If you’re about to embark on the journey of going alcohol-free, you want to know exactly what it could feel like in the first few weeks and months after quitting drinking. At present, there’s no research that points to exactly how you might feel, and that’s largely because the experience of quitting alcohol varies from one person to the next. How often a person drank, how much they consumed while drinking, their age, assigned gender, and a host of other factors mean that there is no blanket experience of quitting drinking.
The same is true for the “science on cessation of alcohol on more subtle medical consequences of alcohol toxicity,” says Dr. Sean Luo, MD, PhD, an addiction psychiatrist in New York. “Some are reversible (sleep, anxiety, some liver function problems), others are potentially permanent (effects on heart muscles and the brain).”
Although the effects of quitting alcohol aren’t possible to predict with certainty and are totally unique to each individual, there is some research we can turn to for an idea of what might happen. Below, we’re getting into what we do know, what changes can be expected, and what we need a lot more science on before coming to any conclusions.
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First Up: What Is Alcohol Withdrawal?
In the simplest terms, alcohol withdrawal is the body’s response to a lack of alcohol after a period of heavy drinking. Exact symptoms of alcohol withdrawal depend on the individual and their drinking patterns:
- Light to moderate drinkers: “For those who are light drinkers and moderate drinkers and have no history of alcohol withdrawal,” says Dr.Luo, “there are often very little noticeable physiological effects—aside from possibly some improvement in sleep and possibly some initial worsening of anxiety which in time improves.”
- Heavy drinkers (>3 drinks/day or >7/week for people assigned “female” at birth and >4/day or >14/week for people assigned “male” at birth): “Patients used alcohol heavily or on a chronic basis can experience a variety of alcohol withdrawal symptoms including tremor, fever, severe anxiety, sweatiness, nausea vomiting, and elevated blood pressure and heart rate. Some of these patients can develop seizures and hallucinations, which are typically called delirium tremens (DT). Severe alcohol withdrawal is life-threatening and requires emergent medical attention.”
For the latter group, the Diagnostic and statistical manual of mental disorders (DSM) has a unique diagnosis to help with treatment options when needed. A diagnosis of alcohol withdrawal requires the person to have recently quit or greatly reduced alcohol use after a pattern of heavy drinking, for that person to develop two (or more) of the following symptoms a few hours or days after cutting back, and for the symptoms to cause significant distress or issues functioning—and not be due to other conditions or disorders:
- Sweating or pulse rate <100 beats per minute
- Increased hand tremor
- Nausea or vomiting
- Transient visual, tactile, or auditory hallucinations or illusions
- Psychomotor agitation
- Grand mal seizures
For those who drink within the light to moderate category, going alcohol-free is likely possible without formal treatment options like rehab likely aren’t needed. Still, it’s nice to have some support, and today, online options are in abundance.
Others may benefit from medication or other types of treatment. (That’s why it’s always a good idea to talk to your healthcare provider if you’re planning on quitting alcohol and have a history of heavier drinking patterns.)
Why Does Alcohol Withdrawal Happen?
Alcohol impacts the neurotransmitters, like γ-aminobutyric acid (GABA) and glutamate, and the neuroreceptors they act through to keep the brain in chemical balance. Frequent heavy drinking actually changes how those neurotransmitters and neuroreceptors function, so suddenly stopping can throw the brain off-kilter and result in withdrawal symptoms.
The Positive Changes: A Timeline
Like we covered a little earlier, there’s no such thing as a perfect “timeline” for what to expect (physically or emotionally) after quitting alcohol.
Still, Lubetkin points to increased anxiety and depression, irritability, sleep issues, low energy, difficulty thinking clearly, and mood swings as commonly experienced behavioral and mood changes that are initial issues someone who quits drinking will likely experience.
However, it’s not all bad. In fact, after a period of various discomforts, positive, lasting changes do come from quitting drinking. Clinically speaking, Dr. Luo adds, “the positive effect of cessation of heavier drinking becomes apparent within the first few weeks—and can gradually increase over the next six months.”
Despite the reality that a true “timeline” doesn’t exist, here’s what studies show you may experience in the early hours, weeks, and months of alcohol-free living.
The First 24 Hours After Your Last Drink
These will likely be the hardest hours for regular and heavy drinkers. The body has come to rely on alcohol, which causes a whole host of changes in hormone levels, among other things.
The first symptoms of alcohol withdrawal may start within eight hours after blood alcohol levels drop post-quitting alcohol.
Three Days After Your Last Drink
Alcohol withdrawal symptoms might peak around 72 hours (three days) after quitting.
On a positive note, your immune system might start to rebound. In a 2015 issue of Alcohol Research: Current Reviews, researchers honed in on the myriad effects alcohol consumption has on the immune system. For those who binge drink on occasion, the immune system is immediately suppressed for a few hours to a day or so, leaving the body susceptible to infection.
For those who drink regularly though, the immune system can be more seriously compromised and will take longer to recover, especially if there are underlying health issues at play.
One Week After Your Last Drink
Symptoms of withdrawal, if they come, will likely get a lot better around days 5-7 after quitting. It’s also likely that your sleeping habits will return to a sense of normalcy.
Though initially, alcohol can increase the appetite, continued alcohol use tends to decrease appetite for food, and people often lose vital nutrients as a result. About a week after quitting drinking, you might find that your appetite starts returning to normal.
Two Weeks to One Month After Your Last Drink
Within the first 2-3 weeks of quitting alcohol, some biomarkers of liver, gut, heart, and bone health may begin to improve (less damage will result in more recovery). Dr. Luo explains, though, that interpreting research like this is complex because of common comorbid conditions and other contributing biological mechanisms.
After one month, there might also be improvements in insulin resistance, and a decrease in the amount of cancer-related growth factors. Alcohol has a big effect on the heart, so barring other complications, quitting drinking could help with heart-related ailments.
You might also notice that bloating and weight decrease as well. Alcohol is full of empty calories, so for moderate and heavy drinkers, cutting out alcohol—without inadvertently replacing it with something else like processed sugars—might mean a bit of weight loss. Likewise, alcohol is an inflammatory, so it can cause bloating for some people, especially those sensitive to other inflammatory ingredients like gluten.
One Month to Five Months After Your Last Drink
After between one and five months of quitting drinking, adverse effects on brain tissue (like loss of brain mass) may be reversed. But, adds Dr. Luo, alcohol’s effects are also hard to predict and interpret because of other causes of cognitive deterioration and dementia.
Another (very small) study saw improved mental health metrics after three months of quitting alcohol.
One Year or More After Your Last Drink
A year post-alcohol, there may begin to be a reduction in the risk of (a type of throat cancer). The risk will likely continue decreasing in the following years.
While there’s a lot of complexity in this topic, one thing is clear from the science: Quitting drinking after frequent heavy use has major health benefits.
As mentioned above, drinking exacerbates issues like anxiety, depression, and co-occurring disorders. Alcohol changes our brain’s chemistry and suppresses the secretion of our feel-good hormones like dopamine, so when we stop drinking, we feel worse initially.
Once the body realizes that we won’t be putting alcohol back into our systems, though—after a period of about 14 months, according to the Recovery Research Institute, production of these hormones starts to increase again. This means that over time, you’ll find pleasure again in the things you once enjoyed before alcohol, like eating chocolate, attending a comedy show, or taking a walk in nature.
Taking Care of Yourself After Quitting Drinking
So, especially given how life after alcohol can’t be predicted with certainty, how can you take care of yourself through whatever you experience? Annina Schmid, MA, a feminist counselor who helps people recover from drinking, using, and disordered eating, explains that the boredom that can come from all that newly freed-up time, not drinking can be a trigger.
“For that reason, my number-one suggestion for taking care of yourself both physiologically and psychologically is to have a list of things you enjoy ready that you can refer back to when you feel lost and are wondering what the heck sober people do with their lives when they don’t have hangovers,” she says.
What kind of activities are we talking about? Schmid has these recommendations:
- Joyful physical movement (e.g., going for a walk, trying new team activities, learning how to skate, taking the dog out, going for a swim)
- Activities you can do at home without too much preparation (e.g., reading, drawing, cooking, knitting, painting, redecorating, tidying)
“If you find you’re having a hard time with determining what your interests are, think back to when you were younger,” Schmid says. “What were you interested in before you started drinking? What did you want to be when you were little? There are some important hints in there.”
Lubetkin adds listening to good music, meditating, connecting with family or friends, journaling, practicing gratitude, making nutritious food choices, and prioritizing self-care (whatever that is for you) to the list.
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One thing some of these recs have in common? The importance of finding and building community. The digital Tempest community brings you 24/7 access to support through Tempest Recovery Coaches and other folks who are navigating what their lives could look like post-drinking. It’s a place to share your experiences, celebrate your new take on physical and mental health, and keep yourself accountable for any goals you set. Whatever you need, this community’s here for you.