Alcohol withdrawal

Overview

Symptoms usually start 6 to 24 hours after the last drink.

Delirium tremens (DTs) can start 2 to 4 days later and is life-threatening.

Symptoms

Common signs:

• Shaking and sweating
• Shaking or tremor
• Shaky hands in the morning, or needing a drink to feel normal
• Worry or anxiety

Less common

• Hallucinations
• Seizures

Look up a symptom: Racing or pounding heartbeat · Shaking or tremor · Shaky hands in the morning, or needing a drink to feel normal · Trouble sleeping · Worry or anxiety

When to get medical care

Causes

Alcohol dependence.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• People who drink heavily every day: Highest risk
• People with past withdrawal: Worse each time

Possible complications

• Seizures: Can happen in the first 2 days
• Delirium tremens: Confusion and shaking, an emergency

Diagnosis

A clinician asks about your symptoms and may order tests.

The exam

A physical exam.

Tests

Tests, if needed:

• Exam:

Treatment

Treatment depends on the cause and how severe it is.

Self-care

• Don't stop suddenly alone after heavy daily drinking

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to an addiction medicine doctor or a licensed counselor.

Living with it

• Keep a regular sleep, meal, and activity routine.
• Tell one trusted person how you're doing, and plan who to call on hard days.
• Limit alcohol and drugs. They often make symptoms worse.
• In a crisis, call or text 988 any time.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• SAMHSA National Helpline: Free, private treatment referrals 24/7: 1-800-662-4357.
• FindTreatment.gov: A government search tool for treatment centers near you.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.
• The Family and Medical Leave Act (FMLA) may let you take unpaid time off for treatment without losing your job.

Children, pregnancy, and older adults

• People with past seizures in withdrawal: Need medical detox.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Many mental health medicines are used safely in pregnancy. Stopping suddenly can cause a relapse.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Mood problems can start during or after pregnancy. Postpartum Support International: 1-800-944-4773.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Listen without judging, and let them know you care.
• Encourage treatment, but don't force it unless they're in danger.
• If they talk about suicide, call or text 988 with them.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Medical detox is safe.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• What's causing this?
• What treatment do you recommend?
• Should I detox in a hospital?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Alcohol withdrawal