Alcohol Detox: Symptoms, Withdrawal Timeline, and Treatments

Alcohol withdrawal symptoms occur when binge drinkers suddenly quit drinking after chronic alcohol use. These symptoms can vary in severity, from mild to severe. Severe withdrawal symptoms can be dangerous and, in rare cases, fatal.

Because symptoms of alcohol withdrawal might worsen with time, it is crucial to know when your withdrawal symptoms are becoming more severe so you can get treatment. The more serious symptoms often appear two to five days after you quit consuming alcoholic drinks. The first two days may not be a good indicator of your risk of developing serious health problems.

In this post, you can learn about alcohol detox, its symptoms, and treatment options available to help you through alcohol withdrawal.

What is Alcohol Detox?

The best way to overcome an addiction to alcohol or any other substance is to stop using it. When someone goes through alcohol detoxification, they abstain from drinking alcoholic beverages on purpose to allow their body time to adjust to life without alcohol.

Alcohol detox can be an unpleasant, stressful, and dangerous process, requiring a person to experience various withdrawal symptoms. Withdrawal can often lead to relapse because of its uncomfortable symptoms and cravings, but a medical detox allows individuals to stop drinking safely and comfortably in a secure environment. An individual who decides to go through withdrawal and does not suppress it by having another drink will take the process very seriously, but the gain is lost if they risk their life by using it again.

Since some alcohol withdrawal symptoms are dangerous, people should detox from alcohol at a treatment center under medical supervision. People who undergo alcohol detox with professional help are more likely to complete the process safely and effectively.

A detox may not be a pleasant process, but it is an essential first step for recovering from alcoholism. After detox, an individual in recovery might begin therapy in a treatment program.

Alcohol Detox Symptoms

The severity of symptoms of alcohol withdrawal you experience depends on various personal factors, including how much and how often you have been drinking, as well as your overall health.

Alcohol withdrawal symptoms can range from mild, unpleasant physical and psychological sensations to severe, life-threatening ones. Aside from withdrawal, there are several additional signs and symptoms of alcohol use disorder (AUD).

Alcohol Withdrawal Syndrome

Alcohol withdrawal syndrome (AWS) is the set of symptoms that develop when a heavy drinker suddenly stops or lowers their alcohol intake.

AWS can cause various physical and mental symptoms, ranging from mild anxiety and exhaustion to nausea. Some AWS symptoms are severe, such as hallucinations and seizures. AWS can be fatal in its most severe form.

Because of the life-threatening health consequences that can occur during AWS, you are strongly advised never to attempt to quit drinking on your own and instead seek treatment at a hospital or specialized treatment facility. Medical professionals can monitor your physical and mental health throughout the day to ensure that symptoms do not worsen.

Common Symptoms of Alcohol Withdrawal

Symptoms of alcohol withdrawal usually appear 8 hours after your last drink, but they can show up days later. Withdrawal symptoms typically peak in 24 to 72 hours but can last for weeks.

  • Headaches
  • Intense cravings for alcohol
  • High temperature and/or chills
  • Irritability and agitation
  • Decreased appetite
  • Mood swings
  • Abdominal pain
  • Depression and anxiety
  • Shaking and shivering
  • Nausea and vomiting
  • Tics and tremors (‘the shakes’)
  • Irregular or increased heart rate
  • Confusion
  • Insomnia
  • Excessive sweating
  • Unpleasant, vivid dreams
  • Fatigue
  • Difficulty concentrating

Severe Symptoms of Alcohol Withdrawal

The most severe symptoms of alcohol withdrawal are known as delirium tremens (DTs) and can be fatal. While withdrawal symptoms are usual for many people who reduce their alcohol intake, a study shows that severe symptoms in the form of delirium tremens occur in around 3-5 percent of those experiencing withdrawal.

If you or someone you care about is struggling with delirium tremens, take it as a medical emergency and seek immediate medical attention.

Delirium tremens symptoms include:

  • High blood pressure
  • Seizures
  • Fever
  • Extreme agitation
  • Severe disorientation and confusion
  • Visual and/or auditory hallucinations

It is important to know that everyone’s experience with alcohol withdrawal will be different. Your personal history and mental and physical health will play a part in the symptoms you experience, their severity level, and the risk they pose to you.

Post-Acute Alcohol Withdrawal Syndrome (PAWS)

Some people may develop long-term side effects after the initial alcohol withdrawal symptoms have faded. This stage, known as post-acute withdrawal syndrome (PAWS), is less common.

PAWS refers to those withdrawal symptoms that appear after acute withdrawal and can make post-rehab living difficult for certain people. PAWS can persist anywhere from a few weeks to a year, depending on the severity of your alcohol abuse.

PAWS symptoms commonly include:

  • Delayed reflexes
  • Intense cravings
  • Anxiety
  • Trouble sleeping
  • Increased accident proneness
  • Chronic nausea
  • Irritability and emotional outbursts
  • Dizziness
  • Low energy
  • Memory problems

PAWS is a leading cause of relapse in those who have completed alcohol addiction treatment. Many people experience PAWS symptoms in cyclical waves: one day, you feel good, and the next, you’re tormented with poor energy and excessive alcohol cravings.

The spontaneity of this withdrawal period might make resisting cravings difficult. However, it is essential to note that each episode of PAWS is usually limited to only a few days at a time. If a person can hang on throughout that time period, the symptoms will fade just as quickly as they started.

Alcohol Detox Treatment

Alcohol is a CNS depressant that your body becomes addicted to over months or years of drinking. Your brain gradually quits generating specific neurotransmitters that it receives from alcohol, and you become addicted to alcohol.

That is why it takes time for your body to adjust once you stop drinking. Withdrawal symptoms include headache, fever, nausea, irregular heartbeat, and hallucinations.

The alcohol detox stage is the initial phase in alcoholism treatment. During this period, alcohol is entirely flushed from your system. Withdrawal symptoms typically fade after 1-2 weeks of beginning detox; however, depending on the severity of your AUD, this might take longer.

After detox, you can concentrate on other aspects of your rehabilitation process, such as different activities, treatments, therapy sessions, and support groups.

Alcohol Detox and Withdrawal Timeline

Detox is the first step in the treatment process for those suffering from alcoholism. Detox is the removal of alcohol from the body after the body has chemically adjusted to having the substance on a daily basis. It can be done in an outpatient or an inpatient medical detox environment. Detox is performed to help the body in overcoming withdrawal symptoms.

Withdrawal symptoms can vary in severity from mild to severe, depending on factors such as how much the individual drank, how often they drank, and whether they have any co-occurring mental disorders. While treatment does not ensure life-long sobriety, alcohol detox might be the first step toward staying sober when combined with rehabilitation or therapy.

Withdrawal symptoms might appear as early as two hours after your last drink. While the most severe symptoms usually go away within a week, specific milder symptoms might persist anywhere from a few weeks to a year. There is no exact alcohol withdrawal timeline for when or what withdrawal symptoms you may experience, but there is a basic outline of what to expect.

The following is a breakdown of the alcohol detox process:

First Six to Twelve Hours:

The initial symptoms of alcohol withdrawal are mild, but they can quickly worsen as time passes. Some early withdrawal symptoms are headaches, anxiety, shaking, nausea, and irritability.

Day One:

As you near the end of the first 24 hours of alcohol detox, your symptoms may worsen. In addition to the effects seen during the first 12 hours, disorientation, hand tremors, and seizures may also occur.

Day Two:

The most painful symptoms will persist on the second day of detox, as they did on the first. Hallucinations and panic episodes are expected during this period when your body detoxifies from alcohol.

Day Three to Seven:

Different withdrawal symptoms may appear and disappear over the rest of your first week of detox. This is also the moment when you are most vulnerable to life-threatening symptoms like delirium tremens.

After One Week:

Many withdrawal symptoms will fade by the end of your first week of detox. While some symptoms may last a few weeks, most are mild and treatable with medications.

Even after the most severe withdrawal symptoms have subsided, some people may have post-acute withdrawal syndrome (PAWS), characterized by prolonged detox symptoms. Anxiety, poor energy, difficulty sleeping, and delayed reflexes are common symptoms that might continue for several months to a year.

Alcohol Detox Medications

Medication is sometimes necessary to lessen withdrawal symptoms to manageable levels. The doctor monitors the withdrawal process and prescribes alcohol detox medications.

Medications used in alcohol detox are available in a wide variety, and what works for one person may not work for another. As the client’s needs change, the type and amount of medication may be adjusted throughout detox.


There are both short-acting and long-acting benzodiazepines that can be used in a detox program. These medications alleviate withdrawal symptoms such as anxiety, sleeplessness, and muscular spasms.


This medicine helps to lessen alcohol cravings. Because it might worsen withdrawal symptoms, naltrexone is typically not recommended or given until a few days into the detox process. Naltrexone is available in pill and injectable forms, and the doctor in charge of your detox and rehabilitation can advise you on which is best for you.


Anticonvulsant drugs may be used for those with a history of withdrawal-induced seizures during detox. Anticonvulsant medications used to treat withdrawal seizures include carbamazepine, divalproex sodium, phenobarbital, levetiracetam, and clonazepam.

Anti-Nausea Medication

Anti-nausea medication is sometimes used during the withdrawal phase of addiction recovery since nausea is a common symptom during detox. Ondansetron and metoclopramide are two anti-nausea medications that are often prescribed during detox.


These drugs alleviate psychotic symptoms such as hallucinations, delusions, and paranoia. Individuals experiencing these symptoms due to alcohol withdrawal may be prescribed antipsychotic medications such as olanzapine and risperidone.

Because these drugs are also used to treat medical conditions such as schizophrenia and bipolar disorder, people undergoing detox may continue to take them throughout and after rehab.


Individuals undergoing alcohol detox who have clinically diagnosed depression may be prescribed antidepressants. These medications also help reduce anxiety, another potential sign of alcohol withdrawal.

In some instances, those with a co-occurring mental health issue may continue to take depression or anxiety medication after the completion of treatment to control their symptoms. Treating mental health disorders is part of rehabilitation since these conditions, if left untreated, increase the chance of relapse later on.


Disulfiram is often used in the later phases of therapy rather than during detoxification. When used with alcohol, this medication has undesirable side effects. The goal of disulfiram is to make alcohol use so uncomfortable that you don’t want to drink anymore. If you consume alcohol while taking disulfiram, you may have nausea, headache, weakness, flushing, and low blood pressure.


Acamprosate may be prescribed to those who have been drinking heavily for a long time. This medication helps to lessen alcohol cravings and supports the brain in recovering to normal functioning after long-term alcohol addiction.