Post-Acute Alcohol Withdrawal: Why Recovery Symptoms Can Continue After Alcohol Withdrawal

Posted on by Stephen Brumwell

What To Know

  • Acute alcohol withdrawal and longer-term recovery are different phases.
  • Cravings, disturbed sleep, anxiety, irritability, reduced pleasure and difficulty concentrating can continue after the initial withdrawal period.
  • Symptoms and timelines vary considerably. Not everyone experiences PAWS, and there is no single pattern that applies to everyone.
  • PAWS is a useful descriptive term, but it is not a formal diagnosis with one agreed symptom list or timeline.
  • Continuing support after detox can make recovery safer and more manageable.

Important: Alcohol withdrawal can cause seizures, hallucinations, severe confusion and other life-threatening complications. If you drink heavily, drink every day, have experienced withdrawal before or are unsure about your risk, seek medical advice before stopping suddenly.

Alcohol recovery can be a challenging journey, and some of the most discouraging symptoms can continue after the acute withdrawal period has ended.

You may have stopped drinking, made it through the first difficult days and expected to feel steadily better. Instead, you may still be dealing with poor sleep, anxiety, irritability, cravings, low motivation or brain fog.

This does not necessarily mean that recovery is going badly. It usually means you are in the longer-lasting symptoms often described as post-acute withdrawal symptoms, post-acute withdrawal syndrome (PAWS) or protracted alcohol withdrawal.

In this article, we’ll dive into what PAWS is, the common symptoms of alcohol withdrawal and how we can best navigate it.

What Is Post-Acute Alcohol Withdrawal?

Acute alcohol withdrawal usually begins within hours after alcohol intake is stopped or substantially reduced. Symptoms can include sweating, tremor, nausea, anxiety, insomnia, a rapid heart rate and, is some more severe chronic cases, we can have seizures or delirium.

Post-acute alcohol withdrawal refers to symptoms that continue after this acute phase has settled.

The American Society of Addiction Medicine uses protracted withdrawal to describe symptoms such as anxiety, irritability and sleep disturbance that persist beyond the expected acute withdrawal period.

The term PAWS remains debated because it is not listed as a separate diagnosis in the DSM-5-TR or ICD-11. There is also no test that can confirm that a symptom is caused by PAWS.

Regardless, i’ll refer to it as PAWS, as essentially, it all ends up meaning the same thing.

Why Can Symptoms Continue After Alcohol Withdrawal?

Alcohol affects several systems involved in calmness, alertness, reward, sleep and stress. When we consume alcohol on a habitual basis, our brain adapts to alcohol becoming a need in our body.

As explained in Alcohol Withdrawal: The Seesaw Effect of Glutamate and GABA, alcohol strengthens inhibitory or slowing signals while suppressing excitatory signals. It’s purely a compensatory effect.

When we remove alcohol, the result is an overactive nervous system, which results in some of those more stimulatory symptoms such as anxiety, sleeplessness, etc.

The most dangerous parts of alcohol withdrawal pass within days, but then the bodies re-calibration or adaptation to no alcohol is where the other difficult symptoms arise.

Our stress signaling, reward processing, sleep architecture and cognitive function continue to change across the following weeks and even months.

Outside of brain chemistry, these symptoms are also impacted by our nutritional health, physical health, and other substances, living conditions and available support.

Common Symptoms During Longer-Term Recovery

Cravings That Gradually Diminish

Let’s set one thing straight first, Intense cravings are common during early abstinence.

Everyone encounters them in sobriety, but it’s often not a straight line when they come and go.

A craving can return suddenly when you are stressed, tired, around alcohol or reminded of an old drinking routine. Even an unexpected opportunity to drink can bring the urge back into focus.

A systematic review of protracted alcohol withdrawal found that craving generally declined across the first weeks and months, although individual experiences and treatment settings varied.

Alcohol cravings isn’t that we’re failing at all. It’s really just an older association to our previous bodies hardwiring. I discuss this further in Cravings 101: Understanding the Fundamentals of Why We Crave.

Impaired Stress Management

Irritability, increased sensitivity and difficulty managing stress are common complaints during extended abstinence.

Once normal ordinary demand sometimes feel more intense. The busy day after a poor nights sleep comes at us stronger than expected. This can be frustrating, particularly when you’re still in the earlier stages of quitting, you thought you’d feel calmer and have it all together, right?

Don’t worry, I did too, but actually stress is a common relapse trigger.

Learning how to recognise rising tension, reduce unnecessary pressure and ask for support is the important part.

The HPA Axis and Stress Sensitivity

The hypothalamic-pituitary-adrenal axis, usually shortened to the HPA axis, is one of the systems that coordinates the body’s response to stress.

Long-term alcohol use and repeated withdrawal can alter this stress-response system. Research reviewed in the PAWS literature suggests that stress signaling may remain disrupted during abstinence, which may contribute to negative mood, heightened stress sensitivity and difficulty coping in some people.

It doesn’t mean everyone is going to have a blunted HPA Axis, and it’s often also impacted by many other factors – Sleep, inflammation, workload and burnout.

The practical takeaway is that if your capacity for stress feels lower than usual, it’s actually useful information.

You have quit drinking alcohol, celebrate this as an achievement in itself and just reduce avoidable pressure where possible. Plan your stress free moments and build that stress management resilience back.

The HPA Axis can also be well supported by nutrients and herbal medicine, so please book a consultation and let me help be part of that stress management support!

Loss of Interest or Lowered Pleasure (Anhedonia)

Anhedonia means a reduced ability to feel interest, pleasure or reward.

Things you normally enjoy? They feel flat, you have difficulty getting motivated and staying motivated by ordinary daily activities.

This is particularly unsettling at any stage of recovery. Alcohol repeatedly activates reward pathways, and the brain can become less responsive to everyday rewards you may expect to give you that pleasure sensation. But it’s all normal during the recovery process.

The pleasure and motivation will return in time, assuming we’re supporting all the foundations of our health (sleep, diet, stress). Of course, persistent anhedonia can also coincide with depression and other health conditions. Do seek professional support if it is severe, worsening, accompanied by hopelessness or making it difficult to function.

Sleep Disturbance

Sleep can remain unsettled after the acute withdrawal period. You may struggle to fall asleep, wake repeatedly, experience vivid dreams or sleep for a long time without feeling refreshed.

Poor sleep also worsens irritability, anxiety, fatigue, cravings. It can be a hinging point where it escalates our stress and pushes us to the point of relapse.

It’s often caused by many factors, our neurochemicals re-balancing, our HPA Axis not functioning as it should. This is often why tailored support from a Naturopath is so beneficial, we can support all of this gently.

Putting into place regular sleep and wake times, morning light, and less stimulation at night can gently support our sleeps natural rhythm. More practical guidance is available in Sleep Hygiene: How To Reset Your Sleep and Circadian Rhythm.

Brain Fog and Cognitive Recovery

Brain fog can include difficulty concentrating, remembering information, planning, changing tasks or making decisions.

You’ve probably experienced it during that hangover stage, that brain “foggy” ness. It’s all part of the picture of our body re-balancing and re-calibrating.

This process can also take time. A 2024 systematic review found that many aspects of attention, executive function, perception and memory recovered over approximately six to twelve months of abstinence. Some abilities improved earlier, while a few showed more variable or slower recovery.

Fatigue

Fatigue is often related to the accumulation of the afforementioned symptoms. It’s tiring, our sleep is disrupted, our nervous system is working hard to regulate stress and a new everyday routine without alcohol.

It makes a lot of sense for us to be tired. You may also be doing it with kids or parenting, even worse (don’t worry, i’ve done it).

Alcohol can also be associated with nutritional deficiencies and a wide range of physical health problems. So some of this fatigue can come from long-term nutrient depletion.

Fatigue should not automatically be labelled as PAWS, particularly when it is severe or persistent.

How Long Does Post-Acute Withdrawal Last?

There is no reliable answer that applies to everyone, it’s a very individual process.

Some models describe it lasting three to six months or longer, but symptoms tend to not always follow the same timeline.

We may have eased cravings in the first month, while sleep, mood and other cognitive changes taking a little longer.

The duration and intensity is also impacted by:

  • How much and how long a person was drinking for.
  • Whether they have experienced repeated withdrawals or attempts to quit.
  • Other drug use or withdrawal.
  • Sleep and nutritional status.
  • Physical and mental health conditions.
  • Medications and treatment.
  • Current stress, safety and social support.

Symptoms may also appear to come in waves. A person may feel noticeably better, have several difficult days and then improve again. This can reflect stress, sleep loss, triggers or normal day-to-day function, which can also be an aggravating factor too.

Not All Of Your Symptoms Are Related

When we quit alcohol, it’s easy to bucket every uncomfortable symptom we have under the PAWS label.

Anxiety, depression, insomnia, fatigue, these may have been present before the drinking became severe. The can also be indicators of chronic health issues impacted by nutritional deficiency, hormone disruption, or other medical related conditions.

This isn’t me trying to minimise your sober journey, but a recommendation to organise a clinical review with a health professional when your symptoms are:

  • Severe, worsening or unexpected.
  • Persisting without improvement long-term.
  • Interfering with work, relationships or basic daily tasks.
  • Making it difficult to remain alcohol-free.
  • Accompanied by persistent low mood, panic or hopelessness.

During your journey, it’s always good to get support as well. This helps provide guidance and also ressurrance.

Long Term Recovery Support Tips

Useful longer-term support may include:

  • Ongoing support. To make it easier and ensure sufficient support, always seek help from your GP and other related health professionals. A Naturopath can also provide gentle support to really soften the impact of your symptoms too, while treating the root cause of something else.
  • Medication where appropriate. Some medications, such as Antabuse, may help for some people to maintain abstinence. This needs to be discussed with your GP.
  • A regular sleep rhythm. Keep wake time as consistent as possible, get morning light and reduce late-night stimulation.
  • Regular meals. Include adequate protein and a range of nutrient-dense foods. Nutritional deficiencies should be assessed and treated appropriately as well.
  • Gradual exercise. Walking, resistance training or another manageable form of movement can support sleep, mood and physical health. Build this habit gradually if you haven’t before so you’re not outrunning fatigue with intense training.
  • Stress regulation. Breathing exercises, quiet time, realistic workloads, time outdoors and structured relaxation can help lower the total stress load.
  • A plan for triggers. Identify the people, places, emotions and situations that increase risk. Recognising your triggers makes it easier to act before a craving becomes overwhelming.
  • Connection and accountability. Linking it back to the first point, support is important. Peer support, trusted friends, family, recovery groups and professional care can reduce isolation and make difficult periods easier to manage.

When To Get Professional Help

Speak with a GP or alcohol and other drug professional if symptoms are persistent, worsening, difficult to manage or increasing the risk of returning to alcohol.

Seek urgent medical care for seizures, hallucinations, severe confusion, chest pain, collapse, extreme agitation or a return of severe withdrawal symptoms. Call 000 if there is an immediate danger.

For free and confidential alcohol and other drug information in Australia, call the National Alcohol and Other Drug Hotline on 1800 250 015. The service directs callers to the relevant service in their state or territory.

If you are feeling overwhelmed, unsafe or unable to cope, contact Lifeline on 13 11 14. If life is in immediate danger, call 000.

The Bottom Line

Finishing alcohol withdrawal is an important step, but it is not always the point at which sleep, mood, stress tolerance and motivation immediately return to normal.

The process is not a straight line, so be patient with the process, and seek support always on the difficult days. Your body and brain are adjusting, so also be kind to yourself.

With time, appropriate care and support, your persistent symptoms will become less. It’s all a journey and a fulfilling life in recovery is achieveable!

If you need further support managing your symptoms or just after some gentle guidance, reach out for a free discovery call.

Frequently Asked Questions

Is post-acute withdrawal syndrome a recognised diagnosis?

PAWS is widely used as a descriptive term, but it is not a separate formal diagnosis in the DSM-5-TR or ICD-11. Researchers and clinicians may instead use terms such as protracted alcohol withdrawal or persistent symptoms during abstinence.

What are the most common symptoms after alcohol withdrawal?

Commonly reported symptoms include cravings, disturbed sleep, anxiety, irritability, reduced pleasure or motivation, fatigue and difficulty concentrating. These symptoms can have other causes, so persistent or severe problems should be assessed.

How long can symptoms continue after quitting alcohol?

There is no fixed PAWS timeline. Some symptoms improve over weeks, while sleep, mood or cognitive changes may continue for months. Drinking history, repeated withdrawals, health, other substances, stress and treatment can all influence recovery.

Why do the symptoms seem to come in waves?

Symptoms can become more noticeable after stress, poor sleep, conflict, skipped meals or exposure to drinking cues. Normal day-to-day variation can also make recovery feel uneven. A symptom wave does not necessarily mean that recovery has reversed.

Does having cravings mean recovery is failing?

No. Cravings are a common part of recovery and can return when an old cue or association is activated. The useful response is to identify the trigger, use your plan and seek support if cravings are becoming harder to manage.

Can the brain recover after long-term alcohol use?

Research indicates that meaningful recovery in many cognitive functions is possible with sustained abstinence. A systematic review found that many aspects of attention, memory and executive function recovered within six to twelve months, although recovery varied between individuals and cognitive abilities.

References

This article provides general information and is not a substitute for individual medical advice, diagnosis or treatment.

Top 6 Safe and Effective Performance-Enhancing Supplements for Alcohol Addiction Recovery: A Quick Reference Guide

Posted on by Stephen Brumwell

Article Snapshot

  • The six supplements covered in this guide are N-acetylcysteine (NAC), L-theanine, B vitamins, protein powder, magnesium and zinc.
  • Supplements do not treat alcohol dependence, prevent relapse or make alcohol withdrawal safe.
  • Thiamine, or vitamin B1, is medically important during alcohol withdrawal. The appropriate dose and form depend on nutritional status and clinical risk.
  • Nutrient deficiencies should be assessed rather than assumed. More is not always better, particularly with minerals.
  • Introduce one supplement at a time and check for interactions with medicines or health conditions.

When it comes to alcohol recovery, have you considered whether carefully chosen supplements could support the process?

Recovery can place substantial demands on the body. Long-term heavy drinking may displace nutritious food, reduce nutrient absorption, increase losses of certain nutrients and make consistent eating difficult. Early recovery may also involve disrupted sleep, anxiety, low appetite, fatigue and reduced physical capacity.

That is where supplements can sometimes play a supporting role. They may help correct a genuine deficiency, make adequate nutrition more achievable or assist with a clearly defined wellbeing goal.

However, supplements are not a cure for alcohol addiction. They should sit alongside appropriate medical care, counselling, peer support and prescribed treatment where needed.

This quick-reference guide focuses on the same six foundational options: NAC, L-theanine, B vitamins, protein powder, magnesium and zinc.

Supplements Are Not Alcohol Withdrawal Treatment

Alcohol withdrawal can be medically serious. Supplements cannot prevent withdrawal seizures, delirium tremens or other complications of suddenly stopping heavy, sustained alcohol use.

If you drink heavily or daily, have experienced withdrawal before, or are unsure whether you are physically dependent, speak with a GP, addiction medicine clinician or alcohol and other drug service before stopping. In an emergency in Australia, call 000.

The Australian Guidelines for the Treatment of Alcohol Problems specifically recommend thiamine for people undergoing alcohol withdrawal. The dose and route depend on nutritional status and clinical risk. Someone who is malnourished or showing signs of Wernicke’s encephalopathy may require injectable treatment rather than an over-the-counter tablet.

For a closer look at nutrition after long-term drinking, read Alcohol and Nutrition: Does Chronic Drinking Cause Nutrient Deficiency?.

1. N-Acetylcysteine (NAC)

N-acetylcysteine, usually shortened to NAC, provides cysteine that the body can use to produce glutathione, an important part of the body’s antioxidant defence system.

Alcohol metabolism can increase the production of reactive oxygen species and disrupt antioxidant balance. In a controlled rat study, Ozaras et al. (2003) found that NAC co-administration reduced several markers of alcohol-induced oxidative stress and liver injury. This supports the biological rationale for NAC, but it is preclinical evidence and cannot establish the same protective effect in people.

That distinction matters because human alcohol-recovery outcomes remain mixed. A 2026 systematic review of placebo-controlled trials found that NAC was generally well tolerated, but did not consistently improve the primary symptoms of alcohol use disorder or co-occurring post-traumatic stress disorder.

This means NAC may be considered as a supportive supplement in an individual plan, but it should not be presented as a reliable way to stop cravings, manage withdrawal or prevent relapse.

Optimal dose: Between 1,000 – 2,400 mg/daily.

Important limit: NAC is not a substitute for evidence-based alcohol treatment.

2. L-Theanine

L-theanine is an amino acid found naturally in tea. It is commonly marketed for calm focus because it may influence stress responses without acting like a strong sedative.

Evidence suggests the effect is modest and context-dependent. In a small randomised, placebo-controlled crossover trial of healthy adults, Hidese et al. (2019) found improvements in verbal fluency and executive-function measures after four weeks of L-theanine. A larger 2026 systematic review and meta-analysis also found a short-term attention benefit, while effects on stress and anxiety were less consistent.

This is relevant because focus and concentration can feel impaired during early sobriety, but neither study tested L-theanine as a treatment for alcohol recovery. It may help some people feel calmer or more focused, but it has not been established as a treatment for alcohol withdrawal, alcohol cravings, anxiety disorders or depression.

Research commonly uses approximately 200 milligrams, although study designs and populations vary. Start conservatively and discuss it with a health professional if you take prescription medicines, have low blood pressure, are pregnant or breastfeeding, or have a mental health condition requiring treatment.

Optimal dose: Between 200 – 400 mg/daily.

Important limit: Do not use L-theanine to delay appropriate care for severe anxiety, depression, insomnia or withdrawal symptoms.

3. B Vitamins

B vitamins help the body release energy from food and support the nervous system, blood-cell formation and many other essential processes.

Chronic alcohol consumption can affect the intake, absorption, storage and metabolism of several B vitamins. An updated review by Sandoval et al. (2022) describes how low levels of vitamins B1, B2, B6, B9 and B12 may occur through a combination of inadequate intake, reduced intestinal absorption, altered metabolism and decreased hepatic storage. The review also notes that evidence for broad vitamin supplementation strategies remains incomplete.

The most medically important B vitamin in alcohol withdrawal is thiamine, or vitamin B1. Thiamine deficiency can lead to Wernicke’s encephalopathy, a serious neurological condition. Warning signs can include confusion, poor coordination, unusual eye movements or vision changes. This requires urgent medical attention.

The Australian Guidelines for the Treatment of Alcohol Problems recommend thiamine for people undergoing alcohol withdrawal. The form, dose and duration depend on nutritional status and clinical risk. Oral thiamine may be suitable in some circumstances, while people with poor nutrition or suspected Wernicke’s encephalopathy may need intramuscular or intravenous treatment.

A general B-complex product may help when dietary intake has been poor, but it should not be treated as a replacement for properly assessed thiamine care. High-dose B-vitamin products can also cause problems when used unnecessarily or for long periods.

Important limit: Do not rely on a standard B-complex supplement to make alcohol withdrawal safe.

4. Protein Powder

Protein powder is essentially a convenient food product. It can help when appetite is low, time is limited or eating a full meal feels difficult.

This may be useful in recovery because prolonged heavy drinking can contribute to irregular meals, weight loss and loss of muscle mass. Adequate protein supports the maintenance and rebuilding of body tissue, and regular meals may also make daily energy and appetite feel more stable.

A systematic review and meta-analysis by Morton et al. (2018) found that protein supplementation produced modest additional gains in muscle mass and strength during resistance training, particularly when it helped participants reach an adequate total intake. The benefit is not unique to whey. Dairy, soy, pea and mixed proteins can all be useful depending on tolerance, preference and the rest of the diet.

For active adults, approximately 1.2 to 1.6 grams of protein per kilogram of body weight per day is a common general range. This is context rather than a personalised prescription.

Someone with kidney disease, significant liver disease, a medically restricted diet, swallowing difficulties or unexplained weight loss should seek individual advice before deliberately increasing protein.

Optimal intake: Between 1.2 – 1.6 grams of protein per kilogram of body weight per day.

Important limit: Protein powder does not directly treat alcohol cravings or repair the effects of alcohol use.

For practical guidance, see Protein Intake for Exercise, Protein Sources Guide and Whey Protein Explained.

5. Magnesium

Magnesium is involved in normal nerve and muscle function, energy production, blood-pressure regulation and hundreds of enzyme reactions.

People with alcohol dependence can be at greater risk of low magnesium because of poor dietary intake, gastrointestinal problems, increased urinary losses and co-existing health issues. The Pavuluri et al. (2022) case-control study also found significantly lower mean serum magnesium in its alcohol-dependence group than in controls. This makes magnesium worth assessing, particularly when food intake has been limited, while recognising that one observational study cannot establish cause or prove a benefit from supplementation.

However, symptoms such as anxiety, insomnia, fatigue or muscle cramps are not specific to magnesium deficiency. They can have many causes, including alcohol withdrawal itself. Feeling anxious after stopping alcohol does not automatically mean that a high-dose magnesium supplement is the answer (but it can help).

Optimal dose: Between 400 – 600 mg/daily.

Important limit: Magnesium does not prevent the dangerous complications of alcohol withdrawal.

For more detail, read Magnesium: Why This Mineral Matters for Energy, Stress, Sleep and the Nervous System.

6. Zinc

Zinc supports normal immune-cell development and signalling, wound healing, DNA synthesis, growth and many enzyme reactions. A review by Maywald and Rink (2022) describes zinc as essential to normal immune defence and explains how deficiency can impair immune responses. This does not mean that extra zinc will boost immunity when zinc status is already adequate.

Low zinc status may be more common in alcohol dependence. In a case-control study of 100 people with alcohol dependence syndrome and 100 controls, Pavuluri et al. (2022) found significantly lower mean serum zinc and magnesium levels in the alcohol-dependence group. Because this was an observational study from one hospital, it shows an association rather than proving that alcohol caused the difference or that supplementation improves recovery.

If zinc intake or status is low, improving food quality or using a carefully chosen supplement may help restore adequate levels. That is different from assuming that more zinc will automatically accelerate recovery, enhance performance or prevent infection.

Excessive zinc can cause nausea, vomiting and stomach discomfort. Long-term high intake may interfere with copper absorption and contribute to copper deficiency. Antibiotics and some other medicines can also interact with zinc supplements (so use with caution long term!).

Optimal dose: Daily intake is approximately 11 mg (males) and 8 mg (females).

Important limit: Avoid combining multiple products containing zinc without checking the total amount.

For more detail, read Zinc: Why It Matters for Immunity, Recovery and Overall Health.

The Takeaway

The six supplements in this guide each have a different potential role.

NAC supports glutathione production, although its alcohol-specific clinical evidence remains inconsistent. L-theanine may provide modest support for attention or stress in some people. B vitamins matter when intake or status is low, with thiamine requiring particular medical attention during alcohol withdrawal. Protein powder can make adequate nutrition easier. Magnesium and zinc may be useful when intake is inadequate or deficiency is present.

None of these supplements replaces treatment for alcohol dependence. None makes withdrawal safe. None can compensate for inadequate food, poor sleep or a lack of professional support.

Always address your foundations first and ensure they are rock solid. This means, rebuild a consistent diet, manage your stress well, and look after your sleep. Once these are established, you can begin to look at supplements as additional supporting tools for recovery.

Frequently Asked Questions

Can these six supplements treat alcohol addiction?

No. NAC, L-theanine, B vitamins, protein powder, magnesium and zinc may support specific nutritional or wellbeing needs, but they do not replace counselling, medical care, peer support or prescribed treatment for alcohol use disorder.

Which supplement is most important during alcohol withdrawal?

Thiamine, or vitamin B1, receives specific attention in Australian alcohol treatment guidance because deficiency can cause serious neurological harm. The appropriate form and dose depend on nutritional status and clinical risk, so it should be discussed with a healthcare professional.

Can NAC reduce alcohol cravings?

NAC has been studied for alcohol use disorder, but current findings are inconsistent. It should not be described as a proven craving treatment or used instead of established care.

Can L-theanine help with anxiety in early recovery?

L-theanine may modestly affect stress or attention in some people, but evidence for anxiety is inconsistent and it has not been established as a treatment for alcohol withdrawal or an anxiety disorder.

Do I need protein powder?

Not necessarily. Protein powder is useful when it helps you reach an adequate protein intake, but ordinary foods can meet the same need.

Should I take magnesium and zinc together?

They may be used together in appropriate amounts, but the total intake from every product should be checked. More is not better, and high doses can cause side effects or nutrient imbalances.

References

  • Ahmed, M. A. E., Amin, M., Abdalla, Y. E., Abdelghani, A., Eid, N., Samy, A., Kassar, O., Alsaadany, K. R., & Mansour, M. E. M. (2026). N-acetylcysteine for patients with alcohol use disorder, post-traumatic stress disorder, and their co-occurrence: A systematic review of placebo-controlled randomized trials. BMC Psychiatry, 26, 384. https://doi.org/10.1186/s12888-026-08124-8
  • Gerolymos, C., Saddier, E., Boyer, L., & Fond, G. (2026). Cognitive and affective effects of L-theanine: A systematic review and meta-analysis of 31 randomized trials. Molecular Psychiatry. Advance online publication. https://doi.org/10.1038/s41380-026-03727-9
  • Haber, P. S., & Lintzeris, N. (2021). Thiamine and other supplements. Guidelines for the Treatment of Alcohol Problems. https://alcoholtreatmentguidelines.com.au/chapter-8-alcohol-withdrawal/thiamine-and-other-supplements
  • Hidese, S., Ogawa, S., Ota, M., Ishida, I., Yasukawa, Z., Ozeki, M., & Kunugi, H. (2019). Effects of L-theanine administration on stress-related symptoms and cognitive functions in healthy adults: A randomized controlled trial. Nutrients, 11(10), 2362. https://doi.org/10.3390/nu11102362
  • Maywald, M., & Rink, L. (2022). Zinc in human health and infectious diseases. Biomolecules, 12(12), 1748. https://doi.org/10.3390/biom12121748
  • Morton, R. W., Murphy, K. T., McKellar, S. R., Schoenfeld, B. J., Henselmans, M., Helms, E., Aragon, A. A., Devries, M. C., Banfield, L., Krieger, J. W., & Phillips, S. M. (2018). A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. British Journal of Sports Medicine, 52(6), 376–384. https://doi.org/10.1136/bjsports-2017-097608
  • National Institutes of Health, Office of Dietary Supplements. (n.d.). Magnesium: Fact sheet for health professionals. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
  • National Institutes of Health, Office of Dietary Supplements. (2025). Zinc: Fact sheet for health professionals. https://ods.od.nih.gov/factsheets/zinc-healthprofessional/
  • Ozaras, R., Tahan, V., Aydin, S., Uzun, H., Kaya, S., & Senturk, H. (2003). N-acetylcysteine attenuates alcohol-induced oxidative stress in the rat. World Journal of Gastroenterology, 9(1), 125–128. https://doi.org/10.3748/wjg.v9.i1.125
  • Pavuluri, P., Jangili, S., Ryakam, L., Vadakedath, S., Tummalacharla, S. C., Kondu, D., & Kandi, V. (2022). The activities of zinc and magnesium among alcohol dependence syndrome patients: A case-control study from a tertiary care teaching hospital in South India. Cureus, 14(4), e24502. https://doi.org/10.7759/cureus.24502
  • Sandoval, C., Farías, J., Zamorano, M., & Herrera, C. (2022). Vitamin supplements as a nutritional strategy against chronic alcohol consumption? An updated review. Antioxidants, 11(3), 564. https://doi.org/10.3390/antiox11030564

Addictive Personality: Is It Real, and Can Those Traits Be Channeled for Good?

Posted on by Stephen Brumwell

Article Snapshot

  • “Addictive personality” is not a formal diagnosis. There is no single personality type that causes addiction.
  • Personality can still influence risk. Traits such as impulsivity, sensation seeking, reward sensitivity and all-or-nothing behaviour may make certain rewards harder to moderate for some people.
  • Being intense, ambitious or highly focused is not the same as addiction. Loss of control and continuing despite meaningful harm are much more important warning signs.
  • Some of the energy once directed towards alcohol or another addictive behaviour can sometimes be redirected into exercise, learning, creative work, business or other purposeful goals.
  • The aim is not to simply swap one compulsion for another. Healthy redirection still needs boundaries, self-awareness and the ability to stop.
  • A more useful question than “Do I have an addictive personality?” may be: Which patterns increase my risk, and which parts of my personality can I use constructively?

I’ve heard the phrase “I’ve got an addictive personality” more times than I can count.

I’ve probably used it myself.

Usually, what people mean is something along the lines of: if I get into something, I really get into it. Maybe it’s alcohol, exercise, work, gaming, food, shopping, business ideas or a hobby that somehow goes from casual interest to full-blown obsession in three days.

I can relate to that all-or-nothing mentality.

When I wrote about this years ago on my older blog, Clarity Sober, I looked at the idea that some of the traits associated with addiction can also show up in highly driven, ambitious and entrepreneurial people. I still think there is something useful in that conversation, but I would frame it differently now.

The idea of a single “addictive personality” is much too simple.

There isn’t one personality type that causes addiction, and the term itself isn’t a formal diagnosis. Addiction is influenced by a mix of biology, genetics, environment, mental health, learning, social factors and behaviour. Personality can be part of that picture, but it is only one part (National Institute on Drug Abuse).

So perhaps the better question isn’t “Do I have an addictive personality?”

Maybe it’s “What patterns do I have that make certain behaviours harder to control, and can some of those same traits be used more constructively?”

Is an Addictive Personality Actually Real?

Not really, at least not in the way the phrase is commonly used.

There is no recognised diagnosis called an addictive personality, and researchers haven’t identified one universal set of personality traits shared by everyone who develops an addiction.

That makes sense when you think about how different people with substance-use problems can be.

One person may be highly impulsive and constantly chasing stimulation. Another may be anxious, cautious and using alcohol to switch off. Someone else may be dealing with trauma, chronic pain, loneliness, depression or a social environment where heavy drinking has simply become normal.

They can arrive at a similar problem through very different pathways.

I think through general discussion, using the term “addictive personality” is okay, but jus know, addiction can be far more complicated than that.

Your Personality and Addiction

Saying there is no single addictive personality doesn’t mean personality has nothing to do with addiction.

Certain traits have been studied in relation to substance use and risky behaviour, particularly impulsivity and sensation seeking. Longitudinal research has found that differences in these traits can relate to different patterns of substance use across adolescence and early adulthood (Quinn & Harden, 2013).

Again, that does not mean someone who is impulsive or adventurous will develop an addiction.

It simply means some traits may influence how strongly a person is drawn toward reward, novelty or immediate gratification.

A few patterns people often describe when they talk about having an “addictive personality” include:

  • getting intensely interested in things very quickly
  • struggling with moderation once something feels rewarding
  • chasing novelty, excitement or stimulation
  • making decisions before fully considering the consequences
  • becoming highly focused on goals or activities
  • feeling restless or bored when there isn’t enough stimulation
  • using certain behaviours as a way to escape uncomfortable emotions
  • tending toward an all-or-nothing mindset

None of those automatically equal addiction, but if you’re ticking all of these boxes, the risks of developing an addiction could be higher.

The All-or-Nothing Personality

There are people who casually decide to take up running, and kind of stop there, right?

Then there are people who buy the shoes, download Strava, research heart-rate zones, sign up for a half marathon and somehow own a Garmin by Thursday. All-or-Nothing.

I fit very much into this category, it’s really a double-edged sword. It keeps you accountable and successful, but also makes you teter on the edge of burnout.

You probably if you fall into this category. This same person might throw themselves into the below categories.

  • Extreme fitness
  • over work
  • Entrepreneurial business
  • Music
  • Academic study
  • creative projects
  • Deep nutrition tracking
  • A new hobby
  • Personal development

This intensity though, can sometimes produce genuinely impress results (and often, build great businesses).

The problem is not necessarily that you care deeply about something or become highly motivated.

The more useful question is “Can you do all these, and choose when to stop when you say you will?”

Passion Is Not the Same as Addiction

I think we need to be careful about pathologising everything people enjoy intensely.

Working long hours during an important business launch isn’t automatically a work addiction.

Loving exercise doesn’t mean you’re addicted to exercise.

Gaming regularly doesn’t automatically mean you have a gaming disorder.

Being incredibly enthusiastic about a hobby is often completely normal.

With addiction, one of the important warning signs is that control starts to deteriorate and the behaviour continues despite meaningful harm or consequences.

It’s all about the warning signs, or what I like to call, the Hallmarks of Addiction, more here: Hallmarks of Addiction: Red Flags That a Habit Has Become Hard to Control.

Can Those Same Traits Be Redirected?

This is the part of the original idea that I still find genuinely interesting.

When someone gives up alcohol or another addictive behaviour, they often don’t suddenly become a completely different person.

They don’t suddenly become bored or unmotivated.

They often still have the intensity, but it’s redirected into challenges, novelty, competition, or highly driven achievements.

Of course, this doesn’t mean the recovery challenges, the cravings or the sobriety milestones disappear. This highly driven energy also doesn’t happen immediately.

Recovery can often create a strange gap. We use to spend some much mental energy around drinking, obtaining alcohol, recovering from alcohol or thinking about when the next drink was coming.

We must learn fill the gap, and redirect the energy in a productive way.

This could be finally establishing a health exercise routine, diving into study for personal development or growth, or even leaning into some new creative work.

There is nothing wrong with becoming deeply invested in something positive that isn’t alcohol

The important part is keeping enough awareness that you don’t simply replace one uncontrolled compulsion with another.

Channel It, Don’t Just Swap It

If someone stops drinking but then starts exercising compulsively, spending uncontrollably or working until their relationships and health fall apart, we probably haven’t solved the underlying problem.

We’ve just changed the behaviour, we’ve swapped it but kept the same issue. Healthy redirection still needs it’s own boundaries.

If you still have that intensity, and you’re channeling it into some new tasks, ask yourself:

  • Is this helping me or harming me?
  • Am I choosing this, or do I feel compelled to do it?
  • Can I take a day off without becoming distressed?
  • Is this activity improving my life overall?
  • Are my relationships, sleep and health still intact?
  • Am I avoiding something emotionally by keeping myself constantly busy?

What About Entrepreneurship and Leadership?

My original article leaned heavily into the connection between addictive personality traits, leadership and entrepreneurship.

There are certainly traits that can be useful in entrepreneurship, including achievement motivation, creativity, persistence and a willingness to tolerate uncertainty or risk. Research on entrepreneurial intentions has also examined characteristics such as risk-taking propensity and achievement motivation (Sun et al., 2020).

And yes, there can be some surface-level overlap with traits people informally associate with an “addictive personality.”

I’ve mentioned them probably already, but that’s traits such as being highly driven, competitive, willing to take tasks, or become highly motivated by achievement and reward.

These maybe “addictive personality” traits don’t create successful entrepreneurs though.

A successful entrepreneur with good leadership qualities also requires good judgement, patience, consistency and healthy emotional regulation.

The same intensity that once went into destructive behaviour may potentially become useful when it is paired with self-awareness, structure and control.

Don’t Romanticise Addiction

The final part I want to discuss is the trap of romanticising addiction.

It’s not a superpower, in fact, being able to control the addiction and stop it for good, that’s the superpower.

Addiction can damage health, relationships, careers, finances and families. For some people, it can be life-threatening.

Maybe you are naturally ambitious, maybe your personality is intense, and maybe you are competitive, curious, and highly driven.

Despite your success, do not use addiction as your motivational angle for your success, because if you do, that double-edged sword will come back to bite you.

The Takeaway

You probably don’t have an “addictive personality.”

You have a personality.

Within that are strengths, vulnerabilities, habits, experiences and behavioural patterns that may influence your risk of addiction.

Some of those patterns may need serious attention.

Others may be parts of you that can be redirected rather than eliminated.

For me, that’s a much more useful way to think about the topic than deciding someone is simply born with the personality of an addict.

Recovery and personal growth aren’t always about becoming a completely different person.

Sometimes they’re about learning to point the same engine in a better direction.

If you’re interested in the behavioural side of addiction and recovery, you may also like to read the following articles

Frequently Asked Questions (FAQs)

Is an addictive personality a real diagnosis?

No. “Addictive personality” is not a formal diagnosis, and there is no single personality profile that explains why someone develops an addiction. Addiction is influenced by a combination of biological, psychological, environmental, social and behavioural factors. Personality may contribute to risk, but it is only one part of the picture.

What personality traits are linked with addiction?

Research has commonly looked at traits such as impulsivity and sensation seeking, along with differences in reward seeking and decision-making. These traits may influence risk for some people, but having them does not mean someone will develop an addiction.

Does being obsessive or all-or-nothing mean I have an addiction?

Not necessarily. You can be highly focused, competitive or deeply interested in something without being addicted to it. A more important question is whether you are losing control and continuing despite meaningful harm. I cover this distinction further in Hallmarks of Addiction.

Can addictive tendencies be channelled into positive habits?

Sometimes. People in recovery may find it helpful to direct time, energy and intensity into exercise, study, creative work, business, volunteering or structured goals. The important part is maintaining boundaries so a positive activity does not simply become another uncontrolled compulsion.

Can you replace one addiction with another?

It can happen. Stopping alcohol or another addictive behaviour does not automatically resolve the patterns underneath it. If exercise, work, shopping, gaming or another activity starts becoming difficult to control or causes harm, it is worth looking at the behaviour rather than assuming it is healthy simply because the original addiction has stopped. For more on how reward and urges can operate, see Cravings 101.

References

Cravings 101: Understanding the Fundamentals of Why We Crave

Posted on by Stephen Brumwell

What to Know

  • Cravings are learned responses involving reward, stress, memory, habit and the environment.
  • A trigger is the cue, a craving is the urge, and withdrawal is the body’s response to reducing or stopping alcohol after physical dependence.
  • Heavy alcohol use can affect dopamine, GABA, glutamate, stress and opioid systems, but cravings are not caused by one simple neurotransmitter imbalance.
  • Cravings can feel relentless, but they often rise, peak and change. The immediate aim is to create time, distance and support before acting.
  • Recognising your common triggers helps you plan for the moments when judgement and impulse control may be under pressure.
  • If you drink heavily, drink daily or have had withdrawal symptoms, seek medical advice before stopping suddenly.

As I drove home on a Friday evening, travelling down my usual route, I noticed a familiar sensation as I passed the bottle shop.

An intense craving.

My mind started creating reasons to pull in:

Come on, you’ve done so well.

You’ve got it this time.

One night will be fine.

For someone trying to stay sober, these thoughts can sound convincing. They can also reopen a pattern that took months of work to interrupt.

Cravings are one of the major roadblocks in recovery from alcohol or other substance use. They can make us vulnerable and may increase the risk of relapse.

The truth is that even when a craving feels relentless, painful and seemingly endless, the intensity can change.

Understanding what is happening gives us more places to intervene.

Cravings Are Old Wiring

A craving is old wiring: a learned connection between a cue, an expected effect and a familiar response. The pathway may have been useful for escaping discomfort in the short term, but it no longer serves the life you are trying to build.

I used to describe it as the body’s old “source code”.

The brain relies heavily on patterns. If alcohol repeatedly follows stress, finishing work, social anxiety, Friday afternoon or a particular route home, those cues can begin to activate the expectation of drinking.

The pattern can look like this:

  1. Cue: a place, time, person, emotion or thought.
  2. Expectation: alcohol will provide relief, reward, confidence or escape.
  3. Craving: attention narrows and the urge becomes stronger.
  4. Response: drinking, buying alcohol or moving closer to the opportunity.
  5. Short-term outcome: the expected state change arrives.
  6. Learning: the brain strengthens the connection between the cue and the response.

This mechanism can trick us into believing alcohol is the only way to get through a situation.

But it is not.

Once we begin to recognise substance cues, or “triggers” as I prefer to call them, we can understand where cravings come from and build a different response.

For many people, cravings become less frequent or less intense with time, new routines and support. They can still return unexpectedly, so the aim is not to prove that you will never have another urge. It is to know what to do when one appears.

Cravings Are Painful, and Your Brain Can Bargain With You

Cravings often narrow attention towards the expected benefit of drinking while pushing previous consequences into the background. That is why the inner argument can sound so reasonable in the moment.

Before you say, “Getting over cravings is not that easy,” I get it.

Cravings can be freakin’ nasty.

There were many times in my own sober journey when I gave in to an intense craving and ended up in a rough patch.

I completed long stints away from alcohol, only for the pattern to return after one apparently harmless thought:

Maybe I have it under control now.

After six months, the mind might say:

You have proven you do not have a drinking problem.

This is a classic priming scenario. The urgency around the original problem fades, the difficult memories feel less immediate, and the idea of drinking again begins to look safer than it is.

That does not mean the brain is deliberately trying to sabotage you. It means reward, memory, stress and habit systems can place enormous weight on the expected short-term effect while the reflective part of the mind is trying to remember the bigger picture.

Craving is clinically important, but it is not a perfect prediction of what happens next. A person can experience a strong urge without drinking, while relapse can also happen with little conscious craving (Tiffany & Wray, 2012).

A craving is an experience. It is not a command.

Cravings on a Biochemical Level

Alcohol cravings involve several interacting brain systems, including reward learning, stress, memory, motivation and executive control. They cannot be reduced to one chemical being simply “high” or “low”.

Heavy or prolonged alcohol use can affect neurological pathways involving dopamine, glutamate, GABA, stress hormones and endogenous opioid systems.

Dopamine is often called a pleasure chemical, but its role is broader. It helps the brain learn which cues deserve attention and motivates us to pursue expected rewards.

If alcohol repeatedly follows a particular cue, the cue itself can become important.

The drive home. The sound of ice in a glass. A difficult meeting. The first quiet moment after the children go to bed.

Glutamate and GABA are also relevant. GABA has inhibitory effects in the nervous system, while glutamate is a major excitatory neurotransmitter. Repeated heavy alcohol exposure can disrupt the balance and adaptation of these systems, which is particularly important in alcohol withdrawal.

The National Institute on Alcohol Abuse and Alcoholism describes addiction as involving changes across reward, stress, memory and executive-control systems. Alcohol-related cues can become powerful because the brain has learned to associate them with alcohol’s effects (NIAAA, 2025).

For a fuller explanation, read Substance Abuse and Neurotransmitters: Understanding the Neurochemistry Behind Addiction and Sobriety.

Our brain chemistry is only part of the picture.

Poor sleep, missed meals, isolation, ongoing stress and a lack of routine can make emotional regulation harder and leave us more exposed when the usual cue appears. These factors do not cause every craving, and fixing them is not a treatment for alcohol dependence. They are part of the foundation that can either support or strain recovery.

Cravings, Triggers and Withdrawal Are Different

A trigger is the cue, a craving is the urge, and withdrawal is the body’s response to reducing or stopping alcohol after physical dependence has developed. They can overlap, but they are not interchangeable.

Withdrawal may include anxiety, sweating, tremor, nausea, agitation, disrupted sleep and an increased heart rate. Severe alcohol withdrawal can involve seizures or delirium and may be life-threatening.

A person in withdrawal may crave alcohol because drinking can temporarily relieve the symptoms.

If you drink heavily, drink daily, have experienced withdrawal before or are unsure about your risk, speak with a GP or alcohol and other drug service before stopping suddenly. The Australian Government advises that some people need medical support to reduce or quit safely (Australian Government Department of Health, Disability and Ageing, 2024).

For more detail, read Alcohol Withdrawal: The Seesaw Effect of Glutamate and GABA.

Substance Cues or “Triggers”

Triggers are situations, thoughts, emotions and environmental cues that can activate a craving or move us closer to drinking. Learning your patterns makes it easier to plan before impulse and judgement come under pressure.

One thing I noticed across longer periods of sobriety, and while writing about recovery, was that certain scenarios repeatedly intensified cravings.

If we can identify those scenarios, we can improve stress adaptation, change the environment and develop different coping responses.

Research on alcohol cue reactivity has found relationships between responses to alcohol-related cues, subjective craving and relapse-related outcomes, although the strength of these relationships varies between people and studies (Witteman et al., 2015).

The triggers I kept seeing fell into four useful categories.

1. Perceived Opportunity Triggers

Perceived opportunity triggers happen when the body senses that alcohol is available or easy to access.

This might be passing a bottle shop or bar, being home alone, having alcohol in the house, receiving a message from someone you used to drink with, or reaching a particular time of day.

Friday evening was a major example for me. The route, the time and the bottle shop formed a familiar sequence.

Early in recovery, there is no prize for testing yourself unnecessarily. Change the route. Remove alcohol from the house. Plan where you will be during the high-risk period. Make the safer response easier to begin.

2. Attention-Allocating Triggers

Attention-allocating triggers occur when alcohol begins taking up more mental space, which can intensify craving and wear down self-control.

You might replay old drinking experiences, focus on what you think you are missing, plan a possible return to drinking or spend hours arguing with the urge.

The aim is not to force every thought away. It is to notice where attention has gone and redirect it deliberately.

A practical activity, conversation, walk, meal, meeting or change of environment can interrupt the mental loop.

3. Stress Triggers

Stress triggers occur when pressure, conflict, fatigue or emotional discomfort activates the old expectation that alcohol will provide relief.

Stress may come from work, family, finances, poor sleep, loneliness, anxiety or the accumulated load of too many demands.

When alcohol has been used as a coping response for a long time, the brain can continue to reach for that option under pressure. Stress-related craving can involve changes in both reward and stress systems, particularly after repeated heavy use (Sinha, 2013).

This is why stress management is not a fluffy extra in recovery. It is part of relapse prevention.

4. Priming Triggers

Priming triggers appear when someone starts believing they can safely control drinking again, often after a longer period of sobriety.

This is the one where the mind loves to bargain:

It has been six months.

I am different now.

I will only drink occasionally.

For some people with a history of alcohol dependence, returning to alcohol can reactivate craving and old patterns quickly.

If this thought appears, bring another person into the decision before acting. Revisit why you stopped, what alcohol was costing you and what happened the last time controlled drinking was attempted.

I explore these four categories in more depth in Identifying Triggers: How to Recognise and Manage the Cues That Lead to Drinking.

What to Do When a Craving Hits

When a craving arrives, focus on the next safe action. Create time, move away from alcohol and contact support before the urge becomes a plan.

Name It

Say: “This is a craving. It is uncomfortable, but I do not have to act on it.”

You can rate the intensity from 0 to 10 and check again after a few minutes. The purpose is to observe change, not to achieve a perfect score.

Delay the Next Action

Do not try to solve the rest of your life while the craving is loud.

Delay the next action. Set a short timer. Shower. Walk. Prepare food. Start a task that occupies your hands. Call someone.

You are creating room for the intensity to shift.

Change the Environment

Leave the bottle shop car park. Take a different route. Go somewhere alcohol-free. Remove access to money or alcohol if that is appropriate and safe.

You do not need to prove your willpower by sitting beside the trigger.

Surf the Urge

Urge surfing treats the craving like a wave.

Notice where you feel it in the body: tightness, restlessness, heat, salivation or a hollow feeling in the stomach.

Observe the sensations as they build and change without feeding them or trying to force them away.

Mindfulness-based relapse prevention has shown promise as one component of treatment for substance use disorders, although it is not a stand-alone solution for everyone (Bowen et al., 2014).

Check the Basics

Ask whether you are hungry, angry or overwhelmed, lonely or tired.

Eat if you have missed a meal. Drink water. Rest if you can. Contact someone if you are isolated.

Basic care does not replace addiction treatment, but it can reduce extra strain in the moment.

Contact Someone

Choose the person before you need them.

A message can be simple:

I am having a strong craving and need to talk for ten minutes.

This might be a friend, sponsor, family member, counsellor, peer worker, GP or alcohol and other drug service.

Record the Pattern

After the craving changes, write down:

  • what happened beforehand
  • where you were
  • what you felt
  • how strong the urge became
  • what you did
  • what helped

This turns a painful moment into information for the next plan.

When Cravings Keep Returning

Frequent, intense or worsening cravings are a reason to strengthen support, not evidence that recovery is impossible.

A GP, addiction medicine specialist or alcohol and other drug clinician can assess:

  • alcohol intake and withdrawal risk
  • mental health
  • sleep and nutrition
  • medications and other substance use
  • social support
  • relapse patterns
  • whether counselling, peer support or medication may help

Medications such as naltrexone and acamprosate may be considered for some people with alcohol dependence as part of a broader treatment plan. They require individual medical assessment and are not suitable for everyone. The Australian Guidelines for the Treatment of Alcohol Problems provide evidence-based guidance on withdrawal, psychosocial care and relapse-prevention treatment.

A return to drinking is serious, but it does not erase everything you learned. Look at what happened, seek support early and strengthen the plan around the point where it broke down.

The Takeaway

There is no hiding it: when we are trying to get sober, cravings suck.

But they are understandable.

Cravings can involve old wiring, learned cues, reward and stress systems, memory, habit, withdrawal and the body’s current state.

If we remind ourselves that the intensity can change, reduce unnecessary exposure to triggers and practise a different response, we can gradually weaken the old pattern.

Start with the next safe action:

Name the craving. Create distance. Change the environment. Contact someone. Let the intensity move.

Then look beyond the immediate moment. Build routines, plan for the four trigger categories and get the level of support that matches the seriousness of the pattern.

If cravings are frequent, intense or connected with withdrawal symptoms, speak with a GP or alcohol and other drug service. In Australia, the National Alcohol and Other Drug Hotline offers free and confidential information, counselling and referrals on 1800 250 015 (Australian Government Department of Health, Disability and Ageing, 2025).

FAQ

How long does an alcohol craving last?

An alcohol craving has no fixed duration. Some urges rise and fall over minutes, while others return in waves or remain in the background for longer. Focus on whether the intensity is changing and what will help you avoid acting on it.

Why do I crave alcohol at the same time every day?

Craving alcohol at the same time each day often reflects a learned routine. The brain may associate that time with reward, transition or relief, such as drinking after work. Changing the environment and planning another activity before the usual time can interrupt the sequence.

Does craving alcohol mean I am addicted?

Craving is one feature considered in alcohol use disorder, but craving alone does not establish a diagnosis. Assessment also considers loss of control, consequences, tolerance, withdrawal, time spent drinking and the role alcohol plays in your life.

Can alcohol cravings happen after months of sobriety?

Alcohol cravings can occur after months of sobriety when a cue, memory, stressor or familiar environment activates an old learned association. A later craving does not erase recovery progress, but it is worth responding to early and reviewing the trigger.

Can medication reduce alcohol cravings?

Medication may reduce cravings or relapse risk for some people with alcohol dependence. Options such as naltrexone or acamprosate require assessment by a doctor because suitability depends on medical history, current alcohol use, other medications and treatment goals.

Is it safe to stop drinking when cravings are strong?

Strong cravings alone do not determine withdrawal risk. If you drink heavily, drink daily, have had withdrawal symptoms or seizures before, or are unsure about your risk, seek medical advice before stopping suddenly because alcohol withdrawal can be dangerous.

References

Australian Government Department of Health, Disability and Ageing. (2024). How can you reduce or quit alcohol? https://www.health.gov.au/topics/alcohol/about-alcohol/how-can-you-reduce-or-quit-alcohol

Australian Government Department of Health, Disability and Ageing. (2025). National Alcohol and Other Drug Hotline. https://www.health.gov.au/contacts/national-alcohol-and-other-drug-hotline

Australian Guidelines for the Treatment of Alcohol Problems. (2026). Guidelines for the treatment of alcohol problems. https://alcoholtreatmentguidelines.com.au/

Bowen, S., Witkiewitz, K., Clifasefi, S. L., et al. (2014). Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders. JAMA Psychiatry, 71(5), 547–556. https://doi.org/10.1001/jamapsychiatry.2013.4546

National Institute on Alcohol Abuse and Alcoholism. (2025). Neuroscience: The brain in addiction and recovery. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/neuroscience-brain-addiction-and-recovery

Sinha, R. (2013). The clinical neurobiology of drug craving. Current Opinion in Neurobiology, 23(4), 649–654. https://pubmed.ncbi.nlm.nih.gov/23764204/

Tiffany, S. T., & Wray, J. M. (2012). The clinical significance of drug craving. Annals of the New York Academy of Sciences, 1248, 1–17. https://pubmed.ncbi.nlm.nih.gov/22172057/

Witteman, J., Post, H., Tarvainen, M., et al. (2015). Cue reactivity and its relation to craving and relapse in alcohol dependence: A combined laboratory and field study. Psychopharmacology, 232, 3685–3696. https://pubmed.ncbi.nlm.nih.gov/25439993/

Alcohol Withdrawal: The Seesaw Effect of Glutamate and GABA

Posted on by Stephen Brumwell

Article Snapshot (AI Generated)

  • Chronic alcohol use can create what I like to call the seesaw effect of glutamate and GABA.
  • The more heavily and regularly alcohol is used, the harder the brain may have to work to keep things balanced.
  • When alcohol is suddenly reduced or removed, the opposite effect can happen: the nervous system can become overstimulated.
  • This is one reason alcohol withdrawal can involve anxiety, shaking, sweating, insomnia, agitation and, in more serious cases, seizures or delirium.
  • Alcohol withdrawal can be medically serious. If you have been drinking heavily or for a long time, speak with a medical professional before stopping suddenly.

Chronic alcohol use creates what I like to call the seesaw effect of glutamate and GABA, and the more alcohol is used, the larger the swing can become.

When we wake up the next day, depending on the amount of alcohol consumed, we can often see the opposite of alcohol’s sedating effect.

Instead of relaxed, we feel anxious. Instead of sleepy, we feel wired.

Instead of calm, the nervous system feels like it has been turned up too high.

In this article, I’ll help you understand what alcohol withdrawal actually is, and unpack what’s known as the seesaw effect of glutamate and GABA.

Understanding Alcohol Withdrawal Symptoms

Alcohol withdrawal can happen when someone who has been drinking heavily or regularly suddenly stops drinking or significantly cuts down.

This is not the same as a standard hangover. A hangover is unpleasant, but alcohol withdrawal involves a nervous system that has adapted to alcohol and is now trying to function without it.

Common alcohol withdrawal symptoms may include:

  • anxiety
  • sweating
  • shaking or tremors
  • nausea or vomiting
  • poor appetite
  • poor sleep
  • increased heart rate
  • agitation or irritability
  • sensitivity to light, sound or stress
  • difficulty concentrating

More severe alcohol withdrawal can include seizures, hallucinations, severe confusion or delirium tremens. These symptoms require urgent medical care.

Alcohol withdrawal can also present as a potentially serious syndrome that can occur after abrupt cessation or reduction of heavy, sustained alcohol intake, with symptoms ranging from autonomic hyperactivity and tremor through to seizures and delirium in more severe cases (Jesse et al., 2017).

If you or someone else has severe confusion, seizures, hallucinations, chest pain, severe dehydration or looks seriously unwell, seek urgent medical help. In Australia, call 000 in an emergency. For non-emergency alcohol and drug support, the National Alcohol and Other Drug Hotline is 1800 250 015.

GABA and Glutamate

GABA and glutamate are two important neurotransmitters in the brain, and neurotransmitters are chemical messengers that help our nerve cells communicate.

GABA is generally inhibitory. It slows things down. It is associated with calm, relaxation, sleep and reduced nervous system activity.

Glutamate is generally excitatory. It speeds things up. It is involved in alertness, learning, memory and normal brain activation.

We need a tightly regulated balance of both, otherwise we may feel too sedated or hyper stimulated. Our body is always trying to maintain this balance.

This is where the seesaw analogy will come into play, we’ll discuss a bit more on this soon.

When both sides are balanced, the nervous system can respond appropriately. When one side is pushed too far, the body tries to compensate.

How Alcohol Affects GABA and Glutamate

Alcohol is a central nervous system depressant.

This means it can slow brain and nervous system activity. Part of this effect happens through GABA and glutamate.

Alcohol can increase GABA activity, which is one reason it may initially feel calming, sedating or relaxing. At the same time, alcohol can reduce glutamate activity, which further slows things down.

So, in simple terms:

  • GABA goes up
  • glutamate goes down
  • the nervous system becomes more sedated
  • We generally, feel pretty good!

The downside? Our brain doesn’t like being pushed out of balance.

When alcohol is used repeatedly, the brain starts compensating. It may reduce some GABA-related activity and increase glutamate-related activity to try to keep the nervous system functioning.

Chronic alcohol consumption creates neuroadaptive changes, including downregulation of GABA receptors and increased NMDA receptor expression, which is part of glutamate signaling (Haber & Lintzeris, 2021).

This is the body trying to restore that balance, and when we drink chronically, it’s almost a never ending cycle that worsens over time..

The Seesaw Effect

Think of alcohol as pushing down on one side of the seesaw. We first, experience the lovely, pleasant, sedating effects that come with it – Queue GABA.

When alcohol is removed after a good nights sleep, the sedating effect begins to dissipate.

The brains compensatory mechanics begin to kick in, and some level of anxiety, stimulation or uncomfortable…ness arises – Queue Glutamate.

This is why alcohol withdrawal can feel like the opposite of alcohol intoxication. Alcohol makes us feel relaxed, numb, sometimes sleepy. When we wake up the morning after, we start to feel more anxious, shaky, jittery, and wired..

StatPearls describes alcohol withdrawal as involving a relative reduction in GABA signaling alongside excess glutamate activity, contributing to the hyperactive state seen in withdrawal (Newman & Duby, 2024).

This does not mean every person will have severe withdrawal. It depends on the person’s drinking history, health, previous withdrawal episodes, medications, nutrition status and other factors.

The more we chronically indulge in repeated episodes of drinking though, the larger our seesaw swings, and the worse the symptoms become.

Why Alcohol Withdrawal Can Feel So Uncomfortable

When the nervous system is overstimulated, the symptoms can feel physical, mental and emotional, all at the same time.

Some key withdrawal symptoms you may see (or familiar with) include:

  • shaking hands
  • sweating
  • racing heart
  • nausea
  • poor sleep
  • anxiety
  • irritability
  • agitation
  • panic-like feelings
  • strong cravings

Most of these symptoms are our nervous system trying to recalibrate.

For some people, this process is uncomfortable but manageable with appropriate support. For others, it can become dangerous.

In individuals with severe alcohol withdrawal, this glutamate/GABA ratio gap can widen significantly (Brousse et al., 2012). If alcohol has been used heavily, daily, or for a long time, get medical advice before stopping suddenly.

That is why also to not guess your own risk level from just a simple blog post alone (Yes, even this one).

The Kindling Effect

Another important concept is kindling.

Kindling refers to the way repeated withdrawal episodes may make the nervous system more sensitive over time.

In practical terms, this means repeated cycles of heavy drinking, stopping, withdrawing and drinking again can sometimes make future withdrawal episodes more severe.

Repeated withdrawal experiences can progressively intensify withdrawal symptoms, and this includes an increased risk of seizure vulnerability (Becker, 2014).

It’s one reason why the stop-start cycle becomes so difficult. The swing is so great that we swing ourselves back to alcohol for comfort. We also just try do it alone, which when it comes to quitting alcohol, you should always get help.

For more on the wider neurochemistry involved in alcohol use and recovery, see Substance Abuse and Neurotransmitters: Understanding the Neurochemistry Behind Addiction and Sobriety.

Best Approaches for Alcohol Withdrawal

If you are drinking heavily or think you may be physically dependent on alcohol, the safest first step is to make it known to others.

This can be your loved one, friends, or other related family. You then need to get medical support; speak to your GP or related health professional before stopping suddenly.

This caveat is important here, because if you have been drinking for a long time, you can experience seizures and your life can be at risk.

Once you have spoken with a health professional for medical assessment/monitoring (and medication where appropriate) you can then look at habits, foundational nutrition, and ongoing peer support.

I would recommend looking at the articles below as well to support cravings and getting your foundations on track.

If you’re still unsure, please reach out or book a discovery call.

The Takeaway

Alcohol withdrawal is not simply a rough hangover. It can be the nervous system rebounding after adapting to regular or heavy alcohol use.

GABA and glutamate are only part of the picture, but they give us a useful way to understand why withdrawal can feel shaky, anxious, wired and physically intense.

The brain has been trying to keep the seesaw balanced. When alcohol is suddenly removed, the swing back can be uncomfortable and, for some people, dangerous.

If you are planning to reduce or stop heavy alcohol use, get medical guidance first. With the right support, withdrawal can be managed more safely, and the next stage of recovery can begin from a steadier place.

FAQ

Is alcohol withdrawal the same as a hangover?

No. A hangover usually follows a drinking episode and may include headache, nausea, fatigue and dehydration. Alcohol withdrawal occurs when someone who is physically dependent on alcohol reduces or stops drinking. It can involve nervous system overactivity and may become medically serious.

Why does alcohol withdrawal cause anxiety?

Alcohol can temporarily increase calming GABA-related activity and reduce excitatory glutamate-related activity. With repeated heavy use, the brain adapts. When alcohol is removed, the nervous system can rebound toward overactivity, which may feel like anxiety, agitation, poor sleep or internal restlessness.

Can alcohol withdrawal cause seizures?

Yes. Alcohol withdrawal can cause seizures in some people, especially when there is heavy long-term alcohol use, previous withdrawal seizures or other risk factors. This is one reason medical advice is important before stopping suddenly.

What is delirium tremens?

Delirium tremens, also called alcohol withdrawal delirium, is a severe form of alcohol withdrawal. It can involve confusion, agitation, hallucinations, tremor, unstable blood pressure and other serious symptoms. It is a medical emergency.

What should I do if I want to stop drinking?

Speak with a GP, addiction medicine clinician or alcohol and other drug service before stopping suddenly, especially if you drink heavily or daily. In Australia, you can call the National Alcohol and Other Drug Hotline on 1800 250 015. In an emergency, call 000.

References

Becker, H. C. (2014). Neurochemical mechanisms of alcohol withdrawal. Handbook of Clinical Neurology, 125, 133-156. https://pmc.ncbi.nlm.nih.gov/articles/PMC6943828/

Brousse, G., Arnaud, B., Vorspan, F., Richard, D., Dissard, A., Dubois, M., Pic, D., Geneste, J., Xavier, L., Authier, N., Sapin, V., Llorca, P.-M., De Chazeron, I., Minet-Quinard, R., & Schmidt, J. (2012). Alteration of glutamate/GABA balance during acute alcohol withdrawal in emergency department: A prospective analysis. Alcohol and Alcoholism, 47(5), 501-508. https://doi.org/10.1093/alcalc/ags078

Haber, P. S., & Lintzeris, N. (2021). Alcohol withdrawal. In P. S. Haber & B. C. Riordan (Eds.), Guidelines for the Treatment of Alcohol Problems (4th ed.). Specialty of Addiction Medicine, University of Sydney. https://alcoholtreatmentguidelines.com.au/chapter-8-alcohol-withdrawal

Jesse, S., Brathen, G., Ferrara, M., Keindl, M., Ben-Menachem, E., Tanasescu, R., Brodtkorb, E., Hillbom, M., Leone, M. A., & Ludolph, A. C. (2017). Alcohol withdrawal syndrome: Mechanisms, manifestations, and management. Acta Neurologica Scandinavica, 135(1), 4-16. https://pmc.ncbi.nlm.nih.gov/articles/PMC6084325/

Newman, R. K., & Duby, J. J. (2024). Alcohol withdrawal syndrome. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK441882/

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