20Evidence B

People who drink daily and experience tremors and palpitations when they stop should not try to quit on their own

People who drink large amounts every day will experience withdrawal symptoms if they stop suddenly. Mild symptoms include hand tremors, sweating, palpitations, and insomnia; severe cases may involve convulsions or the onset of delirium tremens, which is a potentially life-threatening emergency. A Norwegian study tracked over 30,000 people, and among those who had experienced delirium tremens, 8% died each year thereafter. If you want to quit, go to the hospital first and clearly state how much you drink daily.

Cost

Seeing a psychiatrist or addiction specialist costs just a…

Benefit

A 2026 clinical review notes that chronic heavy drinkers often develop withdrawal syndrome after abrupt cessat…

Cost

Seeing a psychiatrist or addiction specialist costs just a few to several dozen yuan. In severe cases, a short hospital stay may be required.

Benefit

A 2026 clinical review notes that chronic heavy drinkers often develop withdrawal syndrome after abrupt cessation or a major reduction in intake; symptoms include tremors, autonomic hyperactivity, anxiety, insomnia, perceptual disturbances, seizures, and delirium tremens — conditions that are “common and potentially fatal” in general medical practice. Norway’s nationwide registry included 36,287 individuals diagnosed with alcohol dependence, withdrawal states, or delirium tremens between 2009 and 2015. The annual mortality rate was 8.0% in the delirium tremens group, 5.0% in the withdrawal state group, and 3.6% in the alcohol dependence group. The standardized mortality ratio for the delirium tremens group was 9.8 (95% CI 8.9–10.7), indicating that their risk of death is roughly 9.8 times higher than that of age‑matched peers.

Original sources

Caputo F, Lungaro L, Costanzini A, De Giorgio R, Addolorato G (2026). Alcohol withdrawal syndrome in hospitalized patients: a practical review. European Journal of Internal Medicine, 107103. https://doi.org/10.1016/j.ejim.2026.107103;Bramness JG, Heiberg IH, Høye A, Rossow I (2023). Mortality and alcohol-related morbidity in patients with delirium tremens, alcohol withdrawal state or alcohol dependence in Norway: A register-based prospective cohort study. Addiction, 118(12), 2352–2359. https://doi.org/10.1111/add.16297

Open source link
Book note

How to judge for yourself: if any one of these applies — you drink almost every day; a day without alcohol causes hand tremors, sweating, palpitations or insomnia; or you need a morning drink to feel comfortable —, do not try to quit abruptly on your own. The standard hospital procedure is to use benzodiazepines to get through these few days while simultaneously supplementing with thiamine (Vitamin B1). The reason it is classified as Grade B is because the Norwegian cohort study discusses "what happens to people who have had delirium tremens later on," rather than "what happens if one tries to quit abruptly on their own"; there is an inference between the two. This is not advising you to continue drinking, but rather to change your method of quitting by going to the hospital to detox. For what amount of weekly drinking is considered excessive, see item 19 of this section (drink less or do not drink); for what to do if you want to drink less, see item 21 of this section (count your number of glasses before seeing a doctor).

My note