Alcohol Withdrawal Timeline

Written by Jackie Calkins

Alcohol is the most widely abused mind-altering substance across the United States. More than 21 million Americans are addicted to mind-altering substances, but a startling 15 million of those Americans are addicted to alcohol. Once addicted to alcohol, stopping use can be near impossible without the help of professionals. For many, the stages of alcohol withdrawal that develop when they stop drinking are too much to handle, so they continue to drink to avoid withdrawal. But, putting forth the effort and dedication (paired with the guidance of trained professionals), those addicted to alcohol can get sober. 

Stages of Alcohol Withdrawal

The stages of alcohol withdrawal and the symptoms that accompany each stage are as follows:

  • Stage 1: Begins approximately six hours after your last drink, and includes symptoms like abdominal cramps, nausea, anxiety, and insomnia.
  • Stage 2: About 24-72 hours after your last drink, stage 2 of alcohol withdrawal sets in and you can experience symptoms like high blood pressure, increased body temperature, confusion, and abnormal heart rate.
  • Stage 3: By 2-4 days after your last drink, you may suffer hallucinations agitation, seizures, and fever. 

For the majority of people who are withdrawing from alcohol, these symptoms usually lessen and begin to fade around 5-7 days after their last alcohol consumption. 

alcohol withdrawal symptoms timeline

Stage 1

Stage 1 of alcohol withdrawal symptoms, as previously mentioned, can begin just a mere six hours after your last drink. Chances are you have already experienced stage 1 alcohol withdrawal symptoms simply by waking up after a night of drinking. This stage feels very similar to a hangover, however, it is not as harmless as the average hangover typically is. This is because as time progresses and you continue to abstain from alcohol, your symptoms will become more intense and severe.  

This first part of alcohol withdrawal is traditionally characterized by anxiety, abdominal cramps, nausea, and insomnia, as these are the most common symptoms that develop during this time. However, these are not the only symptoms that come along with this stage, as there are a handful of other physical and psychological symptoms that can kick in. They can include:

  • Loss of appetite
  • Vomiting
  • Headaches
  • Tremors
  • Mood swings
  • Depression
  • Fatigue

Depending on your threshold for discomfort, you may be able to push through some of these symptoms rather than be crippled by them. It is not uncommon for someone who is struggling with alcohol use disorder to reach for a drink when stage 1 begins, as drinking again quickly eliminates these symptoms. Unfortunately, ignoring the need to continue on through the entire process of alcohol withdrawal only perpetuates your alcohol use disorder, which is deadly when untreated. 

Stage 2

Stage 2 of alcohol withdrawal starts about one to three days after you have had your last drink. At this time, symptoms really start kicking into gear and intensify. Increased body temperature, high blood pressure, and abnormal heart rate are all common during stage 2, however, their presence makes alcohol withdrawal much more serious. 

Increased body temperature can cause health complications that include excess sweating, dehydration, and seizures. In particular, seizures can be deadly on their own, but also can also serve as a catalyst for a fatal fall or injury. This is one reason why withdrawing from alcohol in a professional, supervised setting is beneficial, as there are plenty of healthcare providers who can ensure your safety at this time. 

The cardiovascular impacts associated with stage 2 of alcohol withdrawal are just as alarming as the potential for seizures. Both high blood pressure and abnormal heart rate are linked to strokes and heart attacks, both of which can be deadly depending on the circumstances. Not everyone experiences such severe alcohol withdrawal symptoms, however when they do occur, it is best to be in the care of professionals rather than on your own. 

Additional withdrawal symptoms that can develop during stage 2 of alcohol withdrawal include: 

Stage 3

Right before alcohol withdrawal symptoms begin to settle, symptoms become the most severe. Stage 3 of alcohol withdrawal is defined by hallucinations, agitation, seizures, and fever. These symptoms usually begin about 48 hours to 4 days after the glass is put down, meaning that both stage 2 and stage 3 have the potential to cross over one another. Stage 3 of alcohol withdrawal is the most severe stage of this process and often serves as the final test to whether or not a person is going to continue to stay sober or go back to drinking. 

While only a small percentage of people withdrawing from alcohol experience it, delirium tremens (or the “DT’s), this symptom of alcohol withdrawal is by far the most severe. If you have delirium tremens, it means you are experiencing a heightened state of withdrawal where your symptoms are much more intense. Usually, the symptoms most closely associated with delirium tremens include:

  • Shaking
  • Tremors
  • Dilated pupils
  • Seizures
  • Shallow breathing

Most notably, the delirium tremens can produce hallucinations and severe confusion (or delusions). All of the symptoms linked to the DT’s usually begin during stage 3 of alcohol withdrawal and continue for a few days. In some instances, delirium tremens does not begin until 7-10 days after a person has stopped drinking. 

If you are dependent on alcohol, you will experience some level of alcohol withdrawal when you stop drinking. The symptoms you develop will be a direct reflection of your relationship with alcohol, as well as factors personal to you, such as a history of mental illness, physical health problems, etc. Generally, the more severe the alcohol use disorder, the more intense alcohol withdrawal, and its three stages are. 

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What Happens to Your Body When You Stop Drinking

What happens to your body when you stop drinking depends on a few factors, one of which being whether you are dependent on alcohol or not. If you are dependent on alcohol, it means that you cannot just stop drinking without experiencing withdrawal symptoms. This is because your body has become accustomed to the presence of alcohol in its system that without it, it essentially does not know how to function. Therefore, if you are dependent on alcohol, your body is going to go through many more changes than if you are not dependent on alcohol. The most prominent and immediate changes you will experience will come directly from the withdrawal symptoms you develop when you stop drinking. 

The period of withdrawal that you go through is nothing more than your body finding its new normal post-alcohol abuse. As discussed above, your symptoms can range from headaches and cramps to seizures and delusions. The majority of these symptoms can begin as early as six hours after your last drink and continue up to a week after you’ve stopped drinking. Depending on your situation, you may continue to have withdrawal symptoms for a few weeks after you have stopped drinking. 

While the nausea and high blood pressure and other withdrawal symptoms occur in response to the absence of alcohol in the body, there are several other things that happen within the body at this time:

  • The health of the cardiovascular system improves: The cardiovascular system is one of the hardest-hit systems in the body when a person is abusing alcohol. When that use stops, this system does not return back to its original state, as it has endured damage caused by alcohol. However, the cardiovascular system can do some recovering. Most reversals of damage or repairs of this system occur within the first few months to the first year of sobriety. After that, however, very few changes occur. It is highly recommended that during the beginning stages of one’s recovery, that they focus on eating well, getting enough rest, and exercising regularly to help improve the health of their cardiovascular system. 
  • The liver stops suffering damage: The liver is a main concern for many people who are recovering from alcohol use disorder because of the potential damage it has incurred as a result of the abuse. Those who have abused alcohol for a long time and/or abused it heavily are at increased risk for suffering permanent liver damage. However, when the drinking stops, so does the damage. Instead of alcohol being regularly filtered through the liver, recovering users can improve the health of their liver by drinking and eating healthier. Plus, with no further alcohol abuse, the liver is spared from becoming more damaged.
  • The brain begins to heal: When someone is abusing alcohol, the brain itself suffers. Not only can there be permanent destruction to areas of the brain, but the brain can actually shrink. Studies have shown, however, that when a person stops drinking, the brain restores the majority of its volume — and within a very short period of time. Typically, this occurs within the first two weeks of a person’s sobriety.

In addition to these, stopping alcohol abuse can also allow certain issues in the body the opportunity to heal, such as stomach ulcers and bone damage. It also allows the body to begin regulating hormones appropriately again and encourages the strengthening of the immune system. 

Of course, if you are recovering from alcohol use disorder, all of the issues you have experienced in your body because of your drinking will not magically disappear. The good news is, however, that you receive the opportunity to allow several areas of your body to heal as much as they can, allowing for a better long-term outcome for yourself. 

Getting Help With Medical Detox and Treatment

If you are dependent on alcohol, meaning that you cannot stop drinking without developing withdrawal symptoms, then it is imperative you obtain professional detox services when you stop drinking. As touched on before, detoxing from alcohol can be everything from uncomfortable to life-threatening, which is why going through this process while in the care of professionals is always the best option. Doing so can keep you safe during this process. 

While you are detoxing from alcohol, you will be made as comfortable as possible and you will have access to mental and medical health care professionals around-the-clock. Depending on your needs, you may be administered over-the-counter medications to help control less severe symptoms and/or prescribed medications to help ease the withdrawal. It is common for those who are struggling with intense symptoms to be prescribed a mild benzodiazepine to make the process less painful. Detox is the first and arguably the most important step in your journey towards recovery because of the support it can provide you while you are just beginning to build a sober foundation. But, detox alone does not do the trick. Detox is most effective when it is followed up by the appropriate level of treatment, such as inpatient, intensive outpatient, and/or outpatient programming.

These levels of addiction treatment offer a variety of intensity so that all individuals who are in need of continued care gets the type of care that is best suited for them. They include:

Inpatient treatment

If you participate in inpatient care, you will live at the facility for 30, 60, or 90 days depending on your needs. You will go right from detox into a detailed care plan that will connect you with the therapy you need to begin recovering. You can expect to participate in several therapeutic sessions per day while in an inpatient program. 

Intensive outpatient programs

Not as involved as inpatient, but more focused than outpatient treatment, intensive outpatient programs can offer you the care you need as well as the freedom you want. You will continue to live at home while participating in an IOP, but will spend several days per week at the facility. During that time, you will engage in therapy sessions until your program is complete.

Outpatient program

Outpatient programs have you going to the facility at least one time per week to engage in therapy, just as you would in any other program. However, you do not spend nearly as much time in this program as you would in others, which is why it is usually the best option if you are steady enough in your sobriety to manage your everyday life without the assistance of a daily program.

If you are struggling with alcohol use disorder, know that you do not have to go through it alone. Reach out to us right now to learn more about how we can help you stop drinking once and for all. We can help, so do not wait. Call now.