Whether you’re choosing to end your alcohol dependence or supporting a loved one struggling with alcohol addiction, understanding the signs and symptoms of alcohol withdrawal is a powerful first step in your recovery journey.
Keep reading to learn about the range of alcohol withdrawal symptoms and how to find safe, effective detox options to begin the recovery process. If you believe you or your loved one is experiencing alcohol withdrawal, call our admissions team at (910) 812-1728 for a fast and free assessment to help build a stronger foundation for recovery.
What Is Alcohol Withdrawal?
Alcohol withdrawal, also known as alcohol withdrawal syndrome, is the symptoms that a person may experience when they stop or reduce their alcohol intake. People with alcohol use disorder (AUD) have developed a tolerance and dependence on alcohol, which is why they often experience symptoms of withdrawal from alcohol.
Alcohol withdrawal can be dangerous. Without the effect of alcohol, the brain and central nervous system remain in a hyperactive state as they struggle to regain balance, which can trigger life-threatening symptoms like seizures and hallucinations.
Understanding the Alcohol Use Disorder
Why Does Alcohol Withdrawal Occur?
When someone is heavily drinking for a long amount of time, the brain adjusts by making less dopamine, serotonin, and GABA. This creates a mental and physical dependence on alcohol. After someone stops drinking, the brain works to rebalance the once naturally produced chemicals, triggering withdrawal symptoms that affect both the body and mind.
Can You Prevent Alcohol Withdrawal?
While avoiding heavy drinking is the best way to prevent alcohol withdrawal, this might not be possible for people with addictive behaviors. Statistics show that at least half of North Carolina’s population over age 12 drinks alcohol at least once a month, and 35% of adults report heavy drinking at least once a month.1
Tracking your alcohol intake and being mindful of your drinking habits can help reduce the risk of developing alcohol dependence—and, by extension, withdrawal.
If you or a loved one is struggling with an unhealthy relationship with alcohol, our addiction treatment team in North Carolina offers comprehensive support, resources, and evidence-based treatment to help you stop drinking and manage withdrawal symptoms in a safe, structured environment.
Understanding Your Risk for Alcohol Withdrawal Syndrome
The people who are most likely to experience withdrawal from alcohol are people who:
- Binge drink
- Heavily drink
- Have been diagnosed with alcohol use disorder
- Have previously had alcohol withdrawals
- Have other health conditions
Other factors that could put your or your loved one at risk for alcohol withdrawal symptoms include age, genetics, history of misuse, and history of trauma.
Being aware of the risks that can contribute to alcohol withdrawal syndrome can help you monitor your relationship with alcohol, prevent misuse, or know when it is time to find help for alcohol abuse.
Alcohol Crisis in North Carolina
Alcohol abuse is a serious issue affecting thousands of people in North Carolina. With excessive drinking on the rise, more adults are at risk of physical and mental health conflicts.[1,2]
49%
Adults in North Carolina drink once a month between 2022 and 2023
34%
Adults in North Carolina binge drink once a month in 2021
12%
Adults in North Carolina drink heavily once a month in 2021
728,000
People in North Carolina have Alcohol Use Disorder in 2023
5,500
People in North Carolina die by excessive alcohol use in 2022
The Risks of Alcohol Withdrawal
When alcohol withdrawal is not monitored or treated correctly, the symptoms can be life-threatening. Each person may have a unique experience with alcohol withdrawal, but there are several risks associated with alcohol withdrawal, including3:
- Seizures: Approximately 90% of alcohol withdrawal seizures happen in the first 48 hours after drinking stops. The risk increases with the number of past withdrawal episodes.
- Delirium Tremens (DTs): While occurring in only 5% of people3 who have alcohol withdrawal, this severe and potentially life-threatening condition can develop 2 to 5 days after the last drink. Symptoms include intense shaking, confusion, hallucinations, and severe autonomic instability.
- Wernicke-Korsakoff Syndrome: Although not directly caused by alcohol withdrawal, this condition results from a thiamine (vitamin B1) deficiency, which is common in those with alcohol use disorder. It often emerges during withdrawal because of malnutrition and can lead to severe memory problems and cognitive decline.
- Disturbances in Mood, Thought, and Perception: Symptoms such as anxiety, depression, hallucinations, and sleep disturbances can intensify after cessation and may persist well beyond the initial detox phase.
- Heart Complications: Long-term alcohol misuse can severely damage the heart, increasing the risk of arrhythmias (such as “holiday heart syndrome”) and even heart failure during withdrawal.
- Post-Acute Withdrawal Syndrome (PAWS): PAWS is dangerous because it can trigger relapse through ongoing emotional, cognitive, and physical symptoms—like anxiety, depression, fatigue, poor concentration, and insomnia—that emerge after acute withdrawal ends and make long-term sobriety more difficult to sustain.
- Decline in Neurosteroid Levels: During withdrawal, levels of neurosteroids (such as those related to testosterone and reproductive hormone function) decrease. This hormonal drop may intensify psychological and physical withdrawal symptoms.
Symptoms of Alcohol Withdrawal
Symptoms of alcohol withdrawal syndrome can begin 6 to 24 hours after you stop or significantly cut back on long-term drinking. These symptoms can range from mild to severe.
Symptoms of alcohol withdrawal can include:
- Headaches
- Anxiety
- Insomnia
- Excessive sweating
- Increased blood pressure
- Increased heart rate
- Upset stomach
- Hyperthermia
- Tremors in hands or other body parts
- Confusion
- Hallucinations
- Seizures
- Delirium
If you notice any of these signs after you or a loved one reduces or stops alcohol use, it’s important to seek medical attention immediately. If you believe that one of the symptoms is a medical emergency, call your local emergency number now.
Alcohol Withdrawal Timeline
Alcohol withdrawal symptoms often begin within 6 to 24 hours after a person stops drinking, and they can intensify over the next 24 to 48 hours. The exact timeline varies based on how much and how long someone has been drinking, but there are general stages that can help set expectations during the withdrawal process.
Withdrawal Stage 1: Early Symptoms (6–12 Hours After Last Drink)
Within the first 6 to 12 hours of stopping alcohol, early withdrawal symptoms may begin to surface. These often include headaches, trouble sleeping, and mild feelings of anxiety.
Withdrawal Stage 2: Moderate Symptoms (12–48 hours)
Depending on the severity of dependence, more moderate symptoms like hallucinations may occur. This is also the period when the risk of seizures is highest.
Withdrawal Stage 3: Severe Symptoms (48–72 hours)
Symptoms of withdrawal can peak during this time. Severe effects such as delirium tremens (DTs) may appear. Some physical symptoms may begin to resolve toward the end of this phase.
Post-Acute Withdrawal Syndrome (PAWS)
Prolonged symptoms—such as insomnia, mood swings, and anxiety—can persist for weeks or even months after acute withdrawal has ended. Because each person will have a unique experience with alcohol misuse, alcohol withdrawal symptoms, and timelines can vary.
Understanding the Diagnosis of Alcohol Withdrawal Syndrome
Clinicians typically diagnose alcohol withdrawal syndrome by evaluating a person’s history of alcohol use and current physical symptoms.
According to the DSM-5, an individual may be diagnosed with alcohol withdrawal syndrome if they meet two of the following criteria for alcohol withdrawal4:
- The individual suddenly reduces heavy alcohol intake.
- Two or more of the following symptoms begin within several hours to a few days after alcohol reduction:
- Autonomic hyperactivity, such as sweating or a heart rate exceeding 100 beats per minute
- Increase in hand tremors
- Insomnia
- Nausea or vomiting
- Anxiety
- Generalized tonic-clonic (grand mal) seizures
- Transient visual, tactile, or auditory hallucinations
- Psychomotor agitation (PMA), such as pacing, fidgeting, or talking rapidly
- The symptoms must cause significant distress or impairment to important areas of functioning (social, occupational, etc.).
- The symptoms must not be the cause of another medical condition or better explained by another mental disorder.
Treatment for Alcohol Withdrawal
While withdrawal from alcohol can be uncomfortable and even dangerous, alcohol abuse treatment can help manage symptoms and build strong relapse-prevention skills to lower the risk of future withdrawal.
What Is Alcohol Detox?
Alcohol detoxification, also called alcohol detox, is the first step of alcohol addiction treatment. Medical detox can help patients experiencing moderate to severe alcohol withdrawal detox in a safer and more comfortable environment.
Alcohol detox has 3 phases:
- Evaluation: This phase determines the substance you are withdrawing from, how much is present in your body, and what treatments and medications may be necessary during detox.
- Stabilization: This phase includes all the medical and treatments needed to become substance-free.
- Entering Treatment: In this last phase, patients enter the appropriate level of care to build relapse prevention skills and sustainable recovery.
How Long Is Alcohol Detox?
The alcohol detox timeline varies depending on several factors, including the amount of alcohol consumed and length of use.
A comprehensive program that helps you build the foundation for physical recovery is often 30 to 90 days. Treatment programs that last longer than 30 days significantly reduce the risk of relapse, increase the likelihood of employment, and enhance mental and emotional healing.5
Medications for Alcohol Detox
In cases of severe alcohol withdrawal, a healthcare provider may prescribe alcohol treatment medication to help manage symptoms for a short amount of time and prevent dangerous outcomes. The healthcare provider will determine what the best treatment plan is for your or your loved one’s alcohol detox.
These medications can include benzodiazepines and anticonvulsants like:
- Chlordiazepoxide (Librium)
- Clorazepate (Tranxene)
- Diazepam (Valium)
- Oxazepam (Serax)
- Carbamezpine (Tegretol)
- Gabapentin (Neurontin)
- Oxcarbazepine (Trileptal)
Talk with your healthcare provider and follow their recommendations regarding any prescription medications for addiction treatment.
Alcohol Detox in Wilmington, NC
Finding a safe and supportive environment to detox under the care of medically trained professionals is a vital first step in recovery. While Tree House Recovery does not currently offer alcohol detox services in Wilmington, NC, we provide outpatient levels of care that can help you build coping skills and create a strong relapse prevention plan through evidence-based, holistic treatments.
Alcohol detox is not alcohol treatment. Detox only helps your physical dependence on alcohol but does not treat the underlying addiction.
Alcoholism Treatment Options in Wilmington, NC
Wilmington, NC, offers several alcohol rehab options designed to help individuals build strong relapse prevention plans and support long-term recovery. At Tree House Recovery, we provide a 90-day Intensive Outpatient Program (IOP) that our addiction counselors customize to meet each person’s unique needs and recovery goals.
Our program empowers individuals to build a life that supports sobriety by addressing the biological, psychological, and social factors affected by addiction. Through a supportive, sober community and structured life skills development, we help clients achieve lasting success and live healthy, fulfilling lives.
FAQs for Alcohol Withdrawal and Detox
How common is alcohol withdrawal?
Alcohol withdrawal affects about 50% of people (about 14.4 million adults) with alcohol use disorder who stop or significantly limit their alcohol use.6
Is alcohol detox safe at home?
No, detoxing from alcohol at home can be dangerous and life-threatening. Detoxing at home is not recommended because withdrawal symptoms can be life-threatening without proper medical care.
Tree House Recovery can help you manage long-term alcohol withdrawal symptoms after completing detox to help build relapse prevention skills and reduce the risk of the dangers that come with alcohol withdrawal.
Can you die from alcohol withdrawal?
Yes, alcohol withdrawals can be deadly. Every day in North Carolina, there are 16 alcohol-related deaths due to alcohol use.2 Two notably concerning symptoms of alcohol withdrawal are seizures and delirium tremens.
What does alcohol withdrawal feel like?
After 6 hours of your last alcoholic drink, mild symptoms begin to appear. These symptoms can include headaches, mild anxiety, and insomnia. These symptoms can worsen in the next 24 to 48 hours. Depending on the severity of withdrawal, you could experience hallucinations and seizures.
Finding Treatment for Alcohol Use Disorder in Wilmington, North Carolina
Alcohol withdrawal can be a life-threatening experience, especially if this is not the first time you or your loved one have experienced the symptoms of it. Tree House Recovery is here to help guide you through the recovery process.
Call our admissions team at (910) 812-1728 to start building your treatment plan today at our alcohol rehab in North Carolina.
- NC Department of Health and Human Services. NCDHHS. June 2024. Accessed May 15, 2025. https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/pdf/ExcessiveAlcoholUseinNC-FactSheet.pdf.
- National Surveys on Drug Use and Health, 2022 and 2023. SAMHSA, Center for Behavioral Health Statistics and Quality. Accessed May 15, 2025. https://www.samhsa.gov/data/sites/default/files/reports/rpt56188/2023-nsduh-sae-state-tables_0/2023-nsduh-sae-state-tables.htm.
- Alcohol withdrawal. Harvard Health. November 5, 2024. Accessed May 15, 2025. https://www.health.harvard.edu/diseases-and-conditions/alcohol-withdrawal-a-to-z.
- Trevisan, L. A., Boutros, N., Petrakis, I. L., & Krystal, J. H. (1998). Complications of alcohol withdrawal: pathophysiological insights. Alcohol health and research world, 22(1), 61–66.
- Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
- McKay J. R. (2021). Impact of Continuing Care on Recovery From Substance Use Disorder. Alcohol research : current reviews, 41(1), 01. https://doi.org/10.35946/arcr.v41.1.01
- Alcohol withdrawal. Cleveland Clinic. January 25, 2024. Accessed May 15, 2025. https://my.clevelandclinic.org/health/diseases/alcohol-withdrawal.
- North Carolina Alcohol and Related Harms Data. North Carolina Division of Public Health. Accessed May 15, 2025. https://www.dph.ncdhhs.gov/programs/chronic-disease-and-injury/injury-and-violence-prevention-branch/north-carolina-alcohol-and-related-harms-data#Citations-4205.