Alcohol Detox, what to expect

 

Alcohol withdrawal syndrome is a potentially life-threatening condition that can occur in people who have been drinking heavily for weeks, months, or years and then either stop or significantly reduce their alcohol consumption.

Alcohol withdrawal symptoms can begin as early as two hours after the last drink, persist for weeks, and range from mild anxiety and shakiness to severe complications, such as seizures and delirium tremens (also called DTs). The death rate from DTs — which are characterized by confusion, rapid heartbeat, and fever — is estimated to range from 1% to 5%.

Because alcohol withdrawal symptoms can rapidly worsen, it’s important to seek medical attention even if symptoms are seemingly mild. Appropriate alcohol withdrawal treatments can reduce the risk of developing withdrawal seizures or DTs.

It’s especially important to see a doctor if you’ve experienced previous alcohol withdrawal episodes or if you have other health conditions such as infections, heart disease, lung disease, or a history of seizures.

What is the Alcohol Withdrawal Timeline?

Alcohol withdrawal can be broken down into three stages:

  • Stage 1: Anxiety, insomnia, nausea, and abdominal pain characterize this stage, which begins 8 hours after the last drink.
  • Stage 2: High blood pressure, increased body temperature, unusual heart rate, and confusion come with this stage, which begins 24-72 hours after the last drink.
  • Stage 3: Hallucinations, fever, seizures, and agitation come with this stage, which tends to begin 72+ hours after the last drink.

All symptoms tend to decrease within 5-7 days.

Alcohol Withdrawal Side Effects

Alcohol withdrawal is likely to start between six hours and a day after the last drink, as reported in American Family Physician. Withdrawal can be broken down into three stages of severity:

  • Stage 1 (mild): anxiety, insomnia, nausea, abdominal pain and/or vomiting, loss of appetite, fatigue, tremors, depression, foggy thinking, mood swings, and heart palpitations
  • Stage 2 (moderate): increased blood pressure, body temperature and respiration, irregular heart rate, mental confusion, sweating, irritability, and heightened mood disturbances
  • Stage 3 (severe/delirium tremens): hallucinations, fever, seizures, severe confusion, and agitation

Alcohol withdrawal is highly individual, and it is influenced by several factors, such as length of time drinking, the amount consumed each time, medical history, presence of co-occurring mental health disorder, family history of addiction, childhood trauma, and stress levels. The use of other drugs in conjunction with alcohol can also influence withdrawal and increase the potential dangers and side effects. The more dependent on alcohol a person is, the more likely the person is to experience more severe withdrawal symptoms. Each person may not go through every stage of withdrawal, therefore.


The most serious form of alcohol withdrawal is delirium tremens (DTs), which occurs in 3-5 percent of individuals in alcohol withdrawal, according to the New England Journal of Medicine (NEJM), and it can be fatal without treatment.


DTs may not start for a day or two after alcohol leaves the bloodstream, and it can occur without warning. It is primarily for this reason that alcohol withdrawal should be closely supervised by a medical professional who can continually monitor vital symptoms and ensure the individual’s safety during detox.

Stopping drinking “cold turkey”is never recommended without medical supervision. Alcohol withdrawal can be fatal, as the brain and central nervous system experience a rebound after being suppressed by alcohol repetitively for an extended period of time. Sudden removal of the central nervous system depressant can be life-threatening.

Detox Timeline

There is no specific and concrete timeline for alcohol withdrawal; however, it is typically held that withdrawal will follow the following general timeline, as detailed by the National Library of Medicine (NLM):

  • Roughly 8 hours after first drink: The first stage withdrawal symptoms may begin.
  • After 24-72 hours: Symptoms generally peak in this time period, and stage 2 and 3 symptoms can rapidly manifest.
  • 5-7 days later: Symptoms may start to taper off and decrease in intensity.
  • Beyond the first week: Some side effects, particularly the psychological ones, may continue for several weeks without treatment.

alcohol detox timeline

During detox, the first step is usually to monitor and control the physical symptoms and reach a stable point. This is often accomplished via medical detox, which may use medications to treat symptoms like nausea, dehydration, seizures, and insomnia. Benzodiazepines are commonly used during alcohol detox to reduce some of the potential over-activity the central nervous system may undergo as it attempts to restore its natural order. Blood pressure, heart rate, respiration, and body temperature should all be closely monitored in a medical detox center, and steps can be taken to ensure that they remain at safe levels.

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