According to the 2023 National Survey on Drug Use and Health, over 28 million people in the US struggled with Alcohol Use Disorder in the past year [1]. Many users turn to alcohol to cope with stress, anxiety, and other mental health challenges.
Alcohol increases activity in brain regions such as the basal ganglia and prefrontal cortex, which play a key role in pleasure and reward processing [2]. This can lead to habitual use and addiction.
When recovering from alcohol addiction, detox is often the first step in the process to safely withdraw from alcohol. Withdrawing from alcohol is a complex physiological and psychological process that can lead to distressing symptoms, including severe anxiety.
Understanding the relationship between alcohol withdrawal and anxiety is helpful to provide effective treatment and prevention of relapse in individuals with alcohol use disorders.
Understanding Alcohol Addiction
Alcohol addiction is a widespread public health problem across the US, affecting up to 10% of the population each year [1]. Due to alcohol’s easy accessibility and normalization in society, it is one of the most common substance abuse disorders. There are several causes that can lead people to develop an alcohol abuse problem. These include:
- Family history of drinking
- Trauma
- Anxiety, depression, or other mental health challenges
- Drinking at an early age during youth
- Life stress (work problems, academic pressure, relationship conflict, etc)
- Social or cultural influences
Another factor that can affect the development of alcohol addiction is tolerance. This refers to how much alcohol one must drink to feel the desired effects. Some factors that influence tolerance include weight, sex, age, height, and ethnicity. Current research has also identified two genes that affect alcohol metabolism and tolerance (ADH1B and ALDH2), which may play a role in the development of alcohol addiction [4].
What Happens During Alcohol Withdrawal?
The cycle of alcohol addiction starts by producing pleasure in the brain’s reward circuits, leading to the formation of habit drinking and, eventually, addiction. Initially, alcohol reduces negative feelings and discomfort, but the withdrawal process can cause intense anxiety and pain [3].
This is often one of the most significant factors that deters individuals from attempting to quit. They may have tried in the past and experienced severe anxiety or have a fear of withdrawal symptoms.
For these reasons, it is also recommended to enter a professional detox program when withdrawing from alcohol. It can be extremely difficult and, in some cases, even dangerous, to stop drinking on your own.
In a professional detox program, patients will be medically supervised 24/7, where their vitals will be monitored, and if necessary, medication will be prescribed to alleviate cravings or withdrawal pain.
Effects on The Brain
Over time, chronic alcohol use affects several neurotransmitters, the chemical messengers in the brain. Some of the affected neurotransmitters include serotonin, dopamine, and most significantly, GABA [3].
This disruption can lead to several cognitive effects, including:
- Increased tolerance (e.g., need to drink more to feel the same effects)
- Increased sensitivity to the effects of alcohol
- Increased risk of withdrawal symptoms
- Intense cravings
- Dysregulated executive functioning (e.g., impulse control, decision-making, emotional regulation, etc.)
Effects on The Body
Chronic alcohol use can also damage other parts of the body, including some of our most vital organs, such as the heart, liver, or kidneys. According to the National Institute of Alcohol Abuse and Alcoholism, heavy drinking can increase your blood pressure, cholesterol levels and even increase the risk of stroke [5].
Some of the other effects that drinking can have on the body include:
- Cardiomyopathy (weakening of the heart muscle)
- Heart arrhythmias
- Fatty liver disease
- Cirrhosis of the liver
- Alcoholic hepatitis
- Weakened immune system
- Damage to the digestive tract
- Increased risk of heart attack and stroke
- Increased risk of several cancers (e.g., stomach, liver, colorectal, pancreatic)
Alcohol Withdrawal Timeline
The timeline for alcohol withdrawal can vary for each individual and is based on several factors (e.g., amount consumed, frequency and duration of use, the presence of co-occurring physical health conditions or mental health disorders). However, a general timeline for detox may look like:
- 6-12 Hours After Last Drink: Symptoms of early withdrawal could include gastrointestinal problems, headache, sleep disturbance, anxiety, and mild tremors.
- In 24 Hours: Here, symptoms become more intense, and some people may experience auditory, visual, or tactile hallucinations.
- 24-72 Hours: Symptoms may have already peaked and begin to decrease in severity. However, for some individuals with a long history of chronic alcohol use, the risk of seizures is highest during the 24-48 hour period after the last drink.
The Link Between Anxiety and Alcohol Withdrawal
One of the primary causes of alcohol withdrawal is the impact on the Central Nervous System (CNS). When your brain adapts to alcohol (or any drug dependency), it causes alterations in brain chemicals. If the brain is cut off from alcohol, it triggers a stress response in the nervous system—causing symptoms of anxiety.
While small amounts of alcohol stimulate the neurotransmitter GABA and decrease anxiety, chronic alcohol use can deplete it and cause reverse effects. This is one of the primary reasons why when individuals struggling with alcohol use disorder quit drinking, they often feel increased tension and even experience panic attacks [3].
Coping with Alcohol-Induced Anxiety
Anxiety is one of the most common symptoms that individuals will experience during the detox process. This can leave some fearful to take the first step toward sobriety. In a detox program, under a medically supervised withdrawal process, sometimes medications such as Benzodiazepines may be used to decrease discomfort and painful symptoms.
After detox, most individuals are recommended to enter a rehabilitation program where they can focus on building the skills and support system to encourage their long-term recovery. Residential rehab programs help focus on the underlying causes of what drives someone to drink. They also teach positive coping skills to reduce alcohol-induced anxiety.
Some helpful strategies to lessen the symptoms of anxiety after quitting alcohol include:
- Withdrawal slowly
- Replacement medications (some detox programs may prescribe anti-anxiety medications to ease symptoms)
- Exercise and movement (yoga, dance, hiking, etc)
- Deep breathing exercises
- Meditation
- Staying hydrated and eating healthy nutrients
- Getting enough sleep
- Self-massage
- Speaking with a trusted friend or loved one
- Listening to music
Alcohol Detox and Residential Treatment in Michigan
Rushton Recovery understands the complex nature of alcohol addiction. We prioritize your well-being, safety, and comfort during treatment. Our detox and residential treatment center in Michigan offers a healing space to embark on your journey toward sobriety.
We offer evidence-based therapies designed to evolve with your individual needs and address the root of your substance abuse. Let our team help you get clean, repair relationships, and equip you with the skills to achieve long-term recovery.
Reach out to our Admissions team now.
Sources
[1] Alcohol Use Disorder (AUD) in the United States: Age Groups and Demographic Characteristics. 2024. National Institute on Alcohol Abuse and Alcoholism.
[2] Neuroscience: The Brain in Addiction and Recovery. 2022. National Institute on Alcohol Abuse and Alcoholism.
[3] NEUROCHEMICAL MECHANISMS OF ALCOHOL WITHDRAWAL. 2020. National Library of Medicine.
[4] Genetics and Alcoholism. 2014. National Library of Medicine.
[5] Alcohol Effects on The Body. 2024. National Institute on Alcohol Abuse and Alcoholism.
