Alcohol use can be dangerous. In 2022, there were 10,048 alcohol-specific deaths in the United Kingdom, according to the House of Commons Library. However, it’s important to understand that stopping alcohol use isn’t as simple as just never drinking again.
There are challenges and dangers that need to be navigated to safely stop drinking alcohol. Understanding the stages of alcohol withdrawal is a key part of the recovery process, as it helps you understand the road ahead.
What Is Alcohol Withdrawal Syndrome?
Alcohol withdrawal syndrome (AWS) happens when your body, after getting used to regular alcohol consumption, suddenly has to function without it. This leads to a whole range of physical and psychological symptoms, some of which are relatively mild, and some of which can be dangerous. Alcohol withdrawal syndrome generally affects people with alcohol use disorder (AUD), also known as alcohol addiction.
Stages of Alcohol Withdrawal
The alcohol withdrawal timeline usually begins within a few hours after you begin detoxing from alcohol and can last for a week or more. Alcohol withdrawal symptoms can be mild, but severe symptoms can be potentially life-threatening without medical intervention.
Mild Alcohol Withdrawal
The first stage of alcohol withdrawal is usually 6 to 12 hours after your last drink. At this point, the effects of alcohol withdrawal include shakiness or tremors, feeling anxious or irritable, nausea or vomiting, sweating, headaches, and trouble sleeping.
For most people, this stage is manageable. Your nervous system, which has gotten used to being slowed down by alcohol’s depressant effects, suddenly goes into a heightened state. These mild symptoms usually peak in the first day or two and then start to fade.
Acute Alcohol Withdrawal
This stage of alcohol withdrawal begins between 12 and 48 hours after your last drink. At this stage, severe withdrawal symptoms may include hallucinations or even seizures. Hallucinations might be things you see, hear, or even feel that aren’t there. They can last for hours and can be distressing.
Seizures are another serious symptom and need immediate medical attention. If you’re at risk for acute withdrawal, inpatient alcohol detox may be the safest option. Doctors may give you benzodiazepines to lower seizure risk and keep you stable.
Delirium Tremens
Delirium tremens (DTs) is the most dangerous stage of alcohol withdrawal, usually showing up 48 to 72 hours after your last drink.
Symptoms of DTs include
- Major confusion and not knowing where you are
- Intense agitation
- Mood swings
- Vivid hallucinations or delusions
- Fever and profuse sweating
- Strong tremors
- Convulsions
DTs is rare and only happens in severe cases of long-term alcohol abuse. However, if it does manifest, then it’s vital to contact medical professionals as it can be fatal if left untreated.
Risk Factors for Severe Alcohol Withdrawal
Not everyone experiences withdrawal in the same way. Your risk for experiencing withdrawal symptoms depends on the amount of alcohol you consume, how long you’ve been dependent on alcohol, and your overall health. Some factors can make complications like seizures or DTs more likely. Some of these factors are:
Drinking Patterns
How you drink matters a lot. Long-term heavy drinking forces your brain and nervous system to adapt to alcohol, making you dependent. If you’re drinking a lot every day, you’re more likely to have more than just mild withdrawal. People with alcohol use disorder are at higher risk because their bodies require alcohol to function normally.
Previous Withdrawal Episodes
Your withdrawal history also matters when you try to quit. If you’ve had seizures, hallucinations, or DTs before, you’re more likely to get them again. Even if your first time was mild, repeated cycles of quitting and relapsing can raise your chances of severe alcohol withdrawal symptoms.
If you’ve been through the alcohol detox process before, doctors will probably want to keep a closer eye on you and maybe use preventative meds to keep you stable throughout the process.
Coexisting Health Conditions
Other health issues can make withdrawal more difficult. Heart, liver, or brain problems can all worsen withdrawal symptoms and increase the risk of medical complications. Preexisting high blood pressure or irregular heartbeat, for example, can worsen during withdrawal.
Mental health issues like anxiety or depression can worsen during withdrawal. Polysubstance use can also complicate detox and withdrawal, as other substances may interact with alcohol in unpredictable and potentially dangerous ways.
Medical Detox and Treatment Options
Medical detox is focused on helping you stop drinking alcohol safely and cutting down the risks of dangerous symptoms. Alcohol addiction treatment can potentially mean inpatient care, going to therapy, taking prescribed meds, and getting monitored to prevent serious complications.
Inpatient Versus Outpatient Detox
Inpatient detox happens in a hospital or clinic, where you’re watched around the clock. It’s the go-to choice if you’ve had seizures, DTs, or other major withdrawal problems before. The constant supervision means any issues may be addressed immediately.
Outpatient detox lets you stay at home, with regular check-ins and maybe prescription medication. This works best if your dependence is on the milder side and you’ve got good support at home.
Medications for Alcohol Withdrawal
There are a few medications that can make alcohol withdrawal more manageable. Benzodiazepines are often a first-line treatment as they can help calm you down should you experience alcohol withdrawal and can lower the risk of seizures or delirium. Antipsychotic medications can be used in cases of severe agitation or hallucinations.
You Can Manage Alcohol Withdrawal Symptoms
Depending on your history of alcohol use, you may not go through all the stages of alcohol withdrawal during the detox process. However, medical help is still important. It doesn’t have to be constant supervision, but medical help will be necessary to get you through the recovery process safely.
Frequently Asked Questions
What are the initial symptoms of withdrawal from alcohol?
Usually, you’ll start feeling symptoms within 6 to 12 hours after your last drink. Anxiety, shaking, sweating, nausea, headaches, trouble sleeping. These can be distressing, but for most people, withdrawal is more uncomfortable than dangerous at first.
How long does the acute phase of alcohol withdrawal typically last?
The worst tends to kick in during the first 12 to 48 hours after you stop drinking, and it can drag on for a few days. Most people start to feel somewhat better after about 5 to 7 days, but sometimes symptoms last for up to 10 days.
Can you describe the potential complications associated with alcohol withdrawal?
Some people encounter seizures, hallucinations, or delirium tremens (DTs), which usually begin 48 to 72 hours after the last drink. DTs can mean confusion, mood swings, or really bad tremors, and honestly, it’s life-threatening if not treated.
What treatments are available for managing the symptoms of alcohol withdrawal?
Medical detox can happen in a hospital or sometimes as an outpatient. You’ll get monitoring, fluids, and meds to help with the symptoms and keep things from getting worse. Professional treatment programmes have structured support to keep withdrawal as safe as possible and help you figure out what comes next.
How does the severity of alcohol dependence affect the withdrawal process?
If you’ve been drinking heavily for a long time, withdrawal’s probably going to hit you harder. Previous withdrawals, being older, or having health issues like liver disease can all make things riskier. Everyone is different, so your own health history will shape how your body handles withdrawal.
What is the role of medication in the treatment of alcohol withdrawal syndrome?
Doctors usually try benzodiazepines first; they can calm agitation, keep seizures at bay, and sometimes just help you get some rest. Occasionally, anticonvulsants may be used to help ease symptoms. Once detox is over, medications like naltrexone, disulfiram, or acamprosate may be used to ease cravings and lower the risk of relapse.
