How Long Does Alcohol Withdrawal Last

When someone dependent on alcohol abruptly stops drinking, their body can can experience severe disruptions. This is alcohol withdrawal, and unlike withdrawal from many other substances, it has the potential to be life-threatening. The symptoms can range from a mild case of the shakes to severe complications.

While the prospect of withdrawal might be frightening, safe recovery is possible – but it’s crucial to seek professional medical help. Attempting to quit drinking “cold turkey” can be dangerous for many individuals.

According to the 2022 National Survey on Drug Use and Health (NSDUH), a staggering 221.3 million people ages 12 and older have tried alcohol. This highlights the widespread impact of alcohol use, and the importance of understanding the risks involved when dependence develops.

How Long Does Alcohol Withdrawal Last

The onset and duration of alcohol withdrawal symptoms depend on individual factors. However, many people experience the following stages:

Stage One (Starting within 6 hours of your last drink): This initial stage can last up to a week and often involves milder symptoms.

Stage Two (Typically beginning within the first 48 hours): Symptoms may intensify in this stage, which can also last up to a week.

Stage Three (Usually starting within 48 hours of your last drink):  This stage, lasting up to three days, often includes the most severe withdrawal symptoms.

While not everyone will follow this exact timeline, most individuals experience relief from their symptoms within a week. In some cases, where symptoms persist for a longer duration, a fourth stage of withdrawal may occur.

First stage: Mild symptoms

Alcohol withdrawal can set in surprisingly quickly – sometimes within just 6 hours of your last drink. The initial symptoms, although unpleasant, are generally mild.

These might include:

• Nausea
• Tremors (often called “the shakes”)
• Fluctuations in blood pressure
• Heightened anxiety
• Insomnia and trouble sleeping

For many people, recovery from alcohol withdrawal begins after navigating this first stage. However, these symptoms can linger for up to 7 days.

Stage Two: Risk of Seizures and Other Serious Concerns

Within the first 48 hours after stopping alcohol, serious symptoms can arise, including seizures. Over 5% of people experiencing untreated alcohol withdrawal will reach this stage and have seizures.

While the risk of serious complications decreases after 48 hours, it’s still possible for seizures to occur later. If any severe symptoms develop, seek immediate medical care.

Typically, this second stage of alcohol withdrawal peaks between 24 and 72 hours after the last drink.

The Critical Third Stage: Understanding Delirium Tremens (DTs)

Alcohol withdrawal progresses through stages, with the third being the most severe and potentially dangerous. Up to 5% of individuals experiencing withdrawal may develop a condition known as delirium tremens, or DTs.

This critical condition is marked by:

• Vivid and disturbing hallucinations (seeing or hearing things that aren’t there)
• Profound mental confusion
• Extreme mood swings
• Sudden bursts of energy followed by exhaustion
• Drenching sweats
• High fever (potentially life-threatening)
• Grand mal seizures (causing muscle contractions and loss of consciousness)
• Intense agitation

DTs typically begin within 48 to 72 hours of the last drink, making those first few days of withdrawal the most dangerous. Medical supervision is crucial at this stage, especially if DT symptoms arise. While this intense stage of withdrawal generally lasts 2 to 3 days, lingering effects might persist for up to a week.

Possible Fourth Stage: Post-Acute Withdrawal

For some individuals, the challenges of alcohol withdrawal don’t end with the immediate detox period. They may experience a lingering set of symptoms known as Post-Acute Withdrawal Syndrome (PAWS). This phase often includes persistent sleep difficulties and mood disturbances. The duration of PAWS can vary significantly, potentially lasting from 6 months up to 2 years.

Common Symptoms:

• Anxiety and nervousness
• Depression
• Fatigue
• Irritability and short temper
• You might feel jumpy, shaky, or have tremors.
• Mood swings
• Nightmares
• Clear thinking becomes a challenge.

Additional Symptoms:

• Sweating and clammy skin
• Pupils may dilate.
• Headaches
• Insomnia
• Appetite may disappear.
• Nausea and vomiting
• You might look pale.
• Heart rate might speed up.

Delirium Tremens (DTs): A Severe Form of Withdrawal

DTs demand immediate medical attention. Symptoms can include:

• Intense agitation and irritability.
• Sudden and severe confusion.
• Hallucinations – seeing, hearing, or feeling things that aren’t real.

Can I safely detox from alcohol at home?

The safest way to detox from alcohol dependence is with medical supervision. A hospital or dedicated detox facility provides constant monitoring by professionals. This ensures your comfort and safety throughout the process.

Attempting alcohol detox at home without professional support can be risky, especially if you’re prone to severe withdrawal symptoms like delirium tremens (DTs).  Your risk of DTs may be higher if:

• You’ve been drinking heavily every day for a long time.
• You’ve experienced DTs during previous withdrawals.
• You have a history of seizures.
• You have a current infection.

How do I know if I need medical help for detox?

A healthcare professional is the best judge of your risk for severe alcohol withdrawal complications. Only they can monitor you closely to ensure mild symptoms don’t escalate.

How can I safely overcome alcohol withdrawal?

With the right medical care, safe withdrawal is possible. Seeking professional treatment is always preferable to attempting it alone. A healthcare provider can assess whether home detox is suitable or if you require specialized care in a facility.

Medication for alcohol withdrawal

Medication is a vital part of managing alcohol withdrawal. It addresses both the discomfort and potential dangers of withdrawal symptoms, including the possibility of DTs.

Benzodiazepines (anti-anxiety medication) are frequently used to treat DTs. They help your brain cope with the absence of alcohol and can prevent more severe withdrawal stages.

Your healthcare provider might also recommend additional medications during recovery, such as vitamins to address deficiencies and anti-seizure medication.  After you’re safely through withdrawal, you could be prescribed medication to help reduce alcohol cravings.

Getting Help for Alcohol Dependence

If you or someone you care about is struggling with alcohol dependence, know that you are not alone. Help is available, and recovery is possible. Here’s where to start:

• Talk to Your Doctor: Your doctor can offer an initial assessment, discuss treatment options, and provide referrals to specialized addiction treatment professionals.
• Hotlines: Confidential hotlines provide immediate support and guidance. Consider these resources:
  • SAMHSA National Helpline: 1-800-662-HELP (4357) (https://www.samhsa.gov/find-help/national-helpline)
  • Other specialized helplines are available. Search online for options tailored to specific groups (women, veterans, etc.)
• Support Groups: Mutual support groups like Alcoholics Anonymous (AA) provide a powerful network of understanding and encouragement. Find meetings in your area: https://www.aa.org/
• Treatment Centers: Specialized facilities offer tailored programs to meet a range of needs – from medically supervised detox to long-term rehabilitation.
• Online Resources: Reputable websites offer information, tools, and support communities. Search for trusted sites run by health organizations or treatment centers.