Alcohol withdrawal timeline

According to the CDC, excessive alcohol use causes more than 95,000 deaths in the United States each year, and it is one of the leading causes of preventable death. Even more surprising is that doctors say ethanol, the substance in alcohol that causes its sedative effect, is the most dangerous substance for the body to withdraw from, especially when done without medical supervision.

Why Ethanol Detox is So Dangerous

The dangers of withdrawal occur because of the body’s response to extreme changes in chemical processes in the brain. Frequent heavy drinking causes permanent changes in the brain, and the risks become more significant over time. 

Part of the danger occurs because of the kindling phenomenon, where repeatedly detoxifying from ethanol causes increasingly severe withdrawal symptoms. With each detoxification, symptoms get worse, despite the amount of ethanol consumed.

Heavy drinkers should detox with medical guidance. Skilled professionals can help a person withdraw from ethanol gradually. Otherwise, severe complications may result, including a possibility of death.

What is Alcohol Withdrawal Syndrome (AWS)?

Alcohol Withdrawal Syndrome is a group of symptoms that habitual drinkers may suffer when drastically reducing their consumption or stopping drinking altogether. Alcohol Withdrawal Syndrome is caused by interrupting the constant exposure of the central nervous system to ethanol.

In habitual drinkers, the central nervous system has adjusted to the ongoing presence of ethanol in the body. It counteracts the depressive effects of ethanol on brain function and communication between nerve cells. But when the ethanol level is suddenly lowered, the brain remains overstimulated, causing Alcohol Withdrawal Syndrome.

Common Alcohol Withdrawal Symptoms

  • headaches
  • irritability
  • vomiting
  • nausea
  • severe dehydration
  • anxiety
  • tremors
  • insomnia
  • fatigue
  • mood changes
  • gastrointestinal disturbances
  • heart palpitations
  • increased blood pressure or heart rate
  • hyperthermia
  • rapid abnormal breathing
  • hallucinations
  • seizures
  • delirium tremens

Alcohol withdrawal timeline

Alcohol Use Disorder (AUD)

About 16 million people in the United States have an Alcohol Use Disorder defined as a physiological dependence on alcohol. Therefore, they are more likely to suffer from Alcohol Withdrawal Syndrome.

Misuse of alcohol can increase the risk of developing an Alcohol Use Disorder. For example, consuming more than one drink per day for women or two drinks per day for men is generally considered misuse. In addition, if a man has five drinks or more in a short time — four drinks or more for a woman — it is considered binge drinking, another form of misuse.

The warning signs indicating an Alcohol Use Disorder include:

  • Inability to control or limit drinking
  • Adverse consequences related to drinking
  • More significant amounts required to achieve the desired effect
  • Experience of withdrawal symptoms
  • Negative emotional state when not drinking 
  • Cravings

Risk Factors for Severe Alcohol Withdraw Symptoms

It’s difficult to predict who will develop severe Alcohol Withdrawal Syndrome, but some factors make it more likely. Surprisingly, the number of times a person has gone through detoxification is far more critical than his daily number of drinks. So, clinicians have identified some patient characteristics that indicate potential risk of more severe or prolonged symptoms and specific complications, such as delirium tremens or seizures.

These characteristics include the following:

  • Prior detoxification 
  • More severe dependence on ethanol
  • Development of AWS symptoms in the past
  • Higher levels of ethanol intake
  • Longer duration of abuse
  • Abnormal liver function
  • Experience of seizures or delirium tremens
  • Intense craving
  • Co-existing acute illness
  • Older age
  • Use of other drugs 
  • More severe symptoms when presenting for treatment. 

How Long Will Detoxification Last?

The amount of time it takes to detox varies from person to person. Several factors can play a role in the number of days detoxification will continue, including:

  • Amount of ethanol consumed.
  • How long the person has been drinking
  • How often the person has been drinking regularly
  • Nutritional considerations
  • Weight and age
  • Whether the ethanol combined with other substances
  • Co-occurring mental health conditions 
  • Additional physical health problems

Alcohol Withdrawal Timeline

Despite these considerations, experts generally agree that the symptoms usually fall into three separate stages and follow this general timeline:

Three Stages of Withdrawal

  • Stage 1 (mild): In the first 6 to 12 hours after the last drink, symptoms may include headache, anxiety, gastrointestinal disturbance, insomnia, poor appetite, hand tremors, heart palpitations, vomiting, and nausea.
  • Stage 2 (moderate): In the next 12 to 48 hours, symptoms expand to include increased blood pressure and heart rate, confusion, rapid abnormal breathing, hyperthermia, and hallucinations. After about 24 hours, seizures become a primary concern.
  • Stage 3 (severe): In the next 48 to 72 hours, symptoms expand to include fever, sweating, confusion, rapid heart rate, high blood pressure, disorientation, seizures, delirium tremens with auditory and visual hallucinations, and possible death.
  • Although the patient’s condition usually begins to improve after 48 hours, symptoms sometimes increase in severity.

The most severe outcome of Alcohol Withdrawal Syndrome is delirium tremens.

Symptoms of delirium tremens are:

  • Psychosis
  • Delirious behavior
  • Seizures
  • Hallucinations
  • High body temperature
  • Dangerously elevated blood pressure
  • Coma

A person suffering from delirium tremens also commonly exhibits sweating, tremor, and nausea. He may have a sudden change in mental functioning, appearing agitated or anxious, and he may lose consciousness. Other common complications of delirium tremens include heart attack and aspiration pneumonia.

This condition is life-threatening, and it is critical that people who show symptoms of seizures or delirium tremens get medical treatment immediately.

Protracted Withdrawal

After the immediate stages, there is a more long-term form of withdrawal that may persist for months. Symptoms include memory problems, sleep disturbances, depression, irritability, and difficulty coping with stress.

Individuals should receive ongoing treatment or group support during this time to cope with symptoms and avoid relapse.

Treatment

The goal of treatment is to ease the symptoms of detoxification, prevent the progression of more severe symptoms and emotionally support the patient during this time.

After initial observations to determine the severity of the symptoms, Typical medical treatment may include:

  • Benzodiazepines to reduce the anxiety triggered by the symptoms and to help stop specific symptoms from progressing
  • Anti-seizure drugs
  • Beta-blockers slow the heart rate and calm tremors
  • Antipsychotic medicines
  • Fluids and thiamine — vitamin B1 — to remedy dehydration and malnutrition

Treatment After Detox

After going through the discomfort of detox, many people decide it’s time to quit drinking. Fortunately, several helpful medications can help people give it up.

  • Acamprosate: Works in the brain to decrease cravings.
  • Disulfiram: Causes immediate unpleasant symptoms if you drink.
  • Naltrexone blocks the effects and feelings of ethanol and reduces cravings.

Importance of Professional Help

Ethanol detox is physically and emotionally draining. In addition, it can be dangerous and even life-threatening. Progression from moderate to severe symptoms can happen very quickly without treatment from healthcare experts.

In a skilled rehabilitation center, competent and compassionate professionals can oversee the detoxification process and manage symptoms.

But detoxification is just the first stage of treatment. It helps the brain and body recover from the harmful effects of ethanol, but it doesn’t address unhealthy thought patterns and behavior that contribute to substance abuse. Fortunately, many treatment options exist, providing ongoing support for long-term recovery, including inpatient and outpatient facilities, support groups, and online help.

Take the First Step and Call Today

Millions of people struggle with alcohol addiction and detox. But you don’t have to do it alone. Our caring and competent healthcare professionals at Garden State Treatment Center understand what you are going through and are here to help. We can provide you with an individualized care plan suited to your unique needs.