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Alcohol Withdrawal Timeline

Unfortunately, we live in a binge drinking culture that glorifies the party mindset and all too often ignores the seriousness of heavy drinking. In the short term, such drinking patterns tend to lead towards lowered inhibitions and a whole host of bad decisions such as drunk driving, getting into fights, vandalism, unsafe sex, and a variety of other choices an individual might not make when sober. In the long term, this type of binge drinking is far more likely to lead to health issues and other life-altering consequences.

Now, most people escape these years relatively unscathed, managing to live a life free of alcohol dependence. For some, however, this type of heavy drinking and alcohol abuse can turn into addiction and dependence, which leads to a host of unpleasant side effects. Studies have shown that the earlier a young person starts binge drinking, the likelier they will develop alcohol use disorder at some point in their life. Therefore, it’s crucial that any potential drinking issue is addressed immediately.

If you or a loved one is getting treated for alcohol abuse, it is essential you understand the uncomfortable symptoms of alcohol withdrawal, so you can be prepared both mentally and physically. For serious alcoholics, withdrawals can be dangerous, if not fatal, so we strongly recommended that detox occurs with medical professionals. Below, we will discuss the detox timeline.

What is Alcohol Withdrawal?

Just like with any addictive substance, if you use alcohol heavily for weeks, months, or years, you will inevitably develop a physical and mental dependence for it. You will need to have more drinks and drink more often in order to get drunk, and you will need to drink to prevent the body’s physical cravings from arising.

If you suddenly stop this pattern of heavy drinking, you will likely experience withdrawal ranging somewhere from moderate to severe. Alcohol depresses your nervous system, slowing cerebral messaging and altering the way signals are sent and received.

Eventually, the CNS adapts to the alcohol's presence, and it becomes its new normal. The body works on overdrive to fight the depressant effect of the alcohol and to keep neurotransmitters firing clearly. When alcohol suddenly is no longer present, the brain basically overheats causing symptoms of withdrawal to set in.

Factors of Alcohol withdrawal

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

  • Alternative drug use – If you regularly use other drugs in conjunction with your drinking habits, especially with opioids, you may not only have to deal with symptoms of alcohol withdrawal but symptoms of that other drug withdrawal as well.
  • Co-occurring mental health issues – Quite often, alcoholics use their alcohol to treat an underlying disorder that they might not even know about. Such latent co-occurring disorders can alter the severity and duration of withdrawals.
  • Gender – Men and women drink in different amounts, and their bodies react differently to alcohol withdrawals. This study found that 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 on average start heavy drinking earlier, drink more alcohol in one sitting, drink more frequently, and are larger (statistically) than women.
  • Family History - A family history of alcohol abuse not only increases your likelihood of becoming an alcoholic but also extends or increases the severity of withdrawals.
  • The health of patient – Although it is difficult to be a healthy alcoholic, someone who exercises or at least is of average body weight will likely have less severe withdrawals than someone who is obese, especially since their body is running more efficiently.
  • Length and frequency of alcohol consumption- The more often and more regularly a person drinks, the more likely their mental and physical symptoms will be severe during the alcohol withdrawal timeline.
  • The quantity of alcohol regularly consumed - This should be an obvious one, the more often and more alcohol you are 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.

Timeline of Alcohol Withdrawal

In most cases, alcohol detox takes a week for the alcohol to exit the body entirely, but as mentioned above, withdrawal is different for everyone. There are some who get through it without many issues, and there are others who feel the ripple effects for months after.

Most inpatient or outpatient detox programs will go from three days to a week, depending on the patient’s case. Withdrawal symptoms should completely dissipate by day seven; however, cravings and other side effects may linger for months, if not years following medical detox.

Four Phases of Detox Withdrawal Timeline

Typically, detox programs group the alcohol withdrawal timeline into four phases. The clock for this timeline starts the moment you stop drinking.

Stage 1: 6-12 Hours Post Drinking

Symptoms of stage one begin setting in roughly at hour six, which is why many alcoholics have to start drinking the moment they wake up. Since the symptoms are so severe, many wrongly assume that the first stage is the most dangerous, but in reality, that is the third phase.

Stage 1 symptoms include, but are not limited to:

  • Anxiety – During the initial phases of the alcohol withdrawal timeline, a patient's body and mind are all out of whack. A person will feel uncomfortable, sick, hurt, and a variety of other unpleasant symptoms that can increase a person's anxiety. For those who already suffer from high anxiety, these feelings will be amplified.
  • Cravings – Alcohol is an addictive substance. Naturally, when an alcoholic does not have it, they crave it. Cravings are especially bad at this stage since the patient knows that drinking would alleviate all the unpleasant symptoms of withdrawal.
  • Extreme Sweating – The body begins to overheat when alcohol is no longer in the system. Sweating is your body's attempt to cool down and protect the organs. Sweating through your sheets is expected, which is why keeping fluid levels high is so important to the doctors who are monitoring the process.
  • Headaches – Typically caused by dehydration and loss of body fluid.
  • Insomnia – Alcohol tends to alter the way a person sleeps, skipping the initial phases of sleep and dropping straight to REM it helps someone fall asleep, but doesn’t produce healthy sleep. In this stage, the mind may want to sleep, but be incapable, either from restlessness or other symptoms.
  • Nausea/diarrhea/vomiting – Excessive drinking alters the intestine walls and the amount of stomach acid the body produces. Nausea is quite common during this stage.
  • Shakes – As mentioned, when the brain begins to function on overdrive without the depressant effects of alcohol to counterbalance this hyperactivity, the brain has trouble working normally causing malfunctions in nerve cell activity, leading to shakes and tremors.

Stage 2: 12-24 Hours Post Drinking

In Stage 2 the patient may see a continuation of the previous symptoms in addition to new symptoms. This trend may continue with each following stage.

  • Dehydration – Dehydration really sets in at this stage due to sweating and trips to the bathroom. The benefit of an inpatient detox program is the ability to have medical professionals monitor your levels and make sure you have enough liquids.
  • Hallucinations – Extra dopamine release combined with low blood sugar often turns into hallucinations. Although these can be extraordinarily disorienting or upsetting, hallucinations are not fatal.
  • Malnutrition – As your body experiences all these unpleasant symptoms, the last thing on a patient’s mind is food. A loss of appetite should not be surprising for someone dealing with nausea.

Stage 3: 24-48 Hours Post Drinking

As mentioned above, this is the crux and most dangerous part of the alcohol withdrawal timeline. At this stage, the body is in full panic mode and can have some severe reactions to the lack of alcohol in the system.

  • Irritability – At this point, mood swings are quite common. The patient is uncomfortable, anxious, and their brain and body feel like they are going haywire. Any patience or discipline they might have had initially has already waned, if not completely diminished.
  • Low Blood Sugar Levels – Alcoholism often leads to liver issues. When the liver does not work, it fails to release glucose into the bloodstream. Hypoglycemia is typical at this stage, leading to weakness and exhaustion.
  • Grand Mal Seizures – Roughly, four out of a hundred patients will experience grand mal seizures in the day or two post quitting. The withdrawal seizures arise from water, sleep and nutrient deprivation. For some, these seizures can be a precursor to a much more dangerous symptom known as Delirium Tremens.
  • Delirium Tremens – The possibly fatal part of withdrawals, Delirium Tremens is a sudden case of extreme confusion accompanied by shivering, sweats, seizures, hallucinations, overheating, and in some cases, death. During this period, the body is experiencing biochemical cascade where the brain is malfunctioning and firing off incorrect signals.

Stages 4: 48- 168 Hours Post Drink

At this stage, most physical symptoms have relented if not completely disappeared. Most of these are replaced by mental discomfort and feelings of depression, anxiety, confusion, anger, restlessness, and others.

Now, in recovery, the patient will learn to communicate and manage these feelings as well as coping techniques to battle relapse.

The Detox Timeline

When people talk about going to an inpatient or outpatient detox facility or rehabilitation program, most people immediately think of this detoxification period we discussed above. In reality, the detoxification portion is just one part of the entire alcohol detox timeline. This timeline is composed of three phases:

Phase 1 – Evaluation

The first part of this detox process for alcohol addiction starts with an interview between the patient and a medical professional. This evaluation allows the medical professional to understand the type of addiction, the severity of the habit, and the health of the prospective patient.

Once this screening process is completed, they can craft a treatment plan suited for the individual. They may also prescribe drugs in order to alleviate expected symptoms of withdrawal. For those who suffer from serious alcohol addiction, inpatient treatment is generally recommended over outpatient treatment.

Phase 2 – Stabilization

This is the detox and alcohol withdrawal stage that most people think of when they hear the word rehab. At this point, the medical professional's goal is to help clear the patient's body of the substance and cut off that physical dependence.

Understandably, stabilization is often the most uncomfortable and dangerous segment of the alcohol detox timeline. Because of this underlying danger, a patient will be monitored by medical personnel. These trained professionals will provide both mental and physical support through this trying time.

Phase 3 - Guiding Patient into Treatment

Once stabilization has been completed, the real work begins. During this stage of rehab, a patient will learn healthy habits, routines, stress relievers, coping mechanisms and various other techniques to help prevent a relapse. They will meet for one-on-one therapy as well as group therapy to discuss the feelings and experiences that caused them to drink. This valuable time provides the patients with tools for the battle ahead.

Upon completing the rehabilitation process for alcohol addiction, the patient will be guided into a treatment program that exists outside of rehab. This includes group and one-on-one therapy to monitor and maintain their sobriety. Patients who do not attend or stop attending an aftercare treatment program are significantly more likely to experience an alcohol relapse. Substance abuse is a disorder that lingers and never truly fades away, because of this, patients who are clean must keep up the fight and not grow complacent in their recovery.

Conclusion

Now that we have covered the alcohol withdrawal timeline, hopefully, you or your loved one is more prepared for what's to come. This can be a trying and daunting process, but a life free from alcohol is worth the hardship. That said, it is hard to do on your own. Some trials are better to face with company. Alcoholics need a support system, people to lean upon, to encourage them, and to help lift them up when it might feel like all is lost.

sources:

“Introduction to Alcohol Withdrawal”. Accessed 25 Oct. 2018.

“Alcohol Withdrawal Timeline.” Recovery First Treatment Center, Accessed 25 Oct. 2018.

“Alcohol Withdrawal Symptoms, Detox Timeline & Treatment.” American Addiction Centers, Accessed 25 Oct. 2018.

“Alcohol Withdrawal - Learn the Symptoms and Signs.” Alcohol Rehab Guide, Accessed 25 Oct. 2018.