Alcohol Withdrawal: Signs, Symptoms, & Timeline

While drinking alcohol is legal and socially acceptable, alcohol abuse can lead to dependence, addiction, and alcohol withdrawal symptoms.

Because of the intensity of alcohol withdrawal symptoms, many people delay getting the help they need at addiction treatment centers. However, managing this challenging withdrawal phase effectively is vital to begin a sustained and successful recovery from substance abuse.

In this blog, we’ll break down what you can expect if you engage with treatment for alcohol use disorder and how to find a safe and effective program for alcohol withdrawal.

If you or a loved one need help getting a safe detox for alcohol dependence, call our California rehab today at 866-330-9449.

Alcohol Withdrawal

Alcohol withdrawal syndrome (AWS) is a term used to describe the withdrawal symptoms moderate to heavy drinkers experience if they stop drinking abruptly, or cut back on their consumption. Data shows that roughly half of those diagnosed with alcohol use disorder will experience withdrawal symptoms at some stage during detox [4].

Withdrawing from alcohol is an intense process that should never be done at home. Because of the severity and danger of alcohol withdrawal syndrome, it’s critical that someone coming off of alcohol be treated under the supervision of medical professionals.

When you drink excessive amounts of alcohol long-term, it changes your central nervous system. Alcohol has a strong sedative effect. When you drink large amounts of alcohol, or if you drink to excess long-term, you’ll be almost continuously exposing yourself to a powerful depressant effect. Your brain responds to this imbalance by producing chemicals to negate the sluggish feeling alcohol can induce.

If you are actively addicted to alcohol, your brain will have higher levels of both norepinephrine and serotonin. If you suddenly remove alcohol from the equation, your brain will feel overstimulated. As this happens, your CNS struggles to cope with the absence of alcohol. It is at this point that AWS often manifests.

If you are alcohol dependent or if you have an alcohol use disorder, you should speak with your healthcare provider if you are thinking of committing to sobriety. You should not stop abruptly and without medical guidance, as severe withdrawal symptoms can be fatal if not treated.

How Is Alcohol Withdrawal Syndrome Diagnosed?

To diagnose alcohol withdrawal syndrome, your doctor will use questions from the CIWA-Ar, which assesses the following 10 symptoms [2]:

• • Headaches

• • Anxiety

• • Visual disturbances

• • Tactile disturbances

• • Auditory disturbances

• • Inability to think clearly

• • Agitation

• • Nausea and vomiting

• • Sweating

• • Tremors

Your doctor will also ask you some questions to determine whether you’re thinking lucidly.

Even if you find the idea of opening up to your healthcare provider distasteful, you need to be completely transparent if you want to commit to recovery. Also, if you have been drinking to the extent that it induces symptoms of alcohol withdrawal when you stop, you may have caused more damage inside your body.

Your doctor may also give you some basic nutritional advice if you’ve been eating poorly as a result of alcohol abuse.

Alcohol Withdrawal Symptoms

Alcohol Withdrawal Syndrome (AWS) occurs when someone who has been drinking heavily stops or significantly reduces alcohol consumption. While the symptoms of alcohol withdrawal can be intense, it is critical to go through alcohol detox in order to break free from alcohol addiction or dependence. Even mild symptoms of alcohol withdrawal can be dangerous, especially when alcohol dependence is an issue [1].

For those engaging in moderate to severe alcohol use, a medically supervised withdrawal is necessary for safety, as alcohol withdrawal can be dangerous. Alcohol withdrawal is treated in a specialized alcohol detox facility or hospital setting, supervised 24/7 by licensed medical staff.

Withdrawal symptoms range from mild to severe, depending on factors like duration of alcohol use, overall health, and co-occurring conditions.

Withdrawal symptoms from alcohol can be categorized as follows [3]:

• • Mild alcohol withdrawal

• • Moderate alcohol withdrawal

• • Severe alcohol withdrawal

Mild Alcohol Withdrawal Symptoms

Physical Symptoms:

• • Headaches, tremors, and gastrointestinal discomfort (nausea, vomiting, abdominal pain).

• • Disrupted sleep patterns and appetite loss.

Psychological Symptoms:

• • Feelings of depression early in withdrawal, which typically improve over time.

Moderate Alcohol Withdrawal Symptoms

In addition to mild symptoms, moderate alcohol withdrawal may include:

Physical Symptoms:

• • Increased heart rate, sweating, shallow breathing, and raised body temperature (hyperthermia).

• • Elevated blood pressure, particularly an increase in systolic pressure.

Psychological Symptoms:

• • Mood swings, irritability, and confusion.

Severe Alcohol Withdrawal Symptoms

Severe withdrawal symptoms can be dangerous and require medical supervision.

Physical Symptoms:

• • Fever and dangerously high blood pressure.

• • Increased risk of seizures.

Psychological Symptoms:

• • Disorientation, hallucinations, and delirium tremens (DTs), a life-threatening withdrawal complication.

Alcohol Withdrawal Symptoms Timeline

There are several alcohol withdrawal stages you can expect when going through a detox from alcohol use. Here’s what to expect over the first week without alcohol in your system [3]:

• • 24 hours after the last drink: Alcohol withdrawal symptoms can occur at any stage during the first 9 hours of abstinence

• • 72 hours after the last drink: Symptoms typically peak in intensity after the first 3 days. Some of the more severe alcohol withdrawal symptoms manifest at this point, including delirium tremens.

• • 5 to 7 days after the last drink: Alcohol withdrawal symptoms should start diminishing toward the end of the first week of alcohol-free

• • First week after the last drink: Most of the physical withdrawal symptoms should be gone by now. If they are not properly managed, the psychological effects can linger

Here is a glimpse at when the following common symptoms occur:

• • Tremors, breathing issues, and nausea: Begin within a few hours of the last drink, shaking and tremors (called delirium tremens) might occur. These typically subside within 72 hours. You can expect your blood pressure and pulse to climb. Rapid breathing, profuse perspiration, vomiting, and nausea are standard during the first 3 days. Psychological effects also manifest in the form of nightmares or hyper-vivid dreams, as well as anxiety and increased alertness.

• • Hallucination: Hallucinations might manifest during the first 72 hours. If you experience these, you should ensure you are supervised

• • Seizures: The risk of seizure peaks 24 hours after the last drink. This is the core danger associated with alcohol withdrawal improperly managed

• • Delirium tremens: DTs usually appear after 48 to 72 hours of abstinence. Close medical supervision is paramount. Estimates show between 3% and 5% of all cases end in delirium tremens

It’s important to understand that alcohol withdrawal should never be done at home. Symptoms can be extremely dangerous, with more severe withdrawal symptoms being fatal without immediate medical intervention. Detoxing from alcohol dependence should only be done in a detox facility or hospital to ensure safety.

How Long Do Alcohol Withdrawal Symptoms Last?

Most alcohol withdrawal symptoms begin between 5 and 24 hours after you stop or reduce alcohol intake. While mild withdrawal symptoms usually fade within the first week of abstinence, severe alcohol withdrawal can extend up to a week or more. Severe symptoms typically require medical treatment, often in a residential setting. If you’re unsure whether or not your alcohol use is going to result in mild or severe alcohol dependence,

Alcohol Withdrawal Treatment

Alcohol withdrawal treatment creates a safer, more comfortable experience for those detoxing from alcohol. Medical professionals will use the CIWA protocol to assess withdrawal severity and create a customized treatment plan for each patient. Treatment helps reduce withdrawal symptoms, prevents withdrawal seizures and other complicated withdrawal symptoms, and provides long-term treatment for alcohol use disorder.

Treatment for alcohol withdrawal includes:

1. 1. 24/7 Medical Supervision: For those with moderate to severe symptoms, it’s critical that they receive round-the-clock medical care in order to prevent or treat severe or complicated withdrawal symptoms like alcohol withdrawal seizures that may occur.

1. 1. Medication for Alcohol Withdrawal: Medications are administered to help reduce withdrawal symptoms and cravings. Medications include Gabapentin and benzodiazepines to prevent seizures and neurological symptoms, beta-blockers, and Clonidine to help control blood pressure and heart rate. Naltrexone, Acamprosate, and Disulfiram to help reduce cravings and prevent relapse by blocking pleasure receptors in the brain associated with drinking. MAT (medication-assisted treatment) is delivered in an intensive outpatient or partial hospitalization setting in combination with psychotherapy.

1. 1. Supportive Care & Nutrition: Individuals going through detox are often under a lot of physical stress, both from the detox symptoms and potentially as a result of an alcohol use disorder. In order to help support overall health and promote a swift recovery, doctors may administer vitamins, proper hydration and nutritious meals, as well as emotional support through therapy, counseling, or peer support.

1. 1. Individual and Group Therapy: Psychotherapy like CBT and DBT will help you identify the people, places, and things that lead you to abuse alcohol. Talk therapy in groups and individually will also help you create and implement healthy coping strategies to thrive in your recovery rather than relapse.

1. 1. Transition to Long-Term Substance Abuse Treatment: After detox, the most effective way to prevent relapse is to transition to a follow-up addiction treatment program. These programs provide therapy and treatments that are effective in addressing underlying addiction issues such as mental disorders.

1. 1. Aftercare: Many alcohol addiction treatment programs offer aftercare programs to help patients maintain their sobriety. They offer sober communities to stay accountable with, career placement programs, and more. Exercise and playing sports have also been shown to be very effective in preventing alcohol relapse.

Is It Possible to Avoid Alcohol Withdrawal?

The only reliable way to prevent alcohol withdrawal is to discontinue substance abuse. However, if you’re dependent on alcohol and want to avoid more severe withdrawal symptoms, you can talk to your doctor about tapering off alcohol slowly. While most individuals with moderate to severe alcohol dependence will struggle to do this on their own, some people with mild dependence can do this effectively. That being said, it is never safe to detox from alcohol outside of a medically supervised environment, and you should never stop drinking abruptly.

While only 5% of those withdrawing from alcohol experience delirium tremens, as many as 15% of that percentage die as a result. For this reason, along with the possibility of seizures, medically-supervised detox is critical if you are severely dependent on alcohol and liable to get the DTs.

How about if you’re ready to stop drinking and undergo alcohol withdrawal, then?

Overcoming Alcohol Withdrawal at Renaissance Recovery

It’s important to understand that detox and alcohol withdrawal alone are not a cure for alcohol use disorder (AUD). Recovery is an ongoing process, not a one-time event.

At Renaissance Recovery’s Orange County rehab, we provide detox program referrals and long-term outpatient addiction treatment to ensure your alcohol recovery is as safe and comfortable as possible. Because no two individuals have the same recovery journey, our treatment programs are fully personalized to meet your specific needs and financial situation.

Severe alcohol withdrawal, including delirium tremens (DTs), can be life-threatening. Do not attempt to recover from alcohol abuse alone.

Call Renaissance Recovery’s addiction hotline at 866-330-9449 today to take the first step toward a healthier, alcohol-free future.

Sources

[1] https://medlineplus.gov/ency/article/000764.htm

[2] https://www.ncbi.nlm.nih.gov/books/NBK441882/

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC6084325/

[4] https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-use-disorder-risk-diagnosis-recovery#:~:text=Up%20to%20half%20of%20AUD,to%20manage%20potentially%20dangerous%20symptoms.