Detoxing From Alcohol Addiction: What to Expect

Alcohol addiction, more commonly referred to as alcohol use disorder (AUD), is a chronic, relapsing brain disorder that occurs in at least 14.4 million adults aged 18 and older in the United States. 

Individuals who suffer from the medical condition have an impaired ability to stop or reduce alcohol consumption. Even when some attempt to quit drinking, withdrawal symptoms can be overwhelming (both mentally and physically) and result in relapse and potential overdose. 

Alcohol addiction can represent a recurring cycle of drinking and withdrawal. When individuals decide to stop drinking, negative withdrawal symptoms and strong alcohol cravings can arise. In an attempt to avoid all of this, individuals begin drinking once again, but much more heavily than before.

Fortunately, while alcohol addiction is a challenging medical condition to overcome, scientific evidence and advanced developments in therapies and medications have demonstrated that individuals who want to seek treatment can recover. 

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Alcohol Detox Timeline 

Stopping alcohol consumption can cause the body to experience different stages of detoxification and withdrawal. It is important to understand that while these are general guidelines, individuals may experience symptoms even up to 7 to 10 days after the last drink. 

Stage 1 — 6 Hours

Withdrawal symptoms begin to appear within 6 hours of the last drink. These symptoms tend to be mild. 

Stage 2 — 6 to 12 Hours

Symptoms will gradually intensify and individuals may experience symptoms like tremors or tachycardia (a condition where the heart beats over 100 beats per minute). Other symptoms may include nausea and vomiting.

Stage 3 — 24 to 48 Hours

At this point of withdrawal, depending on the severity of alcohol addiction, individuals may transition to a period known as alcoholic hallucinosis. This stage is characterized by auditory, visual, and tactile disturbances. The last two types of symptoms are not as frequent as the first. 

Examples of such disturbances could include sensitivity to light or hallucinations, intensified harshness or fear of sounds, and a feeling of pins and needles or numbness. In more severe cases, these symptoms can lead to paranoia and agitation. 

Seizures may also occur in some individuals. 

For those suffering from minor withdrawal, symptoms may peak at 18 to 24 hours after the last drink and begin decreasing 4 to 5 days later. 

Stage 4 — 48 to 72 Hours

During this time frame, some individuals may experience delirium tremens (DT), a short-term condition that causes severe physical and psychological symptoms. Similar to alcohol hallucinosis (AH), people with DT will show agitation and hallucinations. The main difference between DT and AH though, is disorientation. Those with DT become disoriented and run the risk of injuring themselves or healthcare staff unintentionally. 

DT is the severest of all the symptoms that manifests during the detox process. It has been reported that DT can occur 7 to 10 days after the last drink. 

Stage 5 — 72 Hours

This stage marks the severity of alcohol withdrawal symptoms at its highest. 

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Common Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms can range from one individual to the next. Some of the many symptoms that comprise withdrawal include:

  • Tremors 
  • Nausea/vomiting
  • Tachycardia (rapid heart rate) 
  • Hyperthermia (irregularly high body temperature can cause heat-related conditions)
  • High blood pressure 
  • Irritability 
  • Mood swings
  • Jumpiness or shakiness 
  • Headaches 
  • Hallucinations

Many may choose to continue drinking alcohol to combat any negative feelings that come with withdrawal. However, while resuming alcohol consumption can bring temporary relief to those negative feelings, it will worsen symptoms of withdrawal that arise during the next period of abstinence.  

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What is Alcohol Withdrawal Syndrome?

Alcohol withdrawal syndrome (AWS) is a clinical condition that occurs primarily in individuals who are alcohol-dependent. It develops within 6 to 24 hours after sudden discontinuation or decreased alcohol consumption. 

AWS has a wide range of symptoms, including agitation, tremors, anxiety, disorientation, fast heartbeat, high blood pressure, and many more. In more severe cases of AWS, individuals require medical attention to treat more life-threatening symptoms like seizures and coma. 

Alcohol withdrawal syndrome is one of the causes of preventable mortality. 

Medications: Reducing Withdrawal Symptoms

As it stands, the FDA has approved three medications to treat alcohol addiction. These medications include:

  • Naltrexone - this drug helps to block opioid receptors that influence both cravings and the rewarding effects of alcohol consumption. It decreases the risk of relapse to heavy drinking. However, genetic differences may affect the efficacy of the drug. 
  • Acamprosate (Campral®) - for those who suffer from more severe addictions, this drug may prove rather effective in minimizing symptoms like insomnia, anxiety, and dysphoria (sensations of unhappiness or unease).
  • Disulfiram (Antabuse®) - this medication can fight chronic alcoholism by causing unpleasant effects whenever alcohol is consumed. Flushing of the face, headaches, nausea, and irregular heartbeat are just some of the many effects to discourage drinking. 

Currently, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) are exploring other breakthrough medications to treat alcohol dependence. One particular drug, Topiramate, has shown promising results thus far in large clinical trials. The anti-epileptic drug has helped some individuals reduce drinking, especially in those with a certain genetic makeup. 

If you believe that you or a loved one are suffering from an addiction, it is important to seek professional medical care to receive proper addiction treatment and guidance. Sudden discontinuation of alcohol consumption can lead to relapse and make future attempts to quit much more difficult. 

While overcoming addiction is never easy, there are many resources, specialists, therapies, and support groups to lead you on a path to recovery. 

Resources

“Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 18 Feb. 2020, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics.

National Institute on Drug Abuse. “Treatment Approaches for Drug Addiction DrugFacts.” National Institute on Drug Abuse, 19 June 2020, www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction.

“Treatment for Alcohol Problems: Finding and Getting Help.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 5 Mar. 2020, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help.

“Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health - Full Report.” Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health - Full Report | Publications and Digital Products, Nov. 2016, store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991?referer=from_search_result.

“Delirium Tremens: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, 2 June 2020, medlineplus.gov/ency/article/000766.htm.

Mirijello, Antonio, et al. “Identification and Management of Alcohol Withdrawal Syndrome.” Drugs, U.S. National Library of Medicine, Mar. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4978420/.

Updated on: August 6, 2020
Author
Anthony Armenta
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Medically Reviewed: July 3, 2020
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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