How Long Does Alcohol Withdrawal Last?

Alcohol withdrawal describes the physical and psychological effects of abruptly quitting alcohol after heavy and continuous use. This condition is also called Alcohol Withdrawal Syndrome (AWS). If you have been drinking heavily for an extended period, going through withdrawal without medical care can be incredibly dangerous, if not fatal. 

According to the U.S. National Library of Medicine, over 50% of individuals with a history of alcohol abuse can experience withdrawal symptoms when they decrease or quit alcohol consumption abruptly.

While many individuals stop experiencing withdrawal symptoms four to five days after their last drink, some may experience withdrawal symptoms for several weeks, depending on the severity of their alcohol dependence.

What Causes Alcohol Withdrawal?

AWS is one of the most obvious indicators of physical dependence on alcohol or alcohol use disorder. The effects of alcohol on the body are far-reaching. Alcohol has a depressive effect on the central nervous system (CNS). It slows down brain activity and alters how nerves send and receive messages.

Excessive alcohol intake on a regular basis alters the chemical makeup of your brain and causes you to develop dependence and tolerance. The CNS of these individuals has adapted to the constant presence of alcohol in the body. It compensates for the depressive effects of alcohol on both brain function and nerve cell communication. As a result, when the alcohol level is abruptly lowered, your body scrambles to adjust to the chemical imbalance, and your brain remains hyperactive, resulting in alcohol withdrawal symptoms.

AWS is most prevalent among alcoholic patients and heavy drinkers who cannot reduce their use gradually. AWS is more prevalent in adults. However, adolescents and young people who consume excessive alcohol may also exhibit symptoms. You are also at risk for AWS if you have previously experienced withdrawal symptoms or required medical detox for an alcohol use disorder.

Symptoms of Alcohol Withdrawal Syndrome

Alcohol withdrawal typically involves various physical, psychological, and emotional symptoms that vary in severity. The intensity of symptoms is proportional to the extent of alcohol dependence. Those with significant and prolonged dependence often have the most severe symptoms.

The most common symptoms include the following:

• Depression
• Anxiety and jitters
• Fatigue
• Irritability
• Insomnia
• Nightmares
• Rapid mood swings
• Difficulty concentrating
• Alcohol cravings 
• Loss of appetite
• Confusion
• Rapid heart rate
• Tremors (alcohol shakes)
• Sweating
• Clammy skin
• Headaches
• Impaired judgment and memory
• Light and sound sensitivity

The following are some of the most severe withdrawal symptoms:

• High fever
• Severe tremors
• Nausea or vomiting
• Increased heart rate
• Increased blood pressure
• Increased agitation
• Disorientation
• Delusions
• Seizures

Alcohol withdrawal seizures are the most serious of these severe manifestations. These seizures can be fatal if not treated properly in a detox program.

According to the U.S. National Library of Medicine, approximately 2% of patients with alcohol use disorder experience Delirium Tremens (DTs) during alcohol withdrawal.

Symptoms of alcohol withdrawal delirium include the following:

• High blood pressure
• Paranoia
• Hallucinations
• Seizures or convulsions

Severe withdrawal symptoms warrant immediate medical attention, as studies indicate a 1-4% mortality rate with delirium tremens episodes. Therefore, people with risk factors for developing DTs should be extremely cautious while undergoing AWS without medical care.

Medical conditions, including cardiac arrhythmia, respiratory arrest, oversedation, and aspiration pneumonitis, have been linked to delirium tremens. All of these conditions carry a high risk of serious infections or death.

Factors That Influence Alcohol Withdrawal Timeline

While the onset of withdrawal symptoms varies from one person to another, you may notice them within a few hours of your last drink. Individuals may experience alcohol withdrawal differently based on a variety of factors, including their:

• Gender, weight, and age
• Length and amount of alcohol intake
• Frequency of use
• Severity of dependence
• Mental and physical health
• Family history of alcoholism
• Polysubstance abuse
• Previous alcohol withdrawal experience

Alcohol Withdrawal Timeline

The severity of alcohol withdrawal can be categorized into three stages: mild, moderate, and severe. 

Symptoms and stages of alcohol withdrawal include the following:

• Mild Stage (six to 12 hours) – Physical changes and an increase in agitation characterize this withdrawal stage. People tend to disregard how their bodies react because the mild symptoms resemble a hangover. These minor withdrawal symptoms usually begin six to 12 hours after the last drink. Mild-stage symptoms may include shaking, anxiety, nausea, headache, sweating, and body tremors.
• Moderate Stage (12 to 48 hours) – During the next 12 to 24 hours, minor withdrawal symptoms, including anxiety and alcohol cravings, can intensify. Moderate symptoms may include breathing difficulties, hypertension, irregular heartbeat, profuse sweating, irritability, fever, and confusion. Alcohol withdrawal symptoms are at their worst over the first 48 hours.

• Severe Stage (48 to 72 hours) – In the severe stage of alcohol withdrawal, the decline in health is evident. After 48 to 72 hours, a patient at this stage will require medical supervision. Symptoms of delirium tremens typically manifest 48 to 72 hours following cessation of excessive alcohol use. DTs normally last three to four days but can last up to eight days in some patients.

Symptoms of alcohol withdrawal typically resolve within five days, though some people may experience prolonged symptoms. 

How Long Does Alcohol Withdrawal Last?

Withdrawal symptoms typically appear six hours after the last drink and peak between 24 and 72 hours. Most people’s withdrawal symptoms will start to subside after 72 hours. Many people stop experiencing symptoms four to five days after their last drink. However, some people can suffer from long-term withdrawal symptoms that can last months or years. This is a rare phase known as post-acute withdrawal syndrome (PAWS).

PAWS is one of the primary causes of relapse after alcohol addiction treatment has been completed. Many patients suffer PAWS symptoms in cycles or waves; one day, they feel good, and the next, they are plagued by fatigue and excessive alcohol cravings. The spontaneity of this withdrawal period can make it difficult to resist temptation. However, it is essential to note that each PAWS episode often lasts only a few days. If you can make it through this period, the symptoms will go as swiftly as they appeared.

Is It Necessary to Seek Treatment for Alcohol Withdrawal?

Those battling an alcohol use disorder have additional health risks and an increased likelihood of relapsing when exposed to AWS. If you don’t get help, withdrawal and relapse will keep happening over and over again. Therefore, to safely manage the physical and emotional repercussions of long-term alcohol misuse, inpatient care or outpatient treatment is often necessary for people with addictions. 

Once a diagnosis of AWS has been made, you will be recommended treatment options to effectively manage your withdrawals, as untreated symptoms can greatly increase the risk of relapse. Medical professionals advise against abrupt cessation for the safe management of alcohol withdrawal. Detoxing from alcohol should always begin with a medical evaluation of your health status. Don’t risk your health by trying to manage detox on your own.

Treatment of Alcohol Withdrawal

Treatment for alcohol withdrawal can occur in inpatient or outpatient settings. In most cases, medically assisted detox and evidence-based treatment programs will ensure a full and prolonged recovery. Alcohol detox is usually accompanied by clinical management of alcohol withdrawal and behavioral therapy in a recovery setting. During the clinical management of AWS, patients may be prescribed medications to help alleviate the severity of withdrawal.

Since there is no “one-size-fits-all” strategy for the treatment of alcohol dependence, recovery programs typically include the following:

Inpatient Treatment – For people battling with alcohol addiction, inpatient care offers a safe, supervised setting. This is the most intensive form of treatment, with 24-hour care with 30, 60, or 90-day programs.

Outpatient Treatment – Outpatient rehabilitation enables patients to maintain their everyday responsibilities while continuing to receive treatment. As individuals will be exposed to drinking triggers and other influences on the outside, this approach is best suited for those with less severe types of alcohol dependence.

It’s important to note that detox is not a treatment for alcohol addiction; it’s an essential component of a comprehensive rehabilitation program that should be followed by psychotherapeutic treatment and supportive care to ensure long-term recovery.

Nearly two million Americans experience alcohol withdrawal syndrome annually. So, it’s important to choose the right program for you when it comes to your recovery journey. You should look for a program that tailors to your specific requirements and gives you a variety of effective treatments to choose from to achieve your desired outcomes and treatment goals. Futures Recover Healthcare recognizes how challenging the road to recovery can be and is dedicated to navigating it with you. 

Our dedicated specialists and experts are committed to providing you with a comprehensive treatment program centered on individualized treatment to assist each patient in their recovery process. If you or a loved one has an alcohol addiction and requires alcohol detox treatment, Futures Recovery Healthcare is here to help.