Alcohol Detox

What to Expect When You Detox from Alcohol

When a person seeks treatment for alcohol addiction, usually, the first step in the recovery process is alcohol detoxification. Alcohol detox happens when the body removes any remaining alcohol from the system.

However, when someone who has developed an alcohol dependence stops drinking alcohol, they may experience withdrawal symptoms during detox. Withdrawal symptoms can range from mild to severe, depending on previous alcohol consumption.

A heavy drinker is more at risk for severe withdrawal symptoms, whereas a less serious drinker may only experience mild symptoms.

Symptoms of Alcohol Withdrawal

For some people who have quit drinking after a period of alcohol abuse, the withdrawal symptoms may be relatively minor.

Some of the more common symptoms of alcohol withdrawal include:

• Anxiety
• Feeling irritable
• Insomnia
• Decreased appetite
• Cravings for alcohol

People who experience more serious acute withdrawal symptoms are more likely to have been heavy drinkers than those who only experience mild symptoms.

Some of the more severe alcohol withdrawal symptoms include:

• Increased body temperature (fever)
• Tremors in hands and arms
• Disorientation or confusion
• Sweating
• Nausea, possible vomiting
• Increased blood pressure
• Increased heart rate

Many more severe withdrawal symptoms won’t appear until 48-72 hours after the last drink. For the most extreme cases of withdrawal, delirium tremens may be present. Individuals showing more severe side effects should seek medical care immediately.

Delirium Tremens (DTs)

Delirium tremens is a condition that can occur in people with the most severe form of alcohol withdrawal syndrome. The symptoms of delirium tremens can be fatal.

Side effects of delirium tremens can include:

• Hallucinations (visual and auditory)*
• Withdrawal seizures
• Severe disorientation
• Extreme tremors
• Inability to regulate blood pressure or heart rate
• Organ failure
• Impaired brain function

By seeking medical detox to manage alcohol withdrawal syndrome, patients gain access to medical care during withdrawal.

Alcohol Detox Timeline

People who go through detox may have varying experiences depending on age, addiction level, other health conditions, etc. However, one of the things you can expect is the process to follow a general timetable.

First 6–12 Hours (Stage 1)

Most people will experience alcohol withdrawal symptoms in the first 6-12 hours following their last drink. During this early stage, your central nervous system begins to feel the impact of no longer getting the sedative effects of alcohol that it had become used to.

Within the first 6-12 hour period, symptoms may include:

• Nausea
• Tremors (aka “the shakes”)
• Anxiety
• Trouble sleeping
• Irritability

Days 1–3 (Stage 2)

Stage two of alcohol detox occurs within the 24 to 72-hour mark. During this phase of withdrawal, symptoms will begin to peak. In addition, some of the more severe withdrawal symptoms can begin to appear.

Seizure risks are the highest during stage two. In addition to seizures, prolonged sleep disturbances, mood changes, and fatigue can also be present.

Stage two possible symptoms:

• Nausea
• Stronger tremors
• Fatigue
• Changes in mood (anxious, irritable)
• Brain fog
• Hallucinations
• Seizures
• Delirium tremens (DTs)

One Week (Stage 3)

For some people, the next week or more may also present symptoms. As the central nervous system returns to normal functioning, severe side effects will likely wane. However, people recovering from alcohol use disorder, in particular, should try to manage expectations during stage three.

Sometimes, mild symptoms may continue to present over this time period. While these symptoms are not serious, they can be disruptive and discouraging. Whether or not symptoms continue during stage three will rely upon the individual, their history with alcohol use (length of time, amount consumed, etc.), and any additional health factors.

Home Detox vs. Medically Supervised Detox

When detoxing from any substance use, your safest option is to consult a healthcare professional beforehand. Some withdrawal symptoms—including those that appear from alcohol—can be dangerous or even deadly.

Choosing a Home Detox

Mild alcohol addiction usually means mild withdrawals and would therefore be safe to go through at home. However, it is best to seek medical advice from a healthcare professional about the risks involved with your individual situation.

If a healthcare professional approves at-home detoxification, you can anticipate experiencing mild withdrawal symptoms as listed above.

During a home detox, the following practices may:

• Hydration: Keeping yourself hydrated during detox will assist your body with naturally flushing out any relevant chemicals.
• Balanced Diet: Eating healthy, nutrient-rich foods will support your body’s healing and fuel you as your body adjusts to the lack of alcohol it had gotten used to.
• Rest: Be sure to get plenty of rest and maintain a normal sleep schedule, allowing your body to continue healing.

If you choose to do a home detox, it is ideal to check with a medical professional to ensure that it is safe for you to do without medical supervision. During detox, seek medical attention as soon as possible if you experience more severe symptoms.

Choosing a Medically Supervised Detox

In some cases, medical detox is the safer choice when detoxing from alcohol use—especially when heavy drinking was the case beforehand. Medical detox allows the recovering individual to go through alcohol withdrawals under medical supervision to ensure their safety.

As mentioned above, more acute withdrawal symptoms can be life-threatening. Having access to medical personnel can be critical.

Medically-supervised detox can be provided on an inpatient or an outpatient level, depending on the severity of previous alcohol use. Various treatment programs are available to assist you through the detox process and provide peace of mind.

Besides monitoring your vitals and working to keep you safe, your medical detox team may also prescribe you certain medications to assist you through the withdrawal process. Some of these medications are designed to lessen the alcohol withdrawal symptoms, while others are meant to help you resist the urge to relapse and return to drinking.

Medications Used During

Here are some of the most common medications utilized to treat alcohol use disorder during the detoxification process:

• Benzodiazepines: Can be used for their sedative effects to prevent withdrawal seizures. Such benzodiazepines may include: chlordiazepoxide (Librium®), diazepam (Valium®), and lorazepam (Ativan®).
• Naltrexone: More commonly prescribed during the late withdrawal stage to prevent relapse.
• Acamprosate: Another common choice for preventing relapse, usually after the main withdrawal symptoms have subsided.
• Disulfiram: Helpful for relapse prevention by causing an unpleasant reaction to drinking alcohol.

Continuing Support for Alcohol Use Disorder

In many cases, aftercare for alcohol use disorder can be just as important as the detox process.

After withdrawal symptoms have subsided, many people seek mental health treatment. Alcohol use disorder affects people mentally and emotionally, not just physically.

Support groups and individual counseling via psychiatry can provide separate but similar benefits to help you or your loved one continue their healing.

Additionally, you or your loved one may already be enrolled in an alcohol rehabilitation program (inpatient or outpatient), and the detox process was just the first step in your journey. Whatever the case, once detox is complete, you have finished one of the most critical steps in alcohol addiction treatment.

Ready to Tackle Detox?

Not sure what alcohol detox treatment options are available to you? You can talk to your doctor or visit the Substance Abuse and Mental Health Services Administration (SAMHSA) program locator to see what treatment facilities are near you.