Alcohol Detox Timeline and Withdrawal – Most American adults 18 and over have drunk alcohol at some point in time. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), nearly 87% of the adult population has consumed at least one unit of alcohol in their lifetime. Unlike most other psychoactive, addictive substances, alcohol is legal to consume over age 21 and is easily accessible.
Many people drink alcohol regularly and have few or no issues. Patterns of binge or heavy drinking, however, can signify a problem with alcohol, according to NIAAA.
Alcohol withdrawals do not strictly follow a specific, concrete routine but rather appear on a general timeline that varies between people according to the extent of their dependence on alcohol. The alcohol detox and withdrawal timeline consists of the following stages that occur after a person stops drinking:
Stage 1: 8 Hours Later
The early hours after a person suddenly stops drinking may be characterized by anxiety, nausea and vomiting, and stomach pain. Other symptoms may include the following:
- Insomnia
- Loss of appetite
- Fatigue
- Tremors
- Depression
- Foggy thinking
- Moodiness
- Heart palpitations.
Stage 2: 24-72 Hours Later
Elevated blood pressure, body temperature, respiration rate, and heart rate can be experienced during this time, and these symptoms often peak and rapidly manifest at this stage. Other symptoms may include confusion, sweating, irritability, and profound mood disturbances.
Stage 3: 3-4 Days Later
Fever, agitation, and, more rarely, delirium tremens (characterized by hallucinations, seizures, and severe confusion) may appear at this time.
Stage 4: 5-7 Days Later
At this point in the alcohol detox timeline, all symptoms usually start to taper off, decreasing in severity. Psychological symptoms, such as depression and anxiety, however, may persist longer.
More About Alcohol Withdrawal
The intensity of alcohol withdrawal symptoms can be quite variable, and are influenced by several factors, such as the following:
- Duration of alcohol use
- Average amount consumed during each session
- Medical history
- Presence of a co-existing mental health condition
- Family history of addiction and substance abuse
- History of childhood trauma
- Stress level
The use of other drugs in combination with alcohol can also impact withdrawal and increase the possible dangers and side effects. The more dependent on alcohol a person has become, the more likely the person is to suffer from more intense withdrawal symptoms.
The most serious (but fortunately, rarest) form of alcohol withdrawal is delirium tremens (DTs). This condition occurs in less than 5% of patients undergoing alcohol withdrawal, and it can be fatal without treatment. About 1 in 20 people who suffer from DTs will die, but this death rate is significantly reduced among those who receive medical care. DTs will probably not begin until a day or two after alcohol is totally eliminated from the bloodstream, and it can occur suddenly and without warning.
It is for this reason that withdrawal symptoms should be closely monitored by a health care professional to ensure the patient’s safety throughout the alcohol detox timeline. Moreover, quitting drinking abruptly or “cold turkey” is never recommended without medical supervision. Alcohol withdrawal results in life-threatening complications, as the brain and central nervous system experience a “rebound” after being frequently subdued by alcohol for an extended period.
Managing Symptoms During a Medical Detox
After physical symptoms have been constrained, mental health professionals can help the patient overcome some of the more intense emotional side effects of withdrawal. Sometimes, this emotional instability, if not controlled, can become even more troublesome than the physical withdrawal symptoms.
Medications can control anxiety and depression, especially when used in conjunction with therapy and counseling. Preventing relapse is an essential part of any alcohol detox program, and group support and individual therapy can offer continual resources for clients through detox and beyond.
Alcohol detox centers may administer one of the following medications, which are approved by the Food and Drug Administration (FDA), to reduce alcohol-related cravings: disulfiram, naltrexone, and acamprosate. These medications work to control withdrawal symptoms and deter patients from drinking again.
Naltrexone attaches to and blocks opioid receptors in the brain, thereby mitigating cravings and potential rewards incurred from alcohol use. Acamprosate is purported to treat long-term withdrawal symptoms, and Disulfiram can cause people to be violently ill if they drink, therefore making drinking quite undesirable.
A fourth medication, an anti-seizure drug known as topiramate, has also shown some promise for the treatment of alcohol use disorders by interfering with the way alcohol “rewards” drinkers. Topiramate is in a class of medications called anticonvulsants, and its primary function is to decrease abnormal excitement in the brain.
Alcohol detox should not be attempted without the supervision of health care professionals in a medical setting or detox center, as symptoms can appear and intensify rapidly. Even after the physical symptoms of alcohol withdrawal have been managed or have passed, protracted withdrawal, or the long-term experience of emotional symptoms and cravings, can persist and may result in a relapse without the appropriate level of support and treatment.
During the alcohol detox timeline, the first step is to monitor and control any existing physical symptoms and reach stabilization. Medications are often used to treat symptoms such as nausea, dehydration, seizures, and insomnia. Benzodiazepines, particularly Ativan, are sometimes used during alcohol detox to reduce over-activity in the central nervous system that may occur as the body attempts to restore its natural order.
Also, blood pressure, heart rate, respiration, and body temperature are all closely monitored, and steps can be taken to guarantee that they stay within safe levels.
Some people dependent on alcohol may also suffer from malnutrition due to poor eating habits and the impact that alcohol has on organs and the digestion of nutrients. Vitamin supplements and the implementation of a healthy diet and regular sleep routine may lessen withdrawal side effects and expedite the healing process throughout the alcohol detox timeline.
How Alcohol Affects the Brain
Alcohol consumption boosts the brain’s levels of the neurotransmitter dopamine, which is responsible for feelings of pleasure and reward. For this reason, alcohol can temporarily elevate mood, increase self-confidence, and reduce inhibitions. As alcohol leaves the bloodstream, however, these feelings rapidly dissipate.
Repeated alteration of dopamine levels can cause the brain to grow accustomed to the presence of alcohol and, as a result, discontinue dopamine production at normal levels without exposure to the substance.
The more alcohol a person drinks, the more a person’s tolerance increases and the more dependent the brain may become on its intrusion. Tolerance is, essentially, a byproduct of the brain’s propensity toward “repeated exposure = diminished response” concerning psychoactive substances.
When the alcohol wears off, a dependent person will experience highly unpleasant and possibly dangerous withdrawal symptoms, ranging from mild to deadly.
Treatment for Alcohol Addiction After Detox
Following detox, those who suffer from an alcohol use disorder are highly encouraged to participate in an inpatient or intensive outpatient program that employs an integrated approach that includes evidence-based treatment modalities such as behavioral therapy, psychoeducation, individual and family counseling, and group support.
Our center is staffed with caring and knowledgeable medical and mental health care professionals who specialize in addiction. We provide clients with the resources they need to achieve abstinence, avoid relapse, and experience long-term happiness and sobriety.
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