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Alcohol Withdrawal Symptoms, Timeline, and Detox

Alcohol addiction, also known as alcohol use disorder (AUD), is an inability to control or stop drinking alcohol even though alcohol use is causing problems in a person’s life, such as negatively affecting health, relationships, work, and other responsibilities.1, 6

One of the criteria for AUD is a physical dependence on alcohol is characterized by withdrawal symptoms. Alcohol withdrawal can have a range of symptoms, some of which can be potentially dangerous or even life-threatening.2, 6, 11

Research on alcohol withdrawal indicates that:

  • As many as 50% of individuals who struggle with alcohol misuse also experience withdrawal symptoms when they lessen or stop their alcohol consumption.3
  • As many as 3 to 5% of individuals who experience alcohol withdrawal symptoms experience severe withdrawal symptoms, which are referred to as delirium tremens.3

This article will discuss what happens during alcohol withdrawal, common withdrawal symptoms, withdrawal timeline, how to detox safely from alcohol, and treatment options.

What Happens During Alcohol Withdrawal?

During alcohol withdrawal, a person can experience several symptoms that range in severity depending on how long they’ve been alcohol dependent, how much alcohol they consume, and other physical health conditions.2

Long-term alcohol use can lead to a person developing a physiological dependence on alcohol. If a person stops drinking or drastically reduces the amount they drink, they may experience withdrawal symptoms.2, 11 Alcohol withdrawal symptoms typically present as the opposite of the pleasurable or positive effects that a person drinks alcohol for.6

Symptoms can range in severity, and severe withdrawal symptoms can sometimes be deadly without proper intervention and care.2

Common Alcohol Withdrawal Symptoms

Withdrawal symptoms can vary widely from person to person. Factors that can influence the course and severity of alcohol withdrawal include:2, 5

  • Overall health status.
  • Underlying medical or mental health concerns.
  • Amount of alcohol regularly used.
  • Length of alcohol use.
  • Substance use history including the use of other substances.

Common alcohol withdrawal symptoms can range from mild to severe and can include:

  • Sweating.7
  • Increased pulse rate.7
  • Increased hand tremor.7
  • Nausea or vomiting.5, 7
  • Insomnia.5
  • Poor concentration.5
  • Hallucinations or illusions.5, 7
  • Psychomotor agitation.7
  • Tonic-clonic seizures.7
  • Delirium tremens and changes in the level of consciousness.5, 7

Alcohol Withdrawal Timeline

Withdrawal symptoms usually begin within 4 to 12 hours after the last drink and resolve within 4 to 5 days.7, 9 Symptoms are typically the most intense around 48 hours after the last drink.7

Seizures are a sign of severe withdrawal. If they do occur, they usually happen in the first 24 to 48 hours after alcohol cessation; however, seizures have occurred within the first 6 hours after the last use.2, 9

Delirium tremens, an agitated, confused state that may occur in the context of alcohol withdrawal, and which may or may not include hallucinations, can begin 48 to 72 hours after the last use.9 Delirium tremens can develop if severe withdrawal symptoms remain untreated during the detoxification period.3

How to Safely Detox from Alcohol

It is important to have medical supervision during alcohol withdrawal because of the potential for severe, potentially fatal withdrawal symptoms.5 Detoxing at home can be dangerous given the unpredictable nature of withdrawal symptoms.

Supervised detox can occur in a variety of settings, including inpatient and outpatient facilities. It may include interventions like:5

  • Medication.
  • Monitoring of vital signs.
  • Coordination of care with other healthcare specialists.
  • Administration of fluids such as electrolytes.

The goal of supervised detox is to help achieve medical stabilization before continuing treatment for an alcohol use disorder.

What Medication Is Given for Alcohol Withdrawal?

Treatment medications can play an important role in managing potentially life-threatening symptoms of alcohol withdrawal. Benzodiazepines are commonly used to help reduce the likelihood and severity of withdrawal seizures and DT.9

Other medications such as anticonvulsants, antipsychotics, beta-blockers, and alpha-adrenergic agonists are sometimes used off-label or to treat specific symptoms as needed.

Alcohol Detox and Treatment

If you are considering putting an end to your alcohol use but are unsure of how to begin, talk to your doctor about the next steps. Your doctor can provide you with an evaluation and resources to get you the help you need. Together, you and a medical or addiction professional will create a comprehensive treatment plan based on your individual needs that were identified during your initial assessment.

Your treatment plan may include a variety of treatment settings including:10

  • Detox centers.
  • Inpatient treatment facilities.
  • Outpatient treatment.

Common interventions in the treatment of AUD include:8

  • Behavioral therapy such as cognitive-behavioral therapy (CBT) and family therapy.
  • 12-Step/Mutual support groups.
  • Medication.
  • Aftercare services, which may include mutual support groups like Alcoholics Anonymous and individual or group therapy sessions.

Finding an Alcohol Detox Center and Treatment

If you are thinking about getting help for AUD, American Addiction Centers (AAC) can help. AAC offers comprehensive addiction treatment in facilities across the country. When choosing an appropriate treatment facility, it is important to consider factors such as the cost of treatment, the location of the treatment center, and accepted insurance plans.

If you have questions about treatment, or the admissions process, or need information about your insurance coverage, call AAC at . Our compassionate admissions navigators are available 24 hours a day, 7 days a week to support you in starting on a new path.

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