The first step toward successful recovery from alcohol use disorder (AUD) is admitting you have a problem and then committing to a treatment that begins with alcohol detox. In this post, we’re going to shed light on the alcohol withdrawal timeline and other important details that people with AUD and their loved ones should be aware of.
Alcoholism Overview
Alcohol use disorder, or alcoholism, is defined as a pattern of alcohol use that involves problems controlling alcohol consumption, being preoccupied with drinking, and continuing to drink even when it causes consequences. Unhealthy alcohol use involves binge drinking and heavy drinking.
The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as consuming five or more drinks (if you’re a man) or four or more drinks (for women) in two hours or on the same occasion. On the other hand, heavy drinking is the consumption of at least four drinks on any day for men or three or more drinks for women.
The numbers show that in 2018, about 14.4 million people ages 18 and older had AUD. Of these, 9.2 million people with alcoholism were men, while 5.4 million accounts for women. Only 7.9% of adults with AUD received treatment.
Alcoholism has serious consequences if left unmanaged. Thankfully, this problem is treatable, and it all starts with alcohol detox.
What is Alcohol Detox?
Alcohol detoxification, or alcohol detox, is the first step in treating alcoholism. It’s defined as the natural process that occurs in the body as it tries to eliminate waste products and toxins from excessive and long-term consumption of alcohol. Therefore, alcohol detox is not a standalone treatment for alcoholism, but only the first phase on the road to a successful recovery.
Who Needs Alcohol Detox?
Men and women who are dependent on alcohol and want to get sober will need to go through alcohol detox. Generally speaking, people who develop severe alcohol dependence and/or have experienced serious symptoms of alcohol withdrawal are the biggest candidates for the detox process.
The best way to determine whether you should look for an inpatient alcohol rehab center in Texas or help with your problem is to take a good look at your drinking habits.
Think about how much alcohol you drink now compared to when you first started drinking.
Does a day go by without you having more than one drink?
Do your relationships, productivity at work, and other aspects of life suffer because you drink alcohol?
Do your friends and family members complain you’re drinking too much?
It’s not uncommon for people to start drinking more without even realizing it. That’s why it’s so important to evaluate your drinking habits. Be honest with yourself.
Many people think they’re occasional drinkers. That being said, occasional use can progress to habitual use wherein a person doesn’t even make a conscious decision to drink; they just do it without thinking.
Do you find yourself doing that?
In other words, does drinking alcohol seems like something you do automatically?
Alcohol detox is necessary when a person suffers from physical symptoms of alcohol dependence. These may include headache, sweating, shaking, nausea, just to name a few.
The whole process starts in the facility where an addiction specialist recommends the proper treatment route based on the severity of the addiction. A thorough physical and mental health evaluation is used to determine the need for alcohol detox.
Alcohol Withdrawal Timeline
The alcohol withdrawal syndrome is a condition that occurs after intentional or unintentional abrupt cessation of heavy or constant drinking in patients with AUD. This is a dynamic and complicated process whose exact course may vary from one person to another. Keep in mind that no two people are the same, so their addiction problems and symptoms differ too. They way they experience detox can also be different.
When it comes to the alcohol detox timeline and withdrawal symptoms, scientific evidence describes the following:
6 Hours
Six hours after a person has had their last drink, minor withdrawal symptoms tend to occur. However, people with a long history of heavy alcohol consumption could experience seizures in this timeframe. The initial symptoms of alcohol withdrawal tend generally mild but may worsen as time goes on.
More precisely, at this stage, you may experience:
- Anxiety
- Headache
- Sweating
- Trembling i.e., “alcohol shakes” (they usually peak in one to two days)
- Upset stomach
12 Hours to 24 Hours
About 12 to 24 hours after stopping drinking alcohol, some people may experience hallucinations. This isn’t a common symptom, though. Only a small percentage of people will experience this symptom of alcohol withdrawal i.e., they see or hear things that aren’t there. Sure, hallucination seems scary, but it’s not considered as serious withdrawal complication. It’s worth mentioning, though, that hallucinations can change the way a person experiences some things such as:
- Sound (auditory stimulation)
- Sight (visual stimulation)
- Touch (tactile stimulation)
When it comes to other withdrawal symptoms, they may become increasingly severe at this point. This is especially the case with pain.
24 Hours to 48 Hours
During this time, minor withdrawal symptoms may be present. Painful symptoms usually tend to persist two days into alcohol detox.
You may experience tremors, headache, and upset stomach. The symptoms tend to peak about 18 to 24 hours after stopping the consumption of alcohol. Then, the symptoms start to weaken after four to five days.
Some people may experience seizures at this stage, but you can expect them to subside after day three. The main characteristics of alcohol withdrawal seizures include the following:
- Some people may experience up to six seizures in six hours
- Seizures could increase the risk of delirium tremens
- A person can have one or two generalized tonic-clonic seizures (grand mal seizures)
48 Hours to 72 Hours
At this point, some people may experience severe complications of alcohol withdrawal – delirium tremens (DT) or alcohol withdrawal medium. We will discuss DTs in more detail below in this post. Other symptoms of alcohol withdrawal may come and go. This happens to be the time when a person is at the highest risk of life-threatening symptoms.
72 Hours
Alcohol withdrawal symptoms are at their worst about 72 hours after a person has had their last drink. Moderate withdrawal symptoms can even last for a month in rare cases. These symptoms may include illusions and a rapid heart rate. Some symptoms may persist for a few weeks, but they can be treated with medications.
Four to Six Weeks
A few weeks after the acute withdrawal symptoms fade, a person may still experience protracted alcohol withdrawal syndrome or post-acute withdrawal syndrome (PAWS). The long-term alcohol detox symptoms may include:
- Anxiety
- Cravings
- Depression
- Low libido
- Hostile behavior
- Fatigue
- Insomnia
- Trouble thinking and concentrating
- Unexplained pain
- Mood swings
Keep in mind that not every person will experience these symptoms in every stage of withdrawal. As mentioned above, people may experience alcohol withdrawal differently.
Why Alcohol Withdrawal Symptoms Occur?
The alcohol withdrawal timeline sees different symptoms occurring as a person’s system is going through detox.
The question is why alcohol detox symptoms happen.
Well, alcohol interacts with gamma-aminobutyric acid (GABA) receptors in the brain. The inhibitory GABA neurotransmitter usually activates these receptors. This happens through the interaction that defines the baseline level of neural activity throughout the CNS (central nervous system).
Alcohol modifies the responsiveness of these receptors, thereby amplifying the inhibitory signaling power of GABA. With long-term use of alcohol, the excitability of CNS keeps decreasing, and the brain starts adjusting to this new reality by down-regulating GABA receptors. More precisely, alcohol depresses the CNS to induce feelings of euphoria and relaxation.
In other words, the more alcohol a person drinks, the more neurochemical and structural changes occur. This leads to tolerance.
The body works to maintain balance, and it starts sending signals to the brain to make more neurotransmitter receptors that stimulate or excite the central nervous system.
The greater tolerance to alcohol, the more you need to drink. Abrupt cessation creates a shock to the brain and its connections, thus impairing signals sent throughout the body. All this leads to withdrawal symptoms. This happens because when you stop drinking, you deprive receptors of the alcohol, which puts the nervous system into the state of being overactive.
That’s why people who undergo alcohol detox as the first stage toward recovery experience symptoms ranging from anxiety and irritability to nausea, rapid heart rate, sweating, and tremors.
How Long Does Alcohol Detox Take?
How long is alcohol detox could be one of the most frequent questions on this subject.
As seen in the timeline above, initial alcohol detox takes about a week. That being said, some people may experience symptoms for longer, even a few weeks after the initial detox. Medications are used to help manage the withdrawal symptoms that linger.
Alcohol detox and withdrawal symptoms affect each patient differently but are carefully monitored by addiction specialists and healthcare professionals who make sure you complete the process successfully.
What is Delirium Tremens?
Delirium tremens (DT) is the most severe form of alcohol withdrawal. Not every person who undergoes alcohol detox will experience DT; the risk is higher among men and women with severe addiction. Delirium tremens is a neurologic syndrome indicated by excitation of the autonomic nervous system and changes in mental status.
People have DT because their brain is unable to adjust its chemistry properly after they stop drinking alcohol. The alteration in the brain leads to dangerous changes in breathing, temperature control, and blood circulation.
People with DT experience vital sign abnormalities and symptoms such as:
- Visual hallucinations
- Tachycardia
- Hypertension
- Hyperthermia
- Agitation
- Diaphoresis (sweating)
Symptoms of DT may show up about three days after alcohol cessation and last up to seven or eight days and may persist even longer.
People who have DT also tend to experience:
- Severe confusion
- Nervousness
- Extreme hyperactivity
- Loss of consciousness
- Sleep problems
- Dehydration
Evidence shows that about 50% of people with AUD experience withdrawal symptoms when they stop drinking, but 3% to 5% will have severe symptoms with DT being the most dangerous.
The factors that increase the risk of experiencing DT include these:
- Abnormal liver function
- History of DT
- Use of other drugs and substances
- Having brain lesions
- Older age at the time of alcohol withdrawal
- Preexisting dehydration
- Seizures with alcohol withdrawals
- Low sodium levels
- Low platelet levels
- Low potassium levels
How are DTs Treated?
As the most dangerous form of alcohol withdrawal, DT is considered a medical emergency. Ideally, delirium tremens should be managed in a locked inpatient ward or the intensive care unit. Treatment of DT revolves around supportive care with continuous sedation through the administration of benzodiazepines. Intravenous fluids are administered to address dehydration and problems with electrolyte levels. For the prevention of hallucinations and to calm agitation, antipsychotic medications are prescribed.
What Happens After Alcohol Detox?
Alcohol detox is only the first phase of alcoholism treatment. Once the detox is over, and withdrawal symptoms go away, or they’re managed with medications, patients undergo rehab. This is mainly performed in an inpatient setting, which provides a greater level of care and structure. Inpatient programs are particularly beneficial for men and women with severe addiction, a tendency to leave outpatient treatments, and patients who need more structure and zero distractions. When looking for alcohol detox near me, I always focus on the level of care and support patients get. That way, you will be confident in the successful completion of your journey to recovery.
Conclusion
Alcohol detox helps men and women with AUD jumpstart their journey toward successful recovery. As the first stage of recovery, detox causes withdrawal symptoms that range from mild to moderate and severe in intensity. For that reason, alcohol detox should be performed under medical supervision. That’s the safest and most effective way to manage withdrawal symptoms.
References
https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6084325/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/
https://pubmed.ncbi.nlm.nih.gov/23713737/
