What Happens When You Stop Drinking Alcohol

Quick Takes:

  • 6 hours after quitting alcohol: An unusual feeling overcomes you. This will coorelate with how much alcohol has been consumed recently
  • 12 to 24 Hours: Extreme Excitation in the brain from quitting can lead to Delirium Tremens (DT)
  • 24-48 Hours: Agitation. The seritonin is back to baseline or less, making you feel terrible. This can lead to drinking again to feel "better" in the short term, regardless of long term recovery.
  • 2 to 3 Days: This can cause an increase in cortisol release, which leads to a lack of appetite, anxiety, decreased focus and stress.
  • 1 Week: Dopamine transporters start to move back to the original baseline.

  • 1 Month: Gut health repair. AUD can lead to leaky gut issues. The bacteria in your GI tract can alter or die, which can lead to depressive symptoms in the 3 weeks after quitting. 

  • 4 to 8 weeks: Your gut really begins to heal and the depressive symptoms start to fade. You should be getting much better sleep. You should start to see improvements in your skin. Your ability to think, remember and problem solve become much better.

  • How long for hormones to balance after quitting alcohol? It depends on how long you've been drinking alcohol and how much you were drinking during that time. Studies show it would take months to years based on this information.

Introduction


Alcohol is one of the most widely used psychoactive substances in the world. Around 3 million people die every year from alcohol related problems. It’s one of, if not the single most cause of preventable death in the world. Roughly 29% of Americans have had some kind of alcohol use disorder at some point in their lives.


It's been a part of different cultures for hundreds of years. Drinking alcohol can have harmful consequences such as various types of cancer, gastrointestinal disease and metabolic problems. Over time, regular alcohol use can lead to alcohol dependence and alcohol withdrawal. This can take a serious, physical and emotional control over a person's life. 


In science and academia we no longer use the term Alcoholic. As mentioned above, we say folks fall on the spectrum of Alcohol Use Disorder (AUD). A series of questions about life experiences help doctors decide where you fall on the spectrum.


Here are the general rules to find out where you may fall on the spectrum. **We’re by no means doctors. If you see this and you do fall somewhere on the spectrum, it may be an excellent choice to talk to your doctor before you do anything*** Here’s a link to the detailed survey as well if you want to get all the info: https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-Symptoms-Of-Alcohol-Use-Disorder.aspx

  1. Mild: Do you try to cut back but are unable?
  2. Moderate: Do you continue to drink despite negative emotions?
  3. Severe: Do you consistently drink and drive?

The Science


Alcoholic drinks contain ethanol. Ethanol reduces the inhibitory and excitatory neurotransmitter pathways in the brain. Inhibitory neurotransmitters make neurons in the central nervous system less likely to fire on action potential. 


This slows you down. Which is why Alcohol is known as a Depressant.


The major inhibitory neurotransmitter, Gamma Amino Butyric Acid (GABA), acts as an off switch and restricts brain activity. Ethanol is a GABA agonist. When it binds to GABA receptors, it makes the inhibitor signals even stronger. 


Ethanol also activates opioid receptors and induces release of Endogenous Morphine, also known as Endorphins. The opioids then bind to receptors on Dopaminergic Neurons in the Nucleus Accumbens. Those trigger the release of Dopamine and Serotonin in that part of the brain. 


This makes you feel really good at that time.


Ethanol also acts as a Glutamate Antagonist. In other words, Ethanol blocks glutamate (which is an excitatory neurotransmitter), from binding with Glutamate Receptors. Making it less likely that those neurons will fire. 


The combined effect Ethanol has on these neurotransmitters varies by the location in the brain. For example in the Nucleus Accumbens and the Amygdala (the reward centers of the brain), Ethanol produces pleasant or rewarding feelings like euphoria. This is important because if a person believes that drinking is going to lead to euphoria, they’re more likely to drink again.


In the Cerebral Cortex, the thought processing part of the brain, Ethanol slows everything down. Making it difficult to think and speak clearly


Ethanol also slows the behavioral inhibition centers like the Prefrontal Cortex. Making people feel more relaxed and less self conscious. 


In the Cerebellum, the area responsible for movement and balance, ethanol causes people to lose their coordination. Making it harder to walk or do complex tasks like driving. 


Ethanol also affects the Hypothalamus and Pituitary Gland, which regulate various hormones and mood. In these areas, ethanol typically increases sexual arousal but decreases ability to engauge in sex. 


In the Medulla, which controls automatic functions like breathing, consciousness and body temperature, ethanol increases sleepiness, slows breathing and lowers the body's temperature to a point where it can be life threatening. 


Alcoholic drinks have various amounts of ethanol. For example 12 fluid ounces of beer, typically has 5% ethanol by volume. 5 fluid ounces of wine has 12% ethanol by volume. 1.5 fluid ounces of 80 proof distilled spirits has 40% ethanol by volume. All three of these alcoholic drinks have about 18 milliliters of ethanol.


Ethanol’s effects on a person are directly related to the blood alcohol content or BAC. This is the percentage of a given alcohol in the blood. BAC’s affected by the amount of ethanol consumed versus a person's blood volume. Blood volume depends on size and sex as well as situational factors like how much they’ve had to eat or drink, what other substances or medications they’re using or how well the body is prepared or the alcohol. 


  • At a BAC of 0 to 0.05%, people typically feel relaxed and happy, but might have slurred speech and have some difficulty with coordination and balance. 
  • BAC of .06 to .15% there will be more impairment. Slurring of speech, loss of memory, attention and coordination. More aggressive behavior and violence. Tasks like driving become dangerous which is why it's illegal to drive with a BAC of .08% or higher. 
  • BAC of .16 to .3% you can expect alcohol poisoning, blackouts, amnesia, vomiting or a loss of consciousness. 
  • BAC’s of above .31% can lead to an inability or impeded breathing or death. 

What happens when you stop drinking alcohol timeline:


It’s very important to note that all are dependent on many factors. One large factor is how much you decided to drink before quitting. If you decide to quit and it may seem even like a little, that you fall on the severe part of the spectrum, please get a doctor involved in your plan to quit. This is ***extremely important**. You’ll see why below.


After 6 hours of quitting:


You may start to feel unusual, but this will always correlate with how much alcohol you’ve been drinking before trying to quit.


12 to 24 Hours:


Serious issues begin to occur. Extreme Excitation in the brain from quitting can lead to Delirium Tremens (DT). Symptoms include seizures and hallucinations that can last a week or longer. It’s possible that Delirium Tremens can lead to death if it’s not taken care of quickly. The rate of mortality for DT is between 1 and 5%. This is why you do not want to find out first hand what happens when you stop drinking alcohol everyday then stop cold turkey.


When you talk to a medical professional before quitting, you can create a plan. That plan is to treat and possibly avoid DT completely.


As we highlighted above, alcohol changes the way your brain and nervous system works. It’s absorbed in the stomach, moves through your intestine, into your bloodstream and makes its way to your brain. Then it suppresses the excitatory neurons affected by the neurotransmitter glutamate. Then it enhances inhibitory neurons affected by the neurotransmitter GABA. 


You get less excitation and more inhibition. Basically the soup for the bad decisions we make when we drink alcohol or what people can call liquid courage. As mentioned above this is also why alcohol is a depressant. 


The euphoric feeling is from the increase in GABA. Information to the brain becomes slower, with only the largest signals coming through. It clarifies your thoughts and can make you happy. Which leads to serotonin release. 


The problem here is when you stop drinking, your body is now addicted to these effects. The GABA stops coming in and your excitatory response puts you into overload. This is why you may get shakes, seizures, hallucinations and delirium tremens. 


24-48 Hours:


Agitation. The pop in serotonin you had from the clear thoughts combined with the uninhibited experiences of alcohol aren’t happening in your brain anymore. You begin to feel worse because there’s now a lower baseline of serotonin in your brain when you quit drinking alcohol. 


This is why people start to drink again. Because we just want to feel better. It’s very important to remember that drinking will never make you actually feel better long term. 


2 to 3 Days:


Your brain starts to release Corticotropin-releasing hormones (CRH). This can cause an increase in cortisol release, which leads to a lack of appetite, anxiety, decreased focus and stress. CRH is the central regulator of the hypothalamic-pituitary-adrenal (HPA) axis, which is the main organizer of the body’s response to stress


This is NOT your fault. When you drink, your brain changes. Then when you stop it’s trying to cope with all the change. 


Animal studies and post mortem brain scans of folks with AUD show that alcohol consumption alters genes that are involved in cellular function. There are actual changes in your mRNA coding in the prefrontal cortex and other parts of the brain. Another study found that 163 genes in various parts of the brain are altered by alcohol consumption. With Moderate and Severe AUD those genes are more likely to be altered than not.


3 Days:


The dopamine transporter binding portion of the brain (the stuff that pumps dopamine) will have a lower baseline. This means you have generally lower dopamine levels than you did before you started to drink heavily. That dopamine level can also stay lower than before. 


This makes it harder for you to feel good in any way while trying to stay sober. If you feel pressured even more to drink at this time to “feel better”, again, its NOT your fault. You are NOT weak, you ARE strong for choosing to go through this process. You are also STRONG for seeking help when you need it. 


What happens when you stop drinking alcohol for a week?


Dopamine transporters start to move back to the original baseline. Giving you your first bit of relief. You can now visualize your brain starting to alter for the better. 


What happens when you stop drinking alcohol for a month?


Gut health repair. AUD can lead to leaky gut issues. The bacteria in your GI tract can alter or die, which can lead to depressive symptoms in the 3 weeks after quitting. 


We’re learning more and more all the time through scientific studies about the causal correlation between your gut microbiome and the specific enzyme, tryptophan dehydrogenase. Tryptophan is an amino acid synthesized in the body. This biological process is wrecked when you drink alcohol. It affects that gut microbiome that produces that specific amino acid which can make you feel depressed awhile after quitting alcohol. 


4 to 8 weeks:


Your gut really begins to heal and the depressive symptoms start to fade. 


You should be getting much better sleep. 


There are a lot of studies out there that tell us that you will fall asleep better with alcohol. There are also studies that tell us that your level of sleep quality is also very poor. Drinking alcohol before bed can increase alpha waves in our brain. Which means that your brain is acting similarly to when it is awake. REM and N3 slow wave sleep issues can easily take up to 4 weeks to begin to recover. 


You should start to see improvements in your skin. 


Drinking alcohol is dehydrating. Alcohol binds to the protein in your body, which makes you urinate the excess water. This is the water you would have kept inside of you to keep you hydrated. There are studies that link AUD to psoriasis and broken blood vessels in your skin, which begin to also heal during this time. 

Your ability to think, remember and problem solve become much better. 

Why is this Related to Kava?

Many folks use kava as another thing to reach for in lieu of alcohol as it is not physically addictive. It can yield similar results but not have the terrible effects described above. 

Depending on your level on the AUD spectrum, kava may not be a good substitute right away. If you have any question if it is ok, share your information with a doctor and get the OK from them to replace alcohol with kava. Please don't get your information for this online anywhere if there is any question about your level of AUD. Take care of YOU first.


Final Thought:


Now you have the information you need to realize that it’s not YOU. You can have sympathy for your own body and what it’s going through during this process. Which can make it just a bit easier to cope when these issues come around. 

How to quit drinking alcohol: 

Get the help you need. If you read through the above, you will understand that doing it alone will be the hardest thing you will ever do. With someone there it will still be difficult, but you will have support. It's worth the time. It's worth the embarrassment you may feel. Letting that go can be our first step.

Note:

You’re at a higher risk of AUD if you’ve experienced a trauma, someone in your family has it or you started drinking before the age of 15. 

 


Sources


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195126/

https://www.nature.com/articles/s41575-021-00527-0

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327759/

https://www.menshealth.com/health/a19532341/what-happens-when-you-stop-drinking-alcohol/

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770975

https://www.menshealth.com/health/a34765197/holiday-pandemic-binge-drinking-control/

https://www.menshealth.com/health/a25631021/how-to-know-if-you-drink-too-much/

https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.12621

https://pubs.niaaa.nih.gov/publications/aa41.htm

https://www.menshealth.com/health/a29996698/elite-athletes-sleep-coaches-performance/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625244/

https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21109

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837343/

https://www.ncbi.nlm.nih.gov/books/NBK441882/

https://www.nature.com/articles/s41398-021-01635-w

https://www.hindawi.com/journals/bmri/2012/854524/

https://www.nature.com/articles/s41598-021-99211-1

https://www.nature.com/articles/s41398-021-01610-5

https://www.nature.com/articles/s41398-020-01163-z

https://www.nature.com/articles/4000514

https://www.webmd.com/mental-health/addiction/ss/slideshow-quit-alcohol-effects

https://www.nature.com/articles/s41398-021-01534-0

https://www.verywellmind.com/what-are-the-benefits-of-alcohol-recovery-67761


Citations:

Slominski A. On the role of the corticotropin-releasing hormone signaling system in the aetiology of inflammatory skin disorders. Br J Dermatol. 2009 Feb;160(2):229-32. doi: 10.1111/j.1365-2133.2008.08958.x. PMID: 19187344; PMCID: PMC2649670.


Medical Disclaimer: Art of Kava is not providing or intending to provide medical advice, diagnosis or recommendation for treatment and are not a substitute for the professional judgment of a healthcare professional in the diagnosis and treatment of any person or animal. The determination of the need for medical services and the types of healthcare to be provided to a patient are the decisions that should be made only by a physician or other licensed healthcare provider. Always seek the advice of a doctor or other qualified healthcare provider with any questions you have regarding a medical condition.

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