Alcohol withdrawal syndrome occurs when a user who has become physically dependent on alcohol suddenly stops drinking. 

Alcohol is a depressant that works in the central nervous system. When we drink alcohol to excess for a continuous period, the central nervous system develops an imbalance in the production of key neurotransmitters. Two such chemicals are: 

• GABA –  an inhibitory chemical that also produces calming effects and sedation
• Dopamine – a neurotransmitter that regulates motivation, rewards, cognition, and motor skills

As tolerance develops, the body starts to assume alcohol’s effect in the body as its new baseline and drastically increases its responses to counteract the depressant effects to maintain chemical balance. When a user stops drinking, and alcohol leaves the system, this, in turn, causes imbalance, and we experience withdrawal symptoms.

Alcohol withdrawal syndrome symptoms can range from slightly uncomfortable to life-threatening. In many cases, even minor symptoms are enough to push users to act on alcohol cravings to avoid them. Withdrawal is a critical time, and successfully and safely beating this condition means seeking medical support.

Minor symptoms of withdrawal from alcohol appear first, even in users who will suffer more severe symptoms later.

These start to manifest around six hours after the last drink but can persist for some time.

People in withdrawal may experience:

• Insomnia
• Tremors
• Anxiety
• Nervous or angry behavior
• Dehydration
• Diarrhea
• Malnutrition
• Depression
• Nausea
• Headache
• Excessive sweating (regardless of temperature or activity level)
• Loss of appetite
• Heart palpitations
• Raised heart rate

Severe complications of alcohol withdrawal can occur and may require specialist care by medical professionals.

These are more likely in users with complex risk factors but can manifest in anyone. Serious symptoms are categorized by when they tend to appear.

12-24 Hours: Hallucinosis

This condition occurs in up to 10% of cases of severe alcohol withdrawal syndrome. On these rare but serious occasions, people who chronically abuse alcohol can experience hallucinations that begin within the first day of cessation. 

These hallucinations tend to be auditory but can also be visual or tactile. Users in severe withdrawal can hear sounds or words that are not being spoken and see or even touch things that are not there. These symptoms usually stop within forty-eight hours but require assistance to manage. 

6-48 Hours: Tonic-clonic Seizures

Once dismissively called rum fits, alcohol withdrawal can also cause seizures in heavy users. These are the most physically dangerous of the immediate effects of untreated alcohol withdrawal syndrome. Different forms of stimuli may bring them on, the most well-studied being sudden loud noises. 

48-72 Hours: Delirium Tremens

In 1813, delirium tremens was known as brain fever. It is characterized by the co-occurrence of extreme versions of the common minor withdrawal symptoms and can often include:

• Visual hallucinations 
• Disorientation
• Rapid heart rate
• Hypertension
• High fever
• Excessive sweating

This condition can last up to five days and has a mortality rate of up to 37% when left untreated. 

Up to one in twenty people who go through alcohol withdrawal experience signs of delirium tremens. While these are not the most common symptoms of alcohol withdrawal, they are still crucial considerations. 

Alcohol withdrawal is fundamentally a medical problem that can have severe complications if the user receives no treatment and is a more significant risk for long-term heavy users who cease drinking. It is not wise to stop without assistance.

People often worry about the potential severity of withdrawal symptoms when making the decision to quit drinking. 

Some risk factors suggest withdrawal symptoms will be more severe, including:

• Past use of alcohol – a history of constant and excessive drinking will almost universally increase the chances of withdrawal symptoms being severe.
• Blood pressure – studies have found that high blood pressure, specifically blood pressure over 140 mm Hg is associated with an increased chance of severe symptoms.
• Past DT – individuals who have already attempted to quit and experienced an episode of delirium tremens are far more likely to undergo severe symptoms if they try to stop again without support.

At the same time, it is crucial to understand that alcohol withdrawal syndrome is unpredictable. There is no specific factor that suggests an individual absolutely will or will not experience severe symptoms. 

If you or someone you know is aware that they need to quit drinking due to alcohol abuse disorder, treatment at an addiction rehabilitation facility is the safest and most comfortable way to begin recovery.

At Cirque Lodge, we offer inpatient treatment that alleviates the discomfort and dangers of alcohol withdrawal in a controlled environment.  

Cirque Lodge is a sober environment, and when you arrive, the first step is to begin detox. We can offer medically assisted detox when necessary at our Studio facility. Treatment plans for alcohol withdrawal can include the prescription of sedatives that help to mitigate the possibility of severe withdrawal complications. As treatment progresses, we taper these out to restore your body’s chemical balance safely. 

Many symptoms of alcohol withdrawal are psychosocial, and we are here to meet any needs that arise. Our therapeutic and psychiatric staff is always available to sit and talk and assist with the emotional side of alcohol withdrawal. We know that recovery from alcoholism is emotionally taxing, and we strive to support each of our clients through this challenging time. 

Many users continue to suffer from alcohol use disorder because of the challenges of withdrawal, but proper medical intervention can help you overcome this in safety and comfort.

Cirque Lodge is a dual diagnosis facility, meaning that we include evaluations for complicating co-occurring disorders such as anxiety and depression. Treating alcoholism is more effective when it is viewed as part of holistic mental health recovery. In the long term, understanding and treating mood disorders in tandem with alcohol use disorder reduces the risk of relapse in the future.

For more on our treatment program, see here.