Side Effects of Alcohol Detox

Detoxification is the first step towards sobriety for anyone suffering from an alcohol use disorder (AUD). For many people with an alcohol addiction, the detox process can be frightening and overwhelming. When you stop drinking alcohol, your body will go through withdrawal. The symptoms of alcohol withdrawal are often intense enough to turn people fall back to drinking.

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The side effects of detoxing can be mild or severe and life-threatening. In fact, one in 20 people undergoing alcohol detox will experience a very serious side effect known as delirium tremens or DTs. Heavy or long-term alcoholics should consider inpatient or residential detox in order to avoid potentially life-threatening complications.

However, knowing what the side effects are and what to expect during detox can help make the process less frightening. Many people are able to break their alcohol dependency with the support of friends, loved ones, and professional addiction treatment. Undergoing detox in an inpatient or residential facility also allows medical professionals to help monitor and assist throughout the process.

Alcohol detoxification causes many side effects, and your body will take time to adjust to operating without alcohol. However, once you go through detoxification, your risk for potentially life-threatening illnesses is greatly reduced.

Why Does Alcohol Detox Cause Side Effects?

When someone consumes large amounts of alcohol on a regular basis, the chemistry in their brain and body (neurotransmitters and central nervous system) gets irritated. Alcohol works as a depressant on the brain, slowing down how it functions. Then your body works hard to counteract this depressive state. 

The brain begins increasing the 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.

Symptoms & Side Effects of Alcohol Detoxing

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

  • Age
  • Gender
  • Co-occurring substance abuse
  • Co-occurring mental health disorder
  • Family history of alcohol use disorder
  • Quantity of alcohol consumed and for how long

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

Withdrawal can be broken down into three stages. 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.

The average time for alcohol detox is five to seven days. However, 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.

side effects

Stage One (Mild Symptoms)

Stage one of withdrawal begins within six 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:

  • Changes in Mood – depression, anxiety, and mood swings
  • Cravings for alcohol
  • Insomnia and fatigue
  • Headaches
  • Mild sweating
  • Nausea, vomiting, and a loss of appetite
  • Minor confusion and problems thinking
  • Muscle spasms
  • Mild heart palpitations
  • Mild tremors or shakes
withdrawal

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 nature. 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
  • Mental confusion
  • Increased irritability

The National Institute on Alcohol Abuse and Alcoholism reports that the rates of ER visits for chronic alcohol use complications, such as withdrawal, increased by 58 percent between 2006 and 2014.

sideeffects

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

These symptoms can include:

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

Life-Threatening Delirium Tremens (DT)

Delirium tremens is the most serious side effect of detoxing and alcohol withdrawal. In addition to the symptoms seen in stage three, DTs can affect normal body function. DTs can affect breathing, cause dangerously high blood pressure, increased heart rate, and interfere with the ability to regulate body temperature. It may precipitate respiratory and cardiovascular failure and, if left untreated, can result in coma or death. 

In fact, the current mortality rate for patients with DTs, despite treatment, is five to fifteen percent.

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
  • Those over 60 are more likely to experience detox complications and DTs
  • Abnormal liver functions

If someone has any of these risk factors, medically monitored detox is necessary in order to avoid possible complications or death. Inpatient and residential detox centers provide 24/7 monitoring and medications to help minimize detox side effects and respond to possible complications.

Acute & Post-Acute Withdrawal Syndrome

Many people continue to experience acute alcohol withdrawal symptoms for one to two 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 going ceasing substance use and going through detoxification. Unlike acute withdrawal, PAWS symptoms are usually more psychological and emotional in nature.

Common symptoms of PAWS 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, and possibly life-threatening for heavy users. Undergoing detox as part of an alcohol addiction treatment program is the best way to make sure you receive the support, care, and medical attention you need in order to overcome your addiction.

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

Inpatient Treatment — Inpatient treatment is the most intensive type of addiction treatment. Patients live at the treatment facility and undergo a detox program, receive medical advice and attention, and take part in therapy programs designed to help set them up for a sober life.

Outpatient Treatment — Outpatient treatment providers are good for people who have a high motivation for getting sober and have responsibilities (such as family, work, or school) that requires their attention.

Medically Assisted Treatment (MAT) — MAT is available at treatment centers around the country. You may be prescribed a benzodiazepine in order to help manage withdrawal symptoms. There are additional medications (such as disulfiram, naltrexone, and acamprosate) that are prescribed to help people stay sober.

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Resources

“Delirium Tremens.” Delirium Tremens - an Overview | ScienceDirect Topics, www.sciencedirect.com/topics/neuroscience/delirium-tremens.

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

Harvard Health Publishing. “Alcohol Withdrawal.” Harvard Health, www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z.

MaryAnn De Pietro, CRT. “Alcohol Withdrawal Syndrome: Symptoms, Treatment, and Detox Time.” Medical News Today, MediLexicon International, 5 July 2018, www.medicalnewstoday.com/articles/322373.php.

“NIH Study Shows Steep Increase in Rate of Alcohol-Related ER Visits.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 23 Feb. 2018, www.niaaa.nih.gov/news-events/news-releases/nih-study-shows-steep-increase-rate-alcohol-related-er-visits.

Trevisan, Louis A., et al. “Complications of Alcohol Withdrawal.” National Institute on Alcohol Abuse and Alcoholism, 1998, www.pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf.

(UK), National Clinical Guideline Centre. “Acute Alcohol Withdrawal.” Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications [Internet]., U.S. National Library of Medicine, 1 Jan. 1970, www.ncbi.nlm.nih.gov/books/NBK65581/.

“What Is the Mortality Rate for Delirium Tremens (DTs)?” Latest Medical News, Clinical Trials, Guidelines - Today on Medscape, 10 Nov. 2019, www.medscape.com/answers/166032-46098/what-is-the-mortality-rate-for-delirium-tremens-dts.

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Updated on: January 21, 2021
Author
Michael Bayba
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Medically Reviewed
Annamarie
Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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