How Long Does Alcohol Withdrawal Really Last?
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Alcohol Withdrawal How Long Does It Last?

If you’re wondering how long alcohol withdrawal lasts, no one has to tell you about how addictive alcohol can be. Its effects pull you back to it again and again, no matter how destructive its forces are in your life.

You can pull away from it. You just need help.

You shouldn’t try to stop drinking on your own because alcohol is one of the few substances that can cause death during detox without proper medical care and supervision. If you have long-term alcohol abuse in your history or a pattern of heavy, regular drinking, the physical and psychological withdrawal symptoms can be severe, but they can be managed.

Everyone is different in terms of the withdrawal symptoms they will experience during alcohol detox. In general, mild symptoms may include:

  • Headache
  • Shakiness
  • Sweating
  • Insomnia
  • Nausea
  • Vomiting
  • Anxiety
  • Irritability

More serious withdrawal symptoms may include hallucinations, seizures, or medical issues that can include high blood pressure, fever, rapid heartbeat, and others.

saying no to alcohol

Timeline

There is no standard timeline that kicks in when someone takes their last drink of alcohol and detox begins. Depending on the existence of co-occurring mental health disorders or medical issues, you can expect some version of the following:

  • First 24 hours: Within 6 to 24 hours, the first symptoms of alcohol withdrawal usually begin. They are often mild at first, compared to later symptoms, but they can still be disruptive, making it impossible to carry on with normal day-to-day tasks.
  • First 3 days: If more serious withdrawal symptoms are going to develop, they usually occur by day 3. Seizures may occur within the first two days as well. If any of these events happen, it is necessary to get immediate medical assistance.
  • First week: Confusion, disordered perceptions, and difficulties managing basic motor tasks and things that used to come naturally can begin around day 4. If none of the more serious symptoms occur, initial symptoms that began in the first few days will continue through the first week.
  • First month: In the weeks following and perhaps for months, different symptoms may continue at steadily lesser degrees until you feel stable and able to manage basic tasks again. Even when all physical withdrawal symptoms fade, psychological cravings for alcohol can continue for years. It is necessary to follow alcohol detox with an intensive and comprehensive alcohol addiction treatment program.

man experiencing withdrawal symptoms

Complications

Alcohol detox does not always go smoothly, and it is important to recognize the risk of medical emergency before beginning the process.

Serious complications can arise in the first few days of detox. So, it is necessary to have expert medical staff on hand who are trained to recognize the signs and equipped to provide life-saving treatment as needed.

  • Alcoholic liver disease: Many people who drink heavily for years have some level of liver damage. Depending on the amount of alcohol ingested, the number of years spent drinking heavily, and if other drugs were abused at the same time, liver damage may be more or less severe.
    Similarly, if there are co-occurring medical issues that also impact liver function, then alcohol detox could be more difficult. For example, alcoholic liver disease can complicate the alcohol detox process, causing liver failure, which can be fatal.
  • Delirium tremens: This refers to a far more difficult alcohol detox process. Significant medical issues occur and can be life-threatening. If they are going to happen they will begin very early on. For example, tremors and transient hallucinations will often occur in the first two days of detox if they are going to, and seizures may begin any time in the first three days. Confusion, disordered sensory perception, and motor and autonomic overactivity can begin around the fourth day, and all of these symptoms may continue at some level for days and even weeks after the initiation of alcohol detox.
    This is more than just a complication. Delirium tremens can be deadly. It is essential to undergo treatment at a medical facility that is equipped to treat any issues that arise proactively.
  • Sex: The gap between the number of women and men experiencing alcohol addiction and the need for alcohol detox has been narrowing rapidly over the past decade, but women still often wait longer than men to get the alcohol addiction treatment they need. Because alcoholism develops more quickly in women compared to men, it can mean that they are more likely to experience significant withdrawal symptoms and medical emergency by the time they enter the alcohol detox process. For this reason, extra care may be necessary.

Additionally, for women who used alcohol as a means of managing trauma, detox can be an emotional as well as physical process, making a sense of safety a priority. Without it, extreme emotional duress may occur, increasing the chance of relapse. 

  • Catatonia: Though exceptionally rare, it is possible that intense alcohol addiction can result in a period of mutism and lack of psychomotor movement called catatonia. Catatonia has not been found to last longer than a few days during alcohol detox, but it can be frightening to caregivers and potentially to the individual. In cases of high-dose alcohol addiction or long-term heavy drinking, medical detox is recommended.

doctor speaking with patient

Medications

Depending on the situation, different medications may be prescribed for the treatment of alcohol detox and addiction. There is no one medication that will work across the board, and some people may prefer no medications at all.

Have an open discussion with your medical provider to determine what medications will have the greatest chance of success. Past medical history and mental health history should be disclosed. It may be necessary to shift gears from one medication to another depending on the situation.

  • Naltrexone: This medication is often used during detox for those who have a difficult time managing to take other maintenance medications on a regular basis. Usually dispensed in the form of a monthly injection called Vivitrol, the drug can create a negative physical response in people who try to drink while the substance is in their system.
    It is usually administered after the detox period but before you return home or transition to an outpatient program. The goal is to help you stay on track and avoid relapse, so you can focus on growth in recovery.
  • Baclofen: At moderate to high doses, baclofen may be an effective part of an alcohol detox treatment, helping people to stay sober once they have stabilized. At low doses, the drug has not shown to be effective, and some people may experience side effects with higher doses of the drug. It is important to consider risk factors and risk of relapse as the drug also requires a regular regimen of use.
  • Disulfiram: Antabuse, or disulfiram, has long been a staple in alcohol addiction treatment once a person is stabilized after detox. The drug has been shown to have a negative impact on the liver, which can be problematic for those who already have liver damage. For that reason, it is sometimes recommended to take the drug for a brief period post detox until stable in recovery. If liver tests look good, it is always an option to go back on the drug for a period of time to assist with difficulties or periods when relapse feels riskier.
  • Gabapentin: This is another medication that has the potential to be a positive addition to alcohol addiction treatment. Because GABA deficit and glutamate excess are common during alcohol withdrawal, gabapentin can help to regulate neurotransmitters responsible for moderation. It also comes with a low abuse potential and less sedation than benzodiazepines, which were once commonly prescribed to help people manage withdrawal symptoms during alcohol detox.

What Style of Detox and Addiction Treatment Is Right for You?

Each person’s use of and experience with alcohol is different and will require a unique approach. For those who recognize that alcohol is becoming a problematic part of life and are able to simply stop drinking on their own without any withdrawal symptoms to speak of, treatment may not be necessary.

But for anyone who struggles with cravings for alcohol or physical withdrawal symptoms of any kind, the chances of successfully navigating through detox and finding sobriety on the other side increases exponentially when there is a team of substance abuse treatment professionals standing by to provide guidance and support.

Even if medical detox and/or pharmacological intervention are not indicated, it is still important to enroll in a comprehensive addiction treatment program, like Ambrosia’s alcohol rehab in Florida. Connecting with traditional and alternative therapies will help you explore what contributed to the development of your substance abuse. This will play a pivotal role in your transition from active alcohol abuse to active recovery.


Complications of Alcohol Withdrawal: Pathophysiological Insights. National Institute on Alcohol Abuse and Addiction (NIAAA).

ICU Management of the Patient With Alcoholic Liver Disease. (May 2017). Evidence-based Critical Care.

Delirium Tremens. (March 2019). MedlinePlus.

A Pilot Randomised Controlled Trial of Varenicline Versus Oral Naltrexone for the Treatment of Alcohol Dependence. (August 2016). NSW Government: Health / South Eastern Sydney Local Health District.

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