Timeline of Alcohol Withdrawal
Alcohol addiction affects millions of Americans, and only a small percentage actively seek help. The National Institute on Alcohol Abuse and Alcoholism estimates that 15.1 million adults suffer from alcohol use disorder. However, only 6.7% of these people will seek professional support to heal the addiction.
Timeline of Alcohol Withdrawal
Alcohol addiction affects millions of Americans, and only a small percentage actively seek help. The National Institute on Alcohol Abuse and Alcoholism estimates that 15.1 million adults suffer from alcohol use disorder. However, only 6.7% of these people will seek professional support to heal the addiction.
Table of Contents
Even a casual drinker will experience the symptoms of alcohol withdrawal after having a few drinks. These symptoms get more severe based on the amount of alcohol that a person consumes and how long they have been drinking to that extent. In cases where a person has become physically dependent on alcohol, these symptoms can be life-threatening if not overseen by a trained medical professional.
Without detox and therapeutic support, it’s almost impossible for an individual to recover from alcohol addiction fully. The first step in healing from the physical, mental, and emotional impacts of alcohol abuse is to detox. The detox process requires the body to withdraw from alcohol use entirely.
So, alcohol detox and withdrawal information are vitally important for individuals (and their loved ones) struggling with alcohol addiction.
Alcohol Addiction: Why It's So Dangerous
Alcohol addiction—also known as alcohol use disorder, alcoholism, and alcohol dependency—is unique among addictions and can be particularly dangerous.
What makes alcohol dependency so dangerous?
1. Alcohol is Legal and Socially Acceptable
Because alcohol is legal to consume and socially acceptable, physical and psychological dependence can develop quickly. People may drink heavily in the normal course of one’s social engagements. Since alcohol is socially acceptable, people may not view their drinking as problematic.
When the addictive substance is illegal, it’s clear from the start that there is a problem. From the beginning, the secrecy and obvious danger of procuring street drugs offer a clue that the person is “playing with fire.”
In contrast, a person may develop a severe alcohol habit before their friends, family, colleagues—or even themselves—notice it. And they can hide their dependence, for a long while, under the guise of “heavy drinking.” That’s what makes alcohol sneaky-dangerous.
2. Alcohol Contributes to a Variety of Illnesses
An alcohol use disorder can contribute to a wide variety of physical illnesses, mental disorders, and emotional disturbances, including:
- Cirrhosis of the liver
- Wernicke-Korsakoff syndrome (wet brain)
- Heart problems
- Digestive problems
- Depression
- Anxiety
- Memory loss
- Interpersonal problems
- Sleep disturbances
3. Alcohol Withdrawal Symptoms Can Be Fatal
Another reason alcohol dependence is so dangerous is that the withdrawal symptoms from alcohol can be fatal. For this reason, professional support for alcohol detox is highly recommended, particularly for those suffering from long-term alcohol dependency.
Signs of Alcohol Dependence
The Department of Health and Human Services dietary guidelines recommend that adults of legal drinking age choose not to drink or drink in moderation.
Drinking in moderation means:
- For men: no more than two drinks per day.
- For women: no more than one drink per day.
There isn’t an objective measure of when someone is classified as an alcoholic. However, a person with an alcohol dependency will almost certainly exceed these drink-per-day recommendations. In addition, a person with alcohol use disorder will find their lives disrupted by the alcohol habit.
An alcoholic, for instance:
- Is unable to stop or control their drinking, despite the negative impact it may have on their relationships, health, work, school, and other areas of life. In other words, they prioritize alcohol over work, family, etc.
- Builds a tolerance to alcohol and needs to drink more to get the same effect.
- Has repetitive thoughts about alcohol and finds it difficult to think about anything else.
- Frequently engages in secret drinking.
- Feels that they need to drink to relax or fit in.
If a person notices themselves engaging in any of the following behaviors, they may be suffering from alcohol use disorder:
- Feeling intense cravings for alcohol.
- Feeling unable to function without alcohol.
- Lying about how much or how often they drink.
- Hiding alcohol bottles/cans and other evidence of drinking.
- Experiencing physical tremors when they haven't had a drink for a while.
- Drinking first thing in the morning, at work, or at other inappropriate times/places.
- Frequently drinking alone.
- Being unable to fulfill commitments due to drinking (e.g., poor job performance or missing important family events).
- Having alcohol-related legal problems, such as a DUI or drunk-and-disorderly charge.
- Stealing money to buy alcohol; or using grocery or rent money to purchase alcohol.
- Frequently driving under the influence of alcohol.
- Blacking out or losing consciousness from drinking.
- Experiencing alcohol poisoning or being hospitalized because of drinking.
- Engaging in risky behavior and sustaining injuries when drunk.
- Drinking every day or binge drinking on the weekends.
Many people are surprised to learn that binge drinkers can experience withdrawal symptoms. Regardless of the frequency of alcohol intake, if an individual is experiencing some or most of these alcohol withdrawal symptoms, they may have alcohol dependence. If this is the case, entering a detox and recovery program would be in their best interest.
What is Alcohol Withdrawal?
The first step in the journey of recovery from alcohol use disorder is to complete a detox. This means that the person needs to eliminate alcohol from the body entirely.
With long-term alcohol consumption, the brain and entire central nervous system become accustomed to the presence of the substance. So, as the body and mind withdraw from their dependency upon alcohol, specific withdrawal symptoms are likely to appear.
The Biochemistry of Alcohol Withdrawal
Alcohol is a depressant that slows down central nervous system functioning.
When individuals use alcohol over a long period, their brain chemistry changes. Because alcohol is a depressant, the body responds by producing more stimulating chemicals. This includes the neurotransmitters dopamine and gamma-aminobutyric acid (GABA). This creation of stimulating neurotransmitters temporarily restores chemical homeostasis. It is the body’s attempt to counteract the effects of long-term alcohol use.
But over time, the body builds up a tolerance to alcohol. And this means that an individual needs to consume larger and larger quantities to achieve the same feeling of being intoxicated. At the same time, the brain is producing more and more stimulating neurotransmitters to “keep up” with the increased alcohol intake. As this cycle continues, the person’s biochemistry becomes increasingly imbalanced.
When a person stops consuming alcohol, there’s a period when their brain hasn’t fully registered this sudden cessation. As a result, the brain so continues to produce stimulating neurotransmitters. And this is what causes withdrawal symptoms.
The Dangers of Alcohol Withdrawal
A person who has a long-term dependency on alcohol will almost certainly experience uncomfortable withdrawal symptoms. And without professional supervision during the detox process, some withdrawal symptoms could be fatal.
For this reason, medical and psychiatric supervision of the alcohol detox process is necessary. Professionals can help people safely detox from alcohol and move forward with their recovery.
Alcohol Withdrawal Symptoms
Alcohol withdrawal symptoms—physical, mental, and emotional—can range from mild to severe.
Generally, the level of dependency on alcohol will correlate to the severity of symptoms. Those whose dependence is deep and long-term will typically experience the most severe withdrawal symptoms.
Mild Withdrawal Symptoms
Mild symptoms of alcohol withdrawal that a person in detox may experience include:
- Mild to moderate tremors
- Anxiety
- Night sweats
- Fever
- Restlessness
- Irritability
- Headache
- Nightmares
- Insomnia
- Depression
- Mood swings
- Fatigue
- Abdominal pain
- Lack of appetite
- Impaired judgment and memory
- Light and sound sensitivity
- Confusion
Severe Withdrawal Symptoms
Some of the more severe symptoms of alcohol withdrawal may include the following:
- High fever
- Severe tremors
- Increased heart rate
- Increased blood pressure
- Nausea or vomiting
- Increased agitation
- Disorientation
- Delusions
- Seizures
The most dangerous of these severe symptoms are seizures associated with alcohol withdrawal. Without proper medical supervision in a detox facility, these seizures can be fatal.
Delirium Tremens (DTs)
Delirium tremens (DTs) is a severe syndrome that occurs in about 2% of people with alcohol use disorder during alcohol withdrawal.
Delirium tremens includes the severe symptoms of alcohol withdrawal (listed above), as well as:
- A change in mental status
- Severe agitation
- Delirium (sudden lack of awareness of their environment and reality)
- Rapid heart rate
- High fever
- Extreme confusion
- Uncontrollable shaking/shivering
- Visual and auditory hallucinations
- Seizures/convulsions
Delirium tremens may also result in further medical complications such as cardiac arrhythmia, respiratory arrest, oversedation, or aspiration pneumonitis. These conditions all have the potential to be fatal—or to cause serious infections.
An individual is at greater risk of delirium tremens if:
- They are middle-aged or elderly
- Have experienced seizures during previous withdrawals
- They have a mental illness
- Have abnormal liver function
- Have abused alcohol over a long period
Alcohol Withdrawal Timeline
There is no exact timeline for alcohol withdrawal because each person is different. The unique circumstances of each person going through detox will influence how long it takes and which withdrawal symptoms are experienced.
Factors That Affect an Alcohol Withdrawal Timeline
Individuals may experience alcohol withdrawal differently depending on several factors, such as:
- Their gender, weight, and age
- The length of their alcohol use
- The severity of their alcohol use
- Their overall mental and physical health
- Whether or not they have a family history of alcoholism
- Whether or not alcohol has been combined with other drugs
- Whether or not they have experienced alcohol withdrawal in the past
Overview of Alcohol Withdrawal Timeline
As mentioned above, the exact timing depends upon several individual factors. But typically, a person undergoing alcohol detox can expect a few things.
Alcohol withdrawal symptoms include:
Stages of Alcohol Withdrawal
The severity of alcohol withdrawal can be categorized into three levels or stages—mild, moderate, and severe. This framework can be used to assess and describe the symptoms that a person is experiencing.
Stage 1 (Mild)
Mild withdrawal consists of less severe symptoms such as headaches, anxiety, irritability, and insomnia.
Stage 2 (Moderate)
Moderate withdrawal includes stage 1 symptoms, sweating, rapid heart rate, lower fever, and slight confusion.
Stage 3 (Severe)
As its name implies, severe stage 3 withdrawals are the most severe and include serious symptoms such as hallucinations, extreme disorientation, and seizures. A stage 3 withdrawal has the potential to be fatal.
Alcohol Withdrawal Timeline by Hour
There are a few common symptoms that appear during the alcohol withdrawal process. Each case is unique and may differ slightly from this timeline.
The Importance of Detoxing from Alcohol
Going through medical detox is the vital first step in recovering from alcohol use disorder. While the journey includes many other steps, they can’t be completed until this first one is completed. The recovery can’t move forward until a person has reduced their physical dependence and overcome the alcohol withdrawal symptoms.
The first few weeks after detox has been completed are also critical. This is because this is when the risk of relapse is highest. So, the person must formulate a plan of how they will abstain from alcohol during this crucial time.
Once alcohol is fully cleared from an individual’s system, they can begin to address the issues that fuel the addiction. And, ultimately, regain their health, freedom, and genuine enjoyment of life.
Treatment Options for Alcohol Withdrawal
Alcohol withdrawal can be a scary and unsettling experience. For this reason—and because there are genuine dangers involved—a person should never attempt to detox from alcohol alone.
In a medical setting, trained professionals can monitor the withdrawal symptoms and be prepared to administer any necessary medications. Medical professionals can provide patients with a safe and comfortable detox experience.
Medical treatment may also help a person with alcohol use disorder prepare to quit drinking. The Food and Drug Administration (FDA) has approved three nonaddictive medications for alcohol use disorder. These medications can help people reduce their alcohol intake and prevent relapse after detox. These medicines include:
- Vivitrol (naltrexone)
- Campral (acamprosate)
- Antabuse (disulfiram)
Behavioral therapies can be successful in helping to prevent relapse and establish new healthy habits and self-care rituals.
Such therapies include:
- Cognitive behavioral therapy
- Dialectical behavior therapy
- Mindfulness-based cognitive therapy
Resources
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