Alcohol Withdrawal Timeline

Having an occasional glass of wine or beer at a social gathering or while having dinner is rarely a cause for concern. But the problem begins when a person starts to indulge in heavy drinking or binge drinking habits frequently. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), heavy drinking is defined as having more than four drinks a day for men and more than three drinks a day for women. Binge drinking is defined as having five or more drinks for men and four or more drinks for women within two hours or at one sitting. 

Individuals who frequently binge drink or consume excessive amounts of alcohol are at a high risk of developing an alcohol use disorder (AUD). This is because excessive drinking alters brain chemicals and causes the brain to depend on this addictive substance to function normally. Alcohol use disorder is a medical condition that is characterized by the inability to control or stop drinking despite occupational, social, and health consequences. Individuals with an AUD find it difficult to quit drinking, particularly due to the withdrawal phase that usually appears during cessation. Withdrawal is one of the main causes cited in most relapses. 

What Is Alcohol Withdrawal Syndrome?

Alcohol withdrawal syndrome (AWS) is a condition that occurs when you reduce or quit drinking abruptly after a prolonged period of use. Since alcohol is a central nervous system depressant that works by increasing the effects of GABA and reducing the levels of glutamate, the excessive consumption of it may force the body to alter the natural production of these chemicals over time. And subsequently, cause the body to rely upon the chemical effects of alcohol instead. When your body forms such a dependence on alcohol, ceasing or reducing its consumption suddenly might deprive the body of the effects needed for proper functioning and send it into a state of shock. This will then trigger symptoms of withdrawal that can range from mild to severe. 

Symptoms of withdrawal can occur in anyone who has been consuming excessive amounts of alcohol, whether it be for weeks, months, or years. It’s more common in adults, but even children and teenagers who participate in binge drinking can develop alcohol withdrawal symptoms. AWS is generally the earliest sign of an alcohol use disorder.

What Is Acute Withdrawal and Post-Acute Withdrawal?

During a medically supervised detox program, most people experience a short phase of physical and psychological discomfort known as acute withdrawals. This stage of AWS generally lasts for a few days to a week during a detox program. 

The second phase of withdrawal symptoms, known as post-acute withdrawal syndrome (PAWS), occurs once acute withdrawals subside. The symptoms of PAWS can vary and are dependent upon many factors, such as the severity of alcohol dependence, weight and gender of the patient, and overall health. PAWS is unique compared to acute withdrawals because of how extensive it is. Unlike acute withdrawals, PAWS can last from six months to two years or longer after achieving sobriety.

Symptoms of AWS

Alcohol withdrawal symptoms can be both physical and psychological. Withdrawals can begin in as little as six hours after your last drink. Some of the common symptoms of acute alcohol withdrawal are: 

• Tremors
• Anxiety 
• Nausea
• Vomiting 
• Headache
• Rapid heart rate 
• Sweating 
• Irritability 
• Confusion 
• Insomnia 
• Nightmares
• High blood pressure

The symptoms of alcohol withdrawals appear within six to 12 hours of the last drink and peak within 24-72 hours.

AWS is highly unpredictable. People can experience mild symptoms at one moment and rapidly progress towards severe symptoms at any given moment. Due to this unpredictability, patients are highly advised against detoxing on their own. If you or someone you love wishes to overcome AWS, seek immediate medical attention from a qualified physician or addiction specialist.

People may also experience a more severe alcohol withdrawal symptom known as delirium tremens (DT) during alcohol detox. Delirium tremens is a potentially fatal medical emergency that most commonly appears within two to three days of the last drink. According to the National Center for Biotechnology Information (NCBI), only a small population of around three to five percent exhibit symptoms of alcohol delirium, but the mortality rate of it is estimated to be as high as 37 percent. Hence it’s vital that you seek immediate medical attention if you experience delirium tremens during detox.

Some of the symptoms of delirium tremens include: 

• Extreme confusion 
• Extreme agitation 
• High fever
• Seizure
• Increased sensitivity to light, sound, and touch 
• Tactile, visual, or auditory hallucinations 

Factors that Influence Alcohol Withdrawal Timeline 

The severity and duration of alcohol withdrawals can vary from one person to another. Factors that influence this may include:

• The duration of alcohol abuse 
• The frequency of use 
• The quantity of alcohol regularly consumed
• Physiological makeup (such as age, gender, and weight)
• Polydrug use
• The presence of any underlying mental health conditions
• Family history of addiction 

6-12 Hours After The Last Drink 

This is the first and earliest stage of acute withdrawals. The symptoms that surface during this timeframe are usually mild and involve minor physical discomfort and changes in mood and behavior. Such symptoms are often overlooked as they resemble a hangover. Some of the earliest symptoms of withdrawal are: 

• Anxiety
• Depression 
• Insomnia
• Nausea
• Headaches
• Vomiting 
• Loss of appetite
• Fatigue
• Tremors 
• Foggy thinking 
• Mood swings 

12-48 Hours After The Last Drink 

This is when the more moderate symptoms of withdrawal take place. Patients must be closely monitored during this stage to avoid any severe complications.

Some of the symptoms that occur during their period are: 

• High blood pressure
• Irregular respiration 
• Fever
• Irregular heart rate  
• Confusion 
• Sweating 
• Irritability 

48-72 Hours After The Last Drink 

The more severe symptoms of withdrawal usually begin around this stage, including delirium tremens. Some of the symptoms that surface during this period are: 

• Hallucinations 
• Fever
• Seizure
• Confusion
• Agitation

Symptoms of withdrawal usually end by the second week. However, certain individuals can experience protracted withdrawal that can last for months or years. This phase is quite uncommon and is known as post-acute withdrawal syndrome (PAWS) and involves symptoms such as:

• Irritability
• Emotional outbursts
• Anxiety 
• Low energy 
• Sleeping troubles 
• Memory problems 
• Dizziness 
• Delayed reflexes
• Intense cravings for alcohol 
• Chronic nausea

How to Overcome Withdrawals?

AWS is a serious condition that can rapidly progress into a life-threatening situation. So, it’s extremely important that you detox from alcohol at a medical facility to avoid the possibility of fatal complications. There are many rehab facilities that offer medically-assisted detox programs to help people safely overcome alcohol withdrawals. Such programs provide constant medical supervision and medications to reduce the severity of certain symptoms of withdrawal. Some of the medications utilized to treat withdrawals are benzodiazepines (such as Librium, Valium, and Tranxene), anticonvulsant medications, and barbiturates. 

However, detox is simply the first step in addiction treatment that helps address and overcome the physical aspect of alcohol dependence. In order to maintain long-term sobriety, it’s vital to identify and address the psychological aspects of addiction as well. This is carried out through a series of counseling and therapy sessions offered by an inpatient or outpatient rehabilitation facility.

Overcoming AUD is a complicated process. Your journey to recovery may entail many obstacles in the form of withdrawals. However, the reward that awaits you far outweighs the struggles you will face during your recovery process. It’s also important to know that you’re not alone. There are many facilities all across the U.S that are dedicated to helping you achieve a prolonged recovery. 

Futures Recovery Healthcare provides a comprehensive treatment program that focuses on the individual needs and requirements of each patient. Our compassionate and dedicated staff are highly invested in helping you achieve a life of sobriety. So start your journey with us today.