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5 Things That Happen in Alcohol Withdrawal

It’s no secret that alcohol withdrawal is one of the worst substance withdrawals you can experience. The symptoms can range from flu-like to completely draining. 

Your own experience during alcohol withdrawal is unique because factors, such as how much you’re drinking and how long you’ve been drinking, affect your withdrawal. If you’ve been a heavy drinker for many years, then you’re more likely to have severe withdrawal symptoms that include tremors and seizures. 

However, this doesn’t mean you shouldn’t try to withdraw from alcohol. It only means that you shouldn’t try to withdraw alone. A certified substance abuse treatment center can help you manage the withdrawal process. Some symptoms can be dangerous if you try to withdraw without medical help. 

Before you start detoxing from alcohol, you should learn what to expect in the process. Being prepared helps you make informed decisions about how to manage the alcohol withdrawal process. 

Learn more about five things that happen in alcohol withdrawal: 

#1) Stomach Upset 

One of the earliest signs of alcohol withdrawal is an upset stomach. You might start feeling sick as soon as six hours after your last drink. 

It usually comes on quickly, then slowly increases in severity over the following 72 hours. Then the stomach upset might go away, or it might continue to some degree for up to three weeks. 

The length of your stomach upset depends on how heavy your alcohol use is. The more heavily you’ve been using alcohol, or the longer you’ve been using, the worse your symptoms are likely to be. 

Your upset stomach might present in a few different ways, including nausea, vomiting, or diarrhea. Some people experience one or two of the symptoms, while others have all three. Again, this usually depends on how severe your alcohol abuse is. 

In treatment, the biggest concern with stomach upset is that it affects your nutrition. It’s hard to stay healthy and nourished when you’re too ill to keep any food down. Your medical team may supplement your diet with intravenous (IV) nutrition if you’re too sick to eat enough. Drugs like Zofran can help reduce nausea too. 

#2) Psychiatric Changes

It’s very common to experience psychiatric changes in alcohol withdrawal. The most common changes are mood changes, including anxiety and agitation. 

Anxiety can be especially severe because many people with alcohol use disorder use the substance to self-medicate. If you’re self-medicating with alcohol, then losing alcohol as a crutch can make the anxiety from withdrawal feel much more intense. 

Agitation is just as common as anxiety. You might feel hopeless, angry, and restless. People who are agitated might act violently or say things that are out of character. 

Insomnia is another change that many people experience. You might have a hard time falling asleep or staying asleep. Some patients have problems with both. 

Most mood changes from alcohol withdrawal can be treated with benzodiazepines, including Ativan and Klonopin. These are drugs that treat anxiety, seizures, and insomnia. Since these conditions are all signs of alcohol withdrawal, benzodiazepines are often used to help detoxing patients be comfortable.

#3) Tremors

Also known as the shakes, tremors are another early sign of alcohol withdrawal. A tremor is a rhythmic shaking that happens in at least one body part. It might happen constantly or it may come and go. 

Most patients start feeling the shakes within six hours of their last drink. If you get tremors several days after your last drink, it could be an early sign of delirium tremens, a serious condition that can cause death. 

When they’re not a part of delirium tremens, tremors are harmless on their own, but they can cause problems functioning. You might find that you can’t write because your hand shakes too hard, or that your voice trembles when you have to speak. 

There aren’t any medications or treatments you can take to treat tremors from alcohol withdrawal. To get rid of tremors, you’ll simply have to wait out the detox period. Once your body is done withdrawing, your tremors should be go away on their own. Withdrawing at a treatment center can help keep you more comfortable by controlling other symptoms and making sure your tremor doesn’t develop into delirium tremens. 

#4) Changing Vital Signs

It’s common for your vital sign readings to all increase when you’re withdrawing from alcohol. Your vital signs include your:

  • Body temperature
  • Blood pressure
  • Respiration rate 
  • Heart rate

When you’re withdrawing from alcohol, you might feel like your heart is racing, your pulse is pounding, and your blood is boiling. It’s common to feel like you’re hyperventilating, or breathing too fast and shallow to get enough oxygen. 

Your vital sign readings will start increasing within six hours of your last drink in most cases, and they’ll continue reading high for anywhere from three days to three weeks. They’ll probably remain high for most of the time you’re withdrawing. 

Sometimes high vital signs can lead to serious health problems, such as: 

  • Brain damage or seizures from fever
  • Stroke or clogged blood vessels from high blood pressure 
  • Low carbon dioxide in your blood from high respiration rate 
  • Low oxygen in your blood from high heart rate

It’s a good idea to be under medical care when you’re withdrawing from alcohol. Your symptoms can be monitored and treated, so you’ll be more comfortable and less at risk for complications.

#5) Delirium Tremens

Delirium tremens is a condition that causes severe confusion. It’s the most severe side effect of alcohol withdrawal and it can cause death. It affects up to 5% of people withdrawing from alcohol, and 37% of those people die from the condition. It’s often called the DTs for short. 

The symptoms of delirium tremens include:

  • Delirium: Delirium is a state of confusion where you can’t tell reality apart from delusions or fantasies. People with delirium tremens have extreme delirium and might be completely incapable of recognizing the real world. 
  • Tremor: A tremor is a rhythmic shaking of one or more body parts. People with the DTs are likely to have a tremor, and the more severe their condition, the more severe the tremor is likely to be. 
  • High blood pressure: Most people with delirium tremens develop high blood pressure. If this is severe, it can cause a stroke, or a blocked blood vessel in the brain. 
  • Fever: It’s common to have a fever with delirium tremens. A fever happens when your body temperature rises above 100.4 degrees Fahrenheit. High fevers can cause brain damage or seizures. 
  • Hallucinations: People with delirium tremens often have hallucinations, or spells where they hear or see things that aren’t real. It can be a result of fever or a part of the condition on its own. 

The condition usually sets in around two days after your last drink and it might last up to five days. Getting medical help sooner means a better prognosis, or better chance of a good outcome. It’s important to catch delirium tremens as early as possible so you can get medical help. 

Delirium tremens is a medical emergency. Over a third of people who develop the condition die. It’s important to seek medical help right away if someone you’re with has delirium tremens. 

Get Treatment for Alcohol Withdrawal and Addiction 

Now that you know what to expect from alcohol withdrawal, you can venture into treatment with confidence. Your next step is to call our treatment specialists for information about setting up a treatment plan. You’ll work with medical professionals to create a treatment plan that’s tailored to your needs, and soon, substance use will be part of your past. Don’t hesitate, call today! 


  1. MedlinePlus: Alcohol withdrawal <>
  2. Harvard University: Alcohol withdrawal <>
  3. United States National Library of Medicine: Alcohol withdrawal tremor <
  4. Healthline: What is alcohol withdrawal syndrome? <
  5. National Center for Biotechnology Information: Delirium tremens <>
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