An estimated 27.9 million people in the United States aged 12 and older had alcohol use disorder (AUD) in the past year. Only about 7.6% of them received any alcohol treatment.
Drinking heavily over time has a serious effect on health. A large share of liver disease deaths involve alcohol, and people who misuse alcohol are at increased risk of heart disease, stroke, stomach bleeding, depression, and several types of cancer. Alcohol also increases the risk of unsafe sexual behavior, motor vehicle accidents, drowning, and injuries from falls and violence.
Despite those risks, people who are physically and psychologically dependent on alcohol struggle to stop. Even a casual drinker can tell you that withdrawal after a few drinks is uncomfortable. People who have been drinking heavily, or drinking for a long time, can experience life-threatening withdrawal symptoms. That is why alcohol detox should happen under medical supervision at a professional alcohol addiction treatment center, where your body can clear alcohol gradually and safely.
But what actually happens to your body during alcohol detox? Fear of that process is one of the main reasons people avoid treatment. Knowing what to expect can make it less overwhelming.
What is alcohol addiction?
Alcohol addiction is also called alcohol use disorder (AUD), alcohol misuse, or alcohol dependence. It is a particularly dangerous condition because, unlike illicit drugs or prescription medications, alcohol is legal, easily available, and socially acceptable. That makes it harder to recognize when drinking has become a problem.
So how can you tell? AUD is a pattern of drinking marked by three things: trouble controlling how much and how often you drink, preoccupation with drinking, and continuing to drink even after it starts causing problems.
Two other signs are common. People with AUD find that over time they need more alcohol for the same effect, which is called tolerance. And they experience unpleasant withdrawal symptoms when they try to cut down or stop.
For how long does alcohol stay in blood?
Detection times depend heavily on the type of test used. As a general guide:
- Blood: up to 12 hours after the last drink
- Breath: 12 to 24 hours
- Saliva: around 12 hours
- Hair: up to 90 days
Urine testing varies the most. Standard urine tests detect alcohol for roughly 12 to 72 hours, while EtG tests, which look for a metabolite rather than alcohol itself, can detect use considerably longer. If a specific test result matters to you, ask which test is being used.
Can you taper off alcohol on your own?
Tapering is a medical decision, not a self-help technique. How much someone can safely reduce, and how quickly, depends on how much they have been drinking, for how long, their withdrawal history, and their other health conditions. Those variables are why a taper should be set and adjusted by a clinician, and why this article does not offer a schedule to follow at home.
If you are physically dependent on alcohol, stopping abruptly can be dangerous, and in some cases fatal. Withdrawal symptoms are also temporarily relieved by drinking again, which is one reason quitting alone so often fails.
If you are drinking daily and want to stop, talk to a doctor or an addiction treatment provider before you change how much you drink.
If cost or access is the obstacle, SAMHSA’s National Helpline is free, confidential, and staffed 24 hours a day at 1-800-662-4357. They can refer you to local options, including low-cost and sliding-scale programs. An emergency room or urgent care can also assess whether it is safe for you to stop drinking.
If you have already stopped and are experiencing tremors, confusion, a racing heart, a fever, or hallucinations, call 911. Alcohol withdrawal can escalate quickly, and it is treatable.
How to overcome alcohol cravings?
When you are changing your drinking behaviors, it is common to have cravings or urges to drink alcohol. This includes both psychological (emotional) triggers that tempt you to drink as well as physical sensations that make you want to drink. Fortunately, alcohol cravings are short-lived and get less severe over time. You can train your mind to recognize, avoid, and cope with these urges. Cognitive behavioral therapy (CBT) is one of the most effective ways to learn this technique and other coping skills, such as making plans for handling alcohol cravings and identifying triggers. Other ways to stop alcohol cravings include:
- Avoid tempting situations, such as hanging out with friends at a bar.
- Distract yourself by calling a loved one when you have the urge to drink.
- Remind yourself why you need to stop drinking by reading a list or listening to a recorded message.
- Ride out the craving by accepting it as a temporary feeling.
When should you seek help to overcome alcohol addiction?
You should seek help to overcome alcohol addiction if:
- You can’t control your need to drink.
- You are preoccupied with alcohol (you’re either drinking or thinking about drinking).
- Other people have warned you that your drinking is out of control.
- Your drinking is causing health problems.
- Your grades at school or your work performance has dropped because of your drinking.
- You’ve got into trouble because of your drinking.
What is alcohol detox?
Alcohol detox is the first step in treating alcohol use disorder (AUD). Many people are apprehensive about quitting alcohol due to the fear of withdrawal symptoms. Withdrawal symptoms are symptoms that occur when a person who is physically dependent on alcohol reduces or stops drinking. They develop because of changes in the levels of excitatory and inhibitory neurotransmitters in the central nervous system. The brain, which has become accustomed to alcohol, is unable to cope when alcohol is suddenly withdrawn, resulting in a range of physical and psychological symptoms. During a medically-supervised alcohol detox, a multidisciplinary healthcare team keeps you as comfortable as possible by managing your withdrawal symptoms. The team also manages any medical complications that arise during alcohol withdrawal.
What are the common alcohol withdrawal symptoms from alcohol detox?
Symptoms of alcohol withdrawal include:
Mild symptoms: headache, insomnia, anxiety, shakiness, fatigue, stomach upset, and mood changes.
Severe symptoms: heart palpitations, increased blood pressure, rapid heart rate, elevated body temperature, rapid breathing, sweating, hallucinations, and seizures.
What makes alcohol withdrawal challenging?
Alcohol withdrawal is challenging because symptoms can develop suddenly and escalate quickly. Stopping abruptly can result in hallucinations, seizures, heart failure, and death. People who develop a severe form of withdrawal called delirium tremens may need intensive care.
This is why alcohol detox should happen under medical supervision. Healthcare providers can treat symptoms to keep you comfortable, monitor vital organs through laboratory testing, and manage complications as they arise. If you develop low blood sugar, they can give intravenous glucose. If you have seizures, they can control them with benzodiazepines. If you have a vitamin deficiency, they can correct it.
Do I need to detox at an alcohol addiction treatment center?
It can be tempting to try to quit at home. But withdrawal can progress from moderate to severe very quickly, and without medical care that can put your life at risk.
There is a second reason home detox often fails. Withdrawal symptoms are relieved almost immediately by drinking again, which makes relapse far more likely when you are managing it alone.
What factors affect the severity of withdrawal symptoms?
Prior drinking habits
Severity depends on how long someone has been drinking and how much. People who have consumed alcohol for one to three months, or drunk large quantities for seven to ten days, typically experience withdrawal lasting 6 to 24 hours after stopping. Those with a longer history or heavier consumption may experience more severe symptoms lasting two weeks or longer.
History of substance use
People who use other drugs alongside alcohol typically experience more severe withdrawal. Detox in these cases can be complicated and requires specialized medical care.
Co-occurring disorders
Many people with substance use disorders, including alcohol dependence, have co-occurring disorders such as anxiety, depression, bipolar disorder, post-traumatic stress disorder, OCD and other mental health conditions. The presence of co-occurring disorders can make alcohol detox more severe, complicated, and prolonged. Treatment centers that specialize in dual diagnosis are best equipped to handle such patients.
What are the different alcohol withdrawal stages?
Alcohol withdrawal symptoms can last anywhere from 6 hours to 2 weeks or longer after starting alcohol detox. Here is what typically happens to your body during the various stages of alcohol withdrawal after your last drink:
Stage one: 6-12 hours after alcohol withdrawal
Withdrawal symptoms are usually mild in the first few hours after your last drink. They may include headache, mild anxiety, insomnia, mild shakiness or tremors, and an upset stomach.
Stage two: 12-24 hours after alcohol withdrawal
During this stage of alcohol detox, withdrawal symptoms become more severe. They can include hallucinations (seeing, hearing, or feeling things that don’t exist) and mood changes.
Stage three: 24-48 hours after alcohol withdrawal
Some alcohol withdrawal symptoms begin to resolve after peaking while others continue and can linger for 1-2 weeks. The risk of seizures is highest 24-48 hours into an alcohol detox. Other symptoms in stage 3 of alcohol withdrawal can include confusion, agitation, and hallucinations.
Stage four: 48 to 72+ hours (delirium tremens)
People who have been drinking heavily and stop abruptly can develop a severe, life-threatening form of withdrawal called delirium tremens, or DTs. It typically develops two to three days after the last drink.
Delirium tremens is uncommon. More than half of people with a history of alcohol use disorder experience some withdrawal symptoms when they stop or cut down. Only about 3% to 5% develop withdrawal severe enough to be classified as delirium tremens.
Symptoms include:
- Fever, sweating, and dehydration
- Nausea, vomiting, and pale skin
- Severe tremors and chest pain
- Increased blood pressure and rapid heartbeat
- Extreme sleepiness or loss of consciousness
- Sensitivity to light and sound
- Hallucinations, seizures, confusion, and agitation
Risk factors include heavy or prolonged drinking, stopping abruptly, previous withdrawal episodes, a history of withdrawal seizures or delirium tremens, and other medical conditions such as liver or heart disease. Clinical guidance is explicit that anyone who has had a complicated withdrawal before should not try to reduce their drinking without consulting their care team.
Delirium tremens is a medical emergency. Published mortality estimates vary considerably depending on how quickly it is treated and on the era of the study.
The direction is consistent across sources, though. With prompt medical treatment and intensive care, deaths are uncommon. Untreated delirium tremens is substantially more dangerous. This is the reason alcohol detox is not something to attempt alone.
Post-acute withdrawal
Most people experience alcohol withdrawal syndrome lasting for a few days to a couple of weeks after their last drink. However, sometimes, quitting alcohol can lead to protracted symptoms called post-acute withdrawal syndrome or PAWS, which can last for several months or even years. This is believed to occur due to changes in the central nervous system on a molecular and cellular level that affects emotions and behaviors long after the physical symptoms of alcohol withdrawal have ended. Our understanding of PAWS remains scant, but people with PAWS often experience sleep problems, mood changes (anger, hostility, irritability), depression, fatigue, problems with thinking and concentrating, decreased sex drive, and physical pain for 1-3 years after they stop alcohol consumption.
Frequently asked questions
How long does it take for alcohol to get out of your liver?
It can take your liver one week or longer to completely detox from alcohol after your last drink. The human liver can process 1 ounce of alcohol every hour.
What is the third stage of alcohol withdrawal typically characterized by?
The third stage of alcohol withdrawal is typically characterized by fever, confusion, agitation, hallucinations, and seizures. However, every person is different and the severity of the withdrawal symptoms can vary from person to person depending on the extent of alcohol use and the person’s underlying health status.
Does everyone experience the 4 stages of alcohol withdrawal syndrome?
No, everyone may not experience the four stages of alcohol withdrawal syndrome. The severity of alcohol withdrawal depends on the several factors, including the duration and extent of alcohol consumption. People who are heavy drinkers or have been drinking for years are more likely to experience all four stages of alcohol withdrawal syndrome and more severe withdrawal symptoms.
Does private health cover inpatient treatment for addiction and rehab?
Many private health insurance plans cover all or some of the cost of inpatient treatment for addiction and rehab. The Affordable Care Act requires private and public insurance plans to cover 10 essential health benefits, one of which is substance use disorders. However, the exact coverage will depend on your specific insurance plan. You may be responsible for part of the costs of your alcohol addiction treatment, depending on your deductible, copay, and coinsurance.
What can be expected during the acute phase of alcohol detoxification?
You can expect to experience alcohol withdrawal symptoms during the acute phase of alcohol detoxification. These symptoms can range from mild symptoms such as headache and anxiety to more serious alcohol withdrawal symptoms such as tremors, hallucinations, and seizures.
How long does the acute phase of alcohol detox typically last?
The acute phase of alcohol detox can last anywhere from 6 hours to 2 weeks.
How can I support a family member going through alcohol detox?
You can support a loved one going through alcohol detox by educating yourself about alcohol withdrawal symptoms, accompanying them to family therapy appointments, supporting their recovery by removing alcohol from the home, and remaining patient and positive throughout the process.
Wrapping up
Being fearful about the stages of detoxing from alcohol is one of the key reasons why people don’t seek the help they need. Understanding the importance of medically supervised alcohol treatment and knowing the stages of alcohol detox can help people take this important first step towards a sober future. If you are worried about yourself or a loved one, Discover Recovery Treatment Center in Washington offers individualized alcohol detox programs. We provide evidence-based medical care and emotional support through all the stages of detox from alcohol. The foundation of our luxury rehabilitation center is a holistic approach where we treat the person as a whole and not just their alcohol addiction. Our inpatient residential program, which begins when you have gone through all the stages of alcohol detox, includes counseling and therapy, nutrition, and other evidence-based practices to heal your mind, body, and soul. Call us today to find out how we can help you overcome your alcohol addiction and hold your hand every step of the way as you detox from alcohol.
Watch our Medical Director, Dr. Kevin Fischer, share more about the dangers of alcohol detox on our YouTube video below:
