Alcohol is the most commonly abused psychoactive substance in our society. Although alcohol is a depressant, its initial effect is an apparent stimulation. Experiencing a feeling of well-being and reducing inhibitions.

Signs and Symptoms

According to the DSM 5, alcohol use disorder can be classified into 3 severity levels ranging from mild, moderate to severe. Overall, 11 factors are taken into consideration to address both physical and psychological components to alcoholism. These factors include:

  1. Alcohol is often taken in larger amounts or over a longer period than was intended.

  2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

  3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.

  4. Craving, or a strong desire or urge to use alcohol.

  5. Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home.

  6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

  7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

  8. Recurrent alcohol use in situations in which it is physically hazardous.

  9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

  10. Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect b) A markedly diminished effect with continued use of the same amount of alcohol.

  11. Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol (refer to criteria A and B of the criteria set for alcohol withdrawal) b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

Examining the severity levels:

  • Mild         –  The presence of 2-3 symptoms.

  • Moderate  –  The presence of 4-5 symptoms.

  • Severe      –  The presence of 6 or more symptoms.

If 2 or more symptoms are identified, it is advised to seek help. Alcohol abuse have hazardous side effects at every phase which may lead to serious health risks. These risks include:

  • Cardiovascular disease

  • Anaemia

  • Dementia

  • Cirrhosis

  • Cancer

  • Seizures

  • Depression

  • High blood pressure

  • Nerve damage

  • Pancreatitis

  • Gout

  • Infectious diseases

Adverse Effects

  • Anxiety

  • Delusions

  • Confusion

  • Hallucinations

  • Memory loss

  • Headaches

  • Nausea and vomiting

  • Poor or decreased sleep

  • Trembling

  • Slower reflexes

  • Increased heart rate and blood pressure

  • Liver disease


Alcohol withdrawal can range from mild to severe and is usually associated with the severity level of the alcohol abuse. Symptoms can occur as early as 2 hours after the last drink but typically peaks within 24 to 48 hours.

The timeline for common withdrawal symptoms is:

6 to 12 hours post-ingestion:

  • Agitation

  • Anxiety

  • Headaches

  • Shaking

  • Nausea and vomiting

12 to 24 hours post-ingestion:

  • Disorientation

  • Hand tremors

  • Seizures

48 hours post-ingestion:

  • Seizures

  • Insomnia

  • High blood pressure

  • Hallucinations

  • High fever and excessive sweating

  • Delirium tremens

Because of the life-threatening health complications that can arise during acute alcohol withdrawal, it is recommended to be supervised by a medical professional during detox.

Some people experience prolonged side effects after the initial withdrawal symptoms have subsided. Post-Acute Withdrawal Symptoms (PAWS) can last up to a year and therefore treatment is advisable.

Common symptoms of PAWS:

  • Irritability and emotional outbursts

  • Anxiety

  • Low energy

  • Trouble sleeping

  • Memory problems

  • Dizziness

  • Increased accident proneness

  • Delayed reflexes