The Alcohol Withdrawal Timeline

Despite all of the incredible challenges that arise from addiction to opioids and other drugs, addiction to alcohol is in some ways even more of a risk. In understanding the alcohol withdrawal timeline, it is important to first understand the unique dangers that alcohol addiction presents:

1. Alcohol is Legal and Socially Acceptable

Due to the pervasiveness of alcohol use and its social acceptability, alcohol, which is one of the most dangerous drugs, has a disproportionate impact. Drinking heavily is accepted in many social situations, which allows people to delude themselves into believing their drinking habit is not problematic. At least with illegal drugs, their very “illegality” makes them difficult to acquire and socially unacceptable to use.

With alcohol, a person can develop a severe alcohol use disorder (AUD) habit right in front of their family and friends before they or anyone else recognizes that social drinking has become an addiction.

2. Alcohol Can Result in a Range of Illnesses

Heavy drinking can result in a number of physical and psychological illnesses including:

• Heart issues
• Gastrointestinal problems
• Cirrhosis of the liver
• Depression
• Anxiety
• Wernicke-Korsakoff syndrome (also known as “Wet Brain”)
• Confusion & memory loss
• Problems with family & friends
• Difficulty sleeping

3. Withdrawal From Alcohol Can Result In Death

Unlike most drugs, the withdrawal symptoms from alcohol can result in death. If for no other reason than this, it is strongly recommended that detox and withdrawal from alcohol be conducted in a professional setting and by trained medical professionals.

Signs of Alcohol Dependence

If someone experiences or exhibits any of the following behaviors, they may be suffering from addiction to alcohol:

• Intense & pervasive cravings for alcohol.
• Feeling unable to function without alcohol.
• Lying about how much or how often they drink.
• Drinking alone.
• Hiding alcohol or other evidence of drinking.
• Stealing money to buy alcohol.
• Using money that is needed for other purposes (rent, groceries) to buy alcohol.
• 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.
• Poor job performance due to drinking.
• Missing important family events.
• Having alcohol-related legal problems, such as a DUI or drunk-and-disorderly charge.
• 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 or sustaining injuries when drunk.
• Daily drinking.
• Binge drinking.

If someone experiences some or most of these symptoms, they may have an addiction to alcohol and receiving addiction treatment is most likely appropriate.

Alcohol Withdrawal

The first step in the journey of recovery from alcohol use disorder is to complete a detox, which involves removing alcohol from the body completely. However, due to the nature of alcohol addiction, experiencing withdrawal symptoms is likely when someone has been drinking heavily for a long time.

What Causes Alcohol Withdrawal?

Alcohol abuse over a long period of time causes a person’s brain chemistry to change. Because alcohol is a depressant, the body responds by producing more of the neurotransmitters dopamine and gamma-aminobutyric acid (GABA). These neurotransmitters act to temporarily restore the chemical stability of the body.

However, over time, the body builds up a tolerance to alcohol, which means the person needs to use more and more alcohol to achieve the same feeling of being intoxicated. Simultaneously, 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 further imbalanced.

When a person suddenly stops consuming alcohol, there’s a period when the brain hasn’t fully registered this sudden cessation. Because of this, their brain continues to produce stimulating neurotransmitters. And this is what causes withdrawal symptoms.

Alcohol Withdrawal Symptoms

In general, the level of a person’s addiction to alcohol correlates to the severity of withdrawal symptoms. Those people who have a long and profound dependence on alcohol typically experience the most severe withdrawal symptoms.

Mild Alcohol Withdrawal Symptoms

• Mild symptoms of alcohol withdrawal that a person can experience in detox include:
• Depression
• Confusion
• Mood swings
• Fatigue
• Restlessness
• Irritability
• Headache
• Anxiety
• Insomnia
• Mild to moderate tremors
• Night sweats
• Fever
• Nightmares
• Abdominal pain
• Lack of appetite
• Impaired judgment and memory
• Light and sound sensitivity

Severe Alcohol Withdrawal Symptoms

• The more severe symptoms of alcohol withdrawal may include the following:
• Elevated heart rate
• High blood pressure
• Fever
• Severe tremors
• Nausea or vomiting
• Increased agitation
• Disorientation
• Delusions
• Seizures

Seizures due to alcohol withdrawal are the most dangerous of these severe symptoms. 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 addicted to alcohol during their alcohol withdrawal.

Delirium tremens includes the severe symptoms of alcohol withdrawal (listed above), as well as:

• Extreme confusion
• Severe agitation
• Delirium (sudden lack of awareness of their environment and reality)
• Rapid heart rate
• High fever
• Uncontrollable shaking/shivering
• Visual and auditory hallucinations
• Seizures/convulsions

Delirium tremens may also result in further medical complications such as respiratory failure, cardiac arrhythmia, oversedation, or aspiration pneumonitis. Each of these is extremely serious and can be fatal.

A person going through alcohol withdrawal is at a higher risk of delirium tremens if they:

• Have abused alcohol over a long period of time.
• Have experienced seizures during previous withdrawals.
• Have abnormal liver function.
• Are middle-aged or elderly.
• Have a mental illness.

Alcohol Withdrawal Timeline

Since each patient is unique, there is no common alcohol withdrawal timeline. The specific circumstances of each person going through detox determines the duration of withdrawal and the specific symptoms that they will experience.

Determining Factors In the Alcohol Withdrawal Timeline

The way that an individual experiences alcohol withdrawal depends on several factors including:

• Age, gender, and weight
• Duration & severity of alcohol use
• Mental & physical health
• Family history of alcoholism
• If alcohol has been combined with other drugs
• Whether or not they have experienced alcohol withdrawal in the past

The 3 Stages of Alcohol Withdrawal

The severity of alcohol withdrawal can be categorized into three levels or stages—mild, moderate, and severe. These stages are used to assess the symptoms that a person is experiencing.

Stage 1: Mild

Mild withdrawal in stage 1 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

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 First 8 Hours of The Alcohol Withdrawal Timeline

The initial alcohol withdrawal symptoms typically appear between 4 and 12 hours after taking the last drink. For most people going through detox, alcohol withdrawal symptoms will begin within the first eight hours. These first symptoms are typically mild at first and begin gradually. They can include:

• Irritability
• Nervousness
• Restlessness
• Loss of appetite
• Pale or clammy skin
• Nausea
• Mild shakiness

12 to 24 of The Alcohol Withdrawal Timeline

During the 12-24 hours after the last drink, most people undergoing detox will experience more noticeable symptoms. These symptoms may still be mild or might increase in severity and include:

• Depression
• Mood swings
• Headaches or migraines
• Gastrointestinal problems
• Vomiting
• Night sweats
• Nightmares
• Difficulty thinking
• Problems sleeping

Hours 24 to 72 of The Alcohol Withdrawal Timeline

Alcohol withdrawal symptoms typically peak as early as 24 hours or closer to 72 hours. The symptoms of this period are the most uncomfortable and severe and may include the following:

• Agitation
• Nausea
• Vomiting
• Tremors
• Seizures
• Hallucinations

This is also the period in which delirium tremens are most likely to occur, which requires immediate medical attention.

The Final Few Weeks of Alcohol Withdrawal

For most people, alcohol withdrawal symptoms will begin to subside after 72 hours, and new physical and psychological patterns start to be established.

In some cases, alcohol withdrawal symptoms can continue for several weeks after the initial detox. In rare cases, the person undergoing alcohol detox may experience more persistent withdrawal-related symptoms including fatigue, difficulty sleeping, exhaustion, and mood swings. These symptoms can last for months.

The Importance of Detoxing from Alcohol

Going through detox is the vital first step in recovering from addiction to alcohol. Recovery can’t move forward until a person has reduced their physical dependence and overcome the alcohol withdrawal symptoms.

The initial weeks after detox has been completed are also critical because this is when the risk of relapse is highest. As a result, the patient must come up with a plan for how they will abstain from using alcohol during this critical time.

Once the alcohol is fully cleared from the patient’s system, they can begin to address the underlying issues that created the addiction in the first place.

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 without professional medical assistance.

In a medical setting, like at New Life Medical Addiction Services, located in Marlton, New Jersey, trained doctors and addiction specialists will monitor a patient’s alcohol withdrawal timeline and are prepared to administer any necessary medications. New Life’s medical professionals can provide patients with a safe and comfortable detox experience.

The U.S. 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)

Also, behavioral therapies can be successful in helping to prevent relapse and establish new healthy habits for people suffering from Alcohol Use Disorder.

If you or someone close to you is suffering from addiction to alcohol, contact us today to see how we can help.

Call us at: 856-942-3700 or send us a Text Message.