Alcohol Withdrawal Symptoms: Severities & Timelines

Withdrawal Symptoms

Robert Gerchalk

Robert is our health care professional reviewer of this website. He worked for many years in mental health and substance abuse facilities in Florida, as well as in home health (medical and psychiatric), and took care of people with medical and addictions problems at The Johns Hopkins Hospital in Baltimore. He has a nursing and business/technology degrees from The Johns Hopkins University.

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The Severities and Timelines of Alcohol Withdrawal Symptoms

If you are suffering from alcohol use disorder, you deserve some empathy and compassion. Contrary to what a lot of people think, alcoholics cannot always be held accountable for their behaviors. There are alcoholism risk factors that can drive someone to start obsessively drinking without ever intending to do so. The list of potential risk factors includes (but is not limited to):

  • Exposure to alcohol at an early age
  • Family history of alcohol or drug use
  • Traumatic life events, like abuse, experiencing a natural disaster, death of a loved one, personal injury from an accident, and legal issues
  • Existence of co-occurring mental disorders, like depression, PTSD, and anxiety
  • Peer pressure and overexposure to social drinking to secure a sense of belonging

Regardless of what might have driven you into the disease of alcoholism, there will come a time when you’ll need to take a hard look at what you are doing. You’ll also need to take a hard look at what alcohol use disorder is doing to your life. 

Most of the following information is going to focus on alcohol withdrawal symptoms and withdrawal timelines. Leading into that discussion, we’ll focus on the signs of alcohol use disorder and the path back to sobriety. 

The Signs of Alcohol Use Disorder

If you are like so many other alcoholics, you might be living in denial. If that’s the case, it’s reasonable that you might not know you have a problem with alcohol. To help remove any doubts, you might want to look at this list of typical signs of alcohol use disorder:

  • Increasing difficulty in personal relationships
  • Drinking more than planned with each drinking session
  • Frequently drinking to blackout
  • Performance problems at school or work
  • Legal issues: theft to support habit, divorce, DUIs, etc.
  • Unkempt personal appearance
  • Problems with concentration even when sober
  • Appetite issues and sleep problems
  • Making excuses related to drinking too much
  • Ignoring responsibilities, like paying bills or cleaning the house

Take a hard look at this list, and check off those that apply to you. If you recognize that you are displaying some of these symptoms, it’s probably time to think about getting help.

The Path Back to Sobriety

No matter how significant your alcohol use disorder might be and as long as you are breathing, there will always be a path back to sobriety. Starting down that path is going to require you to enter the first stage of recovery

Some experts call the first stage of recovery the abstinence or acceptance stage. It’s during this stage that you will have to come to grips with the fact you are powerless over your desire to drink. When you finally see the reality of your situation, it will elicit a lot of feelings and emotions. Hopefully, experiencing those feelings and emotions will drive you to ask for help. 

To be clear, it takes great strength to admit you have a weakness. It takes super strength to put your hand out and admit you need help battling your weakness. When you are ready and able to do these two things, you are signaling that you are ready to start the battle back to a life without alcohol.

You need to understand just how difficult it would be for you to attempt to stop drinking cold turkey and try to abstain from drinking on your own. Danger lurks because of the likelihood of having dangerous withdrawal symptoms (see below) without someone to help you. 

If you really want help with your withdrawal and recovery, rehab might be a good place to start. In an alcohol rehab environment, you would get an opportunity to work with addiction treatment professionals who are trained to lead you down the path of recovery. 

The path of recovery might start with a stint in a detox program. That would be followed by therapy and counseling, which would seek to identify the root causes of your need to self-medicate with alcohol. You would also get a chance to develop coping skills that could help you avoid relapses in the future. 

If all goes well, you will eventually leave the rehab facility with a better sense of how to protect yourself from your drinking disease. If things get a little shaky, there will be some aftercare resources that can help prevent relapses and help manage your triggers. 

Severities and Timelines of Alcohol Withdrawal

Before we begin discussing the importance of detox programs, it seems prudent for us to discuss alcohol withdrawal. Alcohol withdrawal is a biological process that allows the body and mind to “express their displeasure with being denied alcohol.” 

The symptoms of alcohol withdrawal are seemingly proportionate with the severity of the individual’s alcohol use disorder. The deeper the addiction, the worse the symptoms will be. Certainly, withdrawal symptoms and the extent thereof will vary from one person to the next. However, there are some common withdrawal symptoms that most will experience. 

At this point, we would like to divide common alcohol withdrawal symptoms into two categories: Minor/moderate to severe with a further discussion of the typical withdrawal timeline.

Minor to Moderate Alcohol Withdrawal Symptoms

Minor to moderate withdrawal symptoms are alarming but not necessarily dangerous to one’s health. Here is a list of common alcohol withdrawal symptoms that are considered less problematic: 

  • Nausea, vomiting, and diarrhea (digestive issues)
  • Profuse sweating
  • Headaches
  • Increased blood pressure and heart rate
  • Loss of appetite
  • Increase irritability
  • Sleep issues
  • Confusion and problems with concentration

Severe Alcohol Withdrawal Symptoms

If someone has a significant alcohol use disorder, they are far more likely to encounter severe withdrawal symptoms. These are symptoms that pose legitimate threats to the client’s health and life. Here is a list of common alcohol withdrawal symptoms that need to be classified as severe:

  • Nightmares and tactile, visual, and auditory hallucinations 
  • Difficulty breathing
  • Alarmingly high blood pressure and heart rate
  • Delirium Tremens, or DTs
  • Body tremors in the extremities (arms and legs)
  • Onset of psychological issues related to anxiety and depression
  • Seizures

As you can see, this is quite a list. Any one of those symptoms could cause collateral health issues with some issues possibly leading to the threat of life. 

Typical Withdrawal Timeline

Given the alarming nature of these withdrawal symptoms, it’s reasonable for you to question how long it takes to go through withdrawal. 

Again, withdrawal affects everyone differently, but there are several factors that influence the length of withdrawal. These factors include:

  • The amount of alcohol consumed during one drinking session
  • The frequency of drinking sessions
  • The individual’s age and weight
  • The existence of other health conditions
  • The types of alcohol being consumed (generally)

We’ll start with the standard alcohol withdrawal timeline:

  • Six-hour mark: The first symptoms (sweating, agitation, loss of appetite) appear.
  • 12-24 hours: Symptoms, like confusion, problems concentrating and a rise in blood pressure, appear
  • 24-48 hours: This would be the peak time for minor to moderate withdrawal. The symptoms at this point would include nausea, vomiting, headaches, stomach issues, tremors, and some depression and or anxiety.
  • 48-72 hours: This would mark the peak of severe symptoms, which might include body convulsions, hallucinations, DTs, breathing problems, and an elevated heart rate. 
  • Day 5: By day five, the symptoms should start dissipating. Individuals will start to regain their appetite and might need sleep. While the worst issues should be a thing of the past, it’s always possible some symptoms will linger for up to a month or two. 
  • Day 7 – This is liberation day. If individuals make it this far, they should start feeling better and experiencing clarity of mind. This is the point that a lot of rehab facilities will usually deem a client able to start therapy and counseling. 

 

While the above timeline is considered a general rule of thumb, it would be irresponsible to not mention the withdrawal timeline for alcoholics with severe issues with alcoholism. In those cases, withdrawal could extend for months.  

Importance of Detox Programs 

At this point, it should be obvious that withdrawal symptoms create challenges within the recovery process. That’s why rehab administrators are so quick to recommend or prescribe detox programs. They usually make these determinations during the intake process, recognizing that certain clients won’t be suitable for therapy until the alcohol has been substantially removed from their bodies. 

It’s important to note that many rehabs have their own detox facilities while others recommend clients go to outpatient detox programs before returning to rehab for treatment. 

Most clients enter rehab needing a stint in a medically monitored detox program. A medically monitored detox program allows clients to deal with their withdrawal symptoms while under the care of medical professionals. 

If possible, natural detox without medical intervention is always preferred. However, there are times when clients are exposed to health issues, like pain and insomnia. In such cases, there will be a medical professional standing by to prescribe relief medication if needed. The whole point of a detox program is to keep clients safe and comfortable until their withdrawal symptoms have substantially passed.

When a client’s body and mind are able to function closer to normal levels, it makes them more likely to benefit from the rest of the treatment process. That’s the exact intent of detox programs.

As you contemplate how to deal with your alcohol use disorder, remember that dealing with withdrawal comes with the territory. It probably won’t be fun, but it will be necessary. Hopefully, the above information on what symptoms to expect will help. 

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