Alcohol withdrawal is a term for the set of symptoms that people typically experience when they are dependent on alcohol and suddenly stop drinking. The alcohol withdrawal timeline is different for everyone, but usually lasts an average of two to 10 days.
Alcohol withdrawal is often far more dangerous than withdrawal from other drugs and substances since it interacts with brain receptors and neurotransmitters in ways that increase the risk for seizures and heart palpitations. However, those who receive medical alcohol detox at an addiction treatment center can safely withdraw from alcohol and reduce their risk for these serious complications.
Here’s an in-depth look at the alcohol withdrawal timeline, and at the stages people go through to quit drinking and recover from alcohol use disorder.
What Are the Signs of Alcohol Withdrawal?
Alcohol withdrawal can affect anyone of any age who drinks heavily on a regular basis and who suddenly stops drinking. Symptoms of alcohol withdrawal are similar to those experienced with a hangover.
But alcohol withdrawal is far different from hangovers in that alcohol withdrawal occurs when the body becomes accustomed to — or dependent on — a certain amount of alcohol to feel and function normally.
Common signs of alcohol withdrawal include nausea, vomiting, headache, sweating, night terrors, insomnia, agitation, and anxiety. If you or a loved one has been drinking heavily for an extended time and experiences these symptoms when not drinking, it’s highly possible the cause is alcohol dependence.
Alcohol dependence can be treated with alcohol detox to reduce the risk of related complications, such as coma and death. Attempting to quit alcohol abruptly on one’s own is extremely dangerous and risky, and should be avoided.
Many alcohol treatment centers combine alcohol detox with therapy and counseling to help patients experience a full, well-rounded recovery from alcohol use disorder.
Stage 1: Minor Withdrawal Symptoms
The first symptoms of alcohol withdrawal usually set in within six to 12 hours of the last drink. Symptoms usually start out relatively minor and gradually worsen until they peak at between 24 and 72 hours.
Sweating, tremors, nausea, vomiting, high blood pressure, rapid heart rate, fever, and rapid breathing are symptoms people may experience during the first stage of the alcohol withdrawal timeline.
Patients going through minor alcohol withdrawal are often advised to drink between two and four liters of water per day to replace fluids being lost through sweating and vomiting.
Multivitamins and vitamin B1 supplements may be used to help prevent cognitive impairment, which is common among those who suffer from alcohol dependence. Patients may also receive medications and over-the-counter medicines to help control and reduce other symptoms.
Stage 2: Alcoholic Hallucinosis
Alcohol withdrawal symptoms will become more moderate within 12 to 24 hours after the last drink. The second stage of the alcohol detox timeline may be marked by sensory, visual, and auditory hallucinations, especially in heavy drinkers recovering from severe alcohol dependence.
An estimated 25 percent of patients who go through alcohol withdrawal experience hallucinations during this stage. Paranoia and agitation are also common with stage two alcoholic hallucinosis.
Alcohol treatment centers may administer diazepam to help patients manage symptoms of moderate alcohol withdrawal. Diazepam is a type of benzodiazepine drug that interacts with the same brain receptors as alcohol.
Evidence reveals that diazepam is effective at improving symptoms of alcohol withdrawal and at reducing the risk for seizures and a life-threatening form of withdrawal called delirium tremens.
Stage 3: Alcohol Withdrawal Seizures
The third stage of alcohol withdrawal usually sets in between 24 and 48 hours of the last drink. During this stage, patients may suffer tonic-clonic seizures, also known as grand mal seizures. These seizures involve the entire brain and can lead to violent muscle contractions and loss of consciousness. Tonic-clonic seizures affect nearly 10 percent of patients going through alcohol withdrawal. Out of this population, one-third are at risk of experiencing delirium tremens and worsened alcohol withdrawal. However, those who are being closely monitored by medical staff and receiving diazepam at an alcohol detox center may face a reduced risk for seizures.
Stage 4: Delirium Tremens
Of all the alcohol withdrawal stages, stage four poses the greatest health risks. Delirium tremens may set in within 48 to 72 hours of the last drink for those who try withdrawing from alcohol on their own without medical care and supervision. This severe form of alcohol withdrawal is marked by symptoms such as confusion, psychosis, hallucinations, fever, seizures, and coma, and affects about 5 percent of those withdrawing from alcohol.
Delirium tremens can occur as late as seven to 10 days after the last drink and is considered a medical emergency that requires immediate treatment and hospitalization. This stage of the alcohol recovery timeline is rare and can be avoided or minimized with alcohol detox at a treatment center.
Stage 5: Recovery from Alcoholism
After acute symptoms of alcohol withdrawal have been resolved, some symptoms may persist for several additional weeks or months. This is known as protracted alcohol withdrawal syndrome, or post-acute withdrawal syndrome.
Over time, heavy alcohol use disrupts the healthy balance of brain neurotransmitters that regulate mood and motor function. This can lead to slowed motor function and reaction time, anxiety, depression, alcohol cravings, and sleep disturbances.
Therapy and aftercare normally take place following the timeline of alcohol withdrawal to help patients regulate protracted symptoms and stay abstinent. Mood disorders like anxiety and depression may be treated using dual diagnosis therapy and pharmacotherapy. Alcohol cravings can be managed with ongoing medication maintenance involving acamprosate, a prescription drug that reduces the desire to drink alcohol.
Therapies like cognitive-behavioral therapy and rational emotive behavior therapy can also help patients stay abstinent by helping them change negative thoughts and behaviors contributing to alcohol abuse. Individual and group therapy sessions help patients identify and manage drinking triggers so they can achieve long-term abstinence from alcohol.
Legacy Treatment Services offers outpatient and intensive outpatient services to help people recover safely from alcohol dependence and addiction. Browse our locations page to find a treatment center near you or call us directly at 800-433-7365 to learn more about our services and the alcohol withdrawal symptoms timeline.
References:
https://www.ncbi.nlm.nih.gov/books/NBK310652/
https://medlineplus.gov/ency/article/000764.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978420/
https://pubs.niaaa.nih.gov/publications/arh22-1/05-12.pdf
https://medlineplus.gov/ency/article/000766.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268458/
https://www.samhsa.gov/medication-assisted-treatment/treatment