Alcohol Detox and Withdrawal

Alcohol addiction can ruin a person’s life, and yet many continue to abuse the drug knowingly in order to avoid withdrawal. Detox and withdrawal are infamous in the addiction community for being physically and psychologically uncomfortable experiences. If done at home without medical attention, alcohol withdrawal can even turn deadly. However, this time of bodily cleansing is the first step to putting your life back on track. Following detox, you will be ready to enter rehab and learn the sober living skills that will help you during the lifelong process of recovery.

Are you struggling with alcohol addiction, or is someone you know struggling? If the answer is yes, you likely have questions about alcohol withdrawal. You’ll find the answers to those questions on this page, where you can read about alcohol withdrawal symptoms (signs of alcohol withdrawal), or alcohol detox symptoms. You’ll also find an alcohol withdrawal symptoms (commonly misspelled as “alcohol withdrawl symptoms”) timeline, or alcohol detox timeline, to help you better understand what to expect. This alcohol detox timeline details the symptoms. Withdrawal from alcohol can be difficult to understand, in terms of how it affects the body. The symptoms of alcohol withdrawal can be severe and are usually uncomfortable, especially if you or your loved one has been struggling with alcoholism for a long time. But the good news is, help is available.

A person has reached a state of alcohol dependence — the physical half of addiction — when their body experiences withdrawal symptoms once there is no more alcohol in their system. Withdrawal symptoms occur during detox, a natural bodily process that removes toxins from the system.  

Alcohol withdrawal is a physically and psychologically uncomfortable experience — so much so that many heavy drinkers will continue drinking, despite the negative consequences, because it helps them avoid withdrawal. Withdrawal occurs because continued and excessive alcohol use eventually interferes with the brain’s natural functions, disrupting neurotransmitters that send messages to your central nervous system. The primary neurotransmitter tied to the production of feelings like relaxation is gamma-aminobutyric acid (GABA). GABA also helps produce endorphins in the brain, which produce a sense of well-being. Excessive alcohol use causes a GABA imbalance, resulting in negative physical and mental symptoms of alcohol withdrawal:

  • Headaches
  • Heart palpitations
  • Seizures
  • Anxiety
  • Restlessness
  • Confusion

Alcohol abuse also affects dopamine, the neurotransmitter linked to the body’s reward system. This pleasure center regulates your energy, enjoyment and motivation. Dopamine also assists with the body’s sense of attention, motor coordination, cognition and mood. Alcohol releases dopamine, triggering some of the happy feelings addicts crave. As the body begins to build a higher tolerance to alcohol, the brain becomes more dependent on the substance for feel-good neurotransmitters. When a long-term heavy drinker suddenly stops drinking, dopamine production also halts, causing physical and psychological alcohol withdrawal symptoms.

Other symptoms of alcohol withdrawal syndrome include:

  • Tremors
  • Nausea
  • Vomiting
  • Loss of appetite
  • Confusion
  • Irritability
  • Mood swings
  • Sweating
  • Fever

Some alcoholics going through withdrawal may experience a very severe set of symptoms, called delirium tremens. Delirium tremens most commonly occur in those who drink in excess daily for months or even years.

Delirium tremens symptoms include:

  • Altered mental functions
  • Deep sleep
  • Fear
  • Seizures
  • Sudden mood changes
  • Excitement

The severity of withdrawal symptoms can depend on many variables, and therefore is different from person to person. Such factors include how long the person has been abusing alcohol, the quantity of alcohol they consume, how frequently they drink, their history with addiction to other substances, polydrug use, family addiction history, and physiological makeup, such as gender, weight and age. It is important to contact a medical physician if you begin to feel any withdrawal symptoms after you stop using alcohol, as withdrawal symptoms can become life-threatening if not treated appropriately.

Although alcohol detox takes a fairly standard amount of time — about a week — alcohol withdrawal is different for every person who goes through it. For some, the process lasts days. For others, it lasts months.

The process is triggered when an addict stops drinking alcohol. As the liver metabolizes ethanol and moves the drug through a person’s system, withdrawal symptoms will begin. It takes anywhere from 30 minutes to two hours for the body to absorb one serving of alcohol into the bloodstream. Alcohol can be detected in the urine between 12 and 24 hours after consumption, however, because the liver can only metabolize about .25 ounces of it per hour.

Most alcohol detox programs last anywhere from a few days to more than a week, with withdrawal symptoms usually subsiding within seven or more days of the program. However, alcohol cravings and other minor side effects may continue for some time after detox. The following alcohol withdrawal symptoms timeline (alcohol detox timeline) details the symptoms of alcohol withdrawal and when they typically occur:


Alcohol Withdrawal Timeline

Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms are known to come in three different stages: minor, moderate and severe. Minor withdrawal symptoms — such as headaches, slight tremors and nausea — are subject to start anywhere from six to 12 hours after a person’s last drink. More moderate side effects of withdrawal — such as vomiting, sweating, confusion and fever — may follow within 12 to 24 hours. Those who experience severe withdrawal may begin to feel these symptoms — called delirium tremens — between 48 and 72 hours after discontinuing alcohol use.

Delirium tremens are a potentially fatal medical emergency, although awareness of this serious complication of alcohol withdrawal has helped to lower the rate of fatalities. Research shows 5 percent of the roughly 2 million Americans who seek alcohol addiction treatment each year experience delirium tremens, also known as alcohol withdrawal delirium. The mortality rate for delirium tremens can range from 3 to 15 percent each year.

  • Disorientation
  • Confusion
  • Vivid hallucinations
  • Extreme tremors
  • Autonomic hyperactivity, including shortness of breath, sweating, dry mouth and palpitations
  • Rapid heart rate or tachycardia
  • Agitation
Scientists are still determining what causes delirium tremens. Although former research pointed to vitamin deficiencies, more recent studies show the brain releases glutamate during alcohol withdrawal to compensate for the alcohol’s enhancement of gamma aminobutyric acid in the brain. Glutamate is a type of excitatory neuron, which may explain the autonomic hyperactivity and other delirium tremens symptoms.

Fatal complications from delirium tremens include oversedation, respiratory arrest, cardiac arrhythmias and aspiration pneumonitis, which occurs when a person inhales toxic substances into the lungs, resulting in infection.

You may be at risk for delirium tremens if you:

  • Are middle aged or a senior citizen
  • Have experienced seizures during previous alcohol withdrawal
  • Have a co-occurring mental illness
  • Have abnormal liver function
  • Experience intense alcohol cravings
  • Have abused alcohol for an extended period of time
  • Have experienced delirium tremens before

Delirium tremens can be difficult to diagnose, as some symptoms are similar to those of acute alcohol withdrawal. However, acute alcohol withdrawal is rarely deadly, while alcohol withdrawal delirium can be lethal in up to 15 percent of cases. If you undergo detox at an accredited detox facility with experienced addiction professionals, such as those at The Recovery Village, you have a greater chance of experiencing a safe alcohol withdrawal. Delirium tremens often require advanced pharmacotherapy, and in extreme cases may even require a stay in a hospital’s intensive care unit.

Alcohol withdrawal and alcohol detox symptoms can be deadly in certain circumstances, so it’s incredibly important for those detoxing from alcohol to do so in a medical facility.

Alcohol withdrawal can cause many deadly symptoms, including:

  • Heart palpitations
  • Heart arrhythmia
  • Kidney dysfunction
  • Liver dysfunction
  • Seizure
  • Seizure-related head injury
  • Delirium tremens
  • Hallucinations
  • Increased heart rate
  • High blood pressure
  • Hyperventilation

Detox can be dehydrating to the body as it uses any means — most notably vomiting, diarrhea and sweating — to expel alcohol and its toxins. Alcohol in and of itself is also a dehydrating substance. Combining an alcohol user’s pre-existing dehydrating qualities with withdrawal-related dehydration can easily induce seizures and even prove lethal.

Detoxification is the natural bodily process of removing toxins. Any time you consume alcohol, the body naturally begins to detoxify, using the liver to metabolize ethanol and remove it from your system. Those who drink frequently never truly detoxify from the substance because they are always adding more into their system. When someone with alcoholism chooses to get sober, the first thing they must do is stop drinking alcohol and let the body detoxify.

There are two ways to detox — cold turkey, or all at once, or by gradually lowering alcohol dosages, called tapering. Most people who choose to detox on their own at home resort to the cold turkey method. However, cold turkey detox can be dangerous, as the onset of withdrawal symptoms is more severe. In the face of the symptoms, the person detoxing may end up relapsing and putting themselves in danger of alcohol poisoning.

Professional medical detox is the safest option when it comes to stopping drinking. At The Recovery Village, we monitor patients 24/7 to ensure their pain during withdrawal is managed, their vitals are at healthy levels and they are not experiencing any life-threatening symptoms.

Withdrawal from alcohol during detox can be very serious. The primary risks during detox include dehydration and delirium tremens. Severe dehydration can lead to seizures, which can easily become lethal, especially if they occur in a home environment. Delirium tremens can also lead to cardiac arrhythmia and respiratory failure, which can be fatal if left untreated.

Following detox, you will be ready to begin treatment for alcohol addiction. The Recovery Village offers many different treatment options including inpatient and outpatient rehab. Rehab is a proven treatment method for alcohol addiction because it addresses both the physical and psychological sides of the disease. Another component of recovery involves aftercare, which helps prevent relapse. 

Addiction Blog. “How Long Does Alcohol Stay in Your System?” Addiction Blog, 11 Nov. 2011, alcohol.addictionblog.org/how-long-does-alcohol-stay-in-your-system/. Accessed 19 Mar. 2017.
Burns, Michael J. “Delirium Tremens (DTs).” Diseases & Conditions – Medscape Reference, WebMD LLC, 7 Mar. 2017, emedicine.medscape.com/article/166032-overview#a7. Accessed 19 Mar. 2017.
Pelic, Christopher, and Hugh Myrick. “Who’s at Greatest Risk for Delirium Tremens?” Current Psychiatry, Frontline Medical Communications Inc., Jan. 2003, www.mdedge.com/currentpsychiatry/article/66149/schizophrenia-other-psychotic-disorders/whos-greatest-risk-delirium. Accessed 19 Mar. 2017.

Alcohol Detox
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Alcohol Detox was last modified: November 22nd, 2017 by The Recovery Village