September 6th, 2023
Beginning the journey of recovering from alcohol use disorder can be daunting. Many unknowns exist in the space of recovery, and some are downright scary. As a substance abuse professional, when working with folks considering sobriety, a common fear that is mentioned is having to experience withdrawal. These fears are normal, as withdrawal is often painful and sometimes life-threatening; however, getting to the other side is absolutely worth it.
One way to assuage the fears that come with facing early recovery and withdrawal is being prepared for what can happen. Being prepared will allow the person seeking recovery and their support systems to know what to expect and when and how to seek expert support if needed. Common symptoms of acute withdrawal and post-acute withdrawal for alcohol use disorder and tools to manage these symptoms can be found below.
Alcohol withdrawal happens due to the complex impact that alcohol has on our brains and bodies. A less severe withdrawal experience, like a hangover, happens due to dehydration, irritation to the stomach lining, and the body’s adjustments to how alcohol interacts with various bodily systems. Hangovers are like a mini-withdrawal that can last for 24 to 48 hours.
A more typical withdrawal experience occurs in people with a long-term and excessive history of alcohol consumption. This type of alcohol consumption disrupts typical brain activity and impacts the balance between excitatory and inhibitory neurotransmitters like glutamate and GABA respectively. The brain becomes accustomed to this disruption, so if alcohol use stops, the brain will go into a hyper-aroused state to compensate for its adjustments.
Acute withdrawal occurs when someone has initially stopped consuming alcohol after prolonged use and is “sobering up.” Withdrawal occurs in three potential stages (though not everyone will experience all three stages).
Each person’s process through the stages of withdrawal will look different depending on that person’s body and mental health composition. If someone tries to detox from alcohol without the support of a trained healthcare professional, they will likely move from stage 2 to stage 3 of withdrawal quickly and are at a higher risk of death or injury. If you plan to detox from alcohol, it is safest to do so under the care of a professional.
As said before, the safest way to treat acute alcohol withdrawal symptoms is under the care of a trained healthcare professional. Medical detox is typically facilitated at a treatment center for substance abuse or a hospital. While engaging in medical detoxification, patients may receive benzodiazepines to help prevent moderate withdrawal symptoms from progressing to severe. Patients may also be prescribed other medications, vitamins, and fluids to treat their symptoms.
Medical detox typically takes five to seven days, depending on each person’s experience of withdrawal symptoms. Once someone completes medical detox, it is highly recommended that they engage in treatment to support their continuing sobriety and to manage any experience of post-acute withdrawal syndrome (PAWS).
PAWS refers to the lingering impacts of substance abuse and addiction after acute withdrawal has occurred and the brain continues to recalibrate. While acute withdrawal symptoms tend to be more physical, symptoms of PAWS tend to be more emotional and psychological. Additionally, these symptoms can last anywhere from a few weeks to a few months and do not always occur immediately after acute withdrawal.
Awareness of PAWS is highly important as PAWS is often a driving force behind relapses to use. Knowing what to expect from PAWS and managing the symptoms of PAWS effectively can help prevent relapse.
While the symptoms of PAWS can vary from person to person, the most common symptoms of PAWS are:
These symptoms may show up over the course of a few weeks to a few months, which can feel disheartening for someone in early recovery. Having awareness that these symptoms are a part of early recovery and are temporary can support someone’s continued recovery and can support the avoidance of relapse. That said, awareness is not the only way someone can manage PAWS.
As PAWS can be an ongoing experience, it is important to have support in place to manage it. One way to get support is to engage with therapists and psychiatric providers who are trained in addiction medicine. These providers can support mood and medication management while teaching skills that support PAWS management. Additionally, attending group therapy and other support groups can offer those recovering from PAWS spaces to connect with their peers about their experiences. Other tools for managing PAWS include:
Most importantly, remember to not rush recovery. Though it may take the brain time to heal, it will eventually heal from the damage that was done while drinking. Most people report a full recovery within a year or two of their last drink, so while these experiences are difficult, they do not last forever.
Every person’s journey of recovery has its own unique challenges, withdrawal, and PAWS being one of them. Know that working through the difficulty of withdrawal will bring you closer to healing, which is truly worth the effort.
Disclaimer: The information on this page is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions regarding a medical condition or treatment. Never ignore or delay seeking professional help due to information found here.
At Clarity Clinic, we provide mental health care for individuals seeking support with anxiety, depression, trauma, and other emotional challenges. While we do not offer addiction treatment or detox services, we welcome individuals in recovery from substance use who are stable and ready to focus on their mental health. For those actively using substances, a higher level of care may be necessary before engaging in meaningful therapy.
We can provide referrals to external substance use treatment centers and welcome clients back once they are stabilized and ready to work on improving their lives post-treatment. Our team is here to support your mental well-being, whether you’re navigating the emotional impact of past alcohol abuse, relationship changes, or other life transitions
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