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Side Effects of Detoxing

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Detoxification is the first step towards sobriety for anyone suffering from an alcohol use disorder (AUD). For many people, the detox process can be frightening and overwhelming.

The side effects of detoxing can be mild or severe and life-threatening. One in 20 people undergoing alcohol detox will experience a serious side effect known as delirium tremens or DTs

However, knowing the side effects of alcohol detox can help make the process less frightening. Many people can break their alcohol dependency with support from friends, loved ones, and professional addiction treatment. 

Detox Side Effects From Alcohol

Alcohol detoxification causes many side effects. Your body will take time to adjust to operating without alcohol. This process is called alcohol withdrawal.

The most common symptoms of alcohol withdrawal are:

  • Nausea and vomiting
  • Headaches
  • Anxiety
  • Fatigue
  • Dizziness
  • Sweating
  • Muscle aches
  • Shaking or trembling
  • Trouble sleeping
  • Irritability
  • Confusion
  • Memory problems
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Stages of Alcohol Withdrawal

Withdrawal can be broken down into three stages.6 Not everyone will experience each stage. 

For example, a person with mild to moderate alcohol use disorder may only experience stage one symptoms. In contrast, a long-term, heavy drinker is more likely to experience symptoms of all three stages.

Stage One (Mild Symptoms)

Stage one of withdrawal begins within 6 to 12 hours after the last drink. 

As the stimulating chemicals in the brain overpower the diminishing depressive effects of alcohol, symptoms begin to surface. 

These symptoms can include:

  • Depression, anxiety, and mood swings
  • Alcohol cravings
  • Insomnia and fatigue
  • Headaches
  • Mild sweating
  • Nausea, vomiting, and appetite loss 
  • Minor confusion and trouble thinking
  • Muscle spasms
  • Mild heart palpitations
  • Mild tremors or shakes

Stage Two (Moderate Symptoms)

Stage two begins 12 to 24 hours after the last alcoholic drink. 

A person continues to experience symptoms from stage one, though they can become more severe. In addition to the increase in those initial symptoms, other symptoms begin.

The following symptoms can affect vital signs and may be an indicator that medical monitoring is necessary:

  • Dehydration
  • Fever
  • Frequent, loose bowel movements
  • Irregular heartbeat
  • Rapid, irregular breathing
  • Increased blood pressure
  • Confusion
  • Increased irritability

Stage Three (Severe Symptoms)

Stage three begins between 48 and 72 hours after alcohol cessation. This is the most severe withdrawal stage and often causes people to stop detoxing. 

It’s also the stage that poses the greatest risk for medical and life-threatening complications. If you experience stage three detox symptoms, seek medical attention and detox assistance from a healthcare professional.

These symptoms can include:

  • Profuse sweating
  • Severe agitation
  • Impaired thinking and increased to severe confusion
  • Hallucinations that can be auditory, tactile, and visual
  • Seizures
  • Weight loss
  • Delirium tremens (DTs)

What is Delirium Tremens (DT)?

Delirium tremens (DTs) is one of the most serious side effects of alcohol withdrawal. In addition to stage three symptoms, DTs can affect normal body function. 

DTs can affect breathing, cause dangerously high blood pressure, increase heart rate, and interfere with the ability to regulate body temperature. It may also precipitate respiratory and cardiovascular failure. If left untreated, DTs can result in coma or death. 

Not everyone experiences DTs, and certain factors can increase the risk. These include:

  • Co-occurring medical illness
  • Heavy, daily alcohol consumption
  • History of withdrawal seizures
  • Being over 60 years old
  • Abnormal liver function

If someone has any of these risk factors, medically monitored detox is typically necessary to avoid possible complications or death. 

Inpatient and residential detox centers provide 24/7 monitoring. They also offer medications to help minimize detox side effects and respond to possible complications.

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What Causes Alcohol Detox Side Effects?

When someone regularly consumes large amounts of alcohol, their brain and body chemistry become irritated. This includes neurotransmitters and the central nervous system (CNS). 

Alcohol works as a depressant on the brain, slowing down its functions. The body has to work hard to counteract this depressive state. 

As a result, the brain increases its production of stimulating chemicals, such as serotonin or norepinephrine. These stimulating chemicals work to balance out the depressive episodes of heavy drinking.

However, when a person stops consuming alcohol, the brain continues producing stimulating chemicals, resulting in alcohol withdrawal syndrome.

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Factors That Affect Alcohol Detox Symptoms

Detox symptoms are different for everyone and vary depending on the following risk factors: 

While these factors can affect the symptoms a person experiences during detox, there is a predictable pattern and timeline for detox symptoms.

The average time for alcohol detox is five to seven days. However, how long it will take to detox is based on the severity of the addiction. 

One person may complete detox within a few days while another struggles and experiences symptoms for a week or more. Withdrawal risk factors play a significant role in detox.

Acute & Post-Acute Withdrawal Syndrome

Many people experience acute alcohol withdrawal symptoms for 1 to 2 weeks after medical detox.

Acute withdrawal usually involves physical symptoms, including:

  • Nausea
  • Muscle aches
  • Headache
  • Increased heart rate

Post-acute withdrawal syndrome (PAWS) might occur weeks or months after ceasing substance use and undergoing detoxification. Unlike acute withdrawal, PAWS symptoms are usually more psychological and emotional.

Common PAWS symptoms include:

  • Mood swings
  • Irritability
  • Depression
  • Anxiety
  • Fatigue
  • Trouble sleeping (insomnia)
  • Trouble thinking clearly (disorientation)
  • Sexual dysfunction
  • Chronic pain

Alcohol Detox Treatment Options

Going through alcohol detoxification on your own can be very difficult. It’s even life-threatening for heavy users.  

Undergoing detox ensures you receive the support, care, and medical attention you need to overcome your addiction. Detox is usually a part of an alcohol addiction treatment program.

Luckily, several options are available for anyone looking to break free of their alcohol addiction:

Inpatient Treatment 

Inpatient treatment is the most intensive type of addiction treatment. You’ll live at the treatment facility and undergo a detox program. You’ll also receive medical advice and attention and participate in therapy programs designed to help prepare you for a sober life.

Outpatient Treatment 

Outpatient treatment providers are motivated to get sober and have responsibilities (such as family, work, or school). You can continue your daily routine without being at the center all day. This allows you to attend to your responsibilities while receiving support.

Medically-Assisted Treatment (MAT)  

MAT is available at treatment centers around the country. You may be prescribed a benzodiazepine to help manage withdrawal symptoms. Additional medications (disulfiram, naltrexone, and acamprosate) are prescribed to help people stay sober.

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Updated on October 3, 2022
7 sources cited
  1. ScienceDirect Topics. “Delirium Tremens.” 
  2. MedlinePlus, U.S. National Library of Medicine. “Delirium Tremens.”
  3. Harvard Health Publishing. “Alcohol Withdrawal.” 
  4. National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services. “NIH Study Shows Steep Increase in Rate of Alcohol-Related ER Visits.” 2018.
  5. Trevisan, Louis A., et al. “Complications of Alcohol Withdrawal.” National Institute on Alcohol Abuse and Alcoholism, 1998.
  6. (UK), National Clinical Guideline Centre. “Acute Alcohol Withdrawal.” Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications, 1970.
  7. Medscape. “What Is the Mortality Rate for Delirium Tremens (DTs)?” 2019.

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