Alcohol withdrawal syndrome is the group of symptoms that can develop when someone with alcohol use disorder suddenly stops drinking.

Alcohol use disorder was formerly known as alcohol addiction or alcoholism. If a person regularly drinks too much alcohol, their body may become dependent on the substance.

Alcohol is a depressant. Alcohol use disorder or drinking heavily over an extended period can change a person’s brain chemistry due to the continued exposure to the chemicals in alcohol.

Chronic alcohol use can cause complex changes in their brain, including to the neurotransmitters dopamine and gamma-aminobutyric acid (GABA), which affect excitement and a person’s sense of reward.

The production of these neurotransmitters is affected when a person stops or significantly reduces alcohol intake. The brain has to readjust, which leads to withdrawal symptoms.

Symptoms

Alcohol withdrawal syndrome causes anxiety
Symptoms of alcohol withdrawal include nausea, anxiety, and a fast heart rate.

People with alcohol withdrawal syndrome can have a wide variety of symptoms, depending on how much alcohol they drank, their body type, sex, age, and any underlying medical conditions.

Common symptoms of alcohol withdrawal syndrome include:

Less frequently, people can develop severe symptoms of alcohol withdrawal syndrome. Severe symptoms are called delirium tremens or DTs.

Symptoms of DTs include:

  • severe tremors
  • elevated blood pressure
  • hallucinations, usually visual
  • extreme disorientation
  • seizures
  • raised body temperature

The DTs can be life-threatening. In extreme cases, the brain can have problems regulating breathing and circulation.

Drastic changes in blood pressure and heart rate can also develop, which may lead to a stroke or heart attack.

Alcohol withdrawal syndrome vs. a hangover

While some of the symptoms of alcohol withdrawal syndrome are similar to a hangover, they are not the same condition. Alcohol withdrawal syndrome and a hangover have different causes.

A hangover occurs when a person drinks too much alcohol at one time. Alcohol withdrawal syndrome occurs when a person with alcohol use disorder stops or suddenly decreases their alcohol intake.

Too much alcohol can irritate the stomach lining, cause dehydration, and lead to an inflammatory response in the body. As the alcohol wears off, these effects lead to common hangover symptoms, such as headache, nausea, and fatigue.

Alcohol withdrawal syndrome is different. If a person has alcohol use disorder, their body gets used to a certain amount of alcohol in their system.

The continued use of alcohol causes changes in the central nervous system and neurotransmitter production in the brain. When the supply of alcohol is suddenly stopped or decreased, withdrawal symptoms can develop.

When to see a doctor

Alcohol withdrawal syndrome can lead to hospital
It is important to detox from alcohol under the supervision of a doctor.

Anyone that thinks they are dependent on alcohol should consider speaking to a doctor.

Alcohol use disorder can lead to various physical and mental health conditions. However, treatment is available and can be highly effective.

For those trying to detox from alcohol, it is vital to do so under the supervision of a doctor, as the withdrawal symptoms may be severe.

Diagnosis

A doctor can often diagnose alcohol withdrawal syndrome by taking a person’s medical history and doing a physical exam.

The doctor may ask for evidence that there has been a decrease in alcohol use after regular heavy use.

They may also do a blood test called a toxicology screen to measure the amount of alcohol in a person’s system. Blood tests and imaging tests can show if organs, such as the liver, have been affected by a person’s intake of alcohol.

Treatment

Treatment options for alcohol withdrawal syndrome typically involve supportive care to ease the effect of the symptoms.

Doctors usually use a type of drug called benzodiazepines to reduce alcohol withdrawal symptoms.

Heavy alcohol use also depletes the body of vital electrolytes and vitamins, such as folate, magnesium, and thiamine. So, treatment may also include electrolyte corrections and multivitamin fluids.

The American Society of Addiction Medicine has goals for detoxification from alcohol or drugs. The purpose of treating alcohol use disorder is to:

  • Make the withdrawal process safe for the person and help them live alcohol-free.
  • Protect a person’s dignity during the withdrawal process and treat them humanely.
  • Prepare a person for ongoing treatment for alcohol dependence.

Detox process

Drinking in moderation can prevent alcohol withdrawal syndrome
Drinking in moderation is the best way to prevent alcohol withdrawal syndrome.

When a person is detoxing from alcohol, the symptoms may begin anywhere from 6 hours to a few days after their last drink.

Symptoms may gradually worsen over the course of 2 or 3 days.

Most symptoms reduce after about 5 days. In some cases, mild symptoms can continue for several weeks. Although some people choose to detox at home, it is safer to seek help when detoxing.

Symptoms can become severe, and it can be difficult to predict which people will develop life-threatening symptoms.

Anyone who is having severe symptoms of alcohol withdrawal syndrome, such as seizures, hallucinations, or prolonged vomiting needs immediate medical treatment.

People with severe symptoms remain in the hospital for part or all of the detox process so a doctor can closely monitor their blood pressure, breathing, and heart rate and provide medications to ease the process.

Prevention

The most effective way to prevent alcohol withdrawal syndrome is to avoid drinking or drinking only in moderation.

Moderate drinking is officially defined as 1 drink or less per day for women and 2 drinks or less per day for men. However, if a person already has alcohol use disorder, they can help prevent some of the withdrawal symptoms by speaking to a doctor about safe withdrawal.

Risk factors for alcohol use disorder include a family history of problems with alcohol, depression and other mental health conditions, and genetic factors.

For those who think they may have alcohol use disorder or may be dependent on alcohol, seeking help is essential.

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