Updated on February 6, 2024
6 min read

How Long Does Alcohol Withdrawal Last? Symptoms and Treatment

What is Alcohol Withdrawal?

Alcohol withdrawal syndrome (AWS) happens when you stop drinking alcohol after heavy, long-term use. This is caused by the brain staying in an overly excited state triggered by constant alcohol exposure.

Since alcohol slows brain function and nerve communication, the central nervous system (CNS) adapts. It keeps the brain in an awakened state to allow nerve messaging to function. 

When you suddenly remove alcohol from the system, the brain stays stimulated without the depressive effects of withdrawal.

What Causes of Alcohol Withdrawal?

Once your body is dependent on alcohol, abruptly stopping consumption will shock the body and brain, causing alcohol withdrawal.

Since your body has adapted to the constant presence of alcohol, its abrupt removal will disrupt the equilibrium your body has created. You’ll be in a hyper-aroused state, which is a common alcohol withdrawal symptom.

What are the Symptoms of Alcohol Withdrawal?

Alcohol withdrawal can cause severe, life-threatening symptoms. They can range from moderate to severe, depending on other health conditions.

These symptoms occur both mentally and physically. They can start as soon as two hours after the last drink or as late as four days after quitting alcohol.

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How Long Does Alcohol Withdrawal Last? Symptoms and Treatment
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Mild Withdrawal Symptoms

Mild withdrawal symptoms can last up to 7 days, including:

  • Headache
  • Nausea
  • Vomiting
  • Loss of appetite
  • Tremors (shakes)
  • Sweating
  • High blood pressure
  • Anxiety
  • Nervousness
  • Agitation
  • Irritability
  • Restlessness
  • Mood swings
  • Hallucinations
  • Seizures
  • Elevated heart rate
  • Disorientation
  • Insomnia

Severe Withdrawal Symptoms

More severe withdrawal symptoms are common in the first few hours of withdrawal. They gradually become milder in the days and weeks that follow.

Severe withdrawal symptoms can include any mix of:

  • Tremors
  • Anxiety
  • Nausea and vomiting
  • Headache
  • Elevated heart rate or blood pressure
  • Sweating
  • Irritability and confusion
  • Insomnia and nightmares
  • Tactile, auditory, or visual hallucinations

Alcohol withdrawal is a severe condition that requires professional treatment to manage correctly. Without proper treatment, it can lead to coma or death.

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What are Alcohol Withdrawal Seizures? 

Suddenly cutting back or stopping alcohol after heavy long-term drinking may trigger alcohol seizures. Generalized tonic-clonic seizures (formerly known as Grand Mal) are the most severe type of seizures that can occur during alcohol withdrawal.

Tonic-clonic seizures include these activities:

  • Tonic activity: Loss of consciousness, intense muscle spasms, the potential for impaired breathing, gasping and gurgling sounds, and saliva or foam from the mouth
  • Clonic activity: Intense and rapid jerking movements of the face, arms, and legs until the seizure ends

Implications of Alcohol Withdrawal Seizures

People often stay unconscious for several minutes after a seizure while the brain recovers. The risk of seizures is higher in long-term heavy drinkers.

Those who undergo multiple detoxification episodes also have a high potential of experiencing them. Researchers theorize that alcohol withdrawal can permanently alter the brain, increasing seizure risk.

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What is Delirium Tremens?

Delirium tremens (DTs) is also called alcohol withdrawal delirium (AWD). This is a type of severe alcohol withdrawal that typically starts 2-3 days after someone with alcoholism stops drinking.

Delirium tremens usually lasts for only two days. However, lingering symptoms may last up to a week or more. 

Who is Most at Risk for Delirium Tremens?

DTs can lead to cardiac arrest or death if you fail to address and treat them. Delirium tremens most commonly affects the following people:

  • Adult men
  • Those with a history of seizures
  • People who have previously experienced alcohol withdrawal
  • Heavy drinkers
  • Those suffering from long-term substance abuse 

What are the Stages of Alcohol Withdrawal?

Alcohol withdrawal has 3 main stages:

  • Stage 1: Usually happens in the first few days; can cause headaches, trouble sleeping, anxiety, shaking, stomach pain, and fast heartbeat
  • Stage 2: Has many of the same mild symptoms as stage 1, like high blood pressure, fast heartbeat, fever, confusion, and fast breathing
  • Stage 3: The last and most severe stage. Includes ongoing moderate symptoms from stage 2, hearing and seeing things that aren't there, seizures, and trouble focusing
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Timeline of Alcohol Withdrawal Symptoms

The stages above occur over various intervals. They vary from person to person depending on drinking behavior and concurrent mental health or physical issues. 

Below is a general timeline for when alcohol withdrawal symptoms tend to occur on average:

How Long Does Alcohol Withdrawal Last

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Can Alcohol Permanently Damage Your Brain?

Yes, alcohol damages the brain by directly affecting the neurons. Since it’s a toxic substance, it can hurt or kill neurons responsible for normal brain function.

Some long-term drinkers can also develop nutritional deficiencies that lead to brain damage. Prolonged alcohol can also cause brain shrinkage. 

While there are no cures for brain damage from drinking alcohol, early diagnosis and lifestyle changes will stop further damage and reverse the deterioration. New brain cells develop within a year after abstaining from drinking.

Understanding the Brain's Response to Alcohol

Long-term and constant use of alcohol rewires the brain and changes its activity. It changes the functions of GABA (an inhibitory brain chemical) and glutamate (an excitatory brain chemical).

Alcohol slows down the brain, reducing anxiety and causing sedation. To adapt, the brain reacts by increasing glutamate and decreasing GABA. This adaptive function is called "tolerance."

What Happens After Two Weeks of No Alcohol?

After withdrawal's initial danger and unpleasantness, those who quit drinking will experience better sleep and adequate hydration. After 2 weeks, people often feel happier with fewer mood swings.

Concentration improves drastically, and blood pressure begins to normalize. Therefore, the risk of health problems with the heart and liver lessens.

How Long Can Alcohol Withdrawal Symptoms Last?

Alcohol withdrawal symptoms usually last 72 hours or more. They can persist for months in some cases.

The worst or most intense symptoms generally occur within the first week. Someone who has remained alcohol-free beyond this time can begin to experience the benefits of going sober if they do it the right way. 

While this is a generally applicable timeframe, the effects of alcohol withdrawal differ for everybody. The amount of time that symptoms last depends on your drinking’s severity and duration and other pre-existing health conditions. 

Treatment for Alcohol Withdrawal

Those who suffer from alcohol dependence should seek medical attention. Treatment involves:

1. Physical Assessments

Under the guidance of a health professional, the first step involves a series of exams. These physical exams, lab tests, and imaging tests assess organ damage from alcohol use.  

The results are vital in developing a comprehensive treatment plan for you.

2. Substance Abuse Treatment

It’s essential to consult with a healthcare professional to determine the best treatment approach for your circumstance. The initial stage entails detoxification, where you can remedy mild symptoms at home.

For severe symptoms, inpatient treatment is best. Physicians can closely monitor and treat your symptoms at these facilities. They can also prescribe medications that alleviate severe symptoms, including:

  • Naltrexone
  • Disulfiram
  • Topiramate
  • Baclofen
  • Ativan
  • Klonopin
  • Xanax
  • Valium

3. Polysubstance Abuse Disorder and Dual Diagnosis

Polysubstance abuse disorder is a complex condition that occurs when you abuse drugs and alcohol. The interaction between these substances can intensify their effects and increase dependence. 

You will need 24/7 monitoring to treat this condition. You can receive them at an inpatient clinic. 

Doctors may require dual diagnosis treatment when addiction coexists with mental illness. Once you complete treatment, you may opt for counseling and therapy for ongoing support.

Summary

Alcohol withdrawal is a common condition that affects heavy drinkers who suddenly quit. Its physical and mental symptoms can be severe and even life-threatening.

Seeking medical attention is always best when attempting to quit drinking. It helps doctors monitor and treat symptoms, prescribe medications, and diagnose underlying conditions that may contribute to the condition.

Always consult a healthcare professional for guidance on the best treatment approach for your needs. And if you or someone you know is struggling with alcohol addiction, reach out for help today.

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Updated on February 6, 2024
12 sources cited
Updated on February 6, 2024
  1. Kattimani et al. "Clinical management of alcohol withdrawal: A systematic review." Industrial Psychiatry Journal, 2013.
  2. Newman et al. "Alcohol Withdrawal." StatPearls Publishing, 2023.
  3. Kattimani et al. "Clinical management of alcohol withdrawal: A systematic review." Industrial Psychiatry Journal, 2013.
  4. Grover et al. "Delirium Tremens: Assessment and Management." Journal of Clinical and Experimental Hepatology, 2018.
  5. National Library of Medicine. "Alcohol withdrawal." MedlinePlus, 2023.
  6. Newman et al. "Alcohol Withdrawal." StatPearls Publishing, 2023.
  7. Rubio et al. “Alcohol Detoxification.” Interventions for Addiction, 2013.
  8. Tonic-Clonic (Grand Mal) Seizures.” Johns Hopkins Medicine.
  9. Alcohol Use and Your Health.” Centers for Disease Control and Prevention, 2022.
  10. Mason et al. “Alcohol Use Disorder: The Role of Medication in Recovery.” Alcohol Research: Current Reviews, 2021.
  11. Alcohol and mental health.” Mental Health Foundation, 2022.
  12. Revadigar et al. “Substance-Induced Mood Disorders.”  StatPearls Publishing, 2022.

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