Alcohol Withdrawal: What to Expect, Plus a Timeline for Alcohol Withdrawal

If you or someone close to you is preparing to stop drinking, understanding the alcohol withdrawal process and its timeline is crucial. Like other forms of drug withdrawal, alcohol withdrawal can be challenging and sometimes dangerous, but knowing what to expect can empower you to seek the appropriate support and care.

This guide will provide you with a clear overview of the symptoms and stages of alcohol withdrawal, helping you navigate this critical phase with confidence and safety. Remember, you are not alone in this journey, and help is always available.

What Is Alcohol Withdrawal Syndrome?

Alcohol withdrawal syndrome, or AWS, is a collection of symptoms that emerge when a person's dependency on alcohol abruptly quits their consumption or significantly decreases their use of alcohol.

Alcohol Withdrawal Symptoms

The detrimental impacts that ceasing alcohol intake have on people are termed withdrawal symptoms. Some of the typical alcohol withdrawal symptoms are mentioned below:

• Lethargy

• Anxiety or panic attacks

• Sleeplessness

• Irregular sleep cycle

• Headaches

• Seizures

• Agitation

• Tremors

• Mood swings

• Digestive problems (constipation, diarrhea)

• Fast-paced heartbeats

• Elevated blood pressure or pulse rate

• Delusions

• Irregular heart rate

• Hyperthermia

Obsessive Drinking and Alcoholism

The exploitation of alcohol entails alcohol usage that puts you in jeopardy for medical conditions, psychological problems, and interpersonal issues. More than one drink per day for women or two drinks per day for males is termed inappropriate use of alcohol.

Heavy drinking, a type of alcohol misuse problem, occurs when a man consumes more than five drinks or a woman consumes four drinks or above.

Binge drinking, heavy drinking, or excessive alcohol consumption can raise a person's chance of AUD or alcohol use disorder. An AUD represents a disorder defined by failing to regulate one's alcohol consumption in the face of undesirable, damaging consequences. Craving alcohol, developing a capacity for its effects, and suffering withdrawal effects when attempting to discontinue drinking are just a few signs of AUD, according to the Centers for Disease Control and Prevention.

When an individual develops a physical reliance on alcoholic beverages, withdrawal effects that occur after considerably reducing or stopping alcohol use can be exceedingly upsetting and painful, and people frequently return to consuming alcohol to relieve their discomfort.

What Leads to Withdrawal From Alcohol?

Alcohol withdrawal is a complex process influenced by changes in brain chemistry due to prolonged and heavy alcohol use. Here's a concise overview:

• Brain Chemistry and Alcohol: The brain's primary inhibitory neurotransmitter, GABA, and the primary excitatory neurotransmitter, glutamate, play significant roles in the effects of alcohol and the onset of alcohol withdrawal syndrome (AWS). Alcohol consumption affects these neurotransmitters by decreasing GABA activity and increasing glutamate transmission, leading to the depressant effects commonly associated with drinking, such as reduced stress and drowsiness.

• Development of Tolerance: Continued alcohol use alters the function of GABA and glutamate receptors. Over time, the body adapts to these changes, a process known as tolerance, as described by the American Academy of Family Physicians (AAFP).

• Onset of Withdrawal Symptoms: When an individual abruptly stops or significantly reduces alcohol intake, the brain's operation is disrupted. This disruption can result in a hyper-aroused state, causing various withdrawal symptoms that may begin within a few hours after the last drink. The severity and specific symptoms of withdrawal can vary greatly among individuals.

• Prevalence of Withdrawal Symptoms: According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), over 80% of individuals with alcohol use disorder (AUD) experience withdrawal symptoms when they reduce or cease alcohol consumption.

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When Should You Seek Alcohol Addiction Treatment?

In simple terms, you may require alcohol abuse treatment if you cannot manage the level or frequency of your drinking. You might also discover you require assistance with alcoholism when you start experiencing repercussions directly tied to your drinking. To understand your condition better, start with consulting a general practitioner who will evaluate your condition and direct you towards better treatment approaches. Such approaches usually involve admission to an inpatient rehab clinic for medically assisted detox.

The Levels and Intensity of Alcohol Withdrawal

What transpires in the mind and body after you quit alcohol consumption is based on multiple elements. The extent of severe alcohol withdrawal differs amongst individuals concerning their level of physical alcohol dependence.

The AAFP describes three possible detoxification phases an individual may go through. These are some examples:

• Level one (mild): The signs on this level involve sleeplessness, panic attacks, tremors/shakes, digestive issues, headache, and tachycardia.

• Level two (moderate): The signs might include level one mild symptoms and elevated blood pressure, agitation, disorientation, irregular breathing, and moderately high body temperature.

• Level three (severe): Indications include symptoms from level two and sensory delusions, convulsions, confusion, and poor focus.

What Is The Alcohol Withdrawal Timeline?

Many individuals might swiftly advance from level two to level three while attempting to detox from alcohol without a healthcare expert or a medical environment. As per an article published by the Cleveland Clinic Journal of Medicine, while a specific timeline for withdrawing from alcohol differs among various individuals due to varying factors (frequency and period of consumption and underlying health conditions, among others), a typical duration for alcohol detox might be:

• 6 to 12 hours following the previous drink. The comparatively mild signs of early pullback might start, including sleeplessness, shaking, migraine, anxiety, and indigestion.

• After 24 hours, individuals might feel auditory, physical, or visual delusions.

• Between 24 and 72 hours. Multiple symptoms might have escalated and begun to level out or subside (though specific more long-lasting symptoms may persist for days or longer). Seizure chances are between 24 and 48 hours following the previous drink, necessitating constant surveillance and seizure prevention. Withdrawal delirium can occur between 48 and 72 hours following the previous drink.

Though uncommon, some people endure withdrawal-related effects that linger for a while, such as difficulty sleeping, tiredness, and changes in attitude. As per the National Institute on Drug Abuse (NIDA), it is crucial to remember that with adequate medically supervised detox and withdrawal administration services, most patients recover completely.

Treatment for Alcohol Withdrawal or Detoxification

Medication-assisted treatment is frequently seen as the initial step of treatment against AUD. It will assist you in navigating the challenging procedure of detoxing from alcohol; however, it will not tackle the habits of thinking and conduct that encourage alcohol usage. After detox, several strategies for treatment and care can provide the continuing support needed to maintain continuous sobriety.

• Residential or institutionalized treatment includes residing at a rehab center for the course of treatment while receiving 24-hour support and rigorous counseling in private and group meetings.

• Outpatient or ambulatory care treatment includes residing at home or a transitional housing facility and undertaking family, interpersonal, and group counseling sessions at periodically fixed timetables. This enables you to put what you have learned in treatment into practice in everyday situations while dealing with pressures.

Typically, the period of alcohol withdrawal is entirely individualized and depends on the severity of the addiction. Analyzing and evaluation processes do not permit doctors to diagnose with utmost surety who will and will not encounter fatal symptoms. Those who struggle with minor effects of alcohol withdrawal or are afraid about suffering withdrawal episodes might gain from the advice of a medical professional trained to examine and treat people suffering from alcohol abstinence.

Individuals facing mild to serious signs of withdrawal, or those at the peril of developing them (in case you have a history of critical signs of alcohol withdrawal), generally require residential surveillance and alcohol withdrawal care at an intensive care facility. Ambulatory treatment for moderate withdrawal symptoms might be available, but a residential setting might be beneficial in severe cases. Several resources for post-detoxification involve:

• Continued rehabilitation for psychological development

• Online seminars or virtual sessions held by various medical facilities or rehabs to teach coping skills

• Attending community sessions at Alcoholics Anonymous (AA)

• Engaging with other assistive care organizations like SMART recovery or 12-step meetings

• Attending regular therapy sessions focused on family

• Employing cognitive behavioral therapy sessions in your schedule by your therapist's recommendation.

Which Medicines Are Used to Address Alcohol Withdrawal?

Physicians might recommend benzodiazepines to avoid or control withdrawal effects or health troubles that might arise with severe alcohol withdrawal. Such medicines can stop or lessen specific withdrawal symptoms from developing into severe conditions.

Other medicines might also be utilized to regulate patients or provide them with assistive care. They include alcohol withdrawal medications like vitamins that assist in promoting normal body function, growth, and development; sedatives that cause calmness and dulled senses; and anxiolytics that alleviate anxiety and tension. Patients who are malnourished or dehydrated might be offered fluids or specific supplements.

Medicines that are frequently employed in the treatment of alcohol use disorders involve:

• Naltrexone: It assists in obstructing the stimulating or rewarding impacts of alcohol

• Acamprosate or Campral: It helps patients prevent alcohol intake following recovery

• Disulfiram: It leads to painful effects if the patients restart their consumption

Several of these drugs may be recommended following alcohol abstinence or detoxification.

What Are the Health Hazards of Alcohol Use?

Moderate-to-severe symptoms of alcohol withdrawal could be highly destructive and, in certain cases, fatal. The most critical instance of alcohol pullback, delirium tremens, is associated with a 1 to 4 percent death rate, according to an article on the Management of Alcohol Withdrawal in the Emergency Department.

Suffering from serious withdrawal symptoms is relatively infrequent. Still, it is sometimes impossible to anticipate who will suffer from them and who will experience minor withdrawal symptoms. Regardless, research has found multiple indicators of severe withdrawal from alcohol (like withdrawal-related seizures or DTs). These are some examples:

• Heavy alcohol consumption regularly

• Brain tumors

• Anomaly in liver function

• Being in the old age bracket

• Dehydration

• Electrolyte imbalance

• Comorbid disease

• A background of DTs or alcohol-caused seizures

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What Is the Anticipated Level of Drinking to Experience Withdrawal?

It is hard to anticipate who will encounter alcohol withdrawal, the seriousness of withdrawal, or what its course might be. However, there are various factors stated by the Substance Abuse and Mental Health Services Administration (SAMHSA) lead Treatment Improvement Protocol guide for Detoxification and Substance Abuse Treatment that doctors analyze before making a diagnosis, such as:

• The state of your body and its chemistry

• The metabolic rate of your body

• The quantity of liquor you consume each day

• Your age and gender

• Whether or not you suffer from underlying health conditions

With the Right Help, You Can Get Through Alcohol Withdrawal

As you approach the end of the alcohol withdrawal timeline, remember that recovery is a continuous journey that benefits from ongoing support and care. At The Forge Recovery Center, we are here to help you every step of the way.

We know how hard it is to find professional help for alcohol withdrawal. It's often a tough, complicated search that takes up time and resources. The Forge Recovery Center maintains trusted relationships with many of the nation's leading drug detox centers. With our help, you'll be able to find a safe place for alcohol withdrawal that'll meet your needs.

Reach out today, and let us help you build a foundation for a healthier, alcohol-free future.

Written by

Brian Moore

Content Writer

Reviewed by

Jeremy Arzt

Chief Clinical Officer

July 28, 2024