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Alcoholism Recovery: Timeline for Your Path to Sobriety

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What is Alcohol Withdrawal?

Alcohol withdrawal can start within hours of stopping drinking. It refers to the symptoms some people experience when they decide to stop drinking excessively.

Not everyone will experience the same withdrawal symptoms. Some people will have less severe symptoms than others. 

Initial withdrawal symptoms are due to absense of alcohol and the body's reaction. Longer term symptoms often revolve around the social and psychological issues that contributed to the chronic alcohol use.

People are more likely to experience several withdrawal if they:

  • Drink heavily
  • Have been drinking for an extended period
  • Previously experienced withdrawal
  • Have other health conditions

The amount of time it takes for alcohol to completely leave the bloodstream depends on a person’s:

  • Age
  • Gender
  • Health
  • Genetic makeup
  • History of alcohol use (amount, type, frequency, and intake) 

Alcohol detection tests can still pick up alcohol in urine, saliva, and hair after it has completely left the bloodstream.

Alcohol Withdrawal Symptoms Timeline

Alcohol withdrawal symptoms are usually present within 8 hours after the last drink. In other cases, they may first occur days later. 

Physical symptoms usually peak at 24 to 72 hours after the last drink. These symptoms can persist for weeks. However, the timeline for alcohol withdrawal varies from person to person. Psychological symptoms may persist for years.

A general symptom timeline for alcohol detox looks something like:

  • 6 to 12 hours after the last drink: Mild symptoms, including headaches, mild anxiety, insomnia, small tremors, and an upset stomach, may occur.  
  • 24 hours after the last drink: Some people experience hallucinations.
  • Within 24 to 72 hours after the last drink: Some symptoms peak, level off, or resolve; others can persist for weeks or longer. Seizure risk is also the highest 24 to 48 hours after the last drink.
  • 48 to 72 hours after the last drink: Delirium tremens (DTs) can appear in severe cases. These symptoms are life-threatening and require medical attention. 

Common alcohol withdrawal symptoms include:1

  • Anxiety or nervousness
  • Jitters or twitching
  • Depression
  • Tiredness
  • Irritability
  • Jumpiness or shakiness
  • Mood swings
  • Nightmares
  • Inability to think clearly 

Other symptoms may include:1 

  • Sweating, clammy skin 
  • Enlarged pupils 
  • Headache
  • Insomnia (difficulty sleeping)
  • Appetite loss
  • Nausea and vomiting
  • Pale appearance
  • Rapid heart rate
  • Sweating, clammy skin
  • Tremor of the hands or other body parts

A severe type of alcohol withdrawal called delirium tremens can cause:1 

  • Agitation
  • Severe autonomic disfunction (loss of blood pressure control, pulse, respirations, and body temperature)
  • Hallucinations
  • Seizures
  • Severe confusion
  • Death
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Alcoholism Recovery Timeline

Recovery from alcoholism requires time, effort, willpower, and support. 

When you decide to join a formal alcohol treatment program, you’ll begin a journey through distinct recovery stages. You’ll learn to develop a healthy and sober lifestyle.

The four stages of alcoholism recovery are:

1. Treatment Initiation

When you seek help from a professional alcohol rehab program, whether voluntarily or not, treatment initiation is the first stage of recovery.

In the early hours and days of your program, you may feel unsure that your substance abuse problem is serious. 

Be wary of this attitude. Denial and hesitation can be your worst enemies in the first days of your recovery.2 People who don’t admit they have a drinking problem have a difficult time engaging in treatment programs. 

During treatment initiation, the goal is to help you actively decide to participate in the program and accept abstinence as the goal.

After you admit to having a problem with alcohol, you must accept that there is a potential solution. To reach this thinking, a substance abuse counselor may help you:

  • Examine the damaging effects of alcoholism
  • Explore feelings of denial 
  • Become motivated to recover

During initiation, you will also discuss your alcohol and drug use history. Your counselor will work with you to develop a personal treatment plan.

2. Early Abstinence

Once you’ve committed to treatment, you’ll enter the second stage of rehab. This is called early abstinence. Early abstinence from alcohol is linked to positive treatment outcomes.

Early abstinence is most easily achieved in a residential treatment program. In these programs, alcohol is not readily available and nobody is actively drinking. 

However, this can be the hardest stage to cope with due to:

  • Persistent withdrawal symptoms
  • Psychological dependence
  • Physical cravings
  • Triggers that can tempt you to relapse

Challenges at this stage of treatment include:3

  • Cravings
  • Social pressure to drink
  • High-risk situations that trigger alcohol consumption
  • Living or residing in an environment where alcohol is readily available 

During this stage, your counselor will teach you coping skills necessary for leading a sober lifestyle. The tools you learn will help you throughout recovery.

You will learn:

  • About the physical and psychological aspects of withdrawal
  • How to identify alcohol use triggers
  • How to deal with alcohol cravings without drinking

Some helpful strategies include:3

  • Participating in healthy activities, like journaling and meditation
  • Finding alternative behaviors to follow instead of drinking alcohol
  • Attending and interacting with self-help groups that offer support and information
  • Recognizing environmental triggers, like certain people and places, that lead to cravings

3. Maintaining Abstinence

After around 90 days of continuous abstinence, you’ll move to the third stage. This stage is called maintaining abstinence.

If you begin in a residential treatment program, you’ll move to the follow-up counseling phase of your rehab program on an outpatient basis.

One focus of this recovery stage is to maintain abstinence by avoiding relapse. You’ll learn the warning signs that might indicate or lead to relapse.

You’ll also discover how to put the tools you learned in early abstinence to use in other areas of your life. You’ll find that your future quality of life depends on more than simply not drinking alcohol.

Counselors and other recovering alcoholics will teach you new coping skills and tools to help you:

  • Avoid ​substituting addictions
  • Build healthy relationships
  • Follow a ​drug-free lifestyle
  • Learn ​employment and money management skills
  • Manage ​anger
  • Exercise more
  • Learn about nutrition

This stage starts at around 3 months into your rehab program. It will last until you’ve been clean and sober for approximately 9 to 12 months. At this point, follow-up counseling will usually finish.

4. Advanced Recovery

After the first year of abstinence and recovery, you’ll reach the fourth and final stage of rehab: advanced recovery. You’ll take the tools and skills you’ve learned during rehab and use them to live a satisfying, fulfilling life.

During this stage, you’ll learn how and continue to:

  • Create long-term goals
  • Follow a consistent daily schedule
  • Build relationships with people who don’t drink
  • Participate in recreational activities that don’t involve alcohol
  • Find new ways to seek happiness and fulfillment. This may involve religion, spirituality, community work, or social activism 

Many successful people in recovery engage and work with others in early recovery by sharing their experiences. They also help them become:

  • Healthier people
  • Better partners and parents
  • Productive members of society
  • Good neighbors

Recovery is more than staying sober; It's discovering how to live a happier and healthier life. Some people say ‘All you have to do is quit drinking, and change your whole life!’

Benefits of Quitting Drinking

The advantages of quitting alcohol can be easy to overlook, especially because alcohol gives some people many immediate, short-term perks. 

Alcohol can help you loosen up and talk to more people at a party. It can also make you momentarily forget about any problems you’re facing. Some people use alcohol to cope with life challenges they have little control over.

However, those benefits are short-lived. Alcohol can remain in your blood and affect your body longer than you think, especially if you’re depending on it.

There are many physical and mental health benefits you’ll enjoy when you quit drinking, including:

  • Increased heart health
  • Reduced risk of cancer
  • Your body will feel better
  • Healthier weight
  • No more hangovers
  • Increase in rational decision making and impulse control
  • Improved mental health
  • A more stable mood
  • Better sleep
  • More control over your life
  • Fewer regrets and apologies
  • Remembering what you did the night/week before 

In the first month of giving up alcohol, your body is already likely to have benefited greatly. Better hydration and sleep will increase your productivity and daily wellbeing.

Your liver, stomach, and skin will also improve from not drinking alcohol. You’ll also likely have reduced your calorie intake.

The longer you live without alcohol, the more improvements you’ll experience. This includes positive changes in your overall health, relationships, work, finances, and more.

Updated on April 12, 2022
6 sources cited
  1. Alcohol withdrawal, MedlinePlus, February 2022.
  2. Lima-Rodríguez, Joaquín Salvador et al. “Alcoholic patients' response to their disease: perspective of patients and family.” Revista latino-americana de enfermagem vol. 23,6 : 1165-72.
  3. Individual Drug Counseling, Delinda E. Mercer, Ph.D. George E. Woody, M.D. University of Pennsylvania and Veterans Affairs Medical Center, National Institute on Drug Abuse
  4. Kelly E. Dunn, Joseph A. Harrison, Jeannie-Marie Leoutsakos, Dingfen Han, Eric C. Strain, Continuous Abstinence During Early Alcohol Treatment is Significantly Associated with Positive Treatment Outcomes, Independent of Duration of Abstinence, Alcohol and Alcoholism, Volume 52, Issue 1, 1 January 2017, Pages 72–79.
  5. Jesse, S et al. “Alcohol withdrawal syndrome: mechanisms, manifestations, and management.” Acta neurologica Scandinavica vol. 135,1 : 4-16.
  6. Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. [Updated 2021 Nov 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.

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