Alcohol Withdrawal Timeline

What Is Alcohol Withdrawal?

Alcohol withdrawal refers to symptoms that may happen when someone who has been drinking too much alcohol regularly suddenly stops drinking alcohol. The more a person drinks regularly, the more likely they will develop alcohol withdrawal symptoms when they stop drinking. This is according to the National Institute of Health (NIH) [1].

In most cases, mild symptoms may begin to develop within hours of the last shot. Alcohol withdrawal has a broad range of symptoms, from mild tremors to a condition called delirium tremens, which results in seizures and could progress to death if not recognized and treated promptly. Delirium Tremens can be highly disorientating and scary – and it can even cause death. This is one of the more severe reactions indicated by hallucinations, confusion, agitation, tremors, and a high fever. The reported number of death for people who experience delirium tremens is anywhere from 1 to 5%. This is according to the National Center for Biotechnology Information (NCBI) [2].

Delirium tremens are the most severe form of alcohol withdrawal. Symptoms of delirium tremens can last up to seven days after alcohol cessation and may last even longer.

If individuals suddenly stop the pattern of heavy drinking, they will likely experience alcohol withdrawal. This is because alcohol depresses the nervous system, slowing cerebral messaging and altering how signals are sent and received. This begs the question, is alcohol a depressant, or is alcohol a stimulant? Stimulants excite the nervous system and may boost energy, while depressants slow down the nervous system and relax causes the person to relax. Some substances like alcohol have both stimulant and depressant effects. Alcohol may have initial effects that mimic those of stimulants; however, alcohol mainly slows the body down, making it a depressant.

Eventually, the central nervous system (CNS) adapts to the alcohol’s presence, becoming its new normal. The body works on overdrive to fight the alcohol’s depressant effect and keep neurotransmitters firing clearly. When alcohol suddenly is no longer present, the brain overheats, causing withdrawal symptoms to set in [3]. In addition, drinking too much alcohol over a long period of time means the liver doesn’t get a chance to recover. This can result in severe and permanent alcohol liver damage.

Risk Factors of Alcohol Withdrawal

Although there is a general one-week alcohol withdrawal timeline, multiple factors might change the severity of alcohol withdrawal symptoms during that time period. 

Such factors include:

Alternative Drug Use 

If people regularly use other drugs in combination with drinking alcohol, especially with opioids (heroin, fentanyl, Vicodin, Percocet), they may not only have to deal with alcohol withdrawal symptoms but symptoms of that other drug withdrawal as well. That is double jeopardy.

Co-occurring Mental Health Issues

Quite often, individuals suffering from alcohol use disorder use alcohol to treat an underlying mental disorder that they might not even know about. Such underlying co-occurring disorders can change the severity and duration of withdrawals.

Gender 

Men and women drink alcohol in different amounts, and their bodies react differently during alcohol withdrawal timeline. Men tend to experience stronger and more frequent withdrawal symptoms, including a much higher percentage of men who deal with withdrawal seizures. The reasons for this include the fact that men drink more alcohol in one sitting, drink more frequently, on average start heavy drinking earlier, and are larger (statistically) than women.

Family History 

A family history of alcohol use disorder not only increases the possibility of becoming an alcoholic but also extends or increases the severity of alcohol withdrawals.

The Health of the Person 

Although it is difficult to be a healthy alcoholic, someone who exercises or at least is of average bodyweight will likely have less severe withdrawals than someone who is obese, especially since their body is running more efficiently.

Alcohol Withdrawal Timeline
In the recovery field, there are a select number of alcohol withdrawal symptoms that are more severe than others, including delirium tremens, hypothermia, seizures, and cardiac arrhythmias.

Length and Frequency of Drinking Alcohol

The more often and more regularly someone drinks, the more likely their physical and mental symptoms will be severe during the alcohol withdrawal timeline.

The Amount of Alcohol Regularly Consumed 

This is very obvious; the more often and more alcohol someone is drinking, the more the body will notice the alcohol’s absence. After years of adapting to more and more alcohol, when that alcohol is suddenly gone, the body will go into a state of shock.

The Alcohol Withdrawal Timeline

The alcohol withdrawal timeline starts as early as two hours after drinking, peaking in severity approximately two to three days after the last drink. Alcohol withdrawal symptoms can last for up to a year after quitting, although this tends to be limited to temptation and relapse. The variety of symptoms changes, depending on the amount of time since someone last consumed an alcoholic drink. 

6 to12 Hours After Quitting Alcohol

During the first six to twelve hours of the alcohol withdrawal timeline, symptoms begin setting in roughly at hour six. That is the reason why many alcoholics have to start drinking the moment they wake up. Since the symptoms are so severe, many wrongly assume that the 6-12 hours stage is the most dangerous, but that is the 24-48 hours phase in reality.

Symptoms include, but are not limited to:

  • Cravings 
    • Alcohol is an addictive drug or substance. So naturally, when a person suffering from alcohol use disorder does not have it, they crave it. Unfortunately, cravings are terrible at this stage since the person knows that drinking would relieve all the unpleasant symptoms of withdrawal.
  • Anxiety 
    • Throughout the initial stage of the alcohol withdrawal timeline, an individual’s mind and body are all out of whack. A person will feel sick, uncomfortable, hurt, and various other bothersome symptoms that can increase a person’s anxiety. For those who already experience high anxiety, these feelings will be doubled.
  • Extreme Sweating 
    • The body begins to overheat when alcohol is no longer in the system. Sweating is the body’s attempt to protect and cool down the organs. Sweating through your bedsheets is expected, so keeping a high fluid level is so important to the doctors who are monitoring the process.

  • Headaches 
    • It is usually caused by loss of body fluid and dehydration.
  • Insomnia 
    • Alcohol does change the way a person sleeps; skipping the initial phases of sleep and dropping straight to REM helps someone fall asleep, but it doesn’t produce healthy sleep. In this stage of the alcohol withdrawal timeline, the mind may want to sleep but be incapable, either from restlessness or other symptoms.
  • Nausea/vomiting/diarrhea
    • Extreme drinking changes the intestine walls and the amount of stomach acid the body produces. As a result, nausea is quite common during this stage of the alcohol withdrawal timeline.
  • Shakes 
    • When the brain starts to function on overdrive without the alcohol’s depressant effects to counteract this hyperactivity, the brain has trouble working normally, causing malfunctions in nerve cell activity, leading to tremors and shakes.

12 to 24 Hours After Stopping Drinking

In Stage 12-24 hours of the alcohol withdrawal timeline, the person may see a continuation of the previous symptoms in addition to some new symptoms. This trend may continue with each following stage.

  • Dehydration 
    • Dehydration really sets in at this stage of the alcohol withdrawal timeline due to trips to the bathroom and sweating. The advantage of an inpatient detox program is the capability to have medical professionals monitor the levels of care and make sure the person has enough fluids.
  • Hallucinations 
    • Low blood sugar combined with extra dopamine release often results to hallucinations. Although these can be very disorienting or upsetting, hallucinations are not life-threatening.
  • Malnutrition 
    • As the body experiences all these uncomfortable symptoms, the last thing on someone’s mind is food. A loss of appetite should not be surprising for someone dealing with nausea.

24 to 48 Hours Post Drinking

As mentioned above, this is the most dangerous and crucial part of the alcohol withdrawal timeline. At this phase, the alcoholic’s body is in full panic mode and can have some severe reactions to the absence of alcohol in the system.

  • Irritability 
    • At this point of the alcohol withdrawal timeline, mood swings are not unusual. The person is anxious, uncomfortable, and their body and brain feel like they are going haywire. Any patience or discipline they might have had initially had already faded, if not completely diminished.
  • Low Blood Sugar Levels 
    • Alcohol use disorder usually leads to alcoholic liver cirrhosis and alcoholic hepatitis. When the liver does stop functioning, it fails to release glucose into the bloodstream. Hypoglycemia is typical at this stage of the alcohol withdrawal timeline, leading to exhaustion and weakness.
  • Grand Mal Seizures 
    • Approximately four out of a hundred individuals will experience grand mal seizures in a day or two after quitting. The alcohol withdrawal seizures arise from sleep, water, and nutrient deprivation. For some, these seizures can be a warning sign of a much more alarming and dangerous alcohol withdrawal symptom known as Delirium Tremens.
  • Delirium Tremens 
    • The possibly deadly part of alcohol withdrawals, Delirium Tremens, is a sudden case of extreme confusion followed by sweats, shivering, seizures, overheating, hallucinations, and in some instances, death. During this period of the alcohol withdrawal timeline, the body is experiencing a biochemical decline where the brain is malfunctioning and firing off incorrect signals.

48 to 168 Hours Post Drink

At this stage of the alcohol withdrawal timeline, most physical symptoms have softened if not completely disappeared. Most of these are replaced by mental distress and feelings of anxiety, depression, confusion, restlessness, anger, and others. Now, in recovery, the client will learn to express and manage these feelings as well as coping ways to combat relapse.

PAWS (Post-Acute Withdrawal Syndrome) refers to the long-term side effect of alcohol abuse, potentially challenging and affecting a person’s life. Symptoms might continue years after withdrawal and initial detox. That is why it is highly recommended to continue treatment after the initial seven-day detox.

These symptoms include:

  • Hostility
  • Irritability
  • Anxiety & Depression
  • Mood swings
  • Low levels of energy
  • Fatigue
  • Insomnia
  • Inability to focus
  • Lack of sex drive
  • Chronic pain

These symptoms are mainly psychological and have been known to continue for months or years after alcohol cessation. They tend to ‘come and go’ in waves or episodes, and can be triggered by specific circumstances, memories, smells, or people.

Can You Die From Drinking Alcohol?

Yes. The reality is that alcohol can kill if consumed for continued periods of time. This is why it is important to seek support if you or a loved one is suffering from alcohol use disorder.

There are several ways how alcohol can kill you – some are fast, while others will take years. These means include:

Alcohol Poisoning

  • It happens after binge-drinking large amounts and results in coma or death.

Alcohol Liver Damage

  • The liver will not last an eternity, filtering through all the impurities and toxins on a daily basis. After years of constant heavy drinking, you can expect to see liver failure.

Cancers

  • Alcohol can cause several types of cancer, including throat, mouth, liver, breast, colon, pancreas, rectum, voice box, esophagus cancer

Accidents

  • Drunk driving can cause accidents; many result in deaths.

End-stage Alcoholism

  • Several organs will start to fail after years and years of heavy drinking.

Alcohol Detox

Detox is a safe, medically supervised setting where someone can safely detox from alcohol and other substances while getting the proper medical treatment needed to guarantee the most comfortable detox experience possible. 

The staff will provide 24/7 care and supervision while the body, especially the liver, clears itself from alcohol. They will also be ready and able to intervene in the event of a serious medical emergency as a result of alcohol withdrawal.

As the person enters detox, he or she will undergo a professional medical evaluation. Here, a medical professional will assess the severity of the alcohol withdrawal symptoms in addition to the physical and mental health. Professionals will work closely with the client to develop an individualized detox plan to effectively meet the clients’ needs. 

What is the Alcohol – Liver Detox Timeline?

The whole body, including the liver, will start detoxing. The liver was at the focus of attention when a person was drinking, as it filters and processes the fluids ingested during the day. This means that the liver will start to detox once alcohol consumption is stopped [4].

This is the liver detox timeline:

After 8 to 10 hours

The person will start noticing the first symptoms. These include fatigue, abdominal pain, insomnia, restlessness.

24 to 72 hours

The fatigue will continue, and the client will start to experience problems with focusing. Increased anxiety and heart rate will also likely kick in. This is where the symptoms will be at their worst.

After two days and onwards, the cravings will increase. Seizures and tremors are still common during this period.

Find Help in Battling the Symptoms in the Alcohol Withdrawal Timeline

During your rehabilitation, the staff from our substance abuse treatment center will help you identify what caused your substance abuse disorder and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to alcoholism

If you or someone you love is struggling with the symptoms included in the alcohol withdrawal timeline, get them the safest help they need and deserve. Our team at We Level Up NJ specializes in creating an ideal environment and providing effective therapies to help individuals who struggle with alcoholism. We will develop a personalized treatment plan and lead you to recovery. Get started today!

Alcohol Withdrawal Timeline
The role of a good medically monitored detox program is to make sure the client is safe while going through withdrawal.

Sources:

[1] NIH – https://medlineplus.gov/ency/article/000764.htm

[2] NCBI – https://www.ncbi.nlm.nih.gov/books/NBK441882/

[3] NIAAA – https://pubs.niaaa.nih.gov/publications/arh22-1/05-12.pdf

[4] SAMHSA – https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4907.pdf

[5] We Level UpAlcoholic Recovery: How to Help an Alcoholic?