What Are Alcohol Withdrawal Side Effects?

Alcohol withdrawal side effects can be life threatening. Alcohol withdrawal syndrome (AWS) is clinically diagnosed when there is significant physical and emotional distress when a person stops drinking.

Symptoms can begin within a few hours of the last drink. It is imperative that alcohol withdrawal is supervised by a medical professional. This article will tell you about additional symptoms and how to find treatment.

Key Facts

  • 75 percent of the American public, ages 12 and over, have reported lifetime use of alcohol.
  • Alcohol withdrawal side effects can cause death by seizures, cardiac complications, dehydration and delirium. 
  • Other withdrawal symptoms are physically uncomfortable and difficult to manage without medical supervision. 
  • Medically assisted treatment will assist in easing the discomfort and symptoms of alcohol withdrawal.
  • Treatment facilities are available for a continuum of services that will support maintaining recovery long term. 

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What are Alcohol Withdrawal Side Effects?

Alcohol is a central nervous system depressant that causes an overproduction of GABA, which is an inhibitory neurotransmitter preventing conduction in the brain.

Because of an excess of the inhibitory GABA, the brain tries to balance itself by producing glutamate. Glutamate is an excitatory neurotransmitter that stimulates conduction. 

When alcohol is withdrawn from the system, GABA overproduction stops or tapers, but the glutamate continues to be overproduced. This is what causes alcohol withdrawal syndrome.

Overproduction of one neurotransmitter causes intoxication, while the overproduction of another causes withdrawal sickness. These imbalances in brain chemistry can cause seizures and contribute to autonomic instability that may affect heart rhythm.

This is why medically supervised detox is essential for safely withdrawing from alcohol. 

Symptoms & Side Effects: What You Might Experience 

Not everyone experiences each symptom. These symptoms depend on the length of use, amount used over time, and the levels of alcohol in the system when the last drink is taken and detox begins. Use the links below to learn more about these symptoms. 

Seizures 

  • Seizures require emergency medical attention. The peak risk is between six and 48 hours after the last drink. Seizures are caused by imbalances in brain chemistry.
  • When you have experienced past withdrawal seizures you have a higher risk of recurrence during current withdrawal. Dehydration and electrolyte imbalances may exacerbate seizure risk. 

Headaches 

  • These headaches are caused by muscle spasms, dehydration and blood pressure spikes from withdrawal. They generally feel like pressure but can also be caused by grinding and gritting teeth. 
  • Headaches are a red flag when they suddenly become the worst headache you’ve experienced or you notice neurological deficits.

Fatigue

  • Fatigue is a common symptom during alcohol withdrawal, often caused by the body working to rebalance neurotransmitters and repair disrupted sleep patterns.
  • It may also result from calorie deficit or a catecholamine crash, which is the sudden depletion of certain neurotransmitters, such as dopamine or epinephrine.
  • This exhaustion can persist for days or weeks, depending on the severity of withdrawal and overall health.

Insomnia 

  • Insomnia frequently occurs during alcohol withdrawal because the nervous system, once suppressed by alcohol, becomes overactive and disrupts normal sleep cycles as excessive glutamate overstimulates the brain.
  • This can result in rebound REM and hyperarousal. Prioritize sleep hygiene and nonsedating strategies.

Night Sweats 

  • Night sweats are an alcohol withdrawal side effect caused by an overdrive of the sympathetic nervous system that also triggers cardiac fluctuations and blood pressure spikes.
  • These are most intense in the first week and then tend to resolve. It’s important to ensure hydration and seek medical evaluation if it’s accompanied by fever or confusion.

Blood Pressure/Heart Rate Anomalies

  • A temporary surge in the sympathetic nervous system can elevate your blood pressure and heart rate. This can lead to an emergency.
  • Seek immediate medical attention if you develop chest pains, severe headache, confusion, vision changes, or neurological symptoms. 

Diarrhea 

  • Gastrointestinal disruption is triggered by hypermotility and dysautonomia, which can lead to dehydration. The body detoxifies alcohol in the liver, though a small amount is excreted through the kidneys, lungs, and sweat.
  • This process, along with withdrawal-related symptoms, can contribute to dehydration and may require medical attention if you experience a fever, blood in the urine, or severe abdominal pain.

Stomach Pain 

  • Abdominal pain can be triggered by cramping, muscle spasms, vomiting and diarrhea. The pain may be caused by gastritis, an ulcer, or pancreatitis triggered by alcohol use.
  • Persistent vomiting, GI bleeding, or fever warrants immediate medical attention.

Itching

  • Alcohol withdrawal can trigger histamine activity when the alcohol drops, which disrupts the balance of neurotransmitters and inflammatory pathways in the body.
  • When alcohol is removed, histamine release increases, leading to symptoms such as itching, flushing, or anxiety.
  • This can feel like bugs are crawling on your skin. Occasionally itching is related to liver disease from alcohol use, which can trigger jaundice, dark urine, and pale stools. This requires immediate medical attention.

Fever 

  • A low grade fever can persist. When combined with confusion, a medical evaluation is necessary to rule out infection, DTs, or other medical causes. 
  • A high fever requires immediate medical attention.

Bloat 

  • This is common during early withdrawal and is usually self-limited.
  • If swelling is identified in the ankles and lower legs, then a liver examination should be conducted to rule out cirrhosis, hepatitis, or fatty liver disease. 

Risk, Severity & When to Seek Help

If you have been using alcohol regularly and are not sure what level of care you should look for, it is best if a medical professional assesses your history of alcohol use, past withdrawal symptoms, and potential for severe reactions to alcohol withdrawal.

Risks from alcohol withdrawal can include:

  • Wernicke Encephalopathy: A thiamine deficiency that can cause seizures and altered mental status leading to death. 
  • Seizure risk peaks from six to 48 hours after the last use. Seizures can occur without other symptoms and require medical intervention to avoid permanent brain damage. 
  • Psychosis can present as auditory or visual hallucinations that may include paranoia. 
  • Delirium tremens, a condition manifested by confusion and tremors, can happen in the first two to four days but is possible up to 10 days after the last drink.

Who’s at Higher Risk and How Severity is Assessed

Alcohol withdrawal can be life threatening if seizures and delirium occur. Roughly 2% of people experience severe alcohol withdrawal symptoms with delirium tremens that require inpatient treatment. 

medically assisted withdrawal and stabilization inpatient treatment can allow you to safely detox comfortably. It is unsafe to make this determination on your own.

Medical evaluation is essential to differentiate alcohol withdrawal from other medical conditions with similar symptoms, such as thyrotoxicosis, sepsis, or stimulant intoxication, which require far different treatment.

Medical professionals assess severity and withdrawal risk to determine what level of care a person needs to safely withdraw from alcohol.

The most common measure is the American Society of Addiction Medicine (ASAM) scale. The ASAM scale ranges from level 0.5 of early intervention to level 4 which requires medically managed intensive inpatient treatment. 

Another tool is the Revised Clinical Institute Withdrawal Instrument for Alcohol (CIWA-Ar), which measures the severity of current withdrawal symptoms and help guide level of care. 

When to Seek Emergency Care

It is crucial to identify when emergency care is needed. An immediate medical assessment is crucial when these symptoms are present:

  • Tremors
  • Stomach upset
  • Heart palpitations
  • Hallucinations
  • Confusion
  • Seizures
  • Persistent vomiting
  • High blood pressure
  • Fever
  • Chest pain

Emergency inpatient care can save a life. Physicians may administer gabapentin off-label to balance brain chemistry.

Benzodiazepines are used to treat symptoms and protect a person from having seizures or other serious complications. Some professionals also use phenobarbital, a barbiturate, as a rescue treatment for severe symptoms.

Managing Withdrawal Side Effects Safely 

Medical professionals safely manage withdrawal side effects by addressing the physical and psychological symptoms when the body adjusts to the absence of alcohol or drugs.

With medical guidance and supportive care, these challenges can be eased to reduce risks and promote recovery.

Evidence-Based Care in Practice

Several steps may be taken during evidence based treatment to improve symptoms, reduce risks and protect your sobriety.

These steps can include:

  • Symptom-triggered benzodiazepine administration in supervised settings
  • Monitoring of vitals and mental status
  • Avoiding the use of alcohol or other sedatives
  • Administering thiamine before glucose and fluids
  • Correcting fluid and electrolyte imbalances
  • Providing gentle nutrition as tolerated 

Once an inpatient stay is completed and a person is medically stabilized, they can begin individual therapy and peer groups using cognitive behavioral therapy, dialectical behavioral therapy, and other kinds of psychological interventions to learn new life skills during sobriety.

FAQs About Alcohol Withdrawal Side Effects

How Long Do Side Effects Last? 

Side-effects peak within 72 hours and typically improve by day seven. However, certain symptoms can continue for weeks to months, a condition sometimes referred to as post acute withdrawal syndrome (PAWS).

Most PAWS are not physical, but are psychological in nature, such as mood swings and relational problems.

Is High Blood Pressure or a Fast Heart Rate Normal During Withdrawal? 

High blood pressure and a fast heart rate are common during withdrawal but it is not normal. These can be life threatening events that require immediate medically assisted detox.

The absence of GABA and overproduction of glutamine will cause fluctuations in heart rate. 

Why Do I Get Night Sweats During Withdrawal? 

Night sweats are usually the result of hyperactivity of the autonomic nervous system, triggering sweating, especially during the first week. A fever or hormone fluctuations can also trigger night sweats.

When are Withdrawal Headaches a Concern?

A typical headache will improve with hydration, rest, and food. Continued headaches could indicate an ongoing heart, blood pressure or other problem.

If it becomes the worst headache you’ve experienced, it requires immediate medical attention.

Find Treatment Near You

Use the Detox.com directory to find treatment centers for alcohol withdrawal and rehab. The database can be filtered by location, level of care, insurance coverage and special population treatment. 

When you aren’t sure where to start, call today to talk to someone about your treatment options and see if your health insurance will cover alcohol or drug rehab.

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