How Long Do Alcohol Withdrawals Last?
Learn to recognize alcohol withdrawal symptoms and understand the alcohol withdrawal timeline with our complete guide.
If you or someone you love is experiencing the physical and mental health issues associated with an alcohol use disorder, understanding what happens to the body when alcohol intake is stopped can have profound effects on your recovery. Alcohol withdrawal can take many forms, and the alcohol withdrawal stages, symptoms can range from mild symptoms to severe symptoms.
In this guide, we will explore alcohol withdrawal symptoms, including how long the symptoms may last. This information is backed by decades of clinical and diagnostic research from medical professionals at the National Institute on Alcohol Abuse and treatment clinics throughout the United States. Once you learn about the symptoms of alcohol withdrawal, you can make informed decisions about the risk factors and treatment options.
Let’s begin!
Alcohol and its Effects on the Human Body
Alcohol affects the human body in various ways, depending on the amount consumed, the individual’s tolerance, and the duration of consumption. Here’s a breakdown of its effects:
Short-Term Effects
- Central Nervous System (CNS) Depression: Alcohol acts as a depressant on the CNS, slowing down brain function and impairing cognitive and motor skills. This results in slurred speech, impaired judgment, and difficulty with coordination and balance.
- Euphoria and Relaxation: At low to moderate doses, alcohol can cause feelings of euphoria and relaxation by affecting neurotransmitters like dopamine and GABA.
- Reduced Inhibition: Alcohol lowers inhibitions, leading to riskier behavior and poor decision-making, such as engaging in unsafe activities or arguments.
- Dehydration: Alcohol is a diuretic, meaning it increases urine production, which can lead to dehydration. This contributes to symptoms like dry mouth, headaches, and fatigue.
- Nausea and Vomiting: Consuming large amounts of alcohol irritates the stomach lining, leading to nausea and vomiting.
- Hangover: After alcohol consumption, a person may experience a hangover characterized by headaches, fatigue, sensitivity to light and sound, and nausea.
Long-Term Effects
- Liver Damage: Chronic alcohol use can lead to liver conditions, including fatty liver, alcoholic hepatitis, and cirrhosis, where healthy liver tissue is replaced by scar tissue, impairing liver function.
- Heart Problems: Prolonged alcohol use can increase the risk of heart diseases such as hypertension, cardiomyopathy (weakened heart muscles), arrhythmias, and stroke.
- Brain Damage: Chronic drinking can cause long-term damage to the brain, leading to memory problems, cognitive decline, and conditions such as Wernicke-Korsakoff syndrome, a form of alcohol-related dementia.
- Weakened Immune System: Alcohol impairs the immune system, making individuals more susceptible to infections and slowing the body’s ability to heal.
- Increased Cancer Risk: Alcohol is linked to an increased risk of developing cancers, including cancers of the mouth, throat, esophagus, liver, and breast.
- Mental Health Disorders: Chronic alcohol use is associated with depression, anxiety, and can exacerbate existing mental health issues. Prolonged misuse may also lead to alcohol dependence or alcohol use disorder (AUD).
Effects on Different Organs
- Liver: As mentioned, the liver is primarily responsible for metabolizing alcohol. Long-term use can result in severe liver damage.
- Heart: Alcohol can initially dilate blood vessels, but chronic use leads to high blood pressure and heart damage.
- Brain: Alcohol interferes with neurotransmitters, and long-term consumption can cause permanent damage to brain function and structure.
- Pancreas: Chronic alcohol use can lead to pancreatitis, an inflammation of the pancreas.
- Digestive System: Alcohol irritates the stomach lining and can cause ulcers, acid reflux, and gastritis over time.
Social and Psychological Effects
- Alcohol abuse can strain personal relationships, cause financial difficulties, and result in legal issues, such as DUI arrests. Over time, it may contribute to the development of psychological disorders, including depression, anxiety, and an increased risk of suicide.
Reducing or avoiding alcohol consumption can help prevent these adverse effects and promote overall health and well-being.
What is Alcohol Withdrawal?
Alcohol withdrawal occurs when a person who has been drinking heavily for an extended period suddenly reduces or stops alcohol consumption. This happens because the body has become physically dependent on alcohol, and abrupt cessation can cause a range of symptoms, which can be mild to severe. Withdrawal symptoms vary depending on the amount of alcohol consumed, how long a person has been drinking, and their individual health.
Causes of Alcohol Withdrawal
Alcohol depresses the central nervous system (CNS). With prolonged drinking and alcohol addiction, the body adjusts to the consistent presence of alcohol by producing more stimulating chemicals (such as glutamate) to balance the depressant effects of alcohol. When alcohol intake suddenly stops, the CNS becomes overexcited due to the lack of alcohol, leading to withdrawal symptoms.
Symptoms of Alcohol Withdrawal
Mild Symptoms (Begin 6 to 12 hours after the last drink)
- Anxiety and Irritability: Feeling restless, anxious, or moody.
- Tremors (Shakes): Uncontrollable shaking, particularly in the hands.
- Headache: Mild to severe headaches, often caused by dehydration and tension.
- Nausea and Vomiting: Discomfort in the stomach, sometimes leading to vomiting.
- Sweating: Excessive sweating, often accompanied by clamminess or chills.
- Insomnia: Difficulty falling or staying asleep, despite feeling exhausted.
- Rapid Heart Rate and Elevated Blood Pressure: The body’s fight-or-flight response is triggered, leading to an increased heart rate and blood pressure.
Moderate Symptoms (Begin 12 to 48 hours after the last drink)
- Hallucinations: Seeing, hearing, or feeling things that aren’t there. These are typically visual but can also be auditory or tactile.
- Seizures: Some individuals may experience one or more seizures, which can be dangerous and life-threatening.
- Increased Anxiety and Mood Disturbances: Heightened anxiety, panic attacks, and episodes of depression.
Severe Symptoms (Begin 48 to 72 hours after the last drink) – Delirium Tremens (DTs)
Delirium tremens is a severe and potentially life-threatening condition that requires immediate serious medical care and attention. Symptoms include:
- Severe Confusion: The person may be disoriented, unable to recognize their surroundings, or unable to think clearly.
- Fever: High body temperature, which can lead to dehydration.
- Agitation: Extreme restlessness and irritability, often leading to uncontrollable shaking and thrashing.
- Severe Hallucinations: Vivid, terrifying hallucinations involving visions of animals, insects, or other objects.
- Severe Seizures: Prolonged seizures that can lead to loss of consciousness or life-threatening complications.
- Tachycardia and Hypertension: Dangerously high heart rate and blood pressure, putting a strain on the heart and increasing the risk of heart attack or stroke.
Timeline of Alcohol Withdrawal
- 6 to 12 Hours: Mild symptoms such as anxiety, tremors, and headaches begin to appear.
- 12 to 48 Hours: Symptoms intensify, with the potential for hallucinations and seizures.
- 48 to 72 Hours: Severe symptoms, including delirium tremens, are at their peak.
From Mild to Severe: Complications of Alcohol Withdrawal Symptoms
Alcohol withdrawal can lead to serious and potentially life-threatening complications, particularly in individuals with a history of long-term or heavy alcohol use. The body’s reliance on alcohol to maintain balance (homeostasis) means that sudden cessation can disrupt various systems, leading to severe reactions. Here are the major complications of alcohol withdrawal:
1. Delirium Tremens (DTs)
Delirium tremens is one of the most dangerous complications of alcohol withdrawal. It typically occurs 48 to 72 hours after the last drink, but in some cases, it may appear up to a week later. DTs is a medical emergency; severe alcohol withdrawal can be fatal if not properly treated.
Symptoms of Delirium Tremens:
- Severe Confusion and Disorientation: Individuals may not know where they are or recognize familiar people or objects. They may experience memory lapses and an inability to think clearly.
- Severe Agitation and Irritability: Individuals may become extremely agitated, restless, or anxious, leading to violent outbursts or aggressive behavior.
- Hallucinations: These are typically visual (seeing things that aren’t there), but they can also be auditory (hearing voices or sounds) or tactile (feeling things crawling on the skin).
- Tachycardia and Hypertension: A dangerously high heart rate and elevated blood pressure put significant strain on the cardiovascular system, increasing the risk of heart attacks or strokes.
- Hyperthermia: Increased body temperature can lead to fever and dehydration, which can cause complications such as kidney failure if not managed.
- Severe Seizures: Uncontrolled electrical activity in the brain can cause grand mal seizures, where the individual experiences convulsions, loss of consciousness, and other potentially fatal complications.
2. Alcohol Withdrawal Seizures
- Seizures are a common and serious complication of alcohol withdrawal symptoms, particularly during the first 24 to 48 hours. They can range from mild tremors to grand mal seizures, which involve loss of consciousness, violent muscle contractions, and convulsions. Alcohol withdrawal seizures are life threatening symptoms of alcohol withdrawal and must be treated by medical professionals as quickly as possible.
Causes of Seizures in Alcohol Withdrawal:
- Electrolyte Imbalance: Alcohol use can deplete vital electrolytes like magnesium and potassium, which are essential for proper brain function. Low levels of these electrolytes increase the risk of seizures.
- Overactive Nervous System: Alcohol suppresses excitatory neurotransmitters in the brain. When alcohol use stops, the body overproduces these chemicals, leading to hyperexcitability and seizures.
Cardiovascular Complications
Alcohol withdrawal can place tremendous strain on the heart and vascular system, leading to a variety of cardiovascular issues. Withdrawal symptoms that include cardiovascular issues can occur anywhere on the alcohol withdrawal timeline. This is particularly dangerous for individuals with pre-existing heart conditions or high blood pressure.
Cardiovascular Symptoms During Withdrawal:
- Tachycardia: A rapid heart rate (over 100 beats per minute) is common during alcohol withdrawal due to the overactive nervous system. Tachycardia can lead to palpitations, dizziness, and chest pain.
- Hypertension: Alcohol withdrawal can cause significant spikes in blood pressure, increasing the risk of heart attack or stroke.
- Arrhythmias: The heart may beat irregularly due to electrolyte imbalances and overactivation of the nervous system. This can lead to life-threatening arrhythmias if not treated promptly.
What is Alcohol Withdrawal Syndrome?
Alcohol Withdrawal Syndrome (AWS) refers to the range of symptoms that occur when someone who has been drinking heavily or for a prolonged period suddenly reduces or stops alcohol consumption. This syndrome occurs because the body becomes dependent on alcohol, and sudden cessation disrupts the body’s ability to function normally without it. The symptoms of AWS can vary in severity, ranging from mild discomfort to life-threatening complications.
Causes of Alcohol Withdrawal Syndrome
Alcohol is a depressant that affects the central nervous system (CNS). With prolonged use, the body adapts to the presence of alcohol by altering its balance of neurotransmitters. Specifically:
- Alcohol enhances the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, which produces feelings of relaxation and calm.
- It suppresses the action of excitatory neurotransmitters like glutamate.
Over time, the brain compensates for the depressive effects of excessive alcohol, by producing more excitatory chemicals (like glutamate) to maintain balance. When alcohol consumption suddenly stops, these compensatory mechanisms become overactive, leading to hyperactivity in the brain and nervous system, which manifests as withdrawal symptoms.
Symptoms of Alcohol Withdrawal Syndrome
Symptoms of AWS typically begin within 6 to 24 hours after the last drink and may progress over the course of several days. They can be grouped into mild, moderate, and severe categories:
1. Mild Symptoms (6–12 hours after last drink)
- Anxiety: Feeling restless, jittery, or tense.
- Tremors: Shaking, especially in the hands.
- Headaches: Mild to severe headaches often occur.
- Nausea and Vomiting: Feelings of queasiness or actual vomiting.
- Sweating: Excessive sweating, especially at night.
- Insomnia: Difficulty falling asleep or staying asleep despite fatigue.
- Rapid Heart Rate: A fast or irregular heartbeat (tachycardia).
- High Blood Pressure: An increase in blood pressure is common.
2. Moderate Symptoms (12–48 hours after last drink)
- Hallucinations: Visual, auditory, or tactile hallucinations may occur. These can be vivid and frightening but are usually not as severe as those experienced during delirium tremens.
- Agitation and Irritability: Increased emotional volatility and irritability.
- Confusion: Mild disorientation or difficulty thinking clearly.
- Seizures: Grand mal seizures (generalized tonic-clonic seizures) may develop. These seizures can be single or occur in clusters.
3. Severe Symptoms (48–72 hours after last drink) – Delirium Tremens (DTs)
- Severe Confusion and Delirium: Profound disorientation, confusion, and inability to recognize familiar people or surroundings.
- Severe Hallucinations: Often vivid and frightening, including seeing things like insects or animals that aren’t there.
- Extreme Agitation and Restlessness: Uncontrollable shaking or thrashing.
- High Fever: Hyperthermia (elevated body temperature).
- Severe Seizures: These can be life-threatening, causing loss of consciousness and muscle contractions.
- High Blood Pressure and Tachycardia: Dangerously high heart rate and blood pressure, which can lead to heart attack or stroke.
Seeking Treatment for Alcohol Withdrawal or Substance Abuse Disorders
Alcohol withdrawal treatment is designed to manage symptoms, prevent complications, and ensure a safe detoxification process. It typically involves a combination of medications, supportive care, and medical supervision. The severity of the acute alcohol withdrawal and symptoms will determine the type and level of care required, ranging from outpatient monitoring for mild cases to hospitalization for more severe cases.
1. Medical Detoxification
Medical alcohol detox is often the first step in treating alcohol withdrawal, especially for individuals with moderate to severe symptoms. Detoxification involves safely removing alcohol from the body while managing withdrawal symptoms and preventing complications.
2. Medications
Medications are used to reduce withdrawal symptoms, prevent seizures, and ease the body’s transition away from alcohol dependence. Common medications include:
- Benzodiazepines
- Anticonvulsants
- Beta-blockers
- Antipsychotics
- Thiamine (Vitamin B1)
3. Symptom Management
Alcohol withdrawal symptoms such as nausea, vomiting, headaches, and sleep disturbances are managed with supportive care:
- Antiemetics: Medications like ondansetron or metoclopramide may be used to control nausea and vomiting.
- Pain Relievers: Non-opioid pain relievers such as acetaminophen or ibuprofen can help alleviate headaches or body aches.
4. Post-Withdrawal Care
Once the acute withdrawal phase is complete, ongoing care is necessary to support long-term recovery and prevent relapse. Treatment after withdrawal may include:
- Alcohol Counseling: Therapy and counseling to address the psychological aspects of alcohol dependence. Cognitive-behavioral therapy (CBT), motivational interviewing, and group therapy are commonly used approaches.
- Support Groups: Participation in peer support groups like Alcoholics Anonymous (AA) can help individuals maintain sobriety and avoid relapse.
- Medication-Assisted Treatment (MAT): Medications like naltrexone, acamprosate, or disulfiram may be prescribed to reduce cravings, support abstinence, and discourage relapse.
- Inpatient or Outpatient Rehab: Some individuals may benefit from structured inpatient or outpatient rehabilitation programs to address the root causes of alcohol dependence and develop coping strategies for long-term sobriety.
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Contact Journey Hillside Tarzana to Learn More About Alcohol Withdrawal Treatment
Do you have an alcohol use disorder, can’t control your alcohol intake, or were referred to a treatment center for severe alcohol withdrawal symptoms? Journey Hillside Tarzana is experienced in helping those with alcohol use disorder or other substance abuse issues overcome the physical, mental, and social challenges on the road to sobriety.
Contact our intake team today to learn more about our programs and services. Our inpatient treatment blends cutting edge medical detox facility with luxurious surroundings and a peaceful campus, allowing our patients to focus on their recovery.
