When a person drinks, ethanol – a poison found in alcohol – interrupts the process that activates nerve cells. Ethanol also interferes with the processes that keep some nerve cell activity in restraint mode. Withdrawal creates a reversal of these effects, and leads the central nervous system to be in an over-active state. During this state, cortisol and norepinephrine are over-produced, hormones which can damage nerve cells and even damage the areas of the brain responsible for memory and other conditions.

On a mental level, alcohol withdrawal can create anxiety and the person may not be able to think coherently. Depression, irritability, shakiness or quick emotional swings may also occur. Physically, the withdrawal may cause headache, nausea or vomiting, clammy skin, dilated pupils and accelerated heart rate. Tremors and sweating may also be present. In more extreme cases, hallucinations and severe delirium or confusion may be seen. The patient may become very agitated and have a fever or even seizures.

When treating patients with alcohol withdrawal symptoms, medical experts should look for eye movement and heart rhythms that are abnormal. The patient may be dehydrated and have all-over shaking. The liver can go into failure, along with increased breathing rate and heart rate. Toxicology screens and other tests may determine the level of alcohol withdrawal syndrome. Preferred drugs for treating withdrawal include benzodiazepines, with dosage levels being decreased carefully.
Many people may not know that effectively treating alcohol withdrawal can require a hospital stay or a term at a residential facility. This may be especially necessary for people who have preexisting mental illness, such as personality disorders or bipolar disorder. People who have tried unsuccessfully to recover from alcohol addiction may also need additional attention. A 1978 study determined that withdrawal attempts repeated over time can set a patient up for withdrawals of increasing intensity and severity.

On-site housing that removes the person from the alcoholic environment may also be part of a successful recovery plan. A study conducted in 1989 reports that inpatient therapy is more effective than outpatient, with patients showing greater improvement toward alcohol recovery six months following treatment when they stayed at an inpatient facility.
Even with appropriate treatment, the symptoms of alcohol withdrawal can last for weeks or months. Depending on the severity of the addiction, liver and heart damage may be ongoing. The prognosis for maintaining recovery can be good if proper inpatient or outpatient treatment is given, and the body will eventually learn to thrive without alcohol.
For some, however, relapse is an ongoing threat, with experts warning that up to 90 percent of people will find withdrawal too overwhelming and return to drinking. Leading a friend or family member to professional medical and psychological help during withdrawal is a critical step.