple types of treatment to meet their needs. Doctors and therapists are on call 24/7.


Therapists will teach patients how to cope when they leave the facility and live their best life. One of the benefits of a rehab facility is patients spend time with each other. This is good because they are all going through the same thing. Patients understand and support each other for everything they are feeling and going through. Rehab facilities also have integrated and holistic treatment.


The treatments and progressive therapy was developed with the understanding the whole person needs to heal. Patients have access to many different therapies, often including sports therapy, art therapy, relaxation therapy, yoga and massage. These types of therapy have been proven to work for people with long term alcohol addiction and those who have relapsed. Alcohol addiction is different for each person because we are all unique.


Sometimes alcohol abuse is a result of suffering from other mental health conditions. Inpatient rehab centers and medical detox facilities are the best option for treatment for people with unique circumstances. Some people are struggling because they are also addicted to other substances or drugs along with alcohol.


To stay sober these people need the support of their family while working with trained social workers, doctors and therapists. Don’t hesitate to get alcohol abuse treatment for your loved one. Talk to a licensed therapist through medical detox centers. It’s never easy to ask for help. The admissions counselor will walk you through the entire process and go over all the treatment options.


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