A 2012 survey funded by New York State’s Office of Alcoholism and Substance Abuse Services found that 10 percent of adults are reportedly in recovery from substance abuse or addiction. That equates to more than 23 million Americans and highlights the fact that recovery is entirely possible for those who approach it with the right mindset and a strong support group backing them up. There is no single program that will work for everybody, but anyone who has developed a dependence on alcohol will experience at least some of the most common withdrawal symptoms on the path to recovery.

The first phase of getting sober is undergoing medical detox. The intensity and duration of withdrawal symptoms during detox from alcohol vary among individuals depending on the extent of their addiction, but it’s critical to have access to a qualified team of healthcare professionals during the detox phase because life-threatening complications could arise.

The purpose of medical detox is to monitor and control the physical symptoms of withdrawal until the individual becomes stable enough to continue recovery and tackle the psychological symptoms. According to American Family Physician, withdrawal symptoms typically start 6-24 hours after the last drink.

Tremulousness

Tremulousness is the first stage of withdrawal and typically occurs 6-12 hours after the last drink. It usually lasts for about 24 hours and consists of the hands and legs trembling, as well as excessive anxiety. At this phase of detox, the body may also experience symptoms similar to those of a hangover, including night sweats, headache, and nausea.

Protracted Withdrawal

According to the Substance Abuse and Mental Health Services Administration, the final stage of detox is protracted withdrawal, which is simply the presence of withdrawal symptoms beyond the typical timeframe. Other terms for protracted withdrawal are post-use syndrome, protracted abstinence, sobriety-based symptoms, and sub-acute withdrawal. Symptoms of protracted withdrawal vary among individuals, but the most common ones are:

  • Anxiety
  • Depression
  • Shaking hands
  • Unstable blood pressure
  • Fatigue
  • Irregular breathing
  • Inability to concentrate
  • Impaired memory
  • Hallucinations

Seizures

Seizures are some of the most dangerous withdrawal symptoms and can lead to life-threatening complications, which is why it is critical to undergo medical detox with access to healthcare professionals. Seizures are more violent than the tremors that occur in the tremulousness stage, and they affect the entire body. During a seizure, the individual may lose consciousness, making medical intervention a priority.

Seizures might occur as soon as a severely dependent individual has gone 6 hours without alcohol; however, they can also take up to 48 hours to first appear. Seizures will typically continue over the course of a few hours, but they may happen sporadically for several weeks following sobriety. According to a study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), more than 90 percent of seizures that occur due to alcohol withdrawal happen within 48 hours of staying sober.

detox symptoms

Hallucinations

Hallucinations typically start around the same time that seizures do, within 48 hours of the last drink, but they usually continue for several weeks. The hallucinations related to alcohol withdrawal seem very real to the individual experiencing them and often involve small objects, like insects or coins. In the later stages of withdrawal, hallucinations of all types — tactile, visual, and auditory — can occur. Many people who undergo medical detox claim they feel bugs crawling all over their skin. It is important to note that the early hallucinations are not the same type as those that appear later, during the delirium tremens phase.

Delirium Tremens

The New England Journal of Medicine reports that the most serious phase of withdrawal, delirium tremens, occurs in up to 5 percent of individuals going through detox, and it can be fatal without medical intervention. Delirium tremens usually starts between 72 hours and 10 days after sobriety has begun, but it can show up as early as 48 hours after the final drink. For people who experience this stage of the detox process, it generally lasts 7-10 days. There is no way to stop the delirium tremens phase once it starts, but qualified medical technicians can make sure those experiencing it remain safe. Symptoms of this stage include:

  • Auditory or visual hallucinations, including the feeling that there are threatening animals and humans nearby
  • Vast confusion
  • Distress symptoms, including high blood pressure and a rapid heart rate
  • Heart attacks
  • Strokes
  • Grand mal seizures

General Timeline from Start to Finish

CSRI alcohol detox timeline
As far as the entire detox process, there is no set timeline in which symptoms will arrive or subside. Ultimately, everyone experiences the path to recovery differently, which is why it’s so important to undergo detox with the help of healthcare professionals. People don’t truly know how dependent they have become on alcohol until they stop drinking altogether, but doing so without medical intervention can have fatal consequences. It’s important to remember that no matter how dependent a loved one appears to be on alcohol, it is never too late to intervene. With the support of family and friends, withdrawal symptoms can be fairly manageable. The general timeline from start to finish looks like this:

  • 6 hours into sobriety: The individual will experience the start of withdrawal symptoms, which usually includes tremulousness and can last for 24 hours.
  • 24-72 hours into sobriety: Symptoms typically peak 1-3 days following the last drink. Individuals who have developed a serious dependence on alcohol may experience seizures and hallucinations during this time.
  • 5-7 days into sobriety: Physical withdrawal symptoms tend to taper off one week into sobriety; however, psychological symptoms, which include depression, anxiety, and irritability, start to become more apparent around this time.
  • More than one week into sobriety: The worst of the physical withdrawal symptoms typically subside by the end of the first week.

Detox is the body’s way of adjusting to life without alcohol, and there is no way to stop drinking without experiencing at least some symptoms; however, not everyone experiences delirium tremens, hallucinations, or even seizures. Some people only suffer from a mild dependence on alcohol, and they typically experience mild withdrawal symptoms.

Mild Withdrawal Symptoms

According to NIAAA, people who have not developed a serious dependence on alcohol may experience mild physical withdrawal symptoms once they stop drinking. Symptoms include headaches, uneasiness, shaking, and an upset stomach, and they generally subside within one week.

Complications

complications with alcohol detox
Regardless of the extent of addiction, it is critical to undergo medical detox alongside healthcare providers who know how to handle the most common complications that might arise. Developing a dependence on alcohol can have both acute and chronic effects on the body, and some of them are fatal if left untreated. According to the Distance Learning Center for Addiction Studies, some of the more common complications that accompany alcohol abuse both during and after the detox phase are:

  • Jaundice
  • Recurrent diarrhea and abdominal pain
  • Pancreatitis
  • Hypoglycemia and hyperglycemia
  • Gastrointestinal
  • Fatty liver
  • Cirrhosis
  • Heart palpitations
  • Anemia
  • Chronic obstructive pulmonary disease
  • Wernicke-Korsakoff syndrome ‘Wet Brain
  • Nephritis

It’s never too late to help a loved one seek treatment for alcohol dependence; however, it’s important to do so in the right way. Relying on trained medical professionals who know how to handle the ins and outs of each stage of the detox process is the best way to ensure a loved one’s safety and health while pursuing sobriety.