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Alcohol Detox – What to Expect

95,000 Americans Die Each Year from Alcohol Abuse

According to the National Center for Drug Abuse Statistics (NCDAS), 95, 000 Americans die each year from the disastrous effects of alcohol abuse. Worldwide, that number is over 3 million. During COVID, alcohol use was exacerbated further by increasing mental health issues and the stressors instigated by a global lockdown.

If you drink heavily and/or daily, making the choice to stop can seem nearly impossible. After all, alcohol is one of the most readily available and legal substances in the world. Everywhere you look, you can most likely find a place to purchase alcohol products – from corner stores to grocery aisles to restaurants, bars and movie theatres, alcohol is literally EVERYWHERE. That is why there are alcohol rehab centers for assistance.

Stopping severe alcohol use is also challenging because of the well-known symptoms of withdrawal. Detox timing is dependent on several factors including but not limited to how much you drink, how long you’ve been drinking, and whether you’ve gone through alcohol detox before. Most people will notice detox symptoms waning significantly after about four or five days since their last drink, but this too can vary somewhat depending on the individual’s age, other medical or mental health conditions, life circumstances and more.

The following is a timeline to help you understand what withdrawal from alcohol looks like in the first few days and weeks:

6 hours

Although some might feel like the buzz is barely wearing off after 6 hours, one can experience some subtle withdrawal symptoms at this point. For those with an extensive history of heavy drinking, seizures can be a risk at this point.

12 – 24 hours

Although rare, at this point some going through withdrawal may experience auditory and/or visual hallucinations. Although this may be daunting to those witnessing this symptom, it often is not serious or life-threatening.

24 – 48 hours

Minor withdrawal symptoms like stomachaches, headaches, and tremors will typically set in at this point. For those who are not going through major withdrawal from severe alcohol abuse, typically these symptoms will peak at 18 to 24 hours after the last drink is consumed and will really minimize 4-5 days out.

48 – 72 hours

For those detoxing from severe, extended alcohol abuse, some may experience a very difficult symptom that doctors call delirium tremens (DTs) or alcohol withdrawal delirium. People experiencing this side effect of withdrawal will often have a very high heart rate, seizures, or a high body temperature.

72 hours

72 hours marks the unfortunate time when alcohol withdrawal symptoms are typically at their most challenging and intense. These symptoms can include rapid heart rate and visual hallucinations and illusions. This can be a time of great discomfort for those undergoing withdrawal from severe alcohol abuse, so trained medical attention is often recommended during, before and after this point.

Understanding DTs

Generally speaking, alcohol has a depressant impact on the central nervous system. While using, this depressant feature can make people feel euphoric, happy and relaxed. Because the body and brain typically work to maintain balance, the body will send a signal to the brain to do what it needs to do to kickstart and stimulate the central nervous system. As a result when we stop drinking, our nervous systems are in an  overactive state, which can cause anxiety, irritability, sweating, rapid heart rate, tremors, nausea, and in severe cases, delirium tremens, which come with their own set of challenging symptoms including fever, illusions and hallucinations, paranoia, and even seizures. It goes without saying that DTs are considered among the most intense and difficult withdrawal symptoms from alcohol. Some risk factors that come with DTs include a prior history of DTs, abnormal liver function, a history of seizures with alcohol withdrawal, dehydration, other drug use or abuse, low potassium levels, low platelet counts, low sodium levels, advanced age at withdrawal time, and even the presence of brain lesions. If you feel any of this may pertain to you or your loved one struggling with alcohol abuse, it’s important that you engage in withdrawal at a medical facility equipped to treat alcohol-related detox and potential complications.

Withdrawal Length and Timing

There are numerous factors that can impact the rate at which one will withdraw from alcohol. Doctors at alcohol recovery centers will weigh all these factors and more when estimating how severe your withdrawal process will be. In order to properly assess a person’s withdrawal symptoms and best course of treatment, doctors often use a scale called the Clinical Institute for Withdrawal Assessment for Alcohol. The higher the number, the more severe a person’s symptoms may be, and the more extensive treatment they may likely need. It is important to note here that one may not require any medications to support their withdrawal from alcohol. That said, engaging in therapy, spiritual practices and support groups as you go through withdrawal can be extremely beneficial. If you have moderate to severe withdrawal symptoms, you may require medication to assist you with the process such as benzodiazepines, which are prescribed to reduce the likelihood of seizures during alcohol withdrawals. Neuroleptic medications are also used to assist with withdrawal, as they can assist with preventing seizures and the emotional agitation that is often associated with alcohol withdrawal. Moreover, nutritional treatment in the form of thiamine, magnesium and folic acid may be administered to reduce symptoms and to address any nutrient deficiencies that may have been brought about by alcohol use. Other meds such as beta-blockers (such as propranolol) are also sometimes used to reduce high blood pressure.

Once the more severe, short-term withdrawal symptoms have subsided, medicines meant to reduce the likelihood of a relapse may be prescribed, such as disulfiram (Antabuse), which can minimize alcohol cravings, and is known to cause severe feelings of illness in those who drink while on this medication. Naltrexone can also be prescribed to assist with the reduction of cravings as it essentially blocks the feel-good receptors that are activated by alcohol use. Another medication that is sometimes prescribed in later alcohol withdrawal is topiramate (Topamax), which is known to minimize alcohol consumption and extend periods of abstinence.

If you or someone you love is grappling with addiction and is in need of treatment, call Positive Recovery Centers at 713-904-4699. We are experts, we are here to help, and our treatment teams are committed to the ongoing health and safety of all our patients.


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