While the alcohol detox timeline can differ from person to person, symptoms will often gradually improve and dissipate over several days.
Stopping alcohol can be difficult, and knowing what to expect is important. If you have been using alcohol frequently over a prolonged period, withdrawal symptoms can develop. Understanding and anticipating these symptoms will help position you for success.
Alcohol withdrawal can begin within hours once a person stops drinking, though each individual’s experience may vary. Some people may notice milder symptoms, while others develop more serious complications. You may face a higher risk of intense withdrawal if you:
- Frequently consume large amounts of alcohol
- Have been drinking heavily for a prolonged period
- Have gone through withdrawal before
- Live with coexisting medical conditions
How quickly alcohol leaves your bloodstream depends on factors such as age, gender, general health, genetics and past alcohol use. According to the National Library of Medicine, withdrawal symptoms typically begin about eight hours after a person’s last drink, though in some instances, they may not emerge for a few days. Although symptoms tend to peak between 24 and 72 hours, some can continue for several weeks. Even after alcohol has completely cleared your bloodstream, it may still be detectable in urine, saliva and hair.
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Article at a Glance
- Alcohol withdrawal arises when the level of alcohol in the blood drops below a person’s usual level, with mild symptoms sometimes starting just six hours after the final drink.
- Physical withdrawal symptoms often reach their highest intensity between 48 and 72 hours, then gradually diminish over the course of two weeks. However, psychological symptoms can persist for months.
- Delirium tremens (DTs) is a severe, potentially fatal form of withdrawal affecting approximately 5–15% of those in withdrawal, especially older adults and people with a longstanding history of heavy alcohol use.
- In a survey of 2,136 U.S. adults who had undergone alcohol detox, participants reported that withdrawal symptoms lasted an average of 4.83 days. Most (95%) described their symptoms as persisting anywhere from two to eight days.
- Individuals who regularly drink heavily have an increased likelihood of experiencing symptoms such as hallucinations, delirium tremens, seizures and rapid heartbeat.
- Because of the potential dangers of withdrawal, a medically supervised detox program or rehabilitation facility is recommended for managing symptoms safely.
When Does Alcohol Withdrawal Start?
Withdrawal begins once alcohol levels in the bloodstream dip below a person’s normal range. While mild signs can appear as soon as six hours after the final drink, the onset can vary based on age, sex, genetic predisposition, overall health and history of alcohol use.
It is also possible to experience withdrawal symptoms when heavy drinking is significantly reduced, even if not completely stopped. In these situations, symptoms may take longer to emerge and could be subtler.
How Long Does Alcohol Withdrawal Last?
As you detox from alcohol, your body goes through different processes and stages after you stop drinking. While this timeline can differ from person to person, it usually follows a general pattern. Here’s what a person might experience at different times after they stop drinking:
Stage One: 6–12 Hours
Mild withdrawal symptoms, including shaky hands, sweating, headaches and anxiety, may start within the first 6–12 hours after the last drink. You might find it hard to sleep and may feel restless or irritable. Those with more mild dependence may not experience any symptoms this soon after stopping drinking.
Stage Two: 12–24 Hours
During the 12–24 hours, symptoms may continue and worsen. New mild symptoms that didn’t appear in the first 12 hours will begin to appear in this timeframe, and existing symptoms will intensify.
Stage Three: 24–48 Hours
Between 24–48 hours after stopping alcohol, the symptoms will keep worsening. Insomnia and nausea can develop during this time. Some people might experience seizures, which are brain activity abnormalities that lead to sudden, uncontrolled shaking or jerking movements. This stage can be dangerous, and medical help is very important if moderate to severe symptoms occur.
Stage Four: 48–72 Hours
In the 48–72-hour time frame, symptoms will typically peak, reaching their highest intensity. During this time, you might experience the most severe withdrawal symptoms, like delirium tremens. This includes serious confusion, shaking, hallucinations and high fever. This stage is very dangerous and can be life-threatening without medical help for those with serious alcohol dependence.
Stage Five: 72+ Hours
After 72 hours, symptoms will usually slowly get better, gradually improving and dissipating over the next several days. However, psychological symptoms, like cravings, depression or anxiety, may last several weeks or months after their physical symptoms are gone. You might need ongoing help from healthcare providers or support groups to deal with cravings and learn how to live without alcohol.
What Is Delirium Tremens?
Delirium tremens, often called “DTs,” is the most dangerous complication of alcohol withdrawal and can happen within two to four days after your last drink. A person with delirium tremens might be very confused, have hallucinations, shake a lot or have an elevated fever and high blood pressure. It can be deadly if not treated right away. Up to 37% of people with delirium tremens will die if they do not receive medical attention. Someone with delirium tremens must be treated in a hospital setting to help them avoid the complications it can create.
What Causes Alcohol Withdrawal?
Alcohol withdrawal is caused by stopping alcohol use after dependence develops. Dependence is the condition in which the brain adjusts to accommodate the presence of alcohol. For dependence to occur, you must have alcohol in your bloodstream most of the time, which requires heavy and frequent alcohol use.
Once dependence occurs, withdrawal will happen whenever you stop using alcohol and will last about a week to a week and a half. If dependence is present, withdrawal will occur if you stop using alcohol. You can do things to reduce the intensity of withdrawal or treat symptoms that develop; however, withdrawal will be inevitable.
What Is the Difference Between Withdrawal and Detox?
The terms withdrawal and detox are often used interchangeably, and it can be confusing to figure out the difference between them, which is only slight. Technically, detox is the process of stopping alcohol and allowing your body to adjust, while withdrawal refers to the symptoms that occur during detox. Withdrawal can ultimately be thought of as a part of detox.
What Happens During Alcohol Withdrawal and Detox?
Alcohol remains in your system for varying lengths of time, determined by factors like body weight, metabolism and drinking patterns. Once you stop or drastically reduce your drinking, your body may respond with specific withdrawal or detox symptoms, especially if you have been a long-term heavy drinker.
Common Withdrawal and Detox Symptoms
Typical symptoms of alcohol withdrawal and detox include:
- Irritability
- Depression
- Anxiety
- Extreme fatigue
- Sweating or hot flashes
- Nausea and vomiting
- Mood swings
- Rapid heart rate
- Dangerous dehydration
- Tremors (commonly called “alcoholic shakes”)
- Delirium tremens
- Seizures
Factors That Affect the Alcohol Detox Timeline
Several factors can affect the timeline an individual can expect when detoxing from alcohol. These include:
- The amount of alcohol used: The more alcohol you drink each day, the higher the amount of alcohol constantly in your blood, and the more your brain will have to adjust.
- The frequency of alcohol use: The more frequently you use alcohol, the more constant the level of alcohol in your bloodstream will be, making your brain adjust more.
- Your genetics: Genes can influence how quickly you metabolize alcohol, affecting your dependence.
- Previous detox: Your risk of experiencing severe withdrawal symptoms increases with each detox. If you have detoxed before, you are at a greater risk of a longer detox and more severe symptoms.
What Are the Long-Term Implications of Alcohol Withdrawal?
Over the long term, alcohol withdrawal is unlikely to cause significant harm and will provide tremendous health benefits. Long-term complications can occur from a seizure or DTs; however, these are rarely a problem if medical treatment is provided during detox. After physical symptoms are over, medically detoxing from alcohol can help you avoid potential health problems, such as cancer, liver disease, pancreatitis and many other diseases caused by alcohol.
What Are the Treatment Options for Alcohol Withdrawal?
Many different treatment options for alcohol withdrawal exist, depending on the individual. Those likely to only experience mild withdrawal symptoms may be able to detox by themselves at home, potentially with medicines prescribed by a doctor.
Those likely to have more severe symptoms should undergo a medical detox, monitored by trained medical professionals who can recognize complications quickly and treat them as they develop.
In addition to detox treatment options, long-term symptoms, cravings or difficulties coping without alcohol may require rehab. This can be inpatient or outpatient, including medications, therapy, group sessions and other treatment options. Ultimately, each person’s alcohol withdrawal treatment should be individualized to meet their needs and lifestyle.
Typical Treatments
The primary goal of withdrawal treatment is to mitigate symptoms and support patients as their bodies detox. Common treatment steps include:
- Conducting an initial assessment to establish how severe the withdrawal may be
- Prescribing anti-anxiety medications such as benzodiazepines to relieve tension and ease withdrawal
- Using anti-seizure medications like Depakote to help prevent convulsions
- Administering beta-blockers to reduce heart rate, control tremors and lessen anxiety (they can also occasionally help with cravings)
Importance of Seeking Professional Help
Alcohol withdrawal can be life-threatening and is the most dangerous form of substance withdrawal someone can undergo. Because alcohol withdrawal can be so serious, anyone withdrawing from alcohol should speak with a doctor before stopping alcohol.
Medically-supervised withdrawal may not always be necessary but can be incredibly beneficial for someone at risk for more severe withdrawal symptoms. Medical professionals recognize and treat dangerous conditions in real-time and can make the entire withdrawal process more comfortable.
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