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By Boris M | 21 April, 2020 Published in Alcohol Withdrawal Symptoms
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Alcohol detox is an effective way of removing toxins from the body of an individual who consumes a lot of alcohol. It’s a crucial step in rehab, and often the first obstacle to becoming clean.

Those who are dependent on alcohol will need a long period of detox and then rehab to get their lives back on track. The length of time an individual will need in rehab depends on the severity of their addiction, and the detoxification process and timescale ruled by both the amount of alcohol that has been consumed and for how long.

There is a difference, however, between alcohol abuse and alcohol dependence. While alcohol abuse can be harmful to an individual, it is alcohol dependence that’s more long-term and harder to treat. [1]

With alcohol abuse, an individual endures physical or mental harm as a result of binge-drinking. They fail to grasp that binge-drinking can have serious consequences on their careers, social life, health and wellbeing.

Alcohol dependence, however, is a state where an individual is physically dependent on alcohol, and cannot operate normally without it. Alcohol is the sole source of joy and comfort in their lives, and they usually have their preferred choice of drink.

What is more, alcohol dependence means that the individual carries on drinking despite knowing full well the consequences their consumption is having. They would also experience withdrawal symptoms if they were to stay immediately stop their alcohol intake.

When to consider an alcohol detox

As discussed above, differences lie between alcohol abuse and alcohol addiction/ dependence. It is important to remember that not everyone who experiences some of the symptoms listed below (such as sweating, nausea and headaches after drinking) necessarily requires a detox.

It is safe to say that the majority of the population have experienced a hangover and its unpleasant symptoms – but bear in mind that although the same physical effects occur, alcohol withdrawal is much more of a medical concern than a hangover.

To put it simply, a hangover occurs when an individual has consumed too much alcohol in one sitting that the body is not used to. Alcohol withdrawal, on the other hand, is when the body is not receiving enough alcohol as it has previously been reliant on. [2]

There are several factors that will help you decide whether you need an alcohol detox or not. Firstly, you’ll get cues from your environment and also your body that your alcohol consumption is taking a toll on you and the world around you.

You can consider outpatient or inpatient alcohol detox, but that will depend on whether you have support from family and friends, and whether you can commute to the clinic or not.

Inpatient treatment is usually safer and more effective for detox. You’ll receive medications in a controlled environment with a significantly lower risk of complications, under the 24-hour care of doctors and nurses.

This means moving into a residential facility for a specified number of days, where you will receive therapy, counselling, and regular medical checks to ensure your health. This will then be followed by a detailed aftercare programme once you leave the facility.

Outpatient treatment means attending either weekly or bi-weekly therapy and counselling sessions, while still living at home. This option entails travelling to a centre or clinic multiple times a week, with the assistance of alcohol-withdrawal medication delivered to your door.

For more information on both options, visit our alcohol home detox page and our private alcohol rehab clinics page. 

Here are some indicators that alert you as to whether you need an alcohol detox or not: [3]

  • You cannot stay away from the bottle. It is the only thing that makes sense for you
  • You experience withdrawal symptoms when you stop drinking (nausea, vomiting, headaches, tremors)
  • You lost your job recently, or are in financial debt due to your alcohol consumption
  • Your friends and family keep telling you that you need detox or go to rehab
  • You can’t control your intake of alcohol
  • Your physical health is suffering, as is your mental health
  • You have lost interest in the things that once mattered to you because of alcohol’s effects

What is alcohol withdrawal?

After you consume alcohol for longer periods, and you drink heavily, your body will get used to the alcohol. What is more, it will require more and more alcohol to achieve the same results as before. This is called building a tolerance, and is one of the major signs of alcohol addiction or dependence.

As you get drunk, you’ll get a feeling of happiness and joy; and over time, you’ll need more and more alcohol to achieve that state.

But your body will get dependent on it. After you cut off the intake, or drink much less, even, you’ll notice withdrawal symptoms that can be either moderate or severe. And in order to avoid these symptoms, a person might start to drink even more.

This cues the vicious cycle of alcohol addiction, where the individual consumes more alcohol to help keep withdrawal symptoms at bay. Although a common ritual among most who suffer from alcohol addiction, this in turn only makes the withdrawal process worse due to a process called ‘kindling.’

For more information on ‘kindling’ and other serious effects of alcohol, click here.

Some of the most common withdrawal symptoms include: [4]

  • Nausea and vomiting
  • Headaches
  • Tiredness, lack of energy
  • Enlarged pupils
  • Insomnia
  • Sweating
  • Anxiety
  • Depression
  • Cognitive impairment
  • Lack of memory
  • Irritability,
  • Nervousness
  • In more severe cases, seizures and blackouts

How does alcohol dependence cause alcohol withdrawal?

Alcohol targets a person’s central nervous system, and affects the process of neurotransmitters being fired in the brain. This makes the alcohol drinker feel more at ease and relaxed, and they will also experience a period of happiness.

And this is the feeling that chronic drinkers seek – the more they drink, the more alcohol it takes to achieve it. And the brain and the body adjust to the heavy drinking – especially the neurotransmitters, and the chemical reactions this affects.

Once someone who has drank excessive amounts of alcohol for a prolonged period abruptly cuts their intake, there is a chemical imbalance that causes withdrawal symptoms. 

This is because the brain has been so used to producing alternative and excessive neurotransmitters to combat the alcohol in the system, and therefore still produces them even when the alcohol is absent.

These symptoms can be severe, especially if the drinking was heavy and long-term. It is a frightening prospect for some, but with proper support, recovery from the detoxification is possible and everyone who is suffering should remember that medications and research exist to support their journey. [5]

What is the alcohol withdrawal timeline?

There are four stages of alcohol withdrawal as prescribed in the CIWA scale. The symptoms of the withdrawal will range in severity, and it’s at its toughest in phases 2 and 3.

The first phase happens 6-12 hours after stopping drinking, while phase 2 and 3 can occur 24-72 hours during withdrawal. Then, we have phase 4, which can last between the second to third day and continue up to the seventh day after stopping drinking.

Below we have discussed in detail the four separate stages of alcohol withdrawal, and have included a list of expected withdrawal symptoms:

The first 6-12 hours after stopping drinking, the patient will start to experience the first withdrawal symptoms. These will be mild at the start but will start to get tougher after 12 hours or longer. For some, they start earlier.

This is when it might be the most tempting to start drinking again to soothe the symptoms. Headaches will also start to kick in due to dehydration, as well as mild nausea.

The person will start to feel agitated and increasingly irritable, and tremors and shakes might also occur. They will start sweating excessively and have sleeping problems. These symptoms will usually deepen after 12 hours.

Here are the symptoms to expect during Phase 1:

  • Headaches
  • Intense cravings
  • Nausea, vomiting
  • Anxiety, irritability
  • Insomnia
  • Tremors, shakes
  • Excessive sweating

Phase 2 is a continuation of Phase 1, as the symptoms will get harsher. The symptoms from phase 1 are likely to stay, while the person will start to experience new withdrawal symptoms.

During Phase 2, it's not uncommon to see a loss of appetite, especially if the person didn't have a good diet beforehand. Due to the release of extra dopamine, the person might start to experience hallucinations, which are not fatal. Dehydration is also completely normal during Phase 2.

Other symptoms during this phase include:

  • Loss of appetite
  • Hallucinations
  • Dehydration

Phase 3 is probably the toughest period in withdrawal, and this is when some patients are tempted to quit. But it's crucial to stay on route, as this period is a defining one during withdrawal.

The symptoms can get serious to a point where they can become fatal. But with proper support, medical care, and medications, these symptoms are manageable.

Arguably the most challenging condition during phase 3 is Delirium Tremens. It's a condition where the person will get seizures, and will get extremely confused and will lose memory (temporarily).

Overheating, hallucinations and shivering or sweating are also common. Delirium Tremens can be fatal for about 3% of all patients.

Intense mood swings are also to be expected during this phase. Low blood sugar is fairly typical, too. Seizures can happen independently and are not necessarily due to Delirium Tremens.

A list of the most common symptoms to expect during phase three are:

  • DT (Delirium Tremens)
  • Intense mood swings
  • Low Blood Sugar
  • Seizures
  • A continuation of symptoms from Phase 2

After 48 hours or slightly more, the symptoms should start to ease. But some symptoms might still persist, such as confusion, anger, irritability, and general discomfort.

There's a reason for this - your body and your mind just went through a transformative process, so it's normal to see these symptoms.

But this is still not the end of the recovery. After this comes a testing period where the person will go through the real test - whether or not they can stay clean in the real world.

Why is alcohol withdrawal dangerous?

In the field of recovery, there are a select number of alcohol withdrawal symptoms which are more severe than others, which include delirium tremens, hypothermia, seizures, and cardiac arrhythmias.

A small percentage of people who are recovering from alcohol addiction will experience a minimum of one episode or tremors or convulsions during their withdrawal period. They can be a daunting prospect – but do not allow this to put you off from recovery.

Delirium Tremens can be extremely disorientating and scary – and it can even cause death. This is one of the more severe reactions which is indicated by hallucinations, confusion, agitation, tremors, and a high fever. It is highly, highly serious if it is coupled with another symptom that is classed as ‘severe.’ [6]

Experiencing withdrawal at home can be potentially dangerous, and without immediate medical intervention, fatal in some cases. That’s why it’s better to proceed with caution and trust the medical professionals to help you with detox.

Additionally, if a person experiences a seizure, they might find themselves uncomfortable and unable to control their movement. Falls can happen, which can result in injuries. Again, it’s better to do this in a controlled environment, with the help of medical professionals.

To find out more about mild and severe alcohol withdrawal symptoms, follow this page where you will also discover more about why and how alcohol withdrawal is dangerous.

How long does it take to detox from alcohol?

Day1 of detox is when the individual starts their programme: this is usually the first day that they enter a private facility, or when they begin the tapering off schedule at home.

After that, it can take anywhere from 7-10 days, potentially longer. That’s especially the case if the drinking was heavy and long-term. Symptoms are expected to kick in after 6-12 hours and are expected to get tougher after 24-48 hours. Some patients will require acute medical care for several days after this period.

The time it takes to detox from alcohol is really down to how much the individual drank, how long they have been drinking, and whether or not they have completed a detox in the past. According to professionals, most patients experience detox symptoms for up to five days after the process began.

Which factors determine the length of detox?

Below we have listed some of the key factors which can help determine how long your detox process will be. Doctors will assess all of these aspects and will take them into account when prescribing medication and treatment. [7]

The factors include:

  • A person’s health
  • A person’s age
  • Gender
  • If there were multiple substances used
  • How often the use occurred
  • The quantity of alcohol drunk
  • Their liver functions
  • If they have had delirium tremens in the past
  • If there is a history of seizures from alcohol withdrawal
  • The level of platelet counts
  • Potassium levels
  • Sodium levels
  • Dehydration prior to detox
  • If there are any lesions on the brain
  • If other drugs are being abused

What is the liver detox timeline?

Your whole body, including your liver, will start detoxing. Your liver was at the centre of attention when you were drinking, as it filters and process the fluids ingested in during the day. This means that the liver will start to detox once alcohol intake is stopped.

This is the liver detox timeline:

  • After 8-10 hours, you’ll start noticing the first symptoms. These include abdominal pain, fatigue, insomnia, restlessness
  • 24-72 hours after consuming the last drink, the fatigue will continue, and you’ll start to experience problems with focusing. Increased heart rate and anxiety will also likely kick in. This is where the symptoms will be at their worst
  • After two days and onwards, your cravings will increase. Seizures and tremors are still common during this period.

How long does alcohol stay in the system?

Alcohol can stay in a person’s system for up to 2 days, depending on the severity of drinking. Detoxing will help the alcohol out of your body and will help you stay clean.

It can stay in the urine for up to 80 hours, while it takes about 24 hours for it to clear from the blood. However, it may take up to 3 months for it to go out of our hair follicles.

After Detox: acute alcohol withdrawal and PAWS

Expect treatment to be complete after the detox period is over is unreasonable. Recovery is more than scientifically ridding the body of all substances: it entails a detailed maintenance programme and recovery plan that will assist you for later life.

Another factor to look out for after detoxing is acute alcohol withdrawal and PAWS, which are both potentially dangerous complications. Both of these conditions affect a significant number of people recovering from alcohol addiction, and can even impact on the patient for life. [8]

Acute alcohol withdrawal covers the initial symptoms a patient experiences, which tend to be the most intense. These include psychological and physical symptoms such as hallucinations, tremors, vomiting and sweating.

With acute alcohol withdrawal, the symptoms might persist for several days, especially for people who have been drinking for a long time severely. They might come back after several weeks.

PAWS (Post-Acute Withdrawal Syndrome) refers to the long-term side effect of alcohol abuse, which can potentially challenge and affect a person’s life. Symptoms might continue years after withdrawal and initial detox.

These symptoms include

  • Hostility
  • Irritability
  • Anxiety & Depression
  • Mood swings
  • Low levels of energy
  • Fatigue
  • Insomnia
  • Inability to focus
  • Lack of sex drive
  • Chronic pain

These symptoms are manly psychological and have been known to continue for months or years after the cessation of alcohol. They tend to ‘come and go’ in waves or episodes, and can be triggered by specific circumstances, memories, smells or people.

How long does it take to die from alcohol?

The stark reality is that alcohol can kill if consumed for prolonged periods of time. This is why it is crucial to seek support if you or someone you love is suffering from alcohol addiction. [9]

There are several ways how it can kill you – some are fast, while others will take years. These means include:

  • Alcohol poisoning – it happens after binge-drinking large amounts, and results in coma or death
  • Liver diseases or failure – your liver will not last an eternity filtering through all the toxins on a daily basis. After years of heavy drinking, you can expect to see liver failure
  • Cancers – alcohol can cause several types of cancer, including mouth, throat, breast, liver, colon, rectum, voice box, oesophagus, pancreas cancer
  • Accidents – drunk driving can cause accidents; many result in deaths
  • Heart diseases
  • End-stage alcoholism – several organs will start to fail after years and years of heavy drinking

Ready to get help?

We offer high-quality rehabilitation & detoxification services tailored to your individual needs.

To discover your road to recovery, call us today on 0800 140 4690.

References

[1] https://www.health.harvard.edu/press_releases/how-much-alcohol-is-safe-it-varies-from-one-person-to-the-next-accordi
[2] https://www.altamirarecovery.com/blog/understanding-differences-hangover-withdrawal/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/
[4] https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/mental-health/alcohol-withdrawal-symptoms/
[5] https://onlinelibrary.wiley.com/doi/full/10.1111/ane.12671
[6] https://patient.info/doctor/acute-alcohol-withdrawal-and-delirium-tremens
[7] https://journals.lww.com/jan/Abstract/2019/07000/Risk_Factors_for_Severe_Alcohol_Withdrawal.5.aspx
[8] https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS
[9] https://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf

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