Alcohol Withdrawal & Detox

Addiction Treatment for Alcoholism

240 million people suffer from alcohol use disorder. According to the 2019 NSDUH (National Survey on Drug Use and Health), 14.1 million Americans have AUD.

Maybe you or a loved one is struggling with alcohol use disorder. If so, you might have reached the stage where you’re considering alcohol rehab, or your loved one has admitted they have a problem so you are ready to push forward and investigate options for recovery programs.

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By: Renaissance Recovery

Clinically Reviewed by: Diana Vo, LMFT

Last Updated:


What is Alcohol Withdrawal?

If you are wondering about the timeline for alcohol withdrawal, here are some symptoms you can expect. 

AWS (alcohol withdrawal syndrome) refers to the physical and emotional withdrawal symptoms that present when a heavy drinker moderates or discontinues the use of alcohol.

When Does Alcohol Withdrawal Start?

How long before alcohol withdrawal starts depends on the timing of your last drink. Alcohol withdrawal symptoms will begin around 6-12 hours after the last drink, although they most often occur within 24-48 hours after the last drink. 

The severity and timeline of withdrawal symptoms can vary depending on things like:

  • Amount and duration of alcohol consumption

  • Age 

  • Overall health

  • And previous experiences with alcohol withdrawal

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Alcohol Withdrawal Symptoms

Mild AWS is characterized by these symptoms:

  • Anxiety

  • Fatigue

  • Nausea

  • Vomiting

Those who experience severe AWS may experience:

Why do withdrawal symptoms manifest during alcohol detox, though?

Well, the sustained consumption of alcohol typically triggers lasting changes to the CNS (central nervous system).

As a CNS depressant, alcohol has a sedative effect in the brain. Chronic or heavy drinking exposes you continuously to these depressant effects. Your brain will respond by producing chemicals to mitigate this imbalance, counteracting the sluggish feeling that episodes of heavy drinking can induce.

Consuming alcohol regularly will cause your brain to produce higher levels of the neurotransmitters – chemical messengers – norepinephrine and serotonin. If you eliminate alcohol, your brain becomes overstimulated. Alcohol withdrawal symptoms are a physical and emotional response to this temporary imbalance.

The alcohol withdrawal symptoms timeline present over three distinct stages:

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3 Stages of Alcohol Withdrawal Syndrome

The alcohol withdrawal symptoms timeline present over three distinct stages:

1) Mild AWS

These are the most reported mild symptoms of alcohol withdrawal:

  • Nausea

  • Vomiting

  • Appetite loss

  • Headaches

  • Depression

  • Anxiety

  • Tremors

  • Abdominal pain

  • Gastrointestinal issues

  • Insomnia

2) Moderate AWS

If you experience moderate alcohol withdrawal, the above symptoms will manifest in addition to:

  • High body temperature

  • Rapid heartbeat

  • Increased perspiration

  • Shallow breathing

  • Heavy sweating

  • High systolic blood pressure levels

  • Confusion

  • Irritability

  • Mood swings

3) Severe AWS (Delirium Tremens)

Research shows that approximately 5% of those who detox from alcohol will experience severe withdrawal, otherwise known as DTs (delirium tremens). Delirium tremens is one of the most severe symptoms and can involve fatal seizures if untreated.

Anyone liable to develop severe AWS should avoid abruptly quitting alcohol at home. A supervised medical detox will mitigate complications and minimize the chance of relapse in early recovery.

Many variables influence the timeline of alcohol withdrawal syndrome and the severity of symptoms, such as:

  • Duration of alcohol abuse.

  • Amount of alcohol consumed.

  • Physical health conditions.

  • Co-occurring mental health conditions

  • Stress levels.

  • Family history of alcoholism and drug abuse.

Not everyone will experience all of these delirium tremens symptoms. While every case of alcohol use disorder is different, the detox timeline is similar.

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Get evidence-based treatment to overcome alcohol addiction at Renaissance Recovery. Call our team now to learn more about the process.

An infographic of the Alcohol Withdrawal Timeline

Alcohol Withdrawal Symptoms Timeline

These are the symptoms you can expect to encounter during the three stages of alcohol withdrawal timeline outlined above:

  • Mild AWS: Symptoms include headaches, GI disturbances, anxiety, insomnia, and heart palpitations.

  • Moderate AWS: Mild hyperthermia, raised heart rate, confusion, abnormal breathing, and high blood pressure, in addition to the symptoms of mild AWS.

  • Severe AWS: Some of the more severe symptoms of AWS include disorientation, attention issues, hallucinations, seizures, and the symptoms of mild and moderate AWS.

The duration and quantity of alcohol directly impacts the alcohol detox timeline and withdrawal timeline. Any underpinning physical or mental health conditions will also influence how long alcohol withdrawal lasts.

Although all cases of alcohol detox are unique, the following timeline is indicative of what to expect during withdrawal detox timeline. Alcohol detox is a difficult and complex process and is always best to navigate with in a professional substance abuse treatment center environment. 

The Timeline

Outpatient rehab options can be a perfect fit for some, whereas others would do much better in an inpatient, residential setting. Take a look at some of the features of an outpatient alcohol rehab and determine what is best for your situation.

6 Hours After Last Alcoholic Drink

Expect to experience minor alcohol withdrawal symptoms during the early phase of detox.

12 Hours to 24 Hours After Last Alcoholic Drink

The first day of sobriety is when hallucinations can present.

24 Hours to 48 Hours After Last Alcoholic Drink

Tremors, headaches, stomach upsets, and other minor withdrawal symptoms linger. These symptoms should peak after 24 hours, then dissipate after just four or five days.

48 Hours to 72 Hours After Last Alcoholic Drink

Delirium tremens, commonly abbreviated to DTs, is the most severe form of AWS impacting around 5% of people detoxing from alcohol. In the event of seizure, DTs can be fatal. Anyone expecting to experience severe AWS should always consider a medical detox. Quitting at home alone is simply too dangerous.

72 hours after last alcoholic drink

Symptoms of AWS will peak by this phase of the alcohol detox for most people.

How Long Does it Take for Your Body to Return to Normal After Alcohol?

While there is no fixed blueprint for alcohol detox and withdrawal, most case of AWS involve symptoms that subside after no more than five days.

In the event of PAWS (post-acute withdrawal syndrome), symptoms can sometimes persist for a month or more.

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What Is Alcohol Detox?

It is important to understand what alcohol detox is and what to expect. The alcohol detox process involves purging your body of alcohol, and this process can involve disturbing withdrawal symptoms, depending on the level of dependence involved. This is why medical detox is always recommended.

Alcohol withdrawal is believed to arise due to changes in brain activity triggered by prolonged and abusive alcohol consumption. Sustained alcohol misuse disrupts the balance of inhibitory and excitatory neurotransmitter activity in the brain. Withdrawal symptoms are a result of this imbalance being corrected.

Experiencing withdrawal symptoms is one of the symptoms of alcohol use disorder, as outlined in DSM-5, the fifth and updated edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders.

Before we look at the safest way of detoxing from drugs and alcohol, how does the detox timeline unfold?

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an image of an hourglass, representing the timeline for alcohol detox

Alcohol Detox Timeline

According to AAFP (American Academy of Family Physicians), there are three possible stages of alcohol withdrawal. Not everyone will experience all of these stages.

  • Mild alcohol withdrawal: Symptoms include anxiety, insomnia, headaches, heart palpitations, and gastrointestinal disturbances.

  • Moderate alcohol withdrawal: Expect the symptoms of mild alcohol withdrawal in addition to confusion, rapid and abnormal breathing, increased heart rate, and mild hyperthermia.

  • Severe alcohol withdrawal: Severe alcohol withdrawal involves all of the above symptoms, alongside disorientation, impaired attention, hallucinations, and alcohol withdrawal seizures.

In the absence of treatment by a qualified healthcare professional, many people progress from moderate to severe alcohol withdrawal rapidly.

There are many variables that impact the precise timeline for alcohol withdrawal. These include:

  • Duration of alcohol use

  • Alcohol intake

  • Co-occurring physical or mental health issues

How Long Does it Take to Detox from Alcohol?

As a process, alcohol withdrawal begins within hours of the last drink, and causes acute withdrawal symptoms that can last for up to 5 days.

Occasionally, symptoms linger for longer.

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Can You Alcohol Detox at Home?

Alcohol detox at home might seem like a good idea if you feel there’s no place like home.

Unfortunately, unsupervised home detox can carry significant risks, and can be extremely challenging if you don’t have a firm grasp on the alcohol withdrawal timeline and the accompanying dangers. So if you or a loved one is struggling with alcohol addiction and is attempting to detox at home, the best way you can help an alcoholic is making sure they get treatment in a licensed facility where they can detox safely and comfortably under supervision of experts and clinicians.

Beyond this, if you are also using other substances while drinking – whether prescription medications like opioids or benzos, or illicit drugs – this can heighten the intensity of withdrawal symptoms. Polysubstance abuse can also make the withdrawal symptoms more unpredictable.

With home alcohol detox, the pain and discomfort of withdrawal symptoms is so great that many start drinking again just to make the symptoms disappear. This, sadly, perpetuates a vicious cycle.

Co-occurring mental health disorders will also inflame the issues you encounter during alcohol withdrawal, especially if you have been self-medicating your symptoms with substances.

By engaging with an addiction treatment service, you’ll remove yourself from an environment that triggers you to drink alcohol, and you’ll benefit from all the support and structure you need to build a firm foundation for sustained recovery. All that starts with medical detox, but it’s only the first step in a lifelong journey.

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Can You Die From Alcohol Withdrawal?

Alcohol withdrawal can be fatal and can lead to a number of dangerous and life-threatening symptoms if not done in a medically supervised environment.

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What Happens After Alcohol Detox?

After detoxing from alcohol, you’ll be ready to commit to an outpatient treatment program. If you need more support and time commitment than a regular outpatient program, consider an IOP (intensive outpatient program) or PHP (partial hospitalization program).

Following a course of medication-assisted treatment combined with psychotherapy, you’ll be ready to reintegrate with your life alcohol-free.

From this point, you should be equipped with the sober living skills you need to thrive. Many people find 12-step groups like AA beneficial on an ongoing basis. The best rehabs will also offer robust aftercare.

Alcohol Detox & Treating Alcohol Withdrawal at Renaissance Recovery

Here at Renaissance Recovery, we have a selection of outpatient programs to help you conquer your addiction to alcohol.

While not everyone requires a medical detox, for those with more severe alcohol use disorder, this is invaluable. Reach out to the friendly team at Renaissance’s California rehab and we can help you find the best alcohol detox center near you. All you need to do then is prepare for a few challenging days, and then you’ll be primed to engage with our outpatient programming for alcohol use disorder. Call us today at 714.907.1495 to learn more about treatment options and alcohol detox.

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