How Long Does Alcohol Withdrawal Last

Alcohol withdrawal is a challenging phase at the start of your sobriety and recovery journey. The duration of alcohol withdrawal symptoms varies depending on things like the severity of your dependence, the duration of alcohol use, and your health.

During alcohol withdrawal, your body starts to adjust to its absence and symptoms can range from mild shakiness and anxiety to severe complications.

When you understand the alcohol withdrawal timeline and the potential challenges, you can manage your expectations and seek appropriate medical guidance and support.

How Alcohol Dependence Occurs

Alcohol dependence is a medical condition that can be both physical and psychological.

Alcohol affects the brain’s neurotransmitter systems, especially the ones that involve dopamine and gamma-aminobutyric acid or GABA. Over time, regularly consuming alcohol changes these systems, and that leads to changes in mood, impulse control and behavior, resulting in further drinking to avoid negative feelings and discomfort.[1]

With regular use of alcohol, your body can adapt to its presence, and that increases your tolerance. As your tolerance increases, you’re drinking more to achieve the same effects, contributing to a cycle of increased consumption.

As the body relies on alcohol for certain functions, withdrawal symptoms might occur when you’re not consuming it.

What is Alcohol Withdrawal?

Alcohol withdrawal symptoms occur when you’ve been drinking excessively or for a prolonged period, and you stop suddenly or reduce your intake significantly.[2] Withdrawal occurs because of your body’s physical dependence on alcohol that happens over time.

When you’re drinking regularly and in large amounts, your body chemistry adjusts to compensate for the depressive effects of alcohol. Your central nervous system can become hyperactive when accustomed to the presence of alcohol. Your body might continue in that state when you stop drinking, leading to withdrawal.

Your body has to readjust to the absence of alcohol, and this process can be uncomfortable and sometimes dangerous.

Mild alcohol withdrawal symptoms can include:

  • Anxiety
  • Headache
  • Nausea and vomiting
  • Insomnia
  • Sweating
  • Shakiness

Moderate symptoms include:

  • Higher blood pressure
  • Elevated body temperature
  • Increased heart rate
  • Mood disturbances
  • Mental confusion

Severe symptoms can include:

  • Hallucinations
  • Seizures
  • Delirium tremens (DTs) include severe agitation, seizures, fever and hallucinations.

Delirium tremens is the most severe type of alcohol withdrawal, occurring in around 3-5% of people with heavy, prolonged drinking history.[3] Hallucinations, severe confusion and disorientation characterize DTs, as do fluctuations in blood pressure and heart rate. DTs can be life-threatening or medical emergencies.

The Alcohol Withdrawal Timeline

The alcohol withdrawal timeline can vary from person to person but usually follows a somewhat predictable pattern that can be broken down into stages. Each stage is likely to have its own symptoms.

The first stage of the alcohol withdrawal timeline is 6-12 hours after the last drink when initial symptoms start to appear. These earliest symptoms can include:

  • Anxiety
  • Headache
  • Shaking
  • Nausea
  • Vomiting
  • Abdominal pain

From 12-24 hours after the last drink, symptoms may escalate. These can include:

  • Increased heart rate
  • Irritability
  • Mental confusion
  • Less commonly, this time could include hallucinations

Starting from 24-48 hours after your last drink, symptoms could continue and worsen. This is when seizures might become a risk, especially in someone who has a history of seizures related to withdrawal in the past.

From 48-72 hours after the last drink, withdrawal symptoms can start to peak. This is when the risk of delirium tremens is highest.

From days 3-7 in the alcohol withdrawal timeline, symptoms may start becoming less intense, but some people will continue experiencing prolonged withdrawal symptoms or PAWS, which is Post-Acute Withdrawal Syndrome. This can include fatigue, vivid dreams, mood swings and insomnia.

In the weeks that follow the last drink, most physical symptoms start to resolve, but mental symptoms can continue. Cravings, anxiety, depression and emotional disturbances may occur.

Factors Influencing the Alcohol Withdrawal Timeline

Some of the things that can play a role in the length of alcohol withdrawal and the severity of symptoms include:

  • Duration and quantity of alcohol use: Drinking for longer and consuming higher amounts of alcohol can extend the withdrawal timeline and lead to more severe symptoms.
  • Biological and genetic factors: Genetics can be part of how the body processes alcohol and experiences withdrawal.[4] Some people will naturally go through more prolonged or intense symptoms.
  • Medical history: Medical conditions like heart or liver disease can worsen symptoms and complicate withdrawal.
  • Previous withdrawal experiences: If you’ve undergone withdrawal before, especially if you experienced severe symptoms, you could face a more severe process.
  • Concurrent drug use: Using other substances along with alcohol can affect the withdrawal timeline and symptom severity.

Because of how variable and possibly severe withdrawal symptoms are, medical supervision is recommended to safely manage the process. This can help mitigate risks and support long-term recovery.

Treating Alcohol Withdrawal

Treatment for alcohol withdrawal usually involves a combination of medical supervision, medication and supportive care.

Medical supervision is important to ensure you have access to medical interventions if complications or severe symptoms occur.

Different medications may be used to manage symptoms, like benzodiazepines and anticonvulsants. Supportive care can include making sure you get adequate nutrition and hydration because chronic alcohol use can lead to nutritional deficiencies and dehydration.

Medical professionals can monitor for complications, including electrolyte imbalances and signs of DTs.

The intensity and duration of treatment for withdrawal depend on symptom severity and individual needs. Some people may need just outpatient support, while others require inpatient detox.

Following initial detoxification, ongoing treatment is needed to address underlying issues that relate to alcohol use disorder. These treatments could include therapy, counseling, holistic approaches, education on coping strategies, and relapse prevention.

Alcohol withdrawal is a complex, potentially dangerous condition that’s a critical step on the path to recovery when you’re struggling with alcohol dependence. Proper management requires medical supervision, appropriate medication, and supportive care for safety and effectiveness.

Start Your Recovery at our Los Angeles Alcohol Detox Center

If you or a loved one suffers from an alcohol use disorder, professional treatment is vital to obtaining long-term sobriety. The first step in recovery from addiction is medical detox, a program that helps you overcome withdrawal through the use of medical treatments and FDA-approved medications.

At Invigorate Behavioral Health, our alcohol detox program takes an evidence-based and compassionate approach to treating withdrawal. When you are within our facility you will feel safe, comfortable, and supported throughout the entire process.

Invigorate Behavioral Health is a residential medical detox and treatment facility in California offering 24-hour care and medical guidance. Our facility features exclusive residential housing and a team of passionate healthcare professionals who are there to ensure your safety as you begin your recovery journey.

Contact us today for more information on how our alcohol detox program in Los Angeles can help you recover.

References:

  1. American Psychological Association (APA): Understanding alcohol use disorders and their treatment
  2. National Institutes of Health (NIH): Alcohol withdrawal syndrome: mechanisms, manifestations, and management
  3. National Institutes of Health (NIH): Delirium Tremens
  4. NIH: Genetics and alcoholism

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