Alcohol Withdrawal: Signs, Symptoms & Treatment for Veterans

Alcohol use has a high prevalence among Veterans, as one study reports that approximately 11% of patients in the Veterans Affairs medical system meet the criteria for a substance use disorder.¹ In fact, alcohol use disorder remains the most prominent of substance use disorders affecting the Veteran population.¹

Veterans experiencing this type of substance use disorder can face several challenges as a result of their continued misuse of alcohol, one of which being withdrawal when they attempt to stop their use. Withdrawing from alcohol when dependent on it can be dangerous and possibly even deadly.²

In this article, we will define alcohol withdrawal, explain how to identify symptoms, and provide an estimated timeline for alcohol withdrawal. We will also discuss the treatment of alcohol withdrawal and how to get professional help.

What Is Alcohol Withdrawal?

When someone uses a central nervous system depressant like alcohol over a long period of time, their brain and body can become adapted to the presence of it. This is known as dependence, which is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. The nervous system attempts to compensate for alcohol’s depressive effects while also experiencing excessive activity that impacts basic functions such as respiration, heartbeat, and blood pressure.^2,3

Signs & Symptoms of Alcohol Withdrawal

The symptoms of alcohol withdrawal can vary from person to person, depending on several factors, such as how much alcohol is being consumed, how frequently a person is drinking, and how long they have been consuming alcohol.

Some signs of alcohol withdrawal can include the following:^2,4

• Insomnia
• Shakiness
• Anxiety
• Headache
• Cravings
• Loss of appetite
• Gastrointestinal upset
• Excessive sweating
• Heart palpitations
• Seizures

During this time, some individuals may experience a set of side effects of alcohol withdrawal known as delirium tremens, or the DTs.⁴ This is an especially dangerous feature of alcohol withdrawal, as it includes a number of severe symptoms that can put an individual’s health at significant risk. Those who develop delirium tremens during alcohol withdrawal may experience the following symptoms:⁴

• Disorientation
• Increased heart rate
• High blood pressure
• Fever
• Agitation
• Excessive sweating

Individuals with the DTs may also experience one or more serious and potentially life-threatening complications, including severe rhabdomyolysis, arrhythmia, and respiratory failure.^5,6 However, when the DTs are detected early on, appropriate alcohol withdrawal treatment can be provided, helping to mitigate and/or prevent these symptoms and possible dangerous outcomes.⁶

Withdrawal Timeline: How Long Does It Last?

Similar to how the severity of withdrawal symptoms can vary between individuals, the amount of time alcohol withdrawal lasts can also vary depending on factors specific to the individual. Despite these variations, however, there is a common timeline associated with alcohol withdrawal, which resembles the following:⁴

• 6 to 12 hours: Minor withdrawal symptoms, including insomnia, shakiness, anxiety, gastrointestinal upset, headache, excessive sweating, heart palpitations, and decreased appetite typically occur.

• 12 to 24 hours: Alcoholic hallucinosis can occur, which includes visual, auditory, or tactile hallucinations. These symptoms usually resolve within 48 hours. It is also possible for seizures to occur.

• 24 to 48 hours: It is most common for seizures to occur during this timeframe, which is why professional supervision is recommended.

• 48 to 72 hours: Delirium tremens symptoms may occur. This may include hallucinations, disorientation, tachycardia, high blood pressure, low-grade fever, agitation, and excessive sweating. For those who experience delirium tremens, symptoms tend to peak at about 5 days, but can take longer to fully resolve.

In some people, protracted withdrawal may occur, meaning that some symptoms of alcohol withdrawal may last longer than the expected timeline of acute withdrawal.⁷ When a person experiences protracted withdrawal, their withdrawal symptoms linger or may even dissipate for a period of time before reoccurring. Symptoms may be more or less intense based on the unique factors specific to each patient.⁷

Treatment for Alcohol Withdrawal

It is recommended that treatment for alcohol withdrawal occurs in a professional, medically supervised alcohol detox program, as some symptoms (like seizures and those associated with the DTs) can be fatal.⁸ Detoxification is considered the first stage of treatment, and its goals are to provide necessary medical care to manage the health effects that occur as the body clears itself of drugs or alcohol.⁸ Detox usually happens in an inpatient setting and can involve medications administered by a supervising physician.^6,8

While alcohol detox is a common part of treating alcohol addiction, it is only the first step of treatment and does not effectively treat long-term substance misuse.⁸ Patients should be encouraged to continue on in their addiction treatment after the completion of detox.⁸ This can include enrolling in inpatient treatment or an outpatient program that can help them manage ongoing challenges posed by abstinence, as well as manage the effects of protracted withdrawal should they occur.

Alcohol Withdrawal Medications

There are several medications available for the treatment of alcohol withdrawal symptoms during detoxification, including acamprosate, disulfiram, and naltrexone.⁸ Benzodiazepines may also be used to treat severe withdrawal symptoms and are considered a safe and effective way of treating or preventing seizures and delirium.⁴

Finding Treatment for Alcohol Withdrawal

If you or a loved one are a Veteran struggling with alcohol addiction, American Addiction Centers (AAC) has several facilities nationwide that can help. AAC’s Salute to Recovery Program, in particular, is geared specifically toward Veterans and their unique treatment needs.

You may have questions about where to start, what your insurance or Veteran benefits may cover, or how to pay for rehab. It may be helpful to contact an alcohol addiction hotline, such as the one operated by AAC. Our helpful and compassionate admissions navigators can answer your questions and help you to choose the treatment option that is right for you.