Alcohol Detox: Withdrawal Symptoms and Treatment Options

Alcohol withdrawal is experienced by approximately 50% of people with a diagnosable alcohol use disorder, and 20% of patients experience severe and potentially life-threatening symptoms such as hallucinations, seizures, and delirium.

Alcohol withdrawal can be very dangerous and even fatal, especially for those with severe alcohol use disorders. For this reason, medically supervised alcohol detox is highly advised for those going through alcohol withdrawal. It is critically necessary for some.

“Many try quitting cold turkey at home thinking withdrawal will be rough but tolerable. However, without proper medical support, detox can spiral out of control fast for heavy, longtime drinkers,” says psychiatric mental health nurse practitioner (PMHNP) Valerie Puffenberger.

If you or a loved one is considering quitting alcohol, read on to learn what to expect during detox as well as treatment options to help make the process as safe and successful as possible.

When Is Alcohol Detox Necessary?

Alcohol detox is necessary if you suffer from withdrawal when you go too long without a drink. You must go through detox before you can get treatment for alcohol addiction.

In other words, if you have an alcohol use disorder and are considering quitting drinking, the first step toward sobriety is detox.

Alcohol Detox vs. Withdrawal

Alcohol detox is the process of eliminating alcohol from your system. It begins at the time you take your last drink and continues until all the alcohol has been absorbed or eliminated from your body.

Alcohol withdrawal happens during detox, when your system recognizes that there is less alcohol in your body.

What Causes Alcohol Withdrawal?

When a person is dependent on alcohol and they stop or reduce the amount they drink, they will experience a collection of highly unpleasant, potentially deadly symptoms collectively known as alcohol withdrawal.

Alcohol dependence typically grows out of alcohol tolerance, which occurs when an individual consumes alcohol regularly enough that they need to drink increasing amounts of it to feel the same effects.

Eventually, their bodies (especially their central nervous systems) become so accustomed to the presence of alcohol that they are no longer able to function “normally” without it. This is what is known as alcohol dependence.

Alcohol dependence is closely linked with alcohol use disorder (AUD), or alcoholism, as people will often drink to avoid the unpleasant withdrawal symptoms that occur when detoxing from alcohol.

Alcohol Withdrawal Symptoms During Detox

Withdrawal symptoms typically begin within six to 12 hours after your last drink. Your cravings for alcohol will often feel very intense as your body detoxes.

Every individual is different, as is every case of alcohol withdrawal. That means the symptoms that appear during detox as well as their severity will vary from one individual to the next.

Common Symptoms Experienced During Alcohol Detox

Although each instance of alcohol detox is unique, there are some symptoms that are much more commonly experienced than others, like:

• Anxiety and restlessness
• Depression
• Irritability
• Confusion
• Agitation
• Emotional instability and mood swings
• Feelings of unease and nervousness
• Unpleasant or disturbing dreams
• Insomnia
• Nausea and vomiting
• Stomach cramps
• Diarrhea
• Excessive sweating, especially at night
• Shivering and chills
• Tremors, shaking, and trembling, especially in the hands
• Persistent headaches
• Increased sensitivity
• Loss of appetite
• Fatigue

Potentially Dangerous Symptoms Experienced During Alcohol Detox

Because of the dangerous nature of alcohol withdrawal symptoms, medically supervised detox is always advisable. If you or a loved one experience any of the symptoms listed below, especially seizures or delirium tremens, it is critical that you seek out medical attention immediately:

• Delirium tremens (DT)
• Confusion
• Rapid or irregular heartbeat
• Fever
• Visual and auditory hallucinations
• Extreme agitation or restlessness
• Dehydration
• Seizures

Deadly Delerium Tremens (DT)

Delirium tremens is a severe and potentially fatal form of alcohol withdrawal involving sudden and severe mental or nervous system changes. It is estimated that up to 37% of untreated DT cases result in death.

DT usually occurs two to three days after an individual stops heavy, prolonged alcohol use. Symptoms of delirium tremens include:

• Confusion
• Fever
• Hallucinations
• Shaking
• Insomnia
• Seizures

If you or your loved one is detoxing from alcohol and think DT may be occurring, seek medical attention immediately.

Alcohol Detox Timeline

Below is a general timeline that covers what most patients can expect during the alcohol detox process.

1 to 24 Hours after Last Drink – Onset of Withdrawal Symptoms

• First withdrawal symptoms typically appear between six and 12 hours after the last drink.
• Alcohol withdrawal seizures can occur this early in the detox process.
• Common symptoms include:
  • Anxiety
  • Restlessness
  • Insomnia
  • Nausea
  • Sweating
  • Tremors

24 to 72 Hours after Last Drink – Early Withdrawal

• Symptoms typically worsen in number and severity for one to three days after they first appear.
• It is at this stage that serious symptoms, including seizures and delirium tremens (DT) can appear.
• Common symptoms include:
  • Intensified early symptoms
  • Increased heart rate
  • High blood pressure
  • Irritability
  • Mood swings

3 to 5 Days after Last Drink – Peak Withdrawal

• Symptoms are generally most numerous and most severe between the third and fifth days of withdrawal.
• Potential symptoms include:
  • More intense early withdrawal symptoms
  • Delerium tremens (DT)
  • Severe anxiety
  • Hallucinations

1 to 2 Weeks after Last Drink – Subsiding Symptoms

• Symptoms typically begin to subside around a week after withdrawal begins, and most will have disappeared after about two weeks.
• Symptoms are generally decreasing, though psychological symptoms are more likely to persist than physical ones. Cravings and mood swings are some of the biggest concerns at this point.

2 Weeks to 2 Years after last Drink – Post-Acute Withdrawal

• Some individuals may experience lingering withdrawal symptoms for up to two years. These are known as post-acute withdrawal syndrome (PAWS), and generally lessen in severity and frequency over time.
• Emotional and psychological symptoms are most likely to be present, especially mood swings, anxiety, and difficulty concentrating.

Treatments During Alcohol Detox

As mentioned above, every case of alcohol detox is different and depends on a number of factors. So, every patient should have a personalized treatment plan to make sure they get the individualized care they need to achieve and maintain sobriety.

It is critically important that the treatment plan addresses any co-occurring mental health and substance use disorders. Not only do co-occurring disorders serve as underlying causes of addiction, but they also may cause symptoms during detox that could otherwise be falsely attributed to alcohol withdrawal and, therefore, treated improperly.

There are many available treatments that can help alleviate withdrawal symptoms during alcohol detox. The doctor overseeing your alcohol detox can help identify which medicinal and therapeutic treatments would be best for your symptoms.

During alcohol detox, your doctor may use:

• Medications, such as:
  • Benzodiazepines: Benzos, including diazepam, lorazepam, and chlordiazepoxide, are used to help symptoms such as anxiety, insomnia, seizures, and agitation.
  • Antipsychotics: Antipsychotics, including haloperidol and olanzapine, are used to manage severe agitation and hallucinations.
  • Anticonvulsants: Anticonvulsants, including carbamazepine and valproate, are used to prevent or manage seizures.
  • Vitamins and nutritional support: Vitamin supplements, especially thiamine (vitamin B1), are often provided either intravenously or orally to reduce the nutritional deficiencies often caused by alcohol withdrawal.
  • Fluids and electrolyte replacement: Intravenous fluids can be administered to prevent dehydration and electrolyte imbalances.
• Therapies, such as:
  • Monitoring and supportive care: Regular monitoring of vital signs and overall health during detox can address and potentially prevent any emerging complications.
  • Psychosocial support: Psychosocial support, including individual therapy, group therapy, and support groups, is essential for addressing the psychological aspects of alcohol withdrawal.
  • Long-term treatment plans: Developing a comprehensive long-term treatment plan that addresses all underlying causes and triggers for alcohol use is necessary to help patients maintain their sobriety after they get through detox.

Can You Detox from Alcohol at Home?

Alcohol use disorder is a chronic disease that requires professional treatment and management for full and lasting recovery. Attempting to quit on your own and go through alcohol detox at home will typically result in severe alcohol withdrawal symptoms, which can heighten your cravings for alcohol and increase your chances of relapse.

Detoxing from alcohol can be extremely uncomfortable, and some people experience life-threatening symptoms that require medical management. It is not something you want or need to go through alone.

Professional detox programs are designed to help you safely get through your symptoms of alcohol withdrawal. Completing your detox in a professional program decreases your risk of experiencing serious health problems related to withdrawal symptoms and lowers your odds of relapse.

Remember, even if you successfully manage to detox at home, you still need treatment to address the root causes of your alcohol addiction. This is the only way to successfully reach recovery and maintain your sobriety.

Maintaining Sobriety after Alcohol Detox

Alcohol detox is one of the first steps on the journey toward lasting recovery.

One of the first and most important things that every alcohol detox patient must do to maintain sobriety is to create a relapse prevention plan. This plan should identify:

• Situations, emotions, people, and environmental factors that trigger the urge to drink.
• Coping strategies for those triggers, such as mindfulness, deep breathing, distraction exercises, or hobbies.
• Supportive friends, family, and professionals whom you can contact in high-risk situations.

It is highly advisable that patients enter additional treatment programs after they complete detox. You might consider:

• Inpatient rehab, which allows patients to completely separate themselves from their lives and triggers, but it is more rigid and expensive.
• Outpatient rehab, which gives patients the flexibility to maintain personal and professional obligations while still obtaining treatment.
• Ongoing therapy and counseling, which help patients fight relapse and grow in their recovery.

Puffenberger also suggests the following strategies for getting through the early days of recovery and maintaining sobriety:

• Stay hydrated: Drink water, electrolyte-containing fluids, or broth regularly.
• Get nutrition: Getting nutrition from vitamin-rich, easily digested foods like fruits or bone broth can help you regain strength.
• Rest and take it slow: Fatigue, body aches, irritability, and mood swings signal a need to get extra rest. Take it slow and avoid heavy exertion.
• Support network: Surround yourself with a sober support network of friends, sponsors, counselors, or groups who understand what you’re going through and can provide accountability and encouragement.

It may seem like a lot of work, but it absolutely pays off. You will feel the positive effects of the effort you put into your sobriety 10 times over. Just take it one day at a time, and don’t expect perfection. Just focus on progress, and it will get easier with time.

Detox from Alcohol in Safety and Comfort

Alcohol withdrawal is not just unpleasant. It can also be deadly. However, medically supervised alcohol detox can dramatically reduce the discomfort that patients experience and increase the safety of the process. That’s why Legacy Healing Center offers medically supervised alcohol detox that is personalized for each patient.

We also provide a large number of post-detox recovery programs designed to help our patients resist relapse and maintain the sobriety that they worked so hard to achieve.

When it comes to treating alcohol use disorder, we focus on healing the mind, body, and spirit. Our holistic treatment approach includes clinical therapy, integration of life factors, proper medication management, and aftercare.

Call 888-534-2295 today to learn what alcohol detox options are available so you can get your life back.

Alcohol Detox FAQs

What are the symptoms of alcohol detox?

The symptoms that appear during alcohol detox are highly variable and are determined by a large number of individual or situational factors. However, some of the most common and/or dangerous symptoms of alcohol detox include:

• Anxiety, nervousness, and restlessness
• Insomnia
• Gastrointestinal distress, including nausea, vomiting, and stomach cramps
• Autonomic nervous system hyperactivity, including sweating, rapid heartbeat, and elevated blood pressure
• Tremors, especially in the hands
• Psychological symptoms, including irritability, mood swings, depression, and difficulty concentrating
• Visual or auditory hallucinations
• Seizures (potentially fatal)
• Delirium tremens (potentially fatal)

How long does it take to detox from alcohol?

The length of time it takes for an individual to detox from alcohol will vary depending on the severity and longevity of alcohol use, the mental and medical health of the patient, and the policies and procedures of the detox center. However, most individuals will start withdrawal within 24 hours of their last drink. Withdrawal symptoms are generally the most severe and dangerous from three to five days after the last drink. Most withdrawal symptoms end within two weeks, at which point most detox interventions cease, although some symptoms may persist for up to two years.

Are there medications used during alcohol detox?

Many medications are used during alcohol detox, both over-the-counter and prescription. The medications used during alcohol detox are primarily used to alleviate or eliminate withdrawal symptoms. Some of the medications are used to keep patients comfortable, while others are used to keep them safe — for example, from seizures or hallucinations. Examples of medications used during alcohol detox include:

• Benzodiazepines, including diazepam, lorazepam, and chlordiazepoxide
• Antipsychotics, including haloperidol and olanzapine
• Anticonvulsants, including carbamazepine, and valproate
• Vitamins and electrolyte replacements

How can I find addiction support?

There are many different ways that you can find addiction support. Some examples include support groups such as Alcoholics Anonymous (AA), therapists and counselors, nonprofit organizations, federal, state, and local governmental agencies and programs like Substance Abuse and Mental Health Administration (SAMHSA), religious organizations, and rehab centers.

If you’re looking for help now, call 888-534-2295 and speak with a treatment staff member at Legacy Healing Center.

Is alcohol detox timeline different for everyone?

Yes, every individual will experience a different alcohol detox timeline. This is because a large number of factors go into the length and severity of alcohol withdrawal, including:

• Level of alcohol dependence
• Duration of heavy drinking
• Quantity of alcohol consumed
• Individual health factors
• Co-occurring mental health conditions
• Genetic factors
• Age
• Support and treatment
• Nutritional status
• Hydration

However, in general, most individuals will experience the most severe symptoms for the first week of detox, which then largely disappear by the end of the second week. Most patients would exit a detox program at this time or slightly before. In some circumstances, psychological symptoms can persist for several months or even years.