07 Apr Alcohol Withdrawal Timeline
If you’re struggling with an alcohol use disorder (AUD), you aren’t alone. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 17 million adults in the United States had an AUD in 2012. Although a large number of Americans struggle with alcohol addiction, only 1.4 million of those individuals sought treatment. This is a sad statistic, because most people with an AUD can benefit from professional help at an alcohol rehabilitation center.
For those who do seek assistance for alcohol addiction, it’s important to understand the recovery and treatment process. The first step is alcohol detox, which requires the patient to stop drinking alcohol. As the substance leaves their body, they begin to experience withdrawal symptoms that can range in type, severity, and duration.
Alcohol withdrawal symptoms are unpleasant, so it’s natural to wonder how long they will last. As modern Americans, we are accustomed to receiving instant results, but it takes time for withdrawal symptoms to subside during the detox process.
Understanding Alcohol’s Effect on the Body
Before discussing the timeline for alcohol withdrawal symptoms, it makes sense to look at how alcohol impacts the body. When you drink alcohol, you are also ingesting a substance known as ethanol. With each drink, ethanol enters your digestive system and travels to different organs through your bloodstream. The substance has a different effect on each organ, including your brain where it acts as a central nervous system depressant and causes several changes.
• Ethanol causes your brain to release a “feel-good” chemical called dopamine.
• The substance slows your brain’s response to stimuli by deactivating glutamate.
• It makes you feel relaxed and sleepy when it binds to gamma aminobutyric acid (GABA).
With excessive and extended use, alcohol can be addictive. Over time, someone with an AUD will experience changes in their body and brain. One of these changes is an increased tolerance, which means that the person needs to drink more alcohol over time to achieve the same effect. Another change is physical dependence.
Someone who is dependent on alcohol needs to keep drinking it to prevent withdrawal symptoms. These symptoms can occur within two hours of the last drink and they can persist for weeks.
Factors Influencing Alcohol Withdrawal
A person with an AUD will experience withdrawal symptoms when they stop drinking or even simply reduce their alcohol consumption. Symptoms vary from mild and unpleasant to severe and potentially life-threatening.
Since alcohol withdrawal symptoms are not enjoyable, it makes sense that patients want to know how long detox and the accompanying withdrawal symptoms will last. There’s no easy answer to this question, because each person’s experience will be different. The length, severity, and type of symptoms varies based on the following factors.
• How long a person has been drinking: Detox will look different for someone who has been drinking for months as opposed to someone who has been drinking for years.
• How much a person has been drinking: Someone who drinks every day may have more severe withdrawal symptoms than someone who periodically binge drinks.
• Whether alcohol is used with other substances: Using other addictive substances with alcohol can complicate the detox process and make withdrawal symptoms more intense.
• Coexisting mental health conditions: The presence of conditions like anxiety and depression can present additional complications during detox and recovery.
• Age and overall health of the person: The detox process tends to be easier for patients who are young and healthy.
Symptoms of Alcohol Withdrawal
Each person will have a different experience with alcohol withdrawal. Minor symptoms will typically begin five to 10 hours after the last drink. These milder symptoms, which often peak at 24 to 48 hours, may include:
• Elevated pulse
• Rapid breathing
Moderate symptoms of alcohol withdrawal usually begin 12 to 24 hours after the last drink and they can last for up to 48 hours. These symptoms include hallucinations. Many patients report seeing groups of small, moving objects like coins or insects. Unlike patients with more severe withdrawal symptoms, patients who experience these types of hallucinations know they are not real. However, these hallucinations are still distracting and distressing.
Withdrawal seizures are a more serious symptom of alcohol withdrawal, which may occur six to 48 hours after a patient stops drinking. The risk of withdrawal seizures tends to peak at the 24-hour mark though. Patients who have undergone multiple rounds of detox or who have had withdrawal seizures in the past have an increased risk of experiencing this symptom.
Delirium tremens (DTs) are the most severe symptoms of alcohol withdrawal. In fact, DTs have a 1% to 5% death rate. DTs usually strike 48 to 72 hours after the last drink; however, some people may experience DTs seven to 10 days after their last drink. Symptoms of DTs include:
• High blood pressure
• Profuse sweating
• Racing heartbeat
• Severe anxiety
• Severe tremors
• Sleeping for a day or more
Alcohol withdrawal symptoms, especially DTs, can worsen quickly. As a result, it’s important to monitor even seemingly minor withdrawal symptoms. If a patient’s alcohol consumption has been chronic and heavy, they have an increased risk of developing DTs and they should not attempt to complete detox at home. Receiving the right treatment during detox can help manage withdrawal symptoms and prevent more serious symptoms from developing.
Alcohol Withdrawal Timeline
Assuming that a patient has no other underlying conditions and they are not using any other addictive substances, the alcohol withdrawal timeline has three phases.
1. Acute withdrawal: During the acute withdrawal phase, a patient can experience any of the symptoms mentioned above, ranging from mild symptoms to DTs.
2. Early abstinence: During early abstinence, a patient may experience anxiety, depression, and irregular sleep. These symptoms often resolve within three to six weeks, although it can take longer for women.
3. Protracted abstinence: During protracted abstinence, a patient does not experience anxiety or depression on a daily basis; however, minor life challenges can provoke these feelings. Additionally, life stresses can increase the risk of relapse.
The Timeline and Methods for Treating Alcohol Addiction
The Centers for Disease Control (CDC) and the National Institute on Drug Abuse (NIDA) both recommend that patients with an AUD attend a detox and addiction treatment program that is at least 90 days long. While attending a treatment program of any length is better than not receiving any help at all, patients see greater and more lasting success when they attend a program that is 90 days or longer.
Initially, some patients think that three months is a long time to spend in a treatment program. However, addiction produces serious physical and psychological changes, and they will not disappear overnight. Think of it this way: It takes time to acquire an AUD and it takes time to treat it. As such, people in treatment need to be patient as their bodies and minds recover.
In addition to the length of a program, it’s important to think about the location for detox and treatment. The ideal location will vary from patient to patient, depending on the severity of their withdrawal symptoms. If someone has minor symptoms, they may be able to detox at home, but patients with more severe symptoms should only detox at a treatment center or a hospital.
To determine the right setting, patients should discuss their health, home environment, and symptoms with their doctor. By sharing this information, the doctor can select the location that will make the detox process go as smoothly as possible.
• Home can be a detox location for patients dealing with mild withdrawal symptoms. However, these patients still need the right medications and support to be successful.
• Alcohol and Drug Rehab Centers are safe and supportive places to undergo detox. Licensed medical professionals will help treat the physical and psychological effects of addiction.
• Hospitals are the best location for patients with intense withdrawal symptoms like DTs. In the intensive care unit (ICU) of a hospital, physicians can monitor a patient for changes in blood pressure, heart rate, and respiration. If serious changes occur, doctors can administer emergency medicine and life-support to save the patient’s life.
Once a patient has selected the length and location of their detox and treatment program, the last component of treatment they should consider is the program type. A holistic treatment approach that utilizes a combination of counseling, detox, medication, and support tends to produce the greatest sobriety success rates.
As mentioned earlier, the detox process is an important first step for patients. It’s a time when they stop drinking alcohol, so their body can cleanse itself. However, since a substance that the patient has become dependent on is leaving their body, withdrawal symptoms are likely to occur. Doctors may prescribe medications and supplements to help manage these symptoms.
• Ativan and Librium can reduce anxiety for patients who are dealing with withdrawal symptoms. Managing anxiety is critical because it is a symptom that tends to remain during all three stages of the withdrawal process and it can derail treatment success.
• Nutritional supplements are important because alcohol withdrawal symptoms can deplete certain nutrients from the body, including folate, magnesium, phosphate, thiamine, and zinc. To keep patients healthy and strong, it’s critical to replace these essential vitamins and minerals.
After completing detox, it is time to focus on treating alcohol addiction. This process involves counseling, treatment of coexisting mental disorders, and support.
• Counseling is meant to identify and modify the behaviors, lifestyle factors, and thoughts that caused or contributed to a patient’s addiction. It can be performed in a treatment center or on an outpatient basis. It can also be completed individually, with the patient’s family, or in a group setting.
• Treating coexisting mental disorders is important because many patients with an AUD also have another untreated disorder like anxiety or depression. One of the best ways to prevent a relapse after treatment is to identify and treat these mental disorders while also treating the addiction.
• Support is one of the best ways to help patients on the road to long-term sobriety. It can – and should – come from a number of sources, including family, friends, doctors, therapists, and support groups. Love and support from friends and family can help a patient stay on track and remain accountable. Supportive treatment professionals like doctors and therapists can increase treatment success and compliance. Support groups can show patients that they aren’t the only ones fighting to overcome addiction.
When first learning about alcohol withdrawal symptoms, it can feel overwhelming. It’s true that the symptoms are not pleasant and they do not disappear overnight. However, the symptoms don’t last forever. For most patients, the worst symptoms only last for a week or so. Additionally, the symptoms of alcohol withdrawal can be managed with proper and early treatment during the detox process. As a result, in the grand scheme of things, one week of withdrawal symptoms is worth a lifetime of sobriety.
HARP strives to make detox and treatment as comfortable, effective, and safe as possible for our patients. We offer therapeutic and holistic care that is tailored to each patient’s unique situation and needs. Our treatment center helps patients detox from alcohol by providing inpatient care with 24-hour medical monitoring. After completing detox, our staff then focuses on the important work of exploring and treating the root causes of addiction with behavioral and pharmacological therapies in a supportive environment.
If you or someone you love is suffering from an AUD, HARP is here to help. Please contact us to learn more about our approach to helping patients overcome alcohol withdrawal symptoms and addiction.