Alcohol withdrawal occurs when individuals with a physical dependency on alcohol stop drinking. Physical withdrawal symptoms occur because long-time alcohol abuse causes neuro-adaptation in the brain – in other words, the brain and central nervous system have physiologically changed to become dependent on alcohol.
Once this physiological dependence occurs, a sudden drop in blood-alcohol levels can cause the central nervous system to enter a hyper-excitable state, which causes a number of physical symptoms – some of them potentially deadly. These are what alcoholics experience as withdrawal symptoms.
How long does alcohol withdrawal typically last? For most people, the worst of the symptoms occur around two to four days after the last drink. Most individuals will experience withdrawal symptoms for around a week, though this will depend on the individual.
Let’s take a look at a typical alcohol withdrawal timeline for a long-time, heavy alcohol abuser:
Note: that not all people will experience all of these symptoms. The severity of your symptoms will depend on a number of factors, including the duration and severity of your drinking problem.
5-10 Hours After Your Last Drink: Tremors and anxiety
Heavy drinkers who abstain from drinking for 5-10 hours will probably get the shakes. Be extremely wary if you get tremors after a few hours of not drinking – it is highly recommended that you seek out a professional detox facility before continuing. For more information, read “Alcohol Detox At Home – Why It’s A Terrible Idea That Can Kill You”
These can also be accompanied by other symptoms such as:
- A rapid heartbeat
- Elevated blood pressure
- Rapid breathing
- Digestive symptoms like nausea or vomiting
- Anxiety or hypervigilance
- Sleep disturbances. Sleep disturbances can include nightmares and night terrors or lack of sleep.
12-24 Hours After Your Last Drink: Alcoholic Hallucinosis
Distinctive hallucinations may also occur during withdrawal, usually auditory. These hallucinations may continue for up to two days after they begin, and occurs in about 20% of hospitalized alcoholics.
They often take the form of accusing or threatening voices. Your odds of developing hallucinations increase if you have been using other drugs or you have been an alcoholic for a long time. This symptom relatively uncommon and is generally not dangerous, but it can be extremely unsettling.
6-48 Hours After Your Last Drink: Seizures
This is the point at which mortality becomes a possible risk. The risk of seizures peaks around 24 hours, and several seizures over several hours are common.
2-3 Days After Your Last Drink: Delirium Tremens
This symptom does not occur in most patients, affecting only 5-10% in total. However, the mortality rate is about 15%. This is why its extremely important to detox in a facility equipped to handle detox patients.
If you experience this phase of withdrawal, you may also experience:
- Vivid night terrors
- Panic attacks
- Hallucinations (visual and auditory)
While delirium tremens typically occurs within 2-3 days, it may take as long as a week to manifest. The worst of it is generally in full force 4-5 days after your last drink.
What makes this condition particularly dangerous is the nature of the physiological symptoms. Your body’s central nervous system is hyper-excxited, and your circulation and breathing can shift dangerously. You also can experience dehydration that is life-threatening. Blood pressure can increase, and blood flow to your brain can decrease. There is also the very real risk of falling into a comma and death, if proper treatment is not sought. Some patients are also in danger from the psychological symptoms and loss of connection to reality, and may take their own lives.
Detoxing The Right Way
Now you have some idea of what to expect from the alcohol withdrawal symptoms timeline. You also should be aware that its important to seek help when detoxing – especially if you’re a long-time alcoholic.
Generally in the majority of patients, symptoms peak within the first five days, with dramatic improvement following after that time period. Some patients may have a longer withdrawal process lasting for several weeks.
It is highly advised that you detox under proper medical supervision – especially if you’ve been a long-time alcoholic. If for whatever reason you insist on detoxing on your own (a very bad idea), have a friend or family member around so they can get you to a medical facility if you start experience seizures, or symptoms of delirium tremens.
If you’ve read this far, you might be pretty worried about detox. The good news is that – under proper medical supervision – many of these withdrawal symptoms can be mitigated with the right medication, and the risks are significantly reduced. A medical professional may prescribe benzodiazepines like Librium, Valium, Ativan, or Serax to help you with your withdrawal. These drugs act as temporary substitutes for the alcohol as its effects leave your system, mitigating withdrawal symptoms. This can reduce the harmful effects of the withdrawal and make it easier and safer to undergo.
As scary as it can be, in the grand scheme of things the detox process is extremely short. Don’t forget that it is only the first step in your recovery. Make sure to take active steps to pursue holistic growth and avoid situations that are conducive to relapse.