We can answer this question right away:
In most cases, good things happen when you quit drinking.
The most common things people experience when they quit drinking are:
- Increased energy
- Improved overall health
- Better sleep
- Decreased anxiety
- Decreased depressive feelings
However, when some people ask that question – like the person who posed the question in this article in the magazine Women’s Health – what they want to know is whether quitting drinking can help them with something specific about their body, like losing weight.
The answer: maybe. We’ll explain that in detail below.
We do need to say something here, though. If you drink every day, even if you only drink a moderate amount, quitting drinking can trigger alcohol withdrawal. Quitting alcohol is not always dangerous and does not always lead to withdrawal, but when it does, it can be deadly.
Really.
The National Library of Medicine publication “Alcohol Withdrawal” broadly defines alcohol withdrawal as follows:
“Alcohol withdrawal symptoms occur when an individual stops drinking or significantly decreases their alcohol intake after long-term dependence. Withdrawal has a broad range of symptoms from mild tremors to a condition called delirium tremens, which results in seizures and could progress to death if not recognized and treated promptly.”
That’s what we mean by dangerous and deadly.
When people ask us what might happen when they quit drinking, almost none of them think one of our responses could be “…you might experience a condition which, if not recognized and treated promptly, could progress to death.”
That’s why we write articles like this one: to tell people things we think they need to know. And in this case, people need to know that quitting drinking is almost always a good idea, but for some people, quitting alone may not be a wise decision.
What You Need to Know About Quitting Alcohol
To get an initial idea of what happens when you stop drinking, we hosted a quick question and answer session with our Chief Medical Officer, Dr. Chris Johnston. Since the questions people asked in that session are the most common questions people have about quitting drinking and alcohol withdrawal, we decided to use these questions – and his answers – as the jumping off point for detailed answers with sources.
Therefore, during the rest of this article, you’ll read one of those common questions, then read Dr. J’s brief answer, then read an expanded answer to the question. This format will give you the short version and the long version answers side-by-side and tell you most everything you need to know about alcohol withdrawal.
Ready?
Let’s start.
Alcohol Withdrawal Q&A with Dr. J
What are some withdrawal symptoms one may experience when stopping drinking?
Dr. J: Most people who drink daily will experience some restlessness and irritability. Some people will experience tremors, headaches, and an upset stomach. The most serious withdrawals include seizures and disorientation.
Expanded Answer:
Symptoms of withdrawal from alcohol include:
- Anxiety
- Headaches
- Nausea
- Vomiting
- Shakiness
- Gastrointestinal discomfort
- Insomnia
- Excessive sweating
- Anger/irritability
- Mood swings/moodiness
- Hallucinations
- Seizures
Those last two symptoms are what Dr. J means when he refers to “the most serious withdrawals.” In some cases – most often after discontinuing alcohol use after heavy, chronic use – hallucinations, confusion, and tremors/shakiness contribute to a phenomenon called delirium tremens (DT). Delirium tremens appears in about 4 percent of people who discontinue alcohol use. Roughly 3 percent of instances of delirium tremens result in death.
How long will these withdrawal symptoms last?
Dr. J: A few days to a week.
Expanded Answer:
In the 6-12 hours following discontinuation of alcohol use, the following symptoms may appear:
- Headache
- Nausea/vomiting
- Insomnia
- Excessive sweating
- Anxiety
Between 12-72 hours following discontinuation of alcohol use, the following symptoms may appear:
- Mood swings
- Hallucinations
- Seizures
- Delirium tremens, or a combination of:
- Confusion
- Seizures
- Tremors
- Increased heart rate
- Hallucinations
Most withdrawal symptoms begin to fade after 3-4 days and disappear after around a week. In cases of extreme, chronic, excessive alcohol use, physical symptoms may last two weeks or longer. In addition, some people experience what’s knowns as Post-Acute Withdrawal Syndrome (PAWS), wherein some physical symptoms – but mostly psychological symptoms related to mood and cognition – may last for several weeks or months following discontinuation of alcohol use.
Is there any way to minimize these symptoms when you quit drinking?
Dr. J: Tapering gradually before stopping is the best way to minimize these symptoms. There are outpatient protocols that can help to minimize these symptoms. People who have a tough time tapering or past experience with seizures or DTs should go to a place that has 24/7 nursing to carefully adjust medications while withdrawing.
Expanded Answer:
In addition to tapering gradually before completely discontinuing use, or following outpatient protocols during the withdrawal period, the third option Dr. J suggests above – going to a place that has 24/7 nursing – is called medically managed withdrawal symptom management.
Medically managed withdrawal symptom management is what it sounds like: if your alcohol use and/or medical history indicates you need medical supervision during withdrawal, then you choose a treatment facility that offers an inpatient, medical withdrawal symptom management program. These programs last anywhere from four days to two weeks, and include:
- Around the clock medical supervision:
- Nurses are present 24/7
- Physicians are often on-site during daily/early evening working hours, and on-call 24/7 in case of emergency
- Medication to mitigate the physical discomfort of withdrawal symptoms
- Medication to mitigate the psychological and emotional discomfort of withdrawal symptoms
- Safe environment
- In most facilities, plenty of healthy and nutritious food
As Dr. J says above, medically managed withdrawal symptom management is the safest choice, and appropriate for anyone with a history of seizures or DTs.
What happens to your body day by day when you stop drinking? Is there a consistent timeline? What might happen with my weight and your overall health?
Dr. J: It varies a lot. Thin people with poor nutrition will often gain weight when they stop drinking. Some people start eating a more balanced diet and the absence of “empty” alcohol calories will result in weight loss. Irritation of the liver improves quite quickly. Brain scan abnormalities resolve in a couple of weeks.
Expanded Answer:
For a timeline, please refer to the timeline above. When reviewing that, it’s important to remember any withdrawal timeline varies by individual and is directly related to the amount, type, and duration of alcohol use before discontinuing use. With that said, the timeline we provide above gives you a general, evidence-based idea of what will happen and when.
With regards to what happens with your weight and overall health, there’s a comprehensive answer:
Gradually, all your physiological systems regain equilibrium.
This includes the systems that impact your weight. In some cases, discontinuing alcohol use leads to a healthy loss of weight, and in other cases, it leads to a healthy gain of weight: the loss or gain depends on the individual. Aside from weight loss or gain, the overall health benefits of discontinuing alcohol use include:
- Decreased anxiety
- Decreased depressive states
- Improved cardiovascular health
- Improved liver health and function
- Increased energy
- Better sleep
- Clearer skin
- Stronger immune system
These changes – which most people see as positive – are the result of your body returning to its default state after a period of imbalance caused by chronic alcohol use. Every system in your body adapts to chronic alcohol use in some way, and therefore, every system in your body re-adapts in some way when you discontinue use. You may experience physical, psychological, and emotional changes – re-adaptations – that improve your day-to-day life. That’s why most people stop drinking: they know they’re in a state of imbalance, and understand intuitively that in the absence of alcohol, their mind, body, and emotions have chance to rediscover the balance they had before they started drinking.
Can you explain why these changes happen in your body once you stop drinking?
Dr. J: The brain and body adjust to compensate for repeated exposure to the sedating effect of alcohol. Because of this, people who drink alcohol daily, usually require more and more to have the same effect. When you stop drinking alcohol, the brain goes into overdrive, causing a potentially life-threatening storm of stress hormones and adrenaline.
Expanded Answer:
Here’s what you need to know to understand the science behind Dr. J’s answer:
- Alcohol is a central nervous system depressant
- Side-effects of central nervous system depressants include slurred speech, decreased motor control, behavioral disinhibition (explained below), and sedation/drowsiness
- Side effects also include feelings of relaxation and euphoria, which are the reinforcing properties that can lead to AUD
- To trigger the depressive/sedative effect most people who use alcohol desire, alcohol inhibits the excitatory portion of the central nervous system (i.e. the brain) and enhances the inhibitory portions of the central nervous system.
- Part of the depressant effect is the result of alcohol blocking glutamate receptors
- Part of the depressant effect is the result of alcohol enhancing GABA receptors
- With extended exposure, the body becomes reliant on this depressant – alcohol – for daily functioning
- Extended exposure also causes tolerance, which is what Dr. J refers to when he says people who drink alcohol daily usually need to increase their daily intake to feel the same effect.
- Tolerance compounds alcohol-related problems because increased intake exacerbates all the physical problems alcohol causes
- In the absence of the depressant – alcohol – the central nervous system overreacts in an attempt to achieve homeostasis, a.k.a. balance.
- This attempt to restore balance results in an “excitatory overload” that causes the symptoms of withdrawal
That’s what withdrawal is: your body overreacting to the absence of alcohol in an attempt to return to its natural, pre-alcohol dependent, state of functioning. The process of correcting the physical, psychological, and emotional imbalances caused by alcohol can be uncomfortable, unpleasant, and in some cases, dangerous.
How to Use the Information in This Article
You can use the things you learn in this article in three ways:
- To educate yourself on the effects of alcohol on your body and understand what might happen if you decide to stop using alcohol.
- This is important if you’re thinking about quitting.
- To educate others on the effects of alcohol on the body and what might happen if they decide to stop using alcohol
- This is important if a friend or a loved one is thinking about quitting
- To help you decide whether quitting alcohol is the right choice for you
You can use the brief answers provided by Dr. J in situations when a detailed answer with words like tolerance and phrases like central nervous system depressant or delirium tremens would be inappropriate.
Sometimes people want a short, bite-sized answer: that’s what Dr. J’s are.
On the other hand, there are times when you might want to dive into the details, which may include reading/learning medical terminology in journal articles or excerpts from textbooks. That’s where the evidence is, and that’s where the specific details are.
Sometimes you – and people you know – want to know everything there is to know about a topic. That’s what our expanded answers are for: learning and sharing as much as possible about the effect of alcohol on your body, and what can happen when you stop using alcohol after a period of extended, daily use. And in case you missed our links and references above, here are two articles that are information-rich, filled with details on alcohol withdrawal:
- “Alcohol Withdrawal,” published by the National Institutes of Health/National Library of Medicine (NIH/NLM)
- “Delirium Tremens,” also published by the NIH/NLM
We’ll end with something we often tell people when they ask us what happens when you quit drinking, or ask us if we think they should quit or cut back on their drinking:
If you ever have the thought that you might want to reduce your alcohol intake, follow up on that thought: it may be the best decision you’ve ever made. However, if you’ve been drinking every day for a long time, consult a physician first.
We can’t stress that last point enough.
While it’s almost always a good idea to dial back alcohol consumption, heavy/chronic/excessive daily drinkers, or even moderate daily drinkers, absolutely need to consult a physician first. We’re serious: the consequences are too extreme to go it alone if there’s any risk of serious withdrawal.