“Trying to exercise really helps with the anxiety and sleeplessness. I still have trouble sleeping and crave alcohol (especially at night), but I finally am beginning to feel like a human again!”
Symptom Stages for Alcohol Withdrawal
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.
Updated on September 03, 2022
Medically reviewed
Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH).
For those who experience withdrawal symptoms when they quit drinking alcohol, the two most often asked questions are “Is this normal?” and “How long does it last?” However, there is no “normal” when it comes to alcohol withdrawal.
People can experience a wide range of symptoms—ranging from mild to moderate to severe—that start and stop at different times for each person.
Verywell / Brianna Gilmartin
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Firsthand Experiences
Almost 8,000 responses were gathered to the question, “What were your toughest withdrawal symptoms and how did you cope?” The comments reveal a wide variety of symptoms and experiences, even within the same days, from days one to 30 and beyond.
Whereas some experienced mild symptoms in the early days, others reported severe, sometimes frightening ones. Most of those who experience severe alcohol withdrawal symptoms do so because they’re going through their detoxification period “on their own” without the benefit of medical help.
Day One
For many, the first day of abstinence usually follows a day of very heavy alcohol consumption—either a binge or a multi-day bender. As a result, they first experience basic hangover symptoms.
However, as the first day continues and hangover symptoms subside, actual alcohol withdrawal symptoms set in, especially for daily drinkers. Here’s how people reported their symptoms on day one after quitting alcohol.
Mild Symptoms
“I am forgetful, have a hard time concentrating, and sometimes find it hard to formulate meaningful sentences.”
“I am in my first hours of sobriety. I just took the quiz for withdrawal symptoms and scored 60% moderate to severe. Funny, because my average hangover is usually worse than this.”
“I’m shaky, jumpy, and anxious today. I’m really afraid of how I’ll feel tomorrow as I can’t miss work, but I know I have to do this. I can’t imagine that I won’t have a bad withdrawal, given the high volume of alcohol I’ve been consuming on a daily basis.”
Moderate Symptoms
“I’m about four hours away from the 24-hour mark, and my symptoms are finally beginning to subside. The shaking/tremors and pounding heartbeat are gone. My head feels a little cloudy, and I’m tired. And I still have the itching/tingly feeling in my legs and feet.”
“Tried again today, but it was severe this time—bad shaking, sweating, rapid heartbeat. Instead of going to the hospital or doctor, I tried to wean and reduce for a few days.”
“I went to the ER yesterday because I knew, after my last binge, this wasn’t going to be easy. They gave me Librium to take home. I hope the Librium helps and I can make it into work tomorrow.”
Severe Symptoms
“I had to miss work again because I didn’t sleep again. I have had sweat pouring off me all day, I’m shaking so bad, and my chest is hurting. I know if I drink it will go away, but then nothing gets better, I feel like I’m going to die right now.”
“Uncontrollable shaking, hallucinations of people and spiders, all my vision cutting out or going into a tunnel-like view, and a fear of falling over dead at any moment. Scared. I went to the hospital. Blood pressure was 200 over 130 and heart rate [was] 150 BPM lying at rest. They stabilized me with a bunch of IV meds and admitted me for alcohol detox.”
“Shaking so bad I can hardly type, can barely stand up, can’t eat or sleep. Might be time for a trip to the ER.”
Your body and mind are undergoing enormous change as you adjust to sobriety. A healthcare provider can prescribe medications that can help you manage symptoms such as shakes, anxiety, and insomnia. Those who sought help from their healthcare providers and were given medications to alleviate their symptoms reported milder, shorter-lived symptoms overall than those who quit on their own.
Day Two
Going into the second day of abstinence from alcohol, people typically report a wide variety of experiences. For some, symptoms already start to subside, while others begin to experience more severe ones. Those who seek medical attention tend to feel better than whose who do no.
Mild Symptoms
“I am bored, folding laundry, and craving a glass of wine. My anxiety is high, and I hate it!”
“Most of my withdrawal symptoms are gone, but I still have sharp pains in my head, can’t sleep, and get night sweats.”
“I got through day one with hot and cold spells, increased pulse, high blood pressure, and headaches. My jaws hurt as well, but possibly that’s from tension. Already, I feel better and hope every day continues that way.”
Moderate Symptoms
“Throat still hurts a bit from the vomiting, still sweating and clammy, can’t sleep, have a bit of heartburn/indigestion. Visiting the toilet is becoming less frequent. Even managed to get a small meal in.”
“I feel totally horrible. Shakes, sweats, and insomnia. I am hearing noises that don’t exist. Anyways, I talked to my doctor, and she prescribed a small dose of Valium to help me pull through. It seems to be helping. I hope tomorrow I won’t need it.”
“Thankfully, I’m able to sleep, and the shakes come and go, but the anxiety and the dark places are tough.”
Severe Symptoms
“I quit two days ago and have just had the unfortunate experience of a seizure, as well as many visual and tactile hallucinations. Massive sweats and tremors.”
“I think I’ve seriously damaged my brain. Maybe a seizure. Sudden sharp pains in the head. Visual, auditory, and tactile hallucinations. Confusion. Couldn’t walk right.”
“Spent day in ER, heart rate of 160, dehydrated, and generally just sick. Shaking so bad I couldn’t walk. Anxiety attack that convinced me I was having a stroke.”
“Last night was horrible. I was soaking wet with sweat, I jumped a few times in my sleep, and I had very vivid dreams.”
Day Three
Alcohol withdrawal symptoms begin to ease for some and just begin to get intense for others. Some have the same symptoms as on day one and ask, “How long does this last?” The urge to relieve those withdrawal symptoms with a drink can be overwhelming.
For many, it’s very difficult to get past the third day of unrelenting shakes and sweats without picking up a drink.
Mild Symptoms
“My worst symptoms so far seem to be lightheadedness, minor irritability, and insomnia.”
“Doing OK. No major symptoms. This is to let folks know that not everyone has severe physical symptoms.”
“The physical symptoms aren’t so bad, but my mind seems to be trying to figure out how I can have just one drink. I have plans to get some yard work done, so that will keep me busy.”
“I have weird ringing in the ears and dizziness (moderate). I also have cold, clammy skin while feeling hot flashes. I feel sometimes as if I have earmuffs on.”
Moderate Symptoms
“The shakes aren’t that noticeable, and my anxiety/chest pain has gone, but my pupils are huge!”
“Went from shaky to wanting to scream all day. I almost talked myself into ‘just one more’ several times, but somehow made it through.”
“I realized when I couldn’t sleep last night that all day I had been sweating for no reason, and it dawned on me that I was probably having withdrawals. I looked at my hands and was shaky . earlier, I checked my pulse because it felt like my heart was racing.”
Severe Symptoms
“When I was heaving my guts out, I knew something else was going on. I called my doctor, and she sent me to the ER for fluids and blood tests.”
“It’s been really tough, constant inner voice trying to persuade me just the one-night drinking again would be OK. I have just had to surf the urges, keep busy, and use all my strength.”
“I actually slept but still waking up drenched in sweat. The shakes have minimized. I actually ate three meals yesterday.”
“The third day sober feels like I’m in a big black hole and under great pressure—hard to breathe, future feels bleak, lost an old trusted friend in alcohol, can’t find an alternative.”
Day Four
Day four for many brings relief from their most severe symptoms. For some people, however, it’s just the beginning.
Those who experience the most severe withdrawal symptoms, such as hallucinations and seizures, don’t begin to have those symptoms until days four or five.
Mild Symptoms
“Withdrawals seem to be gone, except for not being able to sleep, but I have never been very good at that.”
“Feeling better. Best night’s sleep in some time. Weird dreams but not too nasty and scary. Feel a little weak, but I did avoid food for about four days. Very reflective still.”
“It is absolutely wonderful to wake in the morning with no hangover at all. No tummy upset. No headache. No rundown feeling. Yay for day four!”
Moderate Symptoms
“Feeling a bit better. Luckily, my biggest withdrawals are insomnia and very itchy skin all over (face, arms, legs, back.) One concern I have is my swollen abdomen.”
“Insomnia is the worst thing now. The anxiety, sweats, and nausea in the morning have lessened.”
“Fortunately, not near the hell the first three [days] were. I am hoping that means I may finally sleep tonight. For me, the toughest parts are the vomiting (dry heaves), insomnia, and anxiety.”
“Trying to exercise really helps with the anxiety and sleeplessness. I still have trouble sleeping and crave alcohol (especially at night), but I finally am beginning to feel like a human again!”
Severe Symptoms
“What scares me the most is my inability to think. I am very paranoid and don’t know why, peeking out windows and not thinking rationally.”
“Last night, I felt like I was coming out of my skin. I woke up this morning with a nasty headache and nausea.”
“Called my wife to come home as soon as possible. She drove me and the kids to the ER. My eyes had double vision, I was hallucinating, and from what they said, I wanted to bite everything and everyone.”
Day Five
People trying to quit are most tempted to take another drink at two key points: 1) when symptoms worsen, and 2) when they start to improve. People forget the pain and tell themselves that one drink won’t hurt.
If the withdrawal symptoms persist for five days, many give in and take a drink to get some relief. That’s why some people can say they quit for three or four days 100 times.
Some are finally able to get some sleep at day five, whereas others still have problems sleeping.
For Some, Day Five Brings Relief
“Depression is gone, anxiety gone, and all else gone. Didn’t sleep great last night, but tonight will be good.”
“What finally helped me was exercise. If I was going to sweat as part of the withdrawal, it would be at the gym.”
“Now that most of the physical symptoms have gone away, time to work at staying sober. This is usually where I mess up and drink because I am feeling better and think I can handle it. I know I can’t.”
“Slept in my bed, and I feel good, no night sweats, but prior to going to sleep experienced that my body jumped and trembled. Convulsions maybe?”
For Others, Symptoms Continue
“Still having cravings and thinking a lot about drinking. I’m so exhausted, though, and nauseated, I would probably get sick if I had a drink. I have noticed the cravings for sugar. Raw sugar snap peas take the edge off that.”
“Feels like a mild flu, but the tension is unbelievable. I’m having more problems with stress, losing my temper, and generally being horrible to my loved ones.”
“My insomnia is still pretty bad. Takes forever to get to sleep, and I’m waking up too early. Worst headache yet today, but I’m drinking so much coffee that I’m starting to wonder if it may be the caffeine. As of yet, not too much anxiety. I’ve lost a few pounds.”
“I get bad sweating even when sitting still, my head feels thick, my stomach hurts, and [I have] lots of gas. It’s been getting better by the day, but this morning again, I feel a bit nauseous and am getting hot and cold sweats.”
“My head feels funny, as if thousands of ants are running inside.”
Day Six
Day six of no alcohol consumption usually brings some relief for the most severe withdrawal symptoms, but some nagging symptoms can persist. Sleep—or lack thereof—plays an important role in withdrawal.
Quitting alcohol consumption affects drinkers’ sleep patterns differently. Some are able to return to normal sleep patterns after a few days. Others struggle with insomnia and poor-quality sleep long after they quit drinking.
That could be because they didn’t have normal sleep patterns to begin with. Daily drinking can cause disruptions in sleep as well, so quitting suddenly can be a shock to the system. After six days of sobriety, these people report vastly different experiences with sleep and other alcohol withdrawal symptoms.
Getting Sleep, Dealing With Cravings
“I’ve made it to day six for the first time in a long time, and I’m proud to say that I’m through the worst of the withdrawal. No more sweating and headaches, and I’ve actually had three nights of sound sleep. It’s amazing how different I feel.”
“Already feeling semi-human. Sleeping much better, bloating gone. Anxiety’s still there, but way down. No booze cravings. Clear thinking, social skills improving, lost five pounds, have saved $100 from not buying beer, and can finally stop taking Prilosec for a ruined stomach.”
“The more time that goes by, the clearer the picture becomes. I see my triggers, and I work through them. I’m always thirsty and drink a lot of water. I’m still not sleeping through the night.”
Mood Swings, Brain Fog, and Anxiety
“I haven’t experienced any shakes, pains, or bad dreams. I actually sleep better now than when I was drinking. My problem is the mood swings. I have an irrational rage and sometimes want to destroy everything around me. I have a constant feeling of restlessness.”
“I spent five days in the hospital detoxing. The first 12 hours were horrible! Shaking uncontrollably, sweating, couldn’t eat, couldn’t sleep. The doctor gave me lorazepam to take the edge off. I think I was in a chemically induced coma for those days. I hardly remember anything. I remember having a “fall risk” bracelet on my wrist because I couldn’t walk by myself. I was so dizzy and couldn’t catch my balance.”
“The hardest symptom for me is the anxiety. Every day when I drive home from work, I get a panicked feeling, and I tell myself, ‘If I could just make it home, I could have a beer or a glass of wine as soon as I walk in the door.'”
“Anxiety, dizzy, no sleep, exhausted. Does anyone ever feel like an electric current sometimes runs through your body? But it’s getting better every day.”
“Lightheaded, dizzy, no sleep, pale, weak, and it feels like electric shocks shoot through my body every so often. Crazy anxiety.”
“Every day, I felt sure I was dying from either heart failure, liver disease, or kidney failure. My blood pressure was 151/106 on day two of withdrawal. On day six, my blood pressure is normal again. I still have a tingly numb sensation in my arm.”
“Gradually, it’s getting better. The only symptoms I seem to have now are occasional goosebumps/skin crawling, lack of focus, and anxiety. Still experiencing strange dreams and nightmares, but I remind myself they’re not real and it helps.”
“Feeling much better. Very slight discomfort in the chest occasionally. No sweating. Disturbed sleep? Yes. But I guess in a few days, I should be fine.”
Day Seven
For the vast majority of people, the physical symptoms of alcohol withdrawal have passed by day seven. The main symptom is a craving for alcohol.
The battle now becomes more psychological than physical for most. Professional counseling and/or a support group such as Alcoholics Anonymous can help.
However, for some, the physical symptoms will continue even after seven days. If you’re still experiencing physical alcohol withdrawal symptoms after a week, you should contact your healthcare provider immediately.
Many people who were still having physical symptoms after seven days regretted not seeking medical help.
Cravings, Stress, and Staying Sober
“This disease is certainly as cunning as people say. I’m fighting little voices today that say, ‘Look, you did a week, you proved you can stop anytime you want, but why should you have to? Just pull it back a little.’ I’m just trying to focus on not this drink, not today.”
“The recent nine months’ sobriety [has] done great good for my body. That said, I hope never to forget how much damage I felt in four days of drink.”
“Going back to the office was a little stressful. My physical cravings are somewhat subsiding. I have the psychological urges. More like a bad habit. I’m used to stopping off to buy a couple of bottles on my way home from the office. Even though I don’t have an alcohol craving, these little reminders sometimes bring my mind back for a few seconds.”
“My eyes and face are less puffy, my mind is clearer, and the anxiety and depression are lifting. I actually made it through two evening events this week, one a dinner meeting with excellent wine flowing, and the other a hosted business cocktail reception—and I stuck to sparkling water at one and Diet Coke at the other. I would never have before.”
Seizures, Panic, and More Insomnia
“I can’t believe the luxury of sleep! After a really hard time, I slept for two nights! Not all night, but great sleep.”
“Just laid on the couch and went into a full-blown seizure. Woke up on the floor sore all over. The only thing I remember is extreme tingling all through my body. I was alone and called 911. A paramedic on each side holding me up, I felt like my legs were rubber bands.”
“Starting to feel a little better. If I had the money, I would have gone to a 30-day rehab. I am still having shakes now and again. My head is in a fog constantly.”
“The depression is deep, and racing thoughts are hard to control.”
“It’s the mood swings that scare me. One moment up, the next down, and no concentration. It’s hard to pretend to be happy and normal.”
Day Eight
By day eight of abstinence from alcohol, many begin to see the health advantages of quitting. For most, the craving for alcohol remains a challenge.
Seek medical assistance if your physical symptoms last for a week or longer. The symptoms you’re experiencing may not be the result of alcohol withdrawal symptoms. Only your healthcare provider can tell for sure.
Better Sleep, Lower Blood Pressure
“I feel incredible. I woke up this morning and was just so happy to have no head pounding, no sweats, no guilt, no ‘Can I make it the four hours until liquor stores open?’ feelings.”
“Haven’t listened to the little voice. Thinking about all the money I’m saving. The only issue besides the little voice is insomnia, but [I’m] getting some sleep. My blood pressure and heart rate have come down to just about normal.”
“Physically, I feel fine now, but I still crave alcohol like crazy. That’s going to be the worst part.”
“My biggest challenge over the last few days is dealing with people who won’t take no for an answer where drinking is concerned. People at my new workplace keep asking me to join them for after-work drinks, and even though I’ve managed to say no, it’s not that easy.”
Headache, Nausea, Disrupted Sleep
“When I got out of bed this morning I felt so ill. My head had been aching all night. I feel flat and find the evenings difficult, feeling restless, with alcohol consuming all my thoughts. I can’t imagine my life without a drink just yet and look forward to feeling better.”
“My worst withdrawal symptom is that my brain does not seem to work very well. Lots of spelling errors and poor fine-motor skills. I will not even go into the insomnia.”
“I can’t keep anything down, not even a glass of water.”
Day Nine
The benefits of abstaining often become apparent around this stage. Some nagging symptoms might linger, but the benefits far outweigh the negative after nine days.
Getting Things Done, More Energy
“I feel great! A few cravings every day, but I tell myself how bad it was to detox cold turkey, and how good I feel now. I am actually getting things done in my life that I was putting off because I was always drunk.”
“The whites of my eyes are white again, my urine is starting to look normal, and my bowel movements are getting normal. My energy level and mental alertness are way up, and it’s only getting better.”
“The itching has cleared up. I still feel groggy and confused at times, but at other times, moments of extreme clarity. Headaches are clearing up as well.”
Cravings, Constant Headache
“I am sure I put myself in danger by withdrawing myself (heart palpitations, night sweats, general disorientation), but most symptoms outside of cravings have subsided. Peanut M&Ms have become my new best friend. It really has helped to have the sugar when I need it.”
“It feels good. I feel strong. I am also amazed I have had none of the typical shakes, hallucinations, palpitations, etc. other than a horrific constant headache.”
Day 10
The longer you’re abstinent, the more time your mind and body have to heal. By this time, people are often beginning to feel better and notice more energy.
At 10 days without alcohol, if you still have any physical withdrawal symptoms, as reported below, they’re possibly due to some other condition than alcohol withdrawal. Please seek medical advice.
Advantages of 10 Days of Abstinence
“Feel a lot stronger, eating healthy, and keeping up with everything. Lots of time on my hands I used to spend drinking. My swollen abdomen has already started going down, and I have energy. Plus I have my self-esteem back and don’t feel like a loser at life.”
“Feeling just OK. I am not sure who I am without the demon on board, but I kind of like who I am at the moment.”
“Symptoms are reducing daily, and I have had the best two night’s sleep in a very long time. Just loving waking up without counting the hours to the next drink.”
“My mind has never felt sharper. I have started swimming and going to the gym.”
Cravings, Stomachache, and Anxiety
“I can still feel it talking to me, telling me it’s OK to have one just one. How many times have I fallen for that one? I still find it crazy that we can forget or forgive the horrific withdrawals, the head-splitting depression, the aches, paranoia, and raw anxiety.”
“What I’m noticing now is real bad stomachaches, gas, bloating, nausea, and loud growling.”
“I am starting to feel somewhat normal. I have been keeping busy cleaning the house (which is spotless right now) and staying at work late to resist the temptation. Finally, the night sweats, shakes, and nausea are gone. The anxiety is still there, but I am learning to live with it.”
Day 11
If physical symptoms continue after 11 days of abstinence, seek medical attention. Those persistent symptoms might have some other cause than alcohol withdrawal.
The further they get from their last drinks, the better most former drinkers feel.
Healthy Skin, Feeling Better
“I’ve had aches in every joint, and even now, the periodic taste of alcohol in my mouth. It’s the taste of detox, I’m guessing. Already, I’m sleeping better, feeling better, though I’m a little spacey, and my skin already looks healthier.”
“Happy to say, most of my withdrawal symptoms are gone. No sweating, no shakes, and [I’m> getting some decent sleep. I have actually never felt better.”
“Wow, what a rough night it was last night. I spent what seemed like an eternity struggling with myself not to go and buy beer . Finally, I got up, jumped in the car, and headed to Walmart to purchase some chocolate and, yes, it did the trick.”
Shakes, Numbness, and Rashes
“I still suffer from insomnia and itching, but the rashes are clearing, sweating nearly stopped, shaking’s almost gone, and my head seems a bit clearer.”
“There are still some tiny tremors in my hands, and the neuropathy (numbness) is down to just the toes instead of half of each foot.”
“I needed professional help, as I had severe withdrawal symptoms of a DT nature with hallucinations, a possible seizure, and fear I would fall over dead any second. I went to the ER and detoxed five days in the hospital.”
Day 12
After 12 days of abstinence from alcohol, most people who quit have very few withdrawal symptoms. The struggle at this stage is trying to remain sober.
Intense cravings and irritability are commonly reported after day 12.
Cravings, Irritability, Weird Dreams
“I’m past the horrible withdrawal and am now feeling better, at least physically. I see that I am one person when I drink and another reasonable, ‘normal’ person when I don’t. To even consider drinking again after experiencing all the crap that goes along with it and after having survived the anxiety and physical agony of withdrawal just shows how deep this addiction is: physical, mental, emotional, and spiritual.”
“I feel good today but was very irritable last night. My clothes are fitting better, and my face isn’t as puffy.”
“I’m feeling so much better about my life and my actions. I love life without alcohol. Every day that passes, I realize the cravings are fewer and farther between. I’m not so tired all the time.”
“Today, I went to the grocery store, and I cannot believe how clear everything is getting. It’s amazing how foggy life was.”
“I’m very irritated at times. I feel really good about my choice to quit drinking. I have headaches often and I have weird and bad dreams. Every night I dream that I’m having a drink again.”
Day 13
People in recovery continue to report the benefits of not drinking alcohol after 13 days of abstinence.
Uninterrupted Sleep, Good Appetite
“I feel terrific! I’m still having trouble falling asleep, but once I do, it is very, very sound. And I feel so much better than any morning after having the drink. I had some pain in my esophagus when swallowing, and that is now gone.”
“Most symptoms are gone except constipation and occasional shakes. Been sleeping really good.”
“I am much calmer, anxiety has subsided, stomach better, have an appetite, and sleeping eight hours without waking up at 4 a.m.”
“The headaches have subsided, but I’m itchy as hell! When I do sleep, it’s uninterrupted eight to nine hours, which is very nice!”
Day 14
After two weeks of total abstinence from alcohol, the most common symptom reported is insomnia, but that could be attributed to other factors, as well.
Insomnia, Irritability
“I realize this is no easy task. I am in my 30s and just now have decided to quit. I am not sleeping right. I snap at everyone.”
“Sleep is a problem, but if I sleep at all, it is a good night. I think that I have always had the sleep disorder.”
Week Three
After two weeks of abstinence, the benefits of no longer drinking at harmful levels continue to become evident. For some, even the craving for alcohol begins to subside.
Thinking Clearly, Fewer Cravings
“I’m feeling fantastic. I have lost weight, and my skin looks amazing [I suffered from rashes all over my body and face]. My energy and confidence are back. It is wonderful.”
“I feel like I am actually going into the honeymoon phase of my recovery. I feel great and am finally starting to be able to think clearly.”
“I am starting to feel more human. The exhaustion has gone away, and my concentration seems better.”
“By day five, I started exercising, and by day seven, I cranked the intensity up from there. My skin and eyes look better, and the bloated stomach is starting to recede.”
Symptoms From Other Causes
“I read other people’s withdrawal symptoms and how they seem to be over in a week, but mine are still hanging on . Just stomach problems and anxiety, mostly.”
“I could easily sleep 12 hours a night and still feel tired the next morning.”
“I still feel really anxious and panicky and confused sometimes, especially in public.”
“I am feeling better than I have in a while, a long while. I still have a few side effects like sleeplessness, anxiety, irritability, and I crave sweets all the time.”
“I was feeling great having got over the nausea, shaking etc. within the first week ,but now I am beginning to have what I can only describe as partial withdrawals all over again.”
If you’re continuing to suffer physical symptoms after two weeks of abstinence from alcohol, consult your healthcare provider. Your symptoms could be caused by other conditions or illnesses.
Week Four
In the fourth week of abstinence from alcohol, the benefits keep piling up, according to the reports of those who remained sober for more than three weeks.
Freedom, Weight Loss, Happiness
“I wish I could sleep, if only for a few hours. The good news: Bloated stomach has gone, along with 10 pounds.”
“I hope it helps someone to know the physical stuff will pass. I had a lot of odd symptoms and memory loss etc. but have noticed a definite improvement in the past week. I still crave alcohol, but it’s more the mental side now.”
“I feel great. To all those that are ready to give up because of withdrawals, hang in there! It does get better.”
“No more fuzziness. No more ritual and control, only freedom. My skin is looking fresher and less red and blotchy. The power of being sober is almost overwhelming and calming, a new me, like the me of 35 years ago—only a lot older on the outside but feeling sunny on the inside.”
“Quite relieved to say that I am still sober. Some days are like riding a rollercoaster, up, down, up and down.”
Day 30 and Beyond
After 30 days of sobriety, physical withdrawal symptoms should be well in the past. The remaining battle is to maintain abstinence and recovery.
It is important at this stage for those who want to remain sober to learn how to develop a healthy lifestyle that does not including drinking.
The cravings and the urge to drink do not suddenly disappear after 30 days of abstinence. Quitting drinking, even without making other changes, can help you return to better physical health, but regaining emotional and psychological balance can be challenging. For many, remaining sober and resisting a relapse take real work.
Better Blood Pressure, Fewer Cravings
“I saw the doctor on day two, and my blood pressure was 160/110. I saw him again on day 30, and my BP was 122/80, and I’d lost seven pounds. Now my biggest struggle is just staying away from the first drink, but the more days that go by without, it the less I feel like having it.”
“With hard work and vigilance, I am pleased to be getting more sober time in. I am exercising more and starting to decrease the number of herbs and vitamins I have been taking daily.”
“I still have cravings, but they seem to be getting weaker. When I have cravings to drink, I resist them by thinking about all of the bad things alcohol did to me. “
“I am feeling better each day goes by. I am also very happy I am able to stay sober, I never thought I would be able to do it. Cravings come and go, but the belief in God and prayers have helped me stay strong and sober.”
Day 36
“Well, what I didn’t know, was all of the side effects. I have gone through racing heartbeats, sweats, shakes, crying, depression, rage, panic attacks, and non-stop insomnia. Now, at day 36, I am fatigued all day. No desire to drink—but when will I feel energy again?”
Day 49
“I am going on seven weeks of being sober, and I could not be any happier.”
Day 50
“Last week, I was [on] holiday. Several times, I thought, ‘Well, I will have a drink tonight,” and then I remembered the pain, and it kept me straight.”
Day 53
“I don’t remember ever feeling so incredible. I wake up looking forward to the day. I sleep through the night and work out every morning. It’s a wonderful feeling to be sober!”
Day 62
“I feel like I am getting stronger every day. Things that I have noticed since I have stopped drinking are: better thinking/ judgment, anxiety is a lot better, skin is looking better, and I definitely have better mornings.”
Day 63
“I want to stay sober, but the cravings have been so bad this week. I’m not sure why it all seems to hit me at once—problems with family, work, etc. I drove down the street on my way to my old liquor stop, but something told me to go the other way and just go straight home. So yeah, I made it, and I’ll wake up sober again.”
Day 70
“I had so many emotional twists this week [that] I could have easily found an excuse to jump off the wagon. But I can proudly hold my head high and say I didn’t need any alcohol to handle my situations . I have never felt happier and more complete as a woman. There were others that made me face harsh realities. Through these highs and lows, I learned I don’t need alcohol to cope with disappointment.”
Day 210
“I’m back working, my skin’s cleared up, and I’ve cleaned up the mess I’ve made of my life. The sad truth is, I miss drinking, even after all the hell it has caused. But to go back will be my death.”
Tips for Getting Help
A healthcare provider can help you navigate or even minimize withdrawal symptoms. Be sure to:
- Look for an experienced, reputable professional who specializes in alcohol withdrawal.
- Be completely honest with them so that they can develop an accurate treatment plan for your situation.
- Follow their advice exactly.
If you try to detox on your own, ask someone trusted, healthy, and responsible to keep an eye on you as you go through withdrawal. They can help you get medical attention should you have severe symptoms.
Either way, consider adding a few of these tried-and-true strategies to your efforts:
- Meditation
- Exercise (such as daily walks)
- Psychotherapy
- Mindful breathing
As time passes, time with someone close or even a pet may help you tame anxiety, negativity, and temptation.
If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
- Mirijello A, D’Angelo C, Ferrulli A, et al. Identification and Management of Alcohol Withdrawal Syndrome. Drugs. 2015;75(4):353-365. doi:10.1007/s40265-015-0358-1
- Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: a systematic review. Ind Psychiatry J. 2013;22(2):100-108. doi:10.4103/0972-6748.132914
- Sachdeva A, Choudhary M, Chandra M. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538
- Haass-Koffler CL, Leggio L, Kenna GA. Pharmacological Approaches to Reducing Craving in Patients with Alcohol Use Disorders. CNS Drugs. 2014;28(4):343-360. doi:10.1007/s40263-014-0149-3
- Harvard Health Publishing. Alcohol Withdrawal: What Is It? 2019.
- Heinz A, Beck A, Mir J, et al. Alcohol Craving and Relapse Prediction: Imaging Studies. In: Kuhn CM, Koob GF, editors. Advances in the Neuroscience of Addiction. 2nd edition. Boca Raton, FL: CRC Press/Taylor & Francis; 2010.
- Kharb R, Shekhawat LS, Beniwal RP, Bhatia T, Deshpande SN. Relationship between craving and early relapse in alcohol dependence: a short-term follow-up study. Indian J Psychol Med. 2018;40(4):315-321. doi:10.4103/IJPSYM.IJPSYM_558_17
- Brower KJ, Perron BE. Prevalence and Correlates of Withdrawal‐Related Insomnia among Adults with Alcohol Dependence: Results from a National Survey. Am J Addict. 2010;19(3):238-244. doi:10.1111/j.1521-0391.2010.00035.x
By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.
Alcohol Withdrawal Symptoms: What to Expect
Sarah Bence, OTR/L, is an occupational therapist and freelance writer.
Updated on November 23, 2022
Adjoa Smalls-Mantey, MD, DPhil, is a board-certified psychiatrist and lifestyle medicine physician. She practices emergency psychiatry in New York City at several institutions, including Columbia University Medical Center, where she is an Assistant Clinical Professor of Psychiatry.
Table of Contents
Table of Contents
Alcohol withdrawal symptoms can include shaking, sweating, headache, nausea, and other physical symptoms. You may also experience mood and behavioral symptoms like agitation, irritability, or anxiety. The alcohol withdrawal timeline varies, but symptoms may begin a few hours to a few days after you stop drinking.
People who drink heavily are at greater risk for serious alcohol withdrawal symptoms. Males who have 15 or more drinks per week and females who have 8 or more drinks per week are considered heavy drinkers.
This article will discuss the symptoms of alcohol withdrawal as well as the timeline and process of detox.
Verywell / Theresa Chiechi
Symptoms of Alcohol Withdrawal
When someone drinks alcohol for a prolonged period of time, their brain chemistry changes. Alcohol is a depressant, so the body responds by producing more stimulating chemicals, including the neurotransmitters dopamine and gamma-aminobutyric acid (GABA).
This process temporarily restores homeostasis, or chemical balance, in an effort to counteract the impact of long-term alcohol use on the brain.
Over time, however, the body builds a tolerance to alcohol, and a person may have to drink more and more to get the same feeling. Meanwhile, the brain is producing more and more neurotransmitters, making a person further imbalanced.
When that person cuts out alcohol, there is a period when their brain hasn’t yet received the message and still overproduces the stimulating chemicals. With alcohol out of the equation, though, these chemicals cause withdrawal symptoms.
Severity of Symptoms
Alcohol withdrawal symptoms range from mild to severe. Not always, but typically, the level of dependency on alcohol will correlate to the severity of symptoms.
Mild Symptoms
Mild symptoms of alcohol withdrawal experienced by excessive drinkers and those with alcohol use disorder alike include:
- Mild to moderate tremors
- Anxiety
- Night sweats
- Restlessness
- Irritability
- Nightmares
Severe Symptoms
There are also more severe symptoms of alcohol withdrawal. These include:
- Seizures
- Severe tremors
- Increased heart rate
- Fever
- Nausea or vomiting
- Hallucinations
- Increased agitation
Delirium Tremens
It is rare, but some people will experience a very serious syndrome during alcohol withdrawal, called delirium tremens.
Delirium tremens includes the severe symptoms of alcohol withdrawal, as well as a change in mental status, severe agitation, symptoms of delirium (sudden lack of awareness of their environment and reality), and occasionally hallucinations.
Delirium tremens occurs in 2% of people with alcohol use disorder and less than 1% of the general population.
Delirium tremens is a medical emergency that can result in death. If you or someone you know shows signs of delirium tremens, go to the emergency room immediately.
Timeline of Alcohol Withdrawal
There is no exact timeline for alcohol withdrawal, and individual factors, such as previous level of dependence on alcohol, will influence it.
Alcohol withdrawal can be an unpleasant process, but there are things you can do to prepare. There are a variety of treatment options to ease this process and support you if your goal is to abstain from alcohol in the future.
The following is a general guideline of what you can expect from the alcohol withdrawal process. Since each case is different, don’t be surprised if your own experience is slightly different from this.
First 8 Hours
For most people, alcohol withdrawal symptoms will begin sometime in the first eight hours after their final drink.
Symptoms are usually mild at first and begin gradually. They can include:
- Restlessness
- Clammy or pale skin
- Irritability
- Nervousness
- Loss of appetite
- Shakiness
- Nausea
12–24 Hours
During the 12- to 24-hour time frame after the last drink, most people will begin to have noticeable symptoms. These may still be mild, or the existing symptoms might increase in severity.
A person may begin to experience:
- Mood swings
- Night sweats
- Nightmares
- Depression
- “Brain fog” or not thinking clearly
- Headache or migraine
- Insomnia or difficulty sleeping
- Vomiting
For people who experience hallucinations as part of alcohol withdrawal, these may begin in the 12- to 24-hour time frame.
24–72 Hours
Alcohol withdrawal symptoms typically peak during this time frame. They may peak as early as 24 hours in or closer to 72 hours. Expect the most severe symptoms at this stage, which can include:
- Nausea
- Vomiting
- Tremors
- Agitation
- Seizures
- Hallucinations
Individuals should be prepared to be uncomfortable during this period and have someone on call in case medical help is needed. This is the period in which delirium tremens is most likely to occur, which requires immediate medical attention.
Next Few Weeks
For most people, alcohol withdrawal symptoms will begin to subside after 72 hours. A “new normal” will begin over the next few weeks. However, try not to have too many firm expectations, as symptoms can continue for multiple weeks in some people.
For those with alcohol use disorder, withdrawal is just the first (but very important) step on a long journey to recovery. These first few weeks are critical, because they are when the risk of relapse is highest. Prior to withdrawal, it’s important to have a plan of how you will abstain from alcohol during this time.
You’re Not Alone
Remember you are facing a difficult challenge during alcohol withdrawal, but you are not alone. There are many resources available to help, including peer support groups, counseling, therapy, and inpatient rehabilitation.
Factors That Influence Withdrawal
There may be variations in how you experience the symptoms and timeline of alcohol withdrawal. Your symptoms may be more or less severe depending on a number of factors, such as:
- How long you’ve been drinking
- How much you typically drink
- Whether you stop suddenly or gradually
- Your general health
For example, a person who drinks heavily every day and has been doing so for many years is more likely to experience severe withdrawal symptoms than someone who has been drinking moderately to heavily for less than a year.
It’s important to call out that withdrawal symptoms don’t just affect people with alcohol use disorder (formerly known as alcoholism) who quit drinking. They can also affect those who drink excessively and stop.
This is because regularly consuming large quantities of alcohol—even if you are not dependent on it—still results in the production of too many neurotransmitters.
Excessive drinking is broken down into two categories, which are defined as:
Binge drinking
- Men: Five or more drinks on a single occasion
- Women: Four or more drinks on a single occasion
Heavy drinking
- Men: 15 or more drinks per week
- Women: Eight or more drinks per week
Alcohol use disorder, on the other hand, is defined by the following:
- An inability to stop or control drinking, despite the negative impact it may have on relationships, health, work, school, and other areas of life
- A built-up tolerance and need to drink more to get the same effect
- Repetitive thoughts and difficulty thinking about anything other than alcohol
It’s estimated that 90% of people who drink excessively would not meet the diagnostic criteria of alcohol use disorder. But both binge and heavy drinking put a person at higher risk of developing it over time.
Choosing to Quit
You don’t need to be diagnosed with alcohol use disorder in order to choose to detox. Ultimately, if you find alcohol is interfering with your health or your personal, financial, or professional life, then it’s time to consider quitting.
Going Solo
Some people might choose to go through alcohol detox alone. The important thing is to stay safe in the case of a medical emergency.
You may choose to stay close to supportive family members or friends, or have an “accountability buddy,” who is aware of what you’re doing and can come assist you or call for medical help if needed. Keep a list of important phone numbers on hand, because you might not be thinking clearly during withdrawal.
Try to avoid negative influences (whether that is a person, group, activity, place, or something else) leading up to and throughout your detox.
You may also want to prep meals in advance or get other items that require energy and attention out of the way before you’re going through detox.
Support
There are many support options available that can help guide you through alcohol withdrawal, as well as abstaining from alcohol after withdrawal. These include:
- Social networks: Find a supportive friend or family member to be with you throughout your detox. It may not be easy to find an individual who can support you in this way. Even those who do may find that an organized group or program may be more beneficial.
- Support groups: There are a variety of support groups that provide support from others who have gone through alcohol withdrawal and are in recovery. Many of these groups are free and available to the public, but online support groups are also an option.
- Behavioral treatment: Consider enrolling in a behavioral treatment program with a mental health professional before withdrawal. Programs may use different types of therapy or other techniques to help you prepare for and get through withdrawal.
- Inpatient rehabilitation facilities: Inpatient detox programs allow you to live in a rehabilitation facility throughout the course of your withdrawal and usually for a few weeks afterward, when the chance of relapse is high. These programs are not always covered by insurance, so check with your individual provider. In the United States, most states have low-cost or free rehabilitation programs for those who are uninsured.
Medical Help
In some cases, medical help may be required to get through alcohol withdrawal. There are medications that treat acute alcohol withdrawal syndrome. Antianxiety medications such as benzodiazepines are considered the gold standard.
In the case of severe symptoms or delirium tremens, a person may be admitted to a hospital ward or the intensive care unit (ICU) for medical treatment during alcohol withdrawal. While in the hospital, vitals are monitored and fluids will likely be administered.
Medical treatment may also help a person with alcohol use disorder prepare to quit drinking. Currently, the Food and Drug Administration (FDA) has approved three nonaddictive medications for alcohol use disorder. These medications help reduce alcohol intake and prevent relapse. They include:
- Vivitrol (naltrexone)
- Campral (acamprosate)
- Antabuse (disulfiram)
A Word From Verywell
Making the decision to stop drinking alcohol is a big step. Knowing you could experience alcohol withdrawal symptoms may feel daunting, or even deter you from trying. Remember that the worst of the symptoms typically wear off after 72 hours. In some people, symptoms may continue for a few weeks after their last drink, but they will lessen over time.
Gathering a supportive network of friends and family members, as well as an addiction support group or even an inpatient rehabilitation center, can help you through this process. For maintaining your abstinence from alcohol, you may benefit from support groups or resources from the Substance Abuse and Mental Health Services Administration (SAMHSA) or the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Frequently Asked Questions
Is it dangerous to suddenly stop drinking?
No. It is generally not dangerous to suddenly stop drinking, although you may have uncomfortable withdrawal symptoms, and you may abstain from alcohol more effectively if you make a prior plan. However, in rare cases (1%–2%) a severe syndrome called delirium tremens can occur. This is a life-threatening medical emergency, which needs to be treated right away.
What does the body do during alcohol withdrawal?
During alcohol withdrawal, neurotransmitters in your brain are imbalanced. Because alcohol is a depressant, dependence on alcohol leads to your brain overproducing certain neurotransmitters in order to balance itself out. When you quit drinking, there is a period in which your brain continues to overproduce neurotransmitters before it readjusts. This imbalance can lead to uncomfortable physical symptoms, including sweating, shaking, nausea, vomiting, and more.
What helps with alcohol withdrawal?
Detoxing from alcohol is undoubtedly an uncomfortable and vulnerable experience. To help, set up your “detox space” before you stop or reduce your drinking. You’ll want a comfortable place to sleep and rest, low lighting, ice packs, a thermometer, clean sheets, a change of clothes, and plenty of premade nutritious food and water. It is important to drink plenty of fluids, especially if you have episodes of nausea or vomiting. If you can, have a trusted person stay with you or be on call if you need support.
What is the most effective way to stop drinking?
Everyone is different, and your history with alcohol, previous withdrawals, alcohol use disorder, or co-occurring mental or physical conditions will impact your plan. Talk to your healthcare provider as a first step in making a plan. They may refer you to a substance use counselor or support group, prescribe certain medications to ease withdrawal, or offer community resources.
How can I help someone going through alcohol detox?
If they are open to it, a person may feel supported by your staying with them throughout withdrawal to keep them accountable and safe in case of a medical emergency. You can help them by creating a safe space with low lighting, minimal sensory input, and a plentiful supply of healthy food and water. You can also encourage this person to stay sober after their initial withdrawal period.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
- Sachdeva A, Choudhary M, Chandra M. Alcohol withdrawal syndrome: Benzodiazepines and beyond. J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538
- Grover S, Ghosh A. Delirium tremens: assessment and management. Journal of Clinical and Experimental Hepatology. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012
- MedlinePlus. Alcohol withdrawal.
- Manning V, Garfield JBB, Staiger PK, et al. Effect of cognitive bias modification on early relapse among adults undergoing inpatient alcohol withdrawal treatment: a randomized clinical trial. JAMA Psychiatry. 2021;78(2):133-140. doi:10.1001/jamapsychiatry.2020.3446
- Centers for Disease Control and Prevention. Alcohol and public health frequently asked questions.
- National Institute on Alcohol Abuse and Alcoholism. Understanding alcohol use disorder.
- Mirijello A, D’Angelo C, Ferrulli A, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-365. doi:10.1007/s40265-015-0358-1
By Sarah Bence
Sarah Bence, OTR/L, is an occupational therapist and freelance writer. She specializes in a variety of health topics including mental health, dementia, celiac disease, and endometriosis.
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