Timeline of What to Expect During Alcohol Withdrawal
Alcohol withdrawal is that uncomfortable time after you quit drinking where you feel terrible. Learn more about why withdrawal happens, what to expect, and when to seek medical attention.
What is Alcohol Withdrawal?
When you drink a lot of alcohol regularly, your brain chemistry changes over time in an attempt to balance the sedative characteristics of alcohol. Since alcohol is a central nervous system depressant, your brain works harder to keep itself in an awake and alert state and compensate for the effects of alcohol. When you suddenly stop drinking, your brain can become overstimulated because it stays in that alert state, and physical or mental health symptoms may arise. This is called alcohol withdrawal.
Is Alcohol Withdrawal Dangerous?
The American Academy of Family Physicians and American Addiction Centers describe 3 stages of withdrawal that someone may experience:
Stage 1 (mild): symptoms may include headache, sweating, insomnia, anxiety, hand tremors, nausea, vomiting, and heart palpitations
Stage 2 (moderate): in addition to stage 1 symptoms, you may also experience increased blood pressure or heart rate, confusion, rapid breathing, and mild hypothermia
Stage 3 (severe): in addition to stage 2 symptoms, you may also experience visual or auditory hallucinations and seizures
“Alcohol is different than other drugs with respect to the dangers associated with withdrawing,” says Margie Skeer, Associate Professor of Public Health and Community Medicine at Tufts University School of Medicine.
"While not everyone has serious symptoms, others may develop life-threatening seizures or other severe side effects," Skeer states. Because alcohol withdrawal can be deadly for some people who try to detox on their own without medical care, it’s important to talk to your doctor before you stop drinking.
One of the more severe side effects of alcohol withdrawal is called delirium tremens (DTs). It often requires treatment in an intensive care unit. Alcohol alters the activity in our central nervous system and causes the brain to slow down, which is why we experience decreased anxiety and feelings of relaxation when we drink. The brain is always seeking to stay in balance, and it will release extra excitatory signals to attempt to speed itself back up to normal. This results in tolerance and needing to drink more to get the same relaxing effect. Over time, this adaptation can become extreme and when someone stops drinking suddenly, the brain is still releasing extra excitatory signals to compensate for the effects of alcohol. This causes the central nervous system to rebound during withdrawal, and if the rebound is very severe, it can lead to DTs.
This condition can cause dehydration, rapid heartbeat, high blood pressure, and reduced blood flow to the brain. Symptoms include confusion, loss of consciousness, angry or nervous behavior, hallucinations, soaking sweats, and disturbed sleep. Delirium tremens occurs in only about 5% of people who go through alcohol withdrawal, but is fatal for up to 1 in 20 people who develop it, according to Harvard Medical School.
If you are concerned about withdrawal or are experiencing symptoms like the shakes or extreme confusion, then it is important to talk to your doctor or check in with the emergency room. It’s not worth the risk.
Alcohol Withdrawal Timeline: Day 1-5
Withdrawal symptoms will generally peak within 24-72 hours after your last drink and the worst symptoms tend to resolve within 4-5 days. The severity and duration of withdrawal symptoms are impacted by several factors including:
How many years you drank
How much alcohol you consumed when you did drink
How often you drank
Any co-occurring physical or mental health conditions
If you struggle with other substances
You may be in alcohol withdrawal for up to 2 weeks though, and this is why quitting for a few days and going back to drinking is so difficult. You don’t even get out of the withdrawal stage to see what sobriety can be like.
Learn more about the symptoms of alcohol withdrawal:
Night sweats
Listen to episode 38: Apple Spotify other apps
Anxiety
Listen to episode 22, why alcohol causes anxiety, on: Apple Spotify other apps
Listen to episode 167, what to expect with your anxiety when you quit drinking, on: Apple Spotify other apps
Insomnia
Listen to episode 75 on: Apple Spotify Other Apps
Brain fog
Listen to episode 157 on: Apple Spotify other apps
Irritability
Listen to episode 186 on: Apple Spotify other apps
Fatigue
Listen to episode 175, 5 tips to boost your energy, on: Apple Spotify other apps
Get support to quit drinking
If you’re struggling to stay sober, then it’s important to get more support. Many of us try to do it alone without success. Here are some options:
Alcoholics anonymous (AA)
Therapy
Online communities & virtual meetings
Smart Recovery
Recovery Dharma
Inpatient treatment
Outpatient treatment
Talking to your doctor about medication
Cite this article:
Gillian Tietz. Timeline of What to Expect During Alcohol Withdrawal. Sober Powered. 2023
Please respect my intellectual property by citing me as your source.
Sources:
American Addiction Centers. Alcohol Withdrawal Symptoms, Timeline, Detox, and Treatment. 2023
Leonard, J. Are Night Sweats a Sign of Alcohol Withdrawal. Medical News Today. 2019.
Yoda T, Crawshaw LI, Nakamura M, et al. Effects of alcohol on thermoregulation during mild heat exposure in humans. Alcohol. 2005;36(3):195-200.
Monico, N. Nights Sweats and Alcohol: Why Alcohol Makes You Hot. American Addiction Centers. 2020
Eckelbarger, J. Why Does Alcohol Withdrawal Make You Sweat? Stonegate Center. 2020.
Simou, E et al. Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis. Sleep Medicine. Volume 42, Pages 38-46. 2018
Sievert LL, Obermeyer CM, Price K. Determinants of hot flashes and night sweats. Ann Hum Biol. 2006;33(1):4-16.
McCallum, K. How Sweat Works: Why we Sweat when we’re Hot, as Well as When we’re Not. Houston Methodist Leading Medicine. 2020.
Hilliard, J. What are Central Nervous System Depressants? Addiction Center. 2020.
