Alcohol Withdrawal Symptoms: Effects and Complications

Last Updated: April 5, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

There are many reasons to cut down on the intake of alcoholic drinks or quit drinking altogether. For some people, the motivation is health reasons. For others, it is financial concerns or a personal resolution. Nonetheless, when someone decides to quit drinking, there are many physical and mental challenges. What should be expected when quitting alcoholic beverages? How long does alcohol withdrawal last? Does alcohol detox act as a permanent solution to withdrawal and cravings? This guide highlights the causes of alcohol withdrawal symptoms, what to expect when experiencing alcohol withdrawal symptoms, the alcohol detox process, programs, duration, and psychosocial support for people battling an addiction to alcoholic drinks. It is designed to better understand how to ease withdrawal symptoms, fight cravings, and avoid relapse.

Alcohol Withdrawal and Detox Overview

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines detoxification as a set of interventions for managing withdrawal and acute alcohol intoxication. It is a medically-supervised procedure where doctors manage and treat the physical symptoms of alcoholism. This is the first step in addiction treatment. The alcohol withdrawal timeline is well affected after alcohol detox, and the person in question feels relief from extreme withdrawal symptoms.

Alcohol acts as a depressant in the human body. In other words, it slows down the systems. It affects brain function. With consistent drinking over time, the central nervous system gets used to exposure to alcoholic drinks. The body overcompensates to maintain nerve communication and brain alertness.

What happens when we take alcohol out of this equation? The body cannot instantaneously revert to its original healthy state, and this is what causes alcohol withdrawal symptoms. The craving for alcohol takes priority due to its neurological and compulsive nature. The person is unable to function without drinking.

Chronic Drinking Changes the Brain Chemistry by:

  • inhibiting the functioning of GABA, a neurotransmitter that induces feelings of relaxation.
  • inhibiting the effect of glutamate, a neurotransmitter that induces feelings of excitability.
A man suffering alcohol withdrawal.

What Causes Alcohol Withdrawal Symptoms?

This problem is particular to heavy drinkers. When a heavy drinker abruptly stops drinking, the neurotransmitters in the brain begin to malfunction. Alcohol has a sedating effect which the brain chemically adjusts to by producing balance chemicals such as serotonin and norepinephrine in a much larger quantity than usual. This causes the brain to accelerate in its functions. When the individual decides to abruptly stop taking alcohol, the brain continues to produce these hormones in excess, causing overstimulation and an overdrive. The individual begins to experience alcohol withdrawal symptoms, which is the body’s way of demanding more drink to maintain regular functions.

The most dangerous alcohol withdrawal symptoms are the Delirium Tremens (DT), which reportedly occurs in 1 in every 20 heavy alcohol users. In this dangerous form of health problem, the brain is completely unable to return to its normal chemistry, creating immeasurable health risks. In severe cases, alcohol withdrawal medication may be necessary.

Alcohol Withdrawal Symptoms

Like any substance, the effects of alcohol vary in people, and so do the withdrawal symptoms. The first question on a recovering alcoholic’s mind is probably, how bad will the alcohol withdrawal be? As a general rule, the longer and heavier a person has been drinking, the more severe and prolonged alcohol withdrawal symptoms are.

When do alcohol withdrawals start? The first mild symptoms of alcohol withdrawal, as the case may be, may begin as early as 6 hours after the last drink and may include:

  • Nausea
  • Headache
  • Sweating
  • Vomiting
  • Insomnia
  • Shaky hands
  • Anxiety
  • Loss of appetite
  • Fatigue
  • Depression
  • Foggy thinking
  • Heart palpitations
  • Mood swings

The second wave of symptoms, which may be slightly more severe, include:

  • High blood pressure
  • Irregular heart rate
  • Irritability
  • Stronger mood disturbances

What to expect when detoxing from alcohol if someone has been a heavy drinker? The severest symptoms occur in long-term abusers and include:

  • Hallucinations (12-24 hours after the last drink)
  • Seizures (in the first two days after the last drink)
  • Extreme confusion

All these symptoms occur with intense cravings for alcohol. The individual in question may go to any length to secure more alcohol to pacify their cravings. When one finds themselves experiencing frequent cravings and frequent alcohol withdrawal symptoms, then it is time to seek medical counseling. Also, the separate class of symptoms called delirium tremens, commonly referred to as DTs or “the shakes,” affects about 5 percent of people going through detox from alcohol. They may start anywhere between 48 and 72 hours after the last drink. Individuals in this phase often experience a more frequent relapse due to the extent of alcohol withdrawal symptoms.

Staying sober is extremely difficult in this stage and requires extensive medical treatment to quell the delirium and other related alcohol withdrawal symptoms.

A woman is experiencing alcohol withdrawal symptoms.

Alcohol Detox Programs and Goals of Treatment

Any alcohol detox program’s ultimate goal is to return the affected person to a healthy state safely. This means using specialized medical means and methodologies to suppress the user’s frequent cravings and enable them to build a foundation for sobriety.

The goals of professional medical treatment during withdrawal stages of alcoholic drinks are:

  • To ensure a safe and stable withdrawal period: Alcohol withdrawal symptoms can be extreme. Its symptoms are often quite unpleasant and unbearable. During alcohol detox, pharmaceuticals may be administered to reduce these unpleasant feelings.
  • To prevent relapse: The rate of relapse is highest during the initial period of abstinence. Many recovering addicts relapse when withdrawal symptoms become too unpleasant to bear. By managing the intensity of symptoms, doctors keep the person safe and ensure that they do not revert to old drinking patterns.
  • To get rid of toxins: Alcoholic drinks are toxic to the human body. Until the toxins are flushed out, a recovering addict cannot proceed to the next alcohol detox stage. These toxins contribute to the alcohol withdrawal timeline.
  • To ensure a smooth progression to the subsequent stages of addiction treatment: Alcohol damages the brain and clouds a person’s thinking and reasoning. The presence of alcoholic drinks in the body can impair the ability to think straight and appreciate the treatment’s necessity. Once the toxins are cleared, a recovering addict may be persuaded into participating in the subsequent stages of treatment. This process helps improve the outcome for most people.

Alcohol Detox Duration: How Many Days to Detox From Drinking?

Perhaps the biggest question on a recovering alcohol abuser’s mind is: how long does it take to go through alcohol withdrawal? The alcohol withdrawal timeline varies from one person to the other.

This Depends on a Number of Factors:

  • The duration of alcoholism
  • The number of alcoholic drinks consumed every day
  • The presence of coexisting physiological disorders
  • The presence of concurrent mental illnesses

Withdrawal symptoms are usually the most severe when a person has been drinking for a long time or has been a heavy drinker: the more severe the symptoms, the more prolonged the alcohol detox treatment.

In most cases, it takes around 5-14 days to stabilize the person and control symptoms of withdrawal, provided there are no complications. The presence of coexisting physiological and/or mental disorders can complicate the detox process and prolong it.

Detox Programs: What to Expect From Alcohol Withdrawal?

According to the National Center for Biotechnology Information, an alcohol detox program consists of medications, psychosocial support, or a combination of the two.

Those in a critical stage of addiction and are experiencing severe alcohol withdrawal symptoms are first treated with alcohol withdrawal medication. These medications work differently. Some might inhibit the cravings, while some may negatively alter the appeal for drinking and reduce the negative physical and mental effects felt during the alcohol withdrawal timeline.

Individuals who experience withdrawal symptoms from alcohol, but not in a critical, life-threatening way, can be treated with psychosocial support to learn everything they can about relapse and how important it is to maintain sobriety from alcohol. Some withdrawal symptoms may last for weeks or months. This form of withdrawal symptom is called Post-Acute Withdrawal Syndrome (PAWS).

A man is experiencing side effects of alcohol withdrawal.

Medication Support During Withdrawal

Is it possible to experience no alcohol withdrawal symptoms? If a person has been a heavy drinker, the answer is no, but certain medicines are prescribed to ease withdrawal from alcoholic drinks:

  • Medicines to manage withdrawal symptoms: Medicines commonly used during treatment are chlordiazepoxide and lorazepam. They belong to a class of drugs known as benzodiazepines that affect the central nervous system and have a calming effect. They are prescribed to manage symptoms of anxiety and restlessness.
  • Medicines to boost general health: Alcoholics tend to neglect their diet and often suffer from nutritional deficiencies. Vitamins, folic acid, and iron supplements are administered during treatment to help regain general good health. In fact, alcoholics are typically deficient in vitamin B1 (thiamine). Severe deficiency of this vitamin is associated with neurological complications such as memory loss and even death. Intravenous B1 is sometimes necessary if an alcoholic is diagnosed with a deficiency of this vitamin.
  • Medicines to curb alcohol cravings: A person undergoing a detoxification period suffers from intense cravings. Certain drugs such as acamprosate, naltrexone, and disulfiram reduce the intensity of the cravings. These medicines are prescribed to people detoxing at outpatient facilities as these people spend a part of the day at home or in the workplace where they may be exposed to triggers or obtain access to alcohol.
  • Medicines to manage coexisting mental disorders: Long-term alcoholics often suffer from coexisting mental conditions that are exacerbated when the person abruptly stops drinking. When one undergoes detox from alcohol, doctors treat these mental health issues with a number of drugs, including antipsychotics such as olanzapine and haloperidol, to treat symptoms of schizophrenia.

The medications listed above should be prescribed by a doctor. Do not attempt to self-medicate during the alcohol withdrawal, as it may cause severe adverse reactions, especially in the case of some drug interactions.

Psychosocial Support During Alcohol Detox

Many facilities provide integrated alcohol detox programs where a combination of medications and psychotherapy helps a person overcome the withdrawal symptoms and prepare to stay off alcoholic drinks after completing the treatment.

During psychotherapy, a person’s mind is recalibrated, and they are taught to:

  • cope with stress in a healthy manner without resorting to alcoholic drinks
  • become mindful of cravings and process them without acting impulsively
  • resist cravings and avoid the urge to drink
  • identify triggers in the environment
  • devise habits to stay away from triggers
  • develop ways to deal with triggers and not react to them by drinking
  • rebuild burned bridges and reconnect with friends and family
  • improve social interactions and activities to replace drinking sessions

The hope of every person who is recovering from alcoholism is that alcoholism relapse won’t happen. In this guide, we’ll investigate what alcohol relapse is and how to avoid it effectively.

Some say that the biggest struggle begins once the former alcoholic leaves the alcohol rehab center. The minute that the patient walks out the door of the rehab facility, he or she is faced with familiar situations and cravings that can lead to a relapse.

psychological treatment for alcohol withdrawal.

Why Recovering Alcoholics Struggle With Staying Sober?

On the surface, alcoholism recovery can seem easy to those who have never gone through it or suffered from an addiction. All one has to do is stop drinking, right? Not quite.

How to get sober is hard on its own. But once someone has stopped their habitual use of alcohol, they have to focus on living sober for the rest of their lives. This is much more complicated than people expect.

Why is this? There is a Multitude of Reasons:

  • Alcoholics often form relationships around drinking, so when they stop, their entire social life has to change radically.
  • Drinking is the overall part of the culture, so people who focus on staying sober have to decline drinks or even entire social events just to remain clean.
  • Many people dislike confrontation or telling people no, which can make declining drinks incredibly tricky.
  • Being drunk is often a method of masking various insecurities and awkwardness, and once sober, the person has to face these facts about themselves.
  • The greater the distance the user gets from the bad times of their alcoholism, the easier it is to forget just how awful it was.
  • Being sober means feeling things at full force—while alcohol can dull emotions; once a person is sober, there is nowhere to hide.
  • Heavy alcohol use literally changes the brain, and its absence can trigger all sorts of mental health struggles.
  • Non-drinkers are often stereotyped as being buzz-kills or just generally not fun, and nobody wants to be viewed that way.
  • Sometimes people quit without getting the right help, leaving them without the tools they need to understand how to stay sober.

While a sober life is undoubtedly better than a drunk one, that doesn’t mean it is an easy path to walk for someone suffering from alcoholism. These individuals need maximum support in order to succeed.

Statistics on Sobriety After Quitting Alcohol

One of the most devastating facts about alcoholism is its relapse rate. Roughly 60 percent of people who have been actively treated for alcoholism will relapse within the first year.

Studies have looked exhaustively at possible reasons why people relapse and the life of sobriety that most previous users live in order to draw the inference. According to research, individuals who quit alcohol without any form of professional or medical help were more likely to relapse within 3 years.

The 12-step support program plays a significant role in recovery as studies show that those who attended the program improved in a number of days sober. Another research showed that up to 67% of AA attendants maintained sobriety for more than 16 years.

At least 1 in every 4 alcohol patients maintained sobriety in the first year, while 1 in about 10 people moderately used alcohol.

In fact, only 6.5 percent of adults with alcoholism get treatment each year. While the 1-year-sober mark is critical to passing, those who do are not suddenly out of the woods. A sober life is lived one day at a time, and each day has the potential for relapse. Studies have examined individuals who began drinking again after 16 years without alcohol.

However, a relapse does not mean that the treatment, if they sought any, has failed. However, because of the nature of addiction, treatment can be useful, and the user could still find themselves drinking again. Being sober means putting in the work every day, and a big part of that is staying away from triggers that may cause alcohol relapse.

A person can't stop drinking alcohol and has a relapse.

Alcohol Relapse Overview

The definition of relapse means to slip back into a former state or practice after a period of abstinence from substance abuse. However, the meaning of relapse in recovery-oriented systems of care is getting a make-over. In fact, it is now recognized that for some recovering alcoholics, relapse is part of recovery.

These days, less than 20% of patients remain abstinent for a full year. This is in treatment facilities for people with alcohol use disorder. Those with 2 years of sobriety under their belts have a relapse rate of 40%. In addition, those with 5 years of sobriety, while likely to remain sober, are still at risk for relapse. The threat of a relapse is largely hinged on cravings.

The Role of Cravings in Alcohol Relapse

Craving is the fundamental element, the missing piece to the puzzle of relapse. Most alcoholics who have been sober for years are still at risk of relapse because cravings evolve once they are addicted to the substance. So many things can spur up an alcohol craving. Stress from work, driving past a former hot spot, attending a party, looking at certain pictures can trigger cravings. The problem with cravings is this, for an alcoholic, it can last for hours, weeks, even months, and it can affect a person’s overall mood and behavior. Individuals who have not developed the willpower or have enough family and social support to deal with their cravings may relapse. It is pertinent to remember that a relapse isn’t a failure; rather, it is a call to improve upon the foundations of one’s sobriety journey in order to survive in the long-term.

Who is Likely to Relapse to Alcohol?

First, anyone can relapse. Recovery is a tough journey. Recovery from alcohol misuse can be very challenging.

Some risk factors for relapse:

  • Easy access and availability of alcohol.
  • Early initiation of alcohol use.
  • A family history of alcohol misuse and/or genetic predisposition.
  • Not obtaining treatment or outside support.
  • Co-occurring mental health problems, mood disorders, and depression.
  • Fewer years of education.
  • Medical issues
  • Smoking
  • History of trauma

Incidentally, a person may be in treatment and doesn’t have any of the risk factors mentioned above, and it does not mean they’ll soar through recovery without experiencing a relapse. Expect that it may happen—plan for it to happen.

Anyone can relapse, but people who experience the following are most likely to relapse:

  • Early initiation of alcohol use
  • No treatment
  • No outside support
  • Co-occurring mental health problems
  • Medical problems
  • People who smoke
A woman is experiencing alcohol relapse.

Signs and Stages of Alcohol Relapse

Medical professionals recognize that there are three possible aspects to an alcoholic relapse:

  • Emotional: involves the familiar compulsion to drink due to stress and emotional triggers.
  • Mental: involves seriously thinking about drinking.
  • Physical: involves actually returning to alcohol use and dependence.

To prevent a relapse, one should be aware of warning signs and create a relapse prevention plan. If one is prepared, they will be able to quickly identify when they are in a poor mental state and should ask for help. One will have a strong support network to rely on.

What are the Early Signs of a Relapse?

The signs of impending relapse include:

  • Remembering the past when a person was still an addict.
  • Canceling visits to support group meetings.
  • Reaching out again to former drinking companions.
  • Thinking of enjoying the taste of liquor again.
  • Ignoring people who help to stay sober.
  • Rejection of constructive criticism

Alcohol Cravings and Their Causes

Alcohol is well-known for its impact on the brain. Among other things, its presence alters the standard levels of a family of chemicals known as neurotransmitters. These substances, produced inside specialized nerve cells called neurons, play a vital role in the transmission of information to and from the central nervous system (brain and spinal cord). They make it possible for chains of neurons to communicate and produce the broad array of signals that control other nerves throughout the body.

People who establish a pattern of heavy drinking will almost certainly experience significant changes in their levels of two particular neurotransmitters: dopamine and GABA (gamma-aminobutyric acid). In a brain area called the limbic system, repeated increases in dopamine levels lead to an expectation for high feelings of pleasure. Throughout the brain, repeated increases in GABA levels will lead to a general slowdown in the normal rate of neuron-to-neuron communication.

Sooner or later, the brain will come to treat the altered levels of dopamine, GABA, and other neurotransmitters as an everyday reality. Cravings for further drinking arise when there is not enough alcohol in the blood to support these altered levels. They serve as a first-stage warning to consume more alcohol. If this warning goes unheeded, the brain may follow up with the stronger (and much more unpleasant) mental and physical symptoms of withdrawal.

Alcohol craving and withdrawal symptoms are two of the official criteria for a condition called alcohol use disorder (AUD), which covers both alcoholism and non-addicted alcohol abuse. By themselves, they’re not enough to merit an AUD diagnosis. However, their presence points toward such a diagnosis and clearly indicates a dangerous pattern of alcohol intake.

Cravings are dangerous because they are physical, mental, and emotional. A person may have an emotional attachment to drinking because of an experience they had in the past, or a physical attachment due to a place or event they attended, or probably a mental connection because of how drinking makes them feel. These impacts may frequently cause withdrawal symptoms, leading to relapse and making it extremely difficult to fully recover from alcoholism or staying sober for a very long period of time.

A woman is experiencing alcohol cravings.

Alcohol Craving Symptoms

A person craving alcohol may experience a variety of mental and physical symptoms. Common examples of these symptoms include:

  • Preoccupation with thoughts of drinking
  • A vague sense of unease
  • Unusual irritability
  • Fatigue
  • Lack of appetite
  • Sleep disruption
  • An inability to think clearly
  • A down or depressed mood
  • Unusual anxiousness
  • Unexplained changes in mood
  • Loss of a sense of self-control

These symptoms may appear in mild, moderate, or severe forms. Even in a person committed to not drinking, they can increase the likelihood that alcohol intake will occur. In many cases, cravings are “triggered” by internal or external events. Internal triggers for drinking urges can include such things as:

  • Stressful thoughts
  • Anger or emotional frustration
  • Physical pain or discomfort
  • The positive feelings associated with happiness or excitement

External sources of cravings can include:

  • The sight of other people consuming alcohol
  • Being in a social setting associated with drinking (e.g., a bar or club)
  • Time of day when drinking normally or frequently occurs

Most people find it easier to recognize external triggers and harder to identify internal triggers.

How to Curb Alcohol Cravings?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends some actions that can help reduce alcohol cravings.

Potential steps to take here include:

  • Establishing an alcohol-free household
  • Staying away from events or places that feature drinking as an activity
  • Working with friends and family to establish alcohol-free activity options

People who need to reduce their exposure to cravings will also need to develop some coping skills.

Experts at the NIAAA emphasize the importance of skills such as:

  • Creating reminders that emphasize the importance of sobriety
  • Creating healthy distractions (e.g., exercising, talking with friends)
  • Discussing alcohol cravings with a counselor, friend, or family member
  • Avoiding thought patterns that give strength to alcohol cravings
  • Planning out coping strategies in advance when entering trigger environments
  • Keeping track of personal development

Medication for Alcohol Cravings

In a treatment environment, doctors can help one detox from alcohol craving by prescribing a medication called naltrexone. This medication takes advantage of an essential connection between the effects of alcohol and the impact of opioid-based drugs and medicines. Opioids trigger chemical changes in the brain by accessing sites in the body called opioid receptors. While alcohol is not an opioid, it produces some of its intoxicating effects by activating the same receptors.

Naltrexone is an opioid receptor blocker. When present in the blood, it creates a barrier that shuts off these pathways to the brain. In a person affected by alcoholism, the blockading effect of the medication leads to a reduction in the intensity of drinking urges. It also leads to reduced feelings of alcohol-related pleasure. Studies show that the use of naltrexone can help people in recovery maintain sobriety and avoid drinking relapses. The US Food and Drug Administration has approved a long-acting, injectable form of the medication (branded as Vivitrol) for alcoholism treatment.

A man says no to alcohol.

Foods that Stop Alcohol Cravings

Nutrition can play an essential role in reducing the urge to drink, especially in people affected by alcoholism. There are several key reasons for this fact. First and foremost, many alcoholics develop ongoing nutritional deficiencies that have a widespread impact on their physical and mental well-being. During the withdrawal process, alcoholics can have a hard time telling the difference between the desire to drink and an underlying feeling of hunger. In many cases, if they eat, their cravings will subside, and their sense of stability will increase.

Nutritional well-being also has another significant effect. As demonstrated, many of the triggers for alcohol use are based on negative emotional states such as depression, anxiety, and general mood instability. Consumption of a poor diet increases the likelihood that these emotional states will occur. When an affected person’s nutritional standing improves, mood fluctuations decrease, and the intensity of drinking urges may diminish. Some alternative health aficionados make specific recommendations about the best types of foods for reducing alcohol cravings. However, as a rule, the key is consuming a well-balanced diet that contains a variety of low-fat proteins, healthy carbohydrates, fruits, vegetables, vitamins, and minerals.

Creating Alcohol Relapse Prevention Plan

A relapse prevention plan is a set of guidelines designed to help prevent relapses. A good alcohol relapse prevention plan will help to recognize possible triggers and warning signs and prepare for what to do if one experiences triggers or cravings. Begin by building a support network of family, friends, and groups. Know who to call if one gets into trouble, and maintain an active, healthy lifestyle.

The purpose of planning what to do if one starts to have signs of relapse is to build awareness of triggers that may cause revert to former behaviors. Make a plan on how to deal with these triggers in advance. By doing this, one will be able to cope if or when they occur and work through the triggers. Indeed, recovery plans that include relapse prevention are most likely to succeed.

One of the most common changes is the onset of cravings for more beer, wine, or hard liquor between periods of active drinking. These powerful urges reinforce a pattern of excessive drinking and thereby make it harder to break such a model and establish sobriety. Fortunately, people struggling with this problem can fight alcohol cravings with the help of proven coping strategies. In addition, people under a doctor’s care can receive assistance in the form of urge-reducing medication.

Strong cravings for alcohol can cause problems for alcoholics, as well as for people who don’t currently qualify for an alcohol use disorder diagnosis. No one can say for sure how long alcohol cravings last in any given person. Factors that influence the answer to this question include genetic predisposition for alcohol problems, the presence or absence of alcoholism, and the severity of any alcoholism symptoms. Even after receiving successful treatment, some people continue to feel an urge to drink for weeks, months, or years.

Fortunately, anyone craving a drink can use a range of techniques to fight the urge. Whenever possible, the best course of action may be the avoidance of any situation or event where alcohol consumption occurs. When abstinence is impossible, practical use of coping strategies can help reinforce a commitment to abstinence. In addition, any person who feels intense cravings may gain significant relief by making dietary changes or seeking help from a doctor or trained addiction specialist.

Tips for Staying Sober

Getting sober is only part of the battle for an alcoholic. The greater fight—and arguably, the harder one—is staying clean for life. For those who have lived a life of abuse, how to be sober is not a matter of instinct; it is a conscious decision they have to make every day of their lives. Here is what recovering alcoholics and their loved ones need to know about the process.

Any drinker can understand the benefits of sobriety just by looking at what is going wrong in their lives and how it relates to their alcohol use. But knowing that abstinence is good doesn’t stop someone from craving alcohol or caving in and using it. Users are unlikely to stay sober and clean unless they have a strategy for staying alcohol-free.

While it is best to craft this strategy with a medical professional, users can start thinking about the process on their own.

Below are Nine Tips to Help Recovering Alcoholics Stay Sober:

Recognize Triggers and Understanding Cravings

Some people have the idea that to be sober means to no longer have any cravings for alcohol. While the active desire for using alcohol may disappear with time, random cravings are lasting. Oftentimes, these pop up when the user is feeling stressed or sad or when they are in environments where people are drinking freely.

For many, it is an instinct to just push these down and ignore them. However, an essential sober technique is recognizing when these cravings are felt, identifying them, and understanding why they occur, and this information will be instrumental in suppressing them. Pretending they do not exist doesn’t make them go away. Instead, understanding these cravings and recognizing triggers would better equip one for battling cravings in the long run.

Some Triggers that One Should Take Note of Includes:

  • Troubles in relationships
  • Stress and worries
  • Physical environment
  • Financial and career problems
  • Emotional distress
  • Company of drinkers
People support each other for staying sober.

Recognize Signs and Warnings of Relapse

Most people are unaware of the signs of a relapse and may misinterpret the warnings of a relapse. Those who are very observant would realize that relapse happens even before the individual decides to take the first drink. There are 3 phases of relapse: emotional, mental, and physical relapse.

Possible Warning Signs of Relapse May Include:

  • Looking at alcohol as an option to deal with physical or emotional pain
  • Going back to certain thought pattern from the days of drinking
  • Irrational thoughts and irresponsible behaviors
  • Seeking counsel from people who would likely suggest going back to the old ways
  • Creating excuses ahead of your decision to fail in your commitment

Create a System of Support

No one succeeds in life entirely on their own. This is especially true when it comes to how to get and stay clean. Users have to create a system of support around them.

This means letting go of toxic people who encourage drinking and bringing in people who support sobriety. This might mean attending 12-step meetings, making new friends, bringing the family on board, or even reaching out to others online. However, this support system is critical in preventing relapse.

Establish Structure and Routine

When people think about reasons people drink, boredom isn’t usually at the top of the list. And yet, this is a significant reason why alcoholics will reach for the bottle. Getting clean means awkward silences, and evenings alone cannot be filled with drinking.

But that doesn’t mean the temptation won’t be there.

Anyone in recovery, but especially those in the early stages of sobriety, should focus on staying busy, giving their life structure, and establishing routines that keep them safe.

Living a sober life, when approached correctly, can give someone the chance to make the most out of their existence rather than drinking it away.

Get Comfortable With Confrontation

Confrontation is something that makes a lot of people uneasy, and given that it tends to be more comfortable when inebriated than when sober, recovering alcoholics tend to really struggle with it. Despite that, it is a skill they need when it comes to how to live sober.

Even well-intentioned people can take actions that stand to sabotage sobriety living. They might offer a drink without knowing that one is a recovering alcoholic or keep pressuring them to drink despite it, thinking it is the right thing to do. Alcoholics in recovery have to get used to the idea of saying no, sometimes repeatedly, and possibly telling others, they need to stop their behaviors.

Take Up a Physical Activity

For those who tended to drink because it was an activity that appealed to them at that time, opting for other physical activities instead could be exactly what one needs.

This allows them to occupy their time in a way that helps them avoid drinking and maintain sobriety. Additionally, exercises and physical fitness releases feel-good chemicals that can curb cravings and replace what they were chasing through their alcohol use. There are many things to do sober that involve physical activity, and it can help the user connect to a new, healthier community.

Eat Well and Hydrate

One of the keys to sober living is self-care. A central part of this is eating right and staying hydrated. Being sober for good means fighting a lifelong battle, and the body needs the right fuel to keep the mind sharp. It is a good idea for recovering addicts to work with a nutritionist to develop the best diet plan.

Work With a Therapist

Alcoholism tends to be fueled by underlying mental health conditions, from PTSD to low self-esteem. How to get and stay sober hinges on addressing these co-occurring disorders. Without the proper treatment, users are likely to start self-medicating again. The individual can take adequate precautions with the help of a therapist.

Treat Underlying Physical Health Conditions

While physical conditions tend not to fuel addiction in the same way mental conditions do, they still can contribute to relapse. When people don’t feel their best, it is easy to sink into a depression and start drinking again. A sober lifestyle means taking care of the full self, physically, mentally, and spiritually.

Let Go of Bad Influences

Perhaps one of the essential tips to stay sober is to let go of irresponsible friends.

Drinking is often a social activity, which means heavy drinkers tend to have a social circle filled with people like themselves. If these people are unwilling to embrace sober things to do, or they pressure the person in recovery to drink, it is time to walk away.

People helping an alcohol addict to stay sober.

Dealing with Sobriety

Withdrawal symptoms are often very challenging for heavy drinkers due to the incessant cravings and the evolved brain chemistry. However, withdrawals can be treated with alcohol withdrawal medication and other techniques such as the 12-step program. The problem is that addiction is a lifelong problem, and the individual must stay conscious and change their lifestyle to avoid a relapse. Cravings will come and go once in a while. Some cravings can last from hours to months, pushing the individual towards a relapse. Truly staying sober requires a lot of effort and support from family, friends, and social groups such as AAs.

A big struggle for those in recovery is being sober and staying sober around drinkers. While users can avoid this to a degree, very few can escape drinking altogether. From being seated at a table near the bar in a restaurant to the toast at a wedding, drinking is everywhere, and being social means being unable to avoid these occasions.

A sober person can help themselves navigate these situations in a few ways. First, they should plan their non-alcoholic drinks in advance. This means knowing that the toast is coming and ensuring they have water or a soda so they can take part. Second, they can role-play in their heads how they will handle it. So they might picture how they will turn down that champagne flute tactfully. Third, they need to have a plan for when they have reached their limit. This might mean asking for a different table if they are really struggling that day or leaving the even early if people are getting too drunk.

Ultimately, it is possible to live sober in a world that isn’t committed to sober living. It just takes extra effort.

The first step in getting sober is getting help and treatment. Alcohol rehabilitation centers offer the support people need to stop their use and battle their addiction successfully. With the right support, sober living is within reach.

Hope Without Commitment

Find the best treatment options. Call our free and confidential helpline

Most private insurances accepted

Marketing fee may apply

Page Sources

  1. Schaper A, Ebbecke M. Intox, detox, antidotes - Evidence-based diagnosis and treatment of acute intoxications. Eur J Intern Med. 2017. https://www.ejinme.com/article/S0953-6205(17)30427-2/fulltext
  2. Azuar J, Questel F, Hispard E, Scott J, Vorspan F, Bellivier F. Hospital Stay and Engagement in Outpatient Follow-Up After Alcohol Emergency Detox: A 1-Year Comparison Study. Alcohol Clin Exp Res. 2016. https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.12962
  3. Hartwell EE, Ray LA. Craving as a DSM-5 Symptom of Alcohol Use Disorder in Non-Treatment Seekers. Alcohol Alcohol. 2018. https://academic.oup.com/alcalc/article/53/3/235/4627700
  4. Helstrom AW, Blow FC, Slaymaker V, Kranzler HR, Leong S, Oslin D. Reductions in Alcohol Craving Following Naltrexone Treatment for Heavy Drinking. Alcohol Alcohol. 2016. https://academic.oup.com/alcalc/article/51/5/562/1740449
  5. Melemis SM. Relapse Prevention and the Five Rules of Recovery. Yale J Biol Med. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/
  6. Durazzo TC, Meyerhoff DJ. Psychiatric, Demographic, and Brain Morphological Predictors of Relapse After Treatment for an Alcohol Use Disorder. Alcohol Clin Exp Res. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193554/
  7. Ruben Castaneda. Why Do Alcoholics and Addicts Relapse So Often? US News. https://health.usnews.com/wellness/articles/2017-04-24/why-do-alcoholics-and-addicts-relapse-so-often
  8. Alcohol Facts and Statistics. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
  9. Rudolf H. Moos, Bernice S. Moos. Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction. 2006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1976118/
  10. Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
  11. Reddy VK, Girish K, Lakshmi P, Vijendra R, Kumar A, Harsha R. Cost-effectiveness analysis of baclofen and chlordiazepoxide in uncomplicated alcohol-withdrawal syndrome. Indian J Pharmacol. 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118528/
  12. Rothstein E. Prevention of alcohol withdrawal seizures: the roles of diphenylhydantoin and chlordiazepoxide. Am J Psychiatry. 1973. https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.130.12.1381
  13. Harvard Health Publishing. Alcohol Withdrawal A to Z. https://www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z National Institute of Health. Handling urges to drink. https://www.rethinkingdrinking.niaaa.nih.gov/tools/Interactive-worksheets-and-more/Stay-in-control/Coping-With-Urges-To-drink.aspx
  14. Sarah Sheppard. The Science behind alcohol cravings. 2019. https://www.thetemper.com/science-behind-alcohol-cravings/ Shivanand Kattimani and Balaji Bharadwaj. Clinical management of alcohol withdrawal: A systematic review. 2013 Jul-Dec; 22(2): 100-108. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/
  15. Ankur Sachdeva, Mona Choudhary, Mina Chandra.Alcohol withdrawal syndrome: benzodiazepines and beyond. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/
  16. Valentina Vengeliene, Daniel Bachteler, Wojciech Danysz, Rainer Spanagel. The role of the NMDA receptor in alcohol relapse: a pharmacological mapping study using the alcohol deprivation effect. 2005. https://Www.Sciencedirect.Com/Science/Article/Abs/Pii/S0028390805000304
  17. Jack R Cornelius, Stephen A Maisto, Christopher S Martin, Oscar G Bukstein, Ihsan M Salloum, Dennis C Daley, D Scott Wood, Duncan B Clark. Major depression associated with earlier alcohol relapse in treated teens with AUD. 2004. https://www.sciencedirect.com/science/article/abs/pii/S0306460304000681
  18. Melanie L. Schwandt, Nancy Diazgranados, John C. Umhau, Laura E. Kwako, David T. George & Markus Heilig. PPARy activation by pioglitazone does not suppress cravings for alcohol, and is associated with a risk of myopathy in treatment-seeking alcohol-dependent patients: a randomized controlled proof of principle study. 2020. https://link.springer.com/article/10.1007/s00213-020-05540-w
  19. Jayawickreme, N., Yasinski, C., Williams, M., Foa, E. B. Gender-specific associations between trauma cognitions, alcohol cravings, and alcohol-related consequences in individuals with comorbid PTSD and alcohol dependence. Psychology of Addictive Behaviors, 20212. https://psycnet.apa.org/record/2011-07482-001
  20. Scott O. Lilienfeld, Hal Arkowitz. Does alcoholics anonymous work? 2011. https://www.scientificamerican.com/article/does-alcoholics-anonymous-work/
  21. W R Miller, S T Walters, M E Bennett. How effective is alcoholism treatment in the United States? 2001. https://pubmed.ncbi.nlm.nih.gov/11327187/
  22. National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help
  23. National Institute on Drug Abuse. Research Report. Common Comorbidities with Substance Use Disorders Research Report. Part 1: The Connection Between Substance Use Disorders and Mental Illness https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
  24. Richard A. Brown, Ana M. Abrantes, Jennifer P. Read, Bess H. Marcus, John Jakicic, David R. Strong, Julie R. Oakley, Susan E. Ramsey, Christopher W. Kahler, Gregory G. Stuart, Mary Ella Dubreuil, Alan A. Gordon, Aerobic exercise for alcohol recovery: Rationale, Program description, and preliminary findings. 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829243/

Published on: March 9th, 2018

Updated on: April 5th, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.