Alcohol Withdrawal Syndrome

by Michael_Koger

Alcohol withdrawal syndrome is a serious medical condition which commonly occurs in hospitalized patients.

The occurrence of alcohol withdrawal often indicates that a person has abused the substance over a long period of time. They have, in most instances, consumed large amounts of it. Though there are approximately 1.2 million hospital admissions for that each year in the United States, many cases of withdrawal happen as an incidental finding [1].

In other words, the individual presents to a health care facility for a separate disease and shortly after admission experiences withdrawal because he or she is not able to drink in the hospital. Indeed, four-fifths of these alcohol-dependent patients will suffer from this while they are already in a facility for something else [1].

Dependence on these types of beverages has no socioeconomic boundaries, and it can afflict those with any level of education, age, gender, racial/ethnic group, or other demographic variable. As a result, the diagnosis is not an easy one for hospital staff because they may overlook wealthy clients or those with much education who appear to function well in the community [1].

Clinical Signs and Symptoms

The development of withdrawal will take several hours after hospital admission, and the condition becomes more serious than it has been before hospitalization unless the medical staff initiates aggressive therapy.  For example, the client can experience tremors, insomnia, anxiety, gastrointestinal disturbances, and headache within 6 to 12 hours after the last drink.  There will also likely be sweating, loss of appetite, or a sensation that the heart is skipping beats [1].

If the condition continues without treatment, there may be hallucinations whether visual or auditory, and the person has a feeling or sensation that there are bugs crawling under the skin.  The medical term for this sensation is formication, and it also occurs in some people who use cocaine.  Moreover, the skin may produce a feeling of itching, numbness, burning, or pins and needles [1].

By 24 to 48 hours after the patient has stopped the consumption of alcohol, seizures can occur.  However, the most life-threatening stage for these clients happens two or three days after the last drink.  This is alcohol withdrawal delirium or delirium tremens, and it has a death rate of 5 to 10 percent [1].

Medical Therapy

Vigorous therapy with intravenous fluids, vitamin supplementation such as thiamine, folic acid, and multivitamins will significantly reverse the situation.  Heavy doses of tranquilizers, particularly those of the benzodiazepine class, will abate most of the distressing clinical signs and symptoms.  Within a few days, the risk will no longer be present, and the health care team can discontinue these measures [1].


The occurrence of alcohol withdrawal syndrome requires prompt recognition and management to prevent further complications.


  1. Gortney, J., Raub, J., Patel, P., et al.  (2016).  Alcohol withdrawal syndrome in medical patients.  Cleveland Clinic Journal of Medicine, 83, 67-79.
  2. The photo is of a library at the United States Centers for Disease Control and is reprinted with permission from that organization.


The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 02/08/2016, Michael_Koger
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Michael_Koger on 02/10/2016

That is a good question. In general, it occurs in people who consume a lot of alcohol over a long period of time.

There will be variation in how severe alcohol withdrawal syndrome will be. For example, elderly people tend to have a lower total body water than young people, and the medical condition may be accentuated in older clients. Also, elderly individuals are likely to take medication for chronic disease such as hypertension, heart disease, and others. The intake of alcohol can lead to interactions with these prescription drugs.

Exercise, diet, and metabolism differences will affect how alcohol interacts with the human body too.

frankbeswick on 02/10/2016

This is valuable information. However, I know there to be varying degrees of alcohol dependency, so I would like to ask whether or not these symptoms are confined to those who are clearly alcoholics or whether they would also be found in patients who have a lower, milder level of frequent alcohol use?

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