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Alcohol withdrawal occurs in people who have been drinking heavily for years, months or even weeks and stop all of a sudden or reduce their alcohol consumption significantly.


Symptoms may vary from person to person but the most common symptoms of alcohol withdrawal are as follows:

  • Headache
  • Vomiting
  • Nausea
  • Mild anxiety
  • Insomnia
  • Shaky hands
  • Sweating

Other symptoms may include hallucinations – visual, auditory or tactile.

Risk Factors

Drinking for long periods of time disrupts the brain's neurotransmitters. When heavy drinkers suddenly stop the consumption of alcohol, the previously suppressed neurotransmitters are no longer suppressed, resulting in a phenomenon known as brain hyperexcitability – which leads to anxiety, irritability, tremors, seizures and agitation.


If your doctor suspects a patient to have symptoms of alcohol withdrawal symptoms, he will run some medical tests, take the medical history, how long has the patient been drinking for, whether there is a history of alcoholism in the family, and whether there is history of abuse of any other substances.

Based on this initial assessment, your doctor will run a physical exam to see the extent of damage that the alcohol consumption has had on the vital organs, and to check on any potential complications such as congestive heart failure, coronary artery disease, gastrointestinal bleeding, nervous system impairment, or infections.

Delirium tremens is a severe form of alcohol withdrawal with very sudden dramatic severe mental or nervous system changes. Delirium tremens can occur when you stop drinking alcohol after a period of heavy drinking. This is a medical emergency.

Clinical Features

Delirium tremens usually begins 24-72 hours after alcohol consumption has been reduced or stopped.

It can present with symptoms such as:

  • Hallucinations (auditory, visual, or olfactory)
  • Confusion
  • Delusions
  • Severe agitation
  • Seizures
  • Tachycardia
  • Hyperthermia and excessive sweating
  • Hypertension
  • Tachypnoea
  • Tremor
  • Mydriasis
  • Ataxia
  • Altered mental status


Alcohol withdrawal can be broken down into three stages:

  • Stage 1: Anxiety, insomnia, nausea, and abdominal pain characterize this stage, which begins 8 hours after the last drink.
  • Stage 2: High blood pressure, increased body temperature, unusual heart rate, and confusion come with this stage, which begins 24-72 hours after the last drink.
  • Stage 3: Hallucinations, fever, seizures, and agitation come with this stage, which tends to begin 72+ hours after the last drink.

All symptoms tend to decrease within 5-7 days.


The treatment for alcohol withdrawal syndrome depends on the severity of the condition. For mild to moderate cases, your doctor may suggest an outpatient procedure.

For more severe cases, the following are the usual methods of treatment:

  • Reducing immediate symptoms
  • Preventing complications
  • Long term therapy
  • Promoting alcohol abstinence
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