Alcohol Withdrawal and Detox

Edmund Murphy
Dr. Samantha Miller
Written by Edmund Murphy on 25 August 2021
Medically reviewed by Dr. Samantha Miller on 28 March 2024

The biggest block for addicts wanting to stop substance abuse is the withdrawal process, and alcohol withdrawal is no different. But this does not mean it’s impossible. There are many rehab and treatment centers, as well as support groups that can help with the detox process and start the road to recovery.

Key takeaways:
  • Between the 6 and 12 hour period without alcohol intake, the person going through alcohol detox may begin to sweat without physical activity and become irritable and nauseous. During this time, the heart rate may accelerate and the blood pressure may rise
  • It is possible to go through alcohol withdrawal and detox without supervision for those with a mild disorder or alcohol dependence, but for those who have severe alcoholism, it is essential they undergo this process under medical care
  • Also known as DTs, delirium tremens occurs in about 5% of those with alcoholism who are going through the detoxification process. Delirium tremens can be severe, with the potential to lead to seizures, permanent brain damage, and even death

What is alcohol withdrawal?

Alcohol withdrawal (also known as acute alcohol withdrawal) is personified by a range of symptoms that an alcoholic or someone suffering from alcohol use disorder (AUD) may experience when they stop drinking. While these symptoms may be fairly mild for some, for example, those who partake in binge drinking only once per week, for others, they can seriously impact health and can even be life-threatening. 

Regardless of age, alcohol withdrawal can still have the same adverse effects, from teenagers to the elderly. It is possible to go through alcohol withdrawal and detox without supervision for those with a mild disorder or alcohol dependence, but for those who have severe alcoholism, it is essential they undergo this process under medical care.

Alcohol abuse impairs particular functions in the brain by altering the chemical connections which occur within neural pathways. Alcohol acts as a central nervous system (CNS) depressant, which causes reduced coordination, inhibition, and lapse in memory. Someone who drinks regularly can begin to adapt to the effects of alcohol on their CNS and build a tolerance to alcohol that can only be upheld by continued alcohol abuse, causing them to feel a sense of normality only when intoxicated. This is known as an alcohol dependency. 

It is partly this built-up tolerance that leads to dependence and addiction to alcohol. When alcohol is removed from the system, it shocks the central nervous system, which causes the symptoms of alcohol withdrawal syndrome. Withdrawal is the main obstacle to overcoming alcoholism and the reason many who attempt detox fail without supervision or support.

What is alcohol detox?

Often the only way to defeat alcohol addiction or any substance abuse is to stop using entirely. This process is known as alcohol detoxification, whereby the body is given time to fully remove all traces of the substance from the system. Only then can impulses towards addictive tendencies be dealt with. While this process is often necessary for alcohol addiction recovery, the withdrawal symptoms can make it dangerous, painful, distressing, and harmful to your health.

Severe alcohol withdrawal symptoms can often trigger a relapse, but withdrawal is a necessary step in the detox process, and conquering these symptoms is the only way of ensuring sobriety. Before attempting detox, it is imperative that you seek medical advice to assess your health risk and whether you will be able to detox without medical supervision. 

The safest and most effective way of tackling detox is through an alcohol rehab center with dedicated medical supervision. This reduces the risks of medical complications caused by withdrawal and reduces the likelihood of relapse. Even if an alcoholic attends a rehab or treatment center, the experience of detox will still be unpleasant and is not an assured fix without continued work. That is why it is advisable to seek therapy and ongoing treatment after detox, to ensure sobriety is maintained and relapses are avoided.

How long does it take to detox from alcohol?

The length of time it takes to detox from alcohol varies from person to person, though it often falls in line with the severity of withdrawal symptoms, the length of time alcohol was abused for, how often, how much, the BMI of the individual, and if they have been abusing other substances alongside alcohol. 

Related blog: Mixing Xanax And Alcohol

The body will begin to rid of the toxins in alcohol within six hours of last drinking, with the most severe symptoms of withdrawal appearing within 72 hours. The body will normally have detoxed from alcohol within 4-5 days, though withdrawal symptoms may still be present long after this.

What are the symptoms of alcohol withdrawal?

The severity and variation of alcohol withdrawal symptoms that a person going through detox will experience will differ wildly between individuals based on their level of alcoholism and any underlying medical conditions. Though, anyone with an alcohol use disorder can expect to have at least one of the following:

  • Anxiety
  • Confusion
  • Fatigue
  • Headaches
  • Alcohol craving
  • Heart palpitations
  • High blood pressure
  • Insomnia
  • Irritability
  • Nausea or vomiting
  • Shaking or tremors
  • Sweating
  • Delirium tremens
  • Wernicke’s encephalopathy
  • Korsakoff syndrome

Delirium tremens

Delirium tremens is a medical condition that can occur during the detoxification process in extreme cases of alcoholism. Also known as DTs, delirium tremens occurs in about 5% of those with alcoholism who are going through the detoxification process. Delirium tremens can be severe, with the potential to lead to seizures, permanent brain damage, and even death. 

The first signs of DTs normally manifest within the first three days of stopping alcohol. If you know someone who is detoxing from alcohol and displays any of the below symptoms, you should seek help immediately; 

  • Confusion
  • Emotional distress or agitation 
  • Fever or sweating
  • Hallucinations
  • Palpitations or chest pain
  • Hypersensitivity to sound, touch, and light
  • Withdrawal Seizure

The extremely damaging effects of delirium tremens are why it is highly recommended that someone wanting to recover from alcohol addiction should opt for a full medically supervised detox if possible.

Wernicke’s encephalopathy and Korsakoff syndrome

Wernicke’s encephalopathy (WE) and Korsakoff syndrome are both conditions caused by a deficiency of vitamin B1 (also known as thiamine), common in people who have alcohol use disorder. WE occurs when thiamine reserves are rapidly depleted, which causes irreversible structural damage to the brain, particularly the thalamus and hypothalamus. It results in rapid-onset confusion, reduced ability to concentrate, and sometimes can also affect eye movement and the ability to walk.

Korsakoff syndrome, or Korsakoff psychosis, is a chronic disorder that results from permanent damage to the brain caused by untreated Wernicke’s encephalopathy or thiamine deficiency. It is characterized by a chronic and severe memory impairment that persists for life.

Related: Alcoholic dementia

How long does alcohol withdrawal last?

Alcohol withdrawal symptoms can begin within six hours without drinking alcohol, becoming most severe at the two or three-day mark. The entire withdrawal cycle usually lasts a week but may take longer for those with a higher level of alcoholism such as with functioning alcoholics.

Between the 6 and 12-hour period without alcohol intake, the person going through alcohol detox may begin to sweat without physical activity and become irritable and nauseous. During this time, the heart rate may accelerate and the blood pressure may rise. In some cases, tremors and withdrawal-induced insomnia may also occur between the 12 and 24-hour period. Between 24 hours and 72 hours is often considered the worst stage of withdrawal, where delirium tremens, seizures, and hallucinations are most likely to occur.  

Delirium tremens and other severe withdrawal symptoms may continue into the third to fifth days of alcohol detox, as well as distress and psychological symptoms, such as depression and anxiety. After the fifth day, the physical effects of withdrawal begin to ease, though psychological symptoms (such as anxiety, insomnia, and depression) can continue past the end of the detox period and should be monitored closely and ideally treated with ongoing therapy if persistent.

Treatment for alcohol withdrawal

If you or someone you know is attempting to detox from alcohol, especially if they have significant alcoholism, it is strongly advised not to do it alone. Medical staff at hospitals and alcohol treatment centers are trained to help people with withdrawal symptoms and offer a safe, monitored space to detox. An alcohol detox program may also provide medication, in the form of benzodiazepines and other drugs, that help reduce the physical symptoms of withdrawal, reduce psychological effects, and monitor vital signs to ensure patients remain healthy.

Alcohol addiction treatment and rehab centers also often offer onsite therapy and counseling, which can help with the psychological and emotional effects of withdrawal on mental health, as well as providing long-term tools for dealing with cravings and habits. They will also be able to diagnose psychological or physical illnesses that may co-exist with addiction.

Get help with alcohol addiction today

There is no way out of alcohol addiction without detox, and there is no detox without withdrawal. Withdrawal symptoms are one of the most harmful aspects of alcoholism and can be a daunting prospect for anyone wanting to stop drinking. But, the long-term benefits of sobriety are clear. With the right help, detox can be made as painless as possible, and with time and effort, the lasting effects can be immeasurably beneficial.

If you or someone you care for is ready and willing to start the journey to recovery, contacting an alcohol treatment or rehab center is the next best step. Detox should never be done alone, and the right help can make all the difference.

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Activity History - Last updated: 28 March 2024, Published date:


Reviewer

Dr. Samantha Miller is a practicing NHS doctor based in Glasgow, UK, who regularly contributes as a medical reviewer for mental health and addiction.

Activity History - Medically Reviewed on 11 June 2021 and last checked on 28 March 2024

Medically reviewed by
Dr. Samantha Miller

MBChB

Dr. Samantha Miller

Reviewer

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