How to measure the severity of alcohol withdrawal symptoms

When you suddenly stop drinking after frequent excessive drinking, alcohol withdrawal symptoms may occur, and symptoms range from severe to mild. Severe withdrawal symptoms can be very severe, and in rare cases, they can actually be fatal.

Because they get worse over time, it is important to know whether your symptoms become more severe so that you can seek help. The most severe symptoms usually occur between two to five days after you stop drinking, which means that the first or second day may not be a good indicator of your risk of serious problems.

Moderate and excessive drinking

The Centers for Disease Control and Prevention (CDC) defines moderate drinking as a maximum of one drink a day for women and two drinks a day for men.For most people over the age of 21, moderate drinking is considered safe. Drinking is usually defined as:

  • 12 ounces of beer
  • 8 ounces ale
  • 5 ounces of wine
  • 1.5 ounces of 80% distilled spirits or spirits, such as whiskey, gin, rum, or vodka

Excessive drinking is defined by the CDC as alcoholism, alcoholism, or drinking by anyone who is pregnant or under 21 years of age.Binge drinking refers to drinking multiple glasses of wine on a single occasion.

For women, this is four or more glasses of wine, while for men, it is five or more glasses. Heavy drinking occurs when women drink 8 or more times a week, and men drink 15 or more times a week. Most people who drink excessively do not have an alcohol use disorder and/or are not dependent on alcohol.

How the withdrawal works

If you are an alcoholic—even if you are not an alcoholic—if you suddenly stop drinking, you may have at least some symptoms.Most people use alcohol to relieve anxiety and relax.

Alcohol provides this result by increasing the effects of GABA, a neurotransmitter responsible for creating calm and euphoria. It also reduces glutamate, another neurotransmitter that produces excitability.

READ ALSO:  How to safely stop using methadone

Drinking a lot of alcohol makes it harder and harder to increase GABA and decrease glutamate, so more and more alcohol is needed to achieve the same result. Your body will get used to these changes and respond by producing more glutamate and less GABA.

When you suddenly stop drinking, you no longer affect these two neurotransmitters, but your body still produces too much glutamate and insufficient GABA. As a result, you may become extremely excited: anxious, restless, and trembling.If you are an alcoholic, your symptoms may be much more severe and may develop into tremors, seizures, and severe high blood pressure.

Common withdrawal symptoms

If you drink excessively frequently and suddenly stop drinking, you may experience one or more symptoms of alcohol withdrawal. Depending on your past alcohol consumption, these symptoms can range from mild and uncomfortable to severe and potentially life-threatening.

Although symptoms usually start within eight hours after your last drink, you may not experience any symptoms until a few days later. These symptoms tend to appear within 24 to 72 hours after your last drink, but in some people, milder symptoms may last longer.

Common symptoms include:

  • Feeling anxious or nervous
  • Feeling irritable
  • Moody
  • Feel exhausted and tired
  • Trembling
  • Mood swings
  • Can’t think clearly
  • Nightmares
  • Dilated pupils
  • Sweating
  • Headache
  • hard to fall asleep
  • Nausea and/or vomiting
  • Loss of appetite
  • Faster heart rate
  • Pale complexion
  • Tremor

Severe withdrawal symptoms

One of the most serious consequences of alcohol withdrawal is called delirium tremens, or “DTs.”

Approximately 3% to 5% of abstainers will develop delirium tremens. If left untreated, this condition can be fatal, so if you or your loved one show any symptoms of DT, please seek emergency treatment as the symptoms may get worse.

READ ALSO:  Open letter to non-smoking family and friends

Symptoms of delirium tremens include:

  • fever
  • Extreme restlessness
  • Seizures
  • Extreme chaos
  • Hallucinations (feeling, seeing, or hearing things that don’t exist)
  • hypertension

Hospitals and detox centers have experienced staff who are familiar with these symptoms and have the tools to provide appropriate treatment.


Alcohol withdrawal is mainly diagnosed through medical history and physical examination, and blood tests are usually included to rule out other medical problems. Your doctor will look for physical signs and symptoms, such as:

  • Your hands are shaking
  • Fast heartbeat
  • hypertension
  • Dilated pupils
  • fever
  • Shortness of breath

Your doctor may also use the Clinical Institute Alcohol Withdrawal Assessment (CIWA-Ar) scale to assess how severe your symptoms are. The scale uses 10 questions to measure the following symptoms:

  • Nausea and vomiting
  • Tremor
  • Sweating
  • anxiety
  • agitation
  • Tactile disturbance, which is an abnormal sensation inside, on, or under the skin
  • Hearing impairment, including hearing
  • Visual impairment
  • Headache
  • Puzzled


Treatment will depend on the severity of symptoms.

Mild to moderate symptoms

If you have mild to moderate alcohol withdrawal symptoms, you can give up alcohol at home, but you need someone to accompany you to make sure your symptoms do not worsen. You may need to see a doctor every day until you are also stable.

Your doctor may prescribe a benzodiazepine sedative, such as Ativan (lorazepam), Valium (diazepam), or Klonopin (clonazepam) to help you through the initial stages of withdrawal. You may be tested for other medical issues related to drinking, and you may receive counseling about drinking.

Moderate to severe symptoms

If your symptoms are moderate to severe, you may need to be hospitalized. Your vital signs will be monitored, you will have blood tests, and you may need intravenous (IV) fluids to prevent dehydration. Your doctor may also give you drugs intravenously to help you overcome withdrawal symptoms or treat seizures or other complications.

READ ALSO:  Waterpipe smoking and its risks

Long-term treatment

No matter how severe or mild your symptoms are, the best long-term treatment is to stop drinking alcohol altogether, especially if you have stopped drinking. For this, you need to make sure that you live in an environment that supports alcohol withdrawal.


Most people will fully recover from alcohol withdrawal symptoms. Some people continue to experience destructive symptoms called acute post-withdrawal symptoms for several months, such as difficulty sleeping, fatigue, mood swings, and fatigue. A small percentage of people died of delirium tremens.

If you have underlying health problems, continue to drink heavily and/or your organs are damaged, your recovery will be more complicated. Drinking a lot of alcohol can damage your organs and may cause heart disease, liver disease, and nervous system problems. Therefore, if you have trouble quitting alcohol, it is important to seek help and treatment.

Predict withdrawal symptoms

You may be wondering how severe your withdrawal symptoms will be if you give up alcohol. The answer to this question will depend on many factors-your size, age, gender, drinking habits and genetics.However, by taking a quick test of your symptoms, you can get a good idea of ​​your risk level.

The test is completely confidential and anonymous; your results will not be recorded for your use only, and you will not be asked to provide any personally identifiable information. It can also help if you have recently stopped drinking and are not sure how severe your withdrawal symptoms are.

Note: This test is not a substitute for professional medical assessment. It should only be used as a guide to determine whether your alcohol withdrawal symptoms may indicate that you should seek medical attention before trying to quit. When answering questions, be honest with yourself. You are the only one who will see your test results.