Quitting alcohol gets talked about very casually, but anyone who’s tried to come off it after years of heavy drinking will tell you it’s anything but simple. It’s one of the most common dependencies out there, and like most addictions, stopping isn’t just a switch you flip one morning and get on with your day.
A lot of people assume it comes down to willpower. Just decide you’re done and power through it. But that’s not really how the body works once alcohol’s been in the system long term.
Speaking on Instagram on February 10, Dr Kunal Sood, a Maryland-based physician specialising in anaesthesiology and interventional pain medicine, broke down why quitting can be physically risky if it’s done abruptly.
How alcohol functions inside the brain and why dependency builds over time
Alcohol essentially works like a chemical brake inside the brain. It boosts calming signals, mainly through a neurotransmitter called GABA, while also dialling down excitatory signals such as glutamate. That’s part of why drinking can make people feel relaxed or sedated.
Over time though, the brain adjusts to alcohol being around constantly. If someone drinks heavily for years, their system starts compensating. It reduces its own calming activity and ramps up excitatory signals to keep things balanced while alcohol is present.
As Dr Sood put it, “Alcohol acts as a ‘chemical brake’ in the brain.”
What happens to the brain and body when alcohol is stopped suddenly
The trouble starts when alcohol is suddenly removed.
Once that external brake disappears, the brain is left in an overexcited state. The calming effect is gone, but the heightened stimulation remains. That imbalance is what triggers withdrawal.
“When alcohol is suddenly removed, that balance collapses,” noted Dr Sood. “That calming effect is gone, but the overactive excitatory system remains. That’s when alcohol withdrawal begins,” he added.
How quickly alcohol withdrawal symptoms can begin after the last drink
Symptoms can kick in fairly quickly. In some cases within hours, though more commonly they show up between one to three days after someone stops drinking.
According to Dr Sood, symptoms of alcohol withdrawal can start within hours of quitting, though they usually appear one to three days after the last drink.
They can include tremors, sweating, anxiety, nausea, a racing heart, and spikes in blood pressure.
Severe alcohol withdrawal complications and when it becomes life-threatening
For some people it stops at mild symptoms. For others, it escalates.
Severe withdrawal can lead to seizures or delirium tremens, a dangerous condition marked by confusion, hallucinations, and nervous system instability.
“People say quitting alcohol cold turkey can kill you the same day,” observed Dr Sood. “And while that’s rare, severe alcohol withdrawal can be life-threatening if it is not managed properly,” he warned.
He further added, “So while most people don’t die the same day they stop drinking, abrupt withdrawal in heavy or dependent drinkers can absolutely become life-threatening without treatment.”
Why medical supervision is strongly advised during long-term alcohol withdrawal
This is why medical support is strongly advised for long-term or heavy drinkers trying to quit. Doctors can stabilise the nervous system using medication, fluids, and monitoring, reducing the chances of complications during withdrawal.
“That is why medical supervision is important when it comes to quitting long-term alcohol dependency,” Dr Sood said.
ALSO READ: The story behind India’s 30 ml peg and why it still sets the drinking standard
Quitting alcohol is undeniably a positive move, but how you do it matters just as much as the decision itself. As Dr Sood emphasised, “Stopping alcohol is a positive step, but how you stop matters,” adding that “alcohol withdrawal is a brain chemistry problem, not just a lack of willpower.”
Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice.
