Alcohol Withdrawal Symptom & Timeline Guide
Withdrawal from alcohol can be an uncomfortable and difficult process. One of the key factors involved in a successful detox process is being aware of what occurs during withdrawal. If you know what to expect when quitting alcohol and during treatment, the process is not as intimidating. This article is intended to help you understand:
- Common alcohol withdrawal symptoms.
- The timeline of the alcohol detox process.
- If it is safe to quit drinking alcohol without going to detox.
- Treatment for alcohol withdrawal.
- How to find alcohol addiction treatment, including detox.
Common Symptoms of Alcohol Withdrawal
Alcohol withdrawal syndrome has two types of symptoms: acute & post-acute. Acute symptoms are the first to appear hours after the last drink and generally last for about 4 to 7 days1 These symptoms can be the most dangerous part of alcohol withdrawal.2,3 After the acute withdrawal has resolved, some people may experience ongoing and less intense symptoms that persist for a much longer period of time.1,2,4 This is known as post-acute withdrawal, or protracted withdrawal, and can last for months or years after a person stops drinking alcohol.2,3
A range of physical symptoms is associated with acute alcohol withdrawal. These detox side effects can include:1,2,4
- Becoming much more sensitive to sensory input, such as light, sound, or touch.
- Difficulty falling or staying asleep; having vivid dreams or nightmares.
- Elevated blood pressure.
- Rapid heart rate.
- Restlessness or difficulty sitting still.
- Stomach upset, including loss of appetite, nausea, or vomiting.
- Tremors in the hands.
While the post-acute withdrawal symptoms aren’t as intense as acute withdrawal, they can be mentally taxing since they last much longer.1 Post-acute withdrawal symptoms may include:1,2,3
- Depressed mood.
- Difficulty focusing and thinking clearly.
- Lowered libido.
- Mood swings.
- Strong cravings to drink alcohol.
- Trouble falling or staying asleep.
It is hard to determine how long these symptoms will last. In particular, cravings can be especially difficult to cope with. They affect a person’s thoughts and emotions and are likely to cause people to relapse.1Attending inpatient or outpatient treatment can be especially beneficial for people who are experiencing post-acute withdrawal symptoms. Such programs help participants learn relapse-prevention skills such as strategies for coping with cravings, developing sober supports, incorporating healthy activities into regular routines, and addressing underlying issues that contribute to alcohol use.5 Some facilities may provide medication to help manage symptoms of anxiety or depression associated with post-acute withdrawal.
Factors Impacting Withdrawal Symptoms
Not everyone who drinks will go through withdrawal during detox and it can be difficult to predict who will be affected. 2,4 Various factors can influence the course and severity of withdrawal symptoms.2,4
- Withdrawal symptoms are more likely to appear in those who consistently participate in heavy drinking over a long period of time.2,4,6 The likelihood of withdrawal increases as alcohol consumption and the length of time increases.2 However, some people who drink heavily do not experience withdrawal symptoms while others who are not heavy drinkers may experience some level of withdrawal symptoms.4
- Withdrawal has a genetic component. People with family members who have gone through alcohol withdrawal are more likely to experience withdrawal symptoms.2 Some, however, are less likely to experience withdrawal symptoms regardless of their drinking patterns.4
- Some people with medical conditions who use alcohol may be more prone to experiencing symptoms of withdrawal.2,4
- If a person has gone through alcohol withdrawal in the past, they are more likely to experience withdrawal symptoms again.2,4 In addition, prior withdrawal experiences are likely to indicate that symptoms may be severe.4
- The likelihood of experiencing withdrawal symptoms increases as people get older, as does the likelihood of a more severe course of detox.4
- Since alcohol and benzodiazepines function similarly, if a person abuses benzodiazepines in addition to drinking alcohol, withdrawal symptoms are more likely and could be more severe.2
Alcohol Withdrawal Timeline
Withdrawal symptoms generally begin within a few hours of stopping alcohol use, increase in intensity around days 2 or 3, and then gradually improve over the next few days.1,2 Mild early alcohol withdrawal symptoms can progress to more severe symptoms within 1 to 2 days.6 Alcohol withdrawal is broken down into 3 phases:1,4,6
- Mild withdrawal symptoms can take up to 6 hours to appear. These symptoms include anxiety, feeling irritable, feeling shaky, trouble sleeping, headaches, heart palpitations, involuntary twitching, loss of appetite, and upset stomach. If symptoms do not become more severe within a day or two, they are not likely to worsen.
- Moderate withdrawal symptoms typically appear within 12 to 48 hours and will most likely occur about a day after stopping alcohol use. These symptoms include hand tremors and seizures, which can be isolated or occur repeatedly. Approximately half of all people who experience alcohol withdrawal seizures progress to severe alcohol withdrawal.
- Severe withdrawal symptoms are known as delirium tremens (DTs). This is an extremely serious condition marked by agitation, extreme sensitivity to light and sound, high blood pressure, high body temperature, nausea (with or without vomiting), paranoia, rapid heartbeat, sweating, visible tremors in the arms and hands, visual and auditory hallucinations, and loss of touch with reality. The severe withdrawal phase can last for a week or longer after stopping alcohol intake. Symptoms are generally worst after the third day, and then slowly improve.
Should I Quit Drinking Cold Turkey?
You may be reading this article to learn more about how to stop drinking without rehab. Quitting cold turkey at home may seem appealing because it costs less than attending a treatment facility and you get to stay in the comfort of your own home. However, it’s very important to know that detoxing on your own can be dangerous.4,6
Alcohol withdrawal symptoms can quickly become severe and life-threatening.4 Seizures can be fatal. They can happen suddenly, and the person may vomit or stop breathing. Multiple seizures may sometimes occur.4 Headaches, confusion, or disorientation often follow.4 Proper care ensures that they don’t injure themselves in the event of a seizure and that medical treatment is available.4,6
Delirium tremens is another potentially fatal complication that requires medical care.4 (p55, 63) DTs come on slowly. The condition involves altered perceptions of time, place, and self; hallucinations and delusions; and an inability to regulate body processes.4,6 The best way to treat this condition is to identify it in the early stages and address it before it worsens.4
Other medical complications can also arise during alcohol detox. It is important to have proper monitoring and care throughout the withdrawal process so that fatal symptoms and complications can be prevented or treated.4 In addition, a supportive and structured detox program can manage uncomfortable withdrawal symptoms and cravings that could otherwise lead to relapse.1
Alcohol Detox & Rehab
You have several treatment options for alcohol withdrawal and addiction. Detoxification offers a safe environment with medical monitoring and management of alcohol withdrawal symptoms. In short, detox is the safest way to avoid or manage any medical emergencies related to your withdrawal symptoms.4,5 Your detox treatment plan depends on several factors. This includes, but isn’t limited to, how long you experience acute withdrawal symptoms—which generally last between 4 and 7 days—and what your insurance covers.2,3
In contrast, inpatient and outpatient treatment facilities can provide treatment for 28 to 90+days to help manage post-acute withdrawal symptoms and treat your alcohol addiction through individual therapy and group counseling.5
Alcohol Detox Procedures
When starting treatment at a detox facility, the first step is an assessment of your needs. You will be asked about your substance use history, physical and mental health, vital signs, family history of substance use, any prior treatment episodes, and whether you take any medications or supplements. You will also be given a drug test and asked about any legal, employment, social, or housing issues that you may have.4 This information will be used to determine the best course for you after detox.4
Then a medical doctor will assess your level of withdrawal and prescribe medication to manage your symptoms.4 The most common class of medications used to manage alcohol withdrawal symptoms is benzodiazepines—usually chlordiazepoxide (Librium) or diazepam (Valium)— which are slowly tapered down.4,6
Alcohol detox can occur in a variety of settings. An inpatient facility, which provides 24-hour care, is strongly suggested for alcohol detox.4,6 An outpatient setting is more appropriate for mild withdrawal and people who have strong sober support and responsibilities within the community.4 In very severe cases, hospitalization may be required.4
Inpatient & Outpatient Alcohol Rehab
Since detox merely addresses withdrawal symptoms and not the addiction itself, it should be followed up with additional treatment for best results.4,5 Inpatient care is provided in a residential setting; participants stay for the duration of treatment. Outpatient care occurs in groups that meet throughout the week. You live at home and attend according to your schedule, enabling you to continue going to school or work.5 Both of these settings offer group and individual therapy sessions, although inpatient treatment tends to be more intensive and shorter in duration.5
During treatment, behavioral therapy techniques keep you motivated towards sobriety. You develop skills to maintain sobriety, learn to improve interpersonal relationships, build relapse-prevention skills, develop a supportive peer group, manage parts of your life that have been affected by alcoholism, and explore sober hobbies. All of these techniques can reduce the chances of relapse and the need for alcohol withdrawal treatment in the future.5 Your treatment plan may also include medications that can support your recovery, manage cravings, and prevent relapse.5
Finding Help for Alcohol Withdrawal
While it is easy to conduct an internet search for “alcohol rehab near me,” it doesn’t always guarantee that you’ll find a legitimate treatment facility that makes use of effective treatment methods. American Addiction Centers (AAC) is one of the leading alcohol rehab centers in Nevada and around the country.7 ,8 Its Desert Hope facility provides a full spectrum of care including detox, inpatient, and outpatient services.8
If you want to learn more about how American Addiction Centers facilities or our Nevada alcohol rehab center can help you, we have a free and confidential helpline that you can call 24/7 at 702-800-2682.
- Heilig, M., Egli, M., Crabbe, J.C., & Becker, H.C. (2010). Acute withdrawal, protracted abstinence and negative affect in alcoholism: Are they linked? Addiction Biology, 15(2), 169-184.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Substance Abuse and Mental Health Services Administration. (2010). Protracted withdrawal. Substance Abuse Treatment Advisory, 9(1), 1-8.
- Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series 45, DHHS Publication No. (SMA) 06-4131. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (Third edition).
- Newman, R.K., Stobart Gallagher, M.A., & Gomez, A.E. (2020). Alcohol withdrawal. Treasure Island, FL: StatPearls Publishing.
- American Addiction Centers. (2021). American Addiction Centers.
- American Addiction Centers. (2021). Desert Hope Las Vegas treatment center.
Frequently asked questions