If you’ve ever been overserved (or overserved yourself) with adult beverages, you know how it can wreak havoc on your mind and body. From a throbbing headache to morning-after anxiety, hangover symptoms are just one of the risks associated with overindulging. But when drinking too much becomes a habit, those risks—and symptoms—increase. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol withdrawal symptoms can be potentially life-threatening when someone who has been drinking heavily for a long period of time suddenly stops.
So, what’s actually considered heavy drinking? The Centers for Disease Control and Prevention (CDC) defines it as more than 15 drinks per week for people assigned male at birth and more than eight drinks per week for people assigned female at birth. With long-term heavy alcohol intake, your brain adapts to the effects of booze over time.
It’s important to note that if you over-indulge here and there, you’re not likely going to experience alcohol withdrawal syndrome (which occurs when someone who is physically dependent on alcohol suddenly stops drinking). But if you’re consuming over the recommended amount for weeks, months, or even years, withdrawal symptoms are more likely to pop up. Here’s why: When you suddenly stop drinking, your nervous system kicks into overdrive to compensate, triggering withdrawal symptoms.
What are mild alcohol withdrawal symptoms?
The first symptoms—and maybe the only symptoms—you experience may resemble a bad hangover. These are considered mild, but they can worsen. Although the onset of alcohol withdrawal varies from person to person, symptoms typically appear as early as six to 24 hours after the last drink, Seonaid Nolan, MD, a clinician-scientist at the British Columbia Centre on Substance Use, tells SELF. She adds that withdrawal can also occur after a significant reduction in alcohol consumption.
According to a 2019 systematic review published in the Journal of the American Medical Association, and co-authored by Dr. Nolan, mild withdrawal symptoms are common: “Up to 50% of individuals with a history of long-term, heavy alcohol consumption will experience some degree of mild withdrawal when alcohol use is stopped.”1
Mild symptoms can take between 24 and 48 hours to resolve. If they don’t progress during this period, the worst may be over.2 Here’s what to look out for:
“Generally, the first symptoms to develop include anxiety, agitation, and restlessness,” says Dr. Nolan. In fact, in the early stages of withdrawal, “women with alcohol use disorder consistently report more anxiety symptoms than men,” Kathryn McHugh, PhD, an associate professor of psychology at Harvard Medical School, tells SELF. Withdrawal-related anxiety can perpetuate the cycle of addiction, pushing you to seek out that next drink.
Loss of appetite
This can occur when alcohol causes inflammation in the stomach lining, which can reduce hunger signals.1 Alcoholic hepatitis, a dangerous inflammation of the liver, can occur in some people who drink and may also cause a lack of appetite, according to the Mayo Clinic.
Nausea and vomiting
As your body detoxes, nausea and vomiting are pretty common symptoms. You may also experience periods of dry heaving without vomiting. If severe vomiting is present, you may need to receive IV fluids so you don’t become dehydrated.
Headaches can also crop up in the early stages, likely due to sensitization in certain neurons and cell receptors, as well as a release of chemicals associated with head pain, according to a 2021 study published in the journal BioRxiv. While there aren’t current treatments specifically for alcohol-withdrawal-related headaches, targeting these cell receptors in the brain could be a future treatment option.3
Since alcohol affects your central nervous system, your circulatory system, and pretty much all areas of your body, it’s no surprise that withdrawal can make things go a little haywire. Your autonomic system—basically the bodily functions you do involuntarily—can become hyperexcited, leading to things like profuse sweating.4
Rapid heart rate
In addition to sweating, you may develop heart palpitations from a hyped-up autonomic system. This is characterized as a heart rate of greater than 100 beats per minute.4
This is yet another autonomic nervous system response to alcohol withdrawal. Tremors often affect the hands but can occur elsewhere in the body as well, according to the U.S. National Library of Medicine.
Sleep disturbances are extremely common in the early stages of alcohol withdrawal, according to an older study published in the Journal of Addiction and Addiction Disorders, and may continue for several months, even with continued abstinence from alcohol.5
What are moderate to severe alcohol withdrawal symptoms?
It’s sometimes hard to predict who will go from mild symptoms to moderate or severe symptoms, but generally, the severity of your symptoms will depend on the amount of alcohol you’ve been consuming and how long you’ve been consuming it, according to an older study published in American Family Physician.6 If you progress to moderate or severe alcohol withdrawal symptoms, they may take some time to develop, but can include:
Seizures and hallucinations
Seizures can occur within six to 48 hours, while hallucinations can occur within 12 to 48 hours after drinking is reduced or stopped, says Dr. Nolan. About 3% of people who develop seizures may have what’s called status epilecticus, when a seizure lasts for more than five minutes, or you have more than one seizure in a five-minute period and do not regain normal consciousness between episodes, according to Johns Hopkins Medicine. This is considered a medical emergency because it can lead to permanent brain damage.
Around half of all people who have a seizure during alcohol withdrawal will experience delirium tremens, a medical emergency that affects 3 to 5% of people with a history of alcohol abuse. Delirium tremens appear even later, between 48 and 96 hours after a reduction in drinking.2