How Long Does Alcohol Withdrawal Last?

how long does alcohol withdrawal last

This page's content has been reviewed and fact-checked by a certified addiction therapist and a board-certified physician.

This page's content has been reviewed and fact-checked by a certified addiction therapist and a board-certified physician.

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Alcohol withdrawals can be really challenging when starting your journey toward sobriety.

A key part of this journey is understanding alcohol withdrawal.

Whether it’s for you or a loved one, comprehending the duration of alcohol withdrawal is vital during detoxification.

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How long does Alcohol Withdrawl last?  Alcohol withdrawal typically lasts from a few days to several weeks. Still, the exact duration varies depending on individual factors such as the severity of alcohol dependency, overall health, and history of alcohol use.

Alcohol Key takeaways

Alcohol's impact on the brain

Alcohol affects the brain’s chemistry and functionality in profound ways. It interacts with various neurotransmitters, which are essentially the brain’s messengers, altering their normal functioning.

GABA and Glutamate: These are the two primary neurotransmitters affected by alcohol. GABA is responsible for reducing brain activity and promoting calmness, while glutamate increases brain activity.

Alcohol enhances the effects of GABA and dampens those of glutamate. This imbalance creates a dependence on alcohol for maintaining neurological equilibrium.

The Rebound Effect: Upon cessation of alcohol intake, there’s a “rebound” effect. The suppressed glutamate suddenly becomes overactive, and the enhanced GABA activity decreases. This leads to a state of heightened brain activity, manifesting as withdrawal symptoms.

Understanding Alcohol Withdrawal

Physical and Psychological Symptoms

Physical Reactions: Include tremors, nausea, and rapid heartbeat, as the body readjusts.

Psychological Changes: Mood swings, anxiety, and alcohol cravings are common during withdrawal.

Individual Variability
The severity of withdrawal symptoms varies based on factors like alcohol usage history, personal health, and genetics.

Insights from Research: O’Sullivan et al. (2021)
The study by O’Sullivan et al. (2021) offers valuable insights into the complexities of alcohol withdrawal. It emphasizes the intricate relationship between prolonged alcohol use and the brain’s adaptability.1

This study shows why withdrawal symptoms can be so varied and intense, reinforcing the need for personalized medical approaches during detoxification.

The Science Behind Alcohol Withdrawal

Exploring the biological and neurological processes of alcohol withdrawal provides crucial insight into what happens in the body and brain during this challenging time.

Let’s break down these processes, drawing upon relevant scientific studies to deepen our understanding.

Stages of Alcohol Withdrawal

Symptoms in the First 24-48 Hours

  • Anxiety and Restlessness: One of the most common early symptoms, often accompanied by feelings of nervousness and unease.
  • Insomnia: Difficulty in falling or staying asleep is typical during this stage.
  • Gastrointestinal Disturbances: Symptoms like nausea, vomiting, and loss of appetite are common.
  • Headaches: Withdrawal often triggers mild to severe headaches.
  • Tremors: Shaking or trembling, especially in the hands, is a noticeable sign.
  • Heart Palpitations: An increased heart rate or palpitations can occur.
  • Sweating: Increased sweating, particularly in the palms and face.
  • Mood Swings: Emotional instability or sudden changes in mood might be experienced.

Early Withdrawal Symptoms

The journey through alcohol withdrawal begins shortly after the last drink. In the initial 24-48 hours, several symptoms emerge, signaling the body’s reaction to the absence of alcohol. Understanding these early symptoms, as examined in the study by Linnoila et al. (1987), can prepare individuals and caregivers for what to expect.2

Understanding the Symptom Onset

The onset of these symptoms, as detailed in Linnoila et al. (1987), highlights the body’s immediate response to the absence of alcohol. They represent the beginning of the detoxification process, where the body starts to re-adjust to functioning without alcohol.

Peak Withdrawal Period

The peak withdrawal phase, typically occurring 48-72 hours after the last drink, is a crucial time in the alcohol detoxification process. This period can be more intense and carries higher risks, as documented in the study by Eşel (2006).3 It’s important to understand the symptoms and risks associated with this phase to ensure proper care and support.

Symptoms During the Peak Period

  • Severe Anxiety and Agitation: These symptoms often intensify compared to the early stages.
  • High Blood Pressure: Blood pressure can spike, posing additional health risks.
  • Increased Body Temperature: A significant rise in body temperature is common.
  • Hallucinations: Visual, auditory, or tactile hallucinations may occur, making this phase particularly distressing.
  • Seizures: The risk of seizures is heightened during this period and requires immediate medical attention.
  • Confusion and Disorientation: Known as alcohol-induced psychosis or delirium tremens (DTs), this is a severe and potentially life-threatening condition.

Risks and Complications

The peak phase of withdrawal can be dangerous, and close monitoring is essential. Risks include:

  • Dehydration: Due to vomiting, sweating, and fever.
  • Injuries from Falls or Seizures: Physical safety can be compromised due to loss of coordination or seizures.
  • Mental Health Risks: Severe anxiety and hallucinations can lead to psychological distress.

 

Insights from Eşel (2006)

The study by Eşel (2006) emphasizes the importance of medical supervision during this phase. It highlights the potential severity of symptoms and the need for a controlled environment to manage risks effectively.

Late Withdrawal Phase

The late phase of alcohol withdrawal, typically starting after the first week and extending for weeks to months, is a crucial recovery period. According to the study by Gorky & Schwaber (2016), this stage is characterized by a reduction in physical symptoms but a continuation of psychological and emotional challenges.4

Duration Influences

Factors influencing the length of this phase include the severity of prior alcohol use, overall health, and available support systems. The study highlights ongoing brain adjustments during this phase, explaining why some symptoms persist.

 

Late Withdrawl Characteristics

Mood Fluctuations: Persistent anxiety and depression, varying in intensity.

Sleep Disturbances: Ongoing issues like insomnia.

Diminished Physical Symptoms: Physical discomfort tends to decrease but may sporadically recur.

Cravings: A strong desire to drink alcohol can persist.

Medical Interventions in Alcohol Withdrawal

Medication-Assisted Treatment

Medication-assisted treatment plays a crucial role in managing the symptoms of alcohol withdrawal. It’s a part of a comprehensive approach that often includes counseling and support. One of the primary classes of medications used in this context is benzodiazepines, as detailed in the study by Jessé et al. (2016).5

Role of Benzodiazepines

Benzodiazepines are central to treating alcohol withdrawal symptoms due to their sedative properties, which help in:

  • Reducing the Intensity of Symptoms: They are effective in alleviating symptoms like anxiety, insomnia, and seizures.
  • Preventing Complications: Benzodiazepines can help prevent severe complications like delirium tremens (DTs).
  • Managing Cravings: While not directly reducing cravings, the calming effect of these medications can indirectly assist in managing the urge to drink.

Types and Administration

Common benzodiazepines used include diazepam, lorazepam, and chlordiazepoxide. The choice and dosage depend on factors like:

  • Symptom Severity: More severe symptoms may require stronger or more frequent dosing.
  • Patient History: Past medical history and alcohol use patterns influence medication choice.
  • Risk of Dependency: Long-term use of benzodiazepines carries a risk of dependency, requiring careful monitoring.

Holistic and Supportive Therapies

Alongside medical treatments, holistic and supportive therapies play an indispensable role in the alcohol withdrawal process. These therapies address the psychological and social aspects of withdrawal, providing a well-rounded approach to recovery. The significance of these therapies is highlighted in the study by Pandey et al. (2017), emphasizing their role in successful long-term recovery.6

Psychological Support

Psychological support is vital in managing the mental and emotional challenges of withdrawal:

  • Counseling: Individual or group counseling helps address underlying issues related to alcohol use.
  • Cognitive Behavioral Therapy (CBT): CBT assists in changing negative thought patterns and developing coping strategies.
  • Stress Management: Techniques like meditation and mindfulness can reduce stress and anxiety.

Social Support

A strong social support network can greatly enhance recovery:

  • Support Groups: Groups like Alcoholics Anonymous (AA) provide a community of individuals with shared experiences.
  • Family Involvement: Family therapy and support can strengthen relationships and foster a supportive home environment.

Complementary Therapies

Incorporating complementary therapies can further aid in recovery:

  • Exercise: Physical activity can improve mood and reduce stress.
  • Nutrition: A balanced diet helps restore physical health and can impact mental well-being.
  • Art or Music Therapy: Creative outlets offer a non-verbal means of expression and emotional processing.

Q&A: How long does alcohol withdrawal typically last? The duration of alcohol withdrawal can vary but typically lasts from a few days to several weeks. This variation depends on individual factors such as the amount and duration of alcohol use, overall health, and personal physiology.

Navigating Alcohol Withdrawal

Navigating the path of alcohol withdrawal can be challenging, but understanding its duration and effective management strategies is key to a successful recovery journey. Here, we summarize the key insights about the duration and management of alcohol withdrawal, emphasizing the crucial role of professional medical support and the benefits of a holistic approach.

Understanding the Duration of Withdrawal

  • Varied Timeline: Alcohol withdrawal duration varies from person to person. Typically, it ranges from a few days to several weeks.
  • Stages of Withdrawal: The process involves distinct stages, starting with early symptoms in the first 24-48 hours, peaking around 48-72 hours, and then entering a late phase that can last for weeks or months.

The Role of Professional Medical Support

  • Medical Supervision: Professional medical support is crucial, especially during the peak withdrawal period, to manage severe symptoms and prevent complications.
  • Medication-Assisted Treatment: Medications, particularly benzodiazepines, play a key role in managing withdrawal symptoms, reducing their intensity, and helping to prevent severe complications like seizures and delirium tremens.

Embracing a Holistic Approach

  • Combining Therapies: A holistic approach, combining medical treatments with psychological and social support, leads to better outcomes.
  • Psychological and Social Support: Counseling, cognitive behavioral therapy, stress management techniques, and support groups provide essential psychological and social support, aiding in long-term recovery.
  • Complementary Practices: Incorporating exercise, nutrition, and creative therapies can enhance well-being and support recovery efforts.

Encouraging a Comprehensive Recovery Path

Understanding the complexities of alcohol withdrawal and its management is vital. Encouraging a comprehensive approach including medical and supportive therapies ensures a more rounded and effective recovery process. By combining professional medical support with holistic and supportive therapies, individuals navigating alcohol withdrawal can have a better chance of achieving long-term sobriety and improved overall well-being.

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RECOVERY WRITER & ADVOCATE

Susana is a recovery writer and advocate with over 8 years in addiction recovery. She is passionate about sharing accurate and helpful information about mental health, addiction, and recovery. She holds a Bachelor’s in Christian Studies from Grand Canyon University and has over 7 years of working in the addiction field. 

lionel estrada lisac clinical director

CLINICAL DIRECTOR & REVIEWER

Lionel, a Licensed Independent Substance Abuse Counselor (LISAC) with over 4 years at Cornerstone. Passionate about helping those with addiction, he has trained as an EMDR therapist  adopting a trauma-informed approach to treat the underlying issues of addiction, providing an empathetic approach to addiction.

Articles written prior to August 2023 were also clinically reviewed by Karen Williams, LPC 

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