Substance guides

Alcohol withdrawal symptoms: What to expect and when to get help

Published March 17, 2026 · 9 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals. Editorial process.

Alcohol withdrawal ranges from mild discomfort to a life-threatening medical emergency. Understanding the spectrum helps you recognize where you or a loved one falls — and whether medical supervision is needed.

Mild withdrawal (6-24 hours after last drink)

Anxiety and nervousness, insomnia or disrupted sleep, tremor (shaky hands), sweating, nausea, headache, rapid heartbeat. These symptoms are uncomfortable but not dangerous. Many people experience mild withdrawal regularly without recognizing it — the morning anxiety and shakiness that improve after a drink are withdrawal symptoms.

Moderate withdrawal (24-72 hours)

Increased blood pressure and heart rate, more severe tremors, confusion and difficulty concentrating, irritability and agitation, nausea and vomiting, profuse sweating, and possible auditory or visual hallucinations. At this level, medical monitoring is recommended. Symptoms can progress to severe withdrawal unpredictably.

Severe withdrawal and delirium tremens (48-96 hours)

Delirium tremens (DTs) affects approximately 3-5% of people withdrawing from heavy alcohol use and can be fatal. Signs include severe confusion and disorientation, agitation and combativeness, hallucinations (visual, auditory, tactile), seizures (grand mal), extreme autonomic instability (fever, rapid heart rate, dangerous blood pressure changes), and profuse sweating. DTs is a medical emergency with a mortality rate of 1-5% even with treatment, and up to 35% without treatment. If someone is showing signs of severe withdrawal, call 911 immediately.

Who needs medical detox

Medical detox is strongly recommended if you drink daily, drink more than 8-10 drinks per day, have experienced withdrawal seizures or DTs before, are over 65, have significant medical conditions, or use benzodiazepines or other sedatives alongside alcohol. In medical detox, benzodiazepines are administered based on symptom severity to prevent seizures and reduce discomfort. Vital signs are monitored continuously. The typical stay is 5-7 days.

Find a location near you

Shelby County Treatment Center

Alabaster, AL

Call 205-216-0200

RMC Health System

Anniston, AL

Call 256-235-5745

Journey Detox and Recovery LLC

Ashland, AL

Call 256-354-1121

BHG Bessemer Treatment Center

Bessemer, AL

Call 205-425-1200

Browse all facilities →

Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC · FDA · ASAM

Frequently asked questions

Can alcohol withdrawal kill you?

Yes. Alcohol withdrawal seizures and delirium tremens can be fatal. Alcohol is one of only two substances (with benzodiazepines) where withdrawal itself can directly cause death. Medical supervision is critical for heavy drinkers.

How long does alcohol withdrawal last?

Mild symptoms begin 6-24 hours after last drink and typically resolve within 3-5 days. Severe symptoms (DTs) peak at 48-96 hours. Post-acute symptoms (anxiety, insomnia) can persist for weeks to months.

Can I detox from alcohol at home?

Only if your drinking is moderate and you have never experienced withdrawal seizures or severe symptoms. If you drink daily or heavily, medical detox is strongly recommended for safety.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.