The Alcohol Withdrawal Timeline: What Happens (and When) After the Last Drink

Most people who have struggled with an alcohol use disorder (commonly known as alcoholism) know that quitting brings its own challenges – not the least of which are physiological effects that can be mild to life-threatening in severe cases. Fortunately, medications are available to assist in alcohol detox, and with medical supervision, you can treat those symptoms to make it a little easier to endure.

Physiological effects and symptoms associated with alcohol withdrawal are typically classified in three stages of severity:

• Stage 1 of alcohol withdrawal

  Stage 1 occurs approximately 6 to 24 hours after the final drink and can result in abdominal pain and discomfort, nausea and vomiting, insomnia, headaches, anxiety, and depression. The individual may also experience tremors, heart palpitations, fatigue, foggy thinking (also known as “brain fog”), and mood swings.

• Stage 2 of alcohol withdrawal

  Stage 2 brings about abnormal vital signs such as increased body temperature/fever, sweating, faster respiration rate, increased blood pressure, and irregular heart rate, as well as greater mental confusion, irritability, and more pronounced mood disturbances. Stage 2 usually starts 24 to 72 hours after the last drink.

• Stage 3 of alcohol withdrawal

Occurring 2 to 4 days after the final drink, stage 3 of alcohol withdrawal is associated with the most severe symptoms, among them fever, seizures, confusion, and delirium tremens (DTs), which can be fatal if not treated. Individuals who want to stop drinking are advised to never go “cold turkey,” without medical supervision, because sudden removal of alcohol can depress the central nervous system, leading to death.

Withdrawal symptoms usually cease 5 to 7 days after the last drink. But it’s important to keep in mind that no two people will withdraw from alcohol the same way, and not every person will experience each stage of withdrawal. A number of factors can impact someone’s experience when they stop drinking, including medical history, how long they’ve been drinking, how much they regularly consume, other mental health disorders, and a family history of substance abuse, as well as current trauma or stress levels.

When going through detox in a treatment center under medical supervision, healthcare professionals will observe and treat physical symptoms to stabilize the individual. Doing so may involve the use of medications to alleviate nausea, seizures, insomnia, and dehydration that may occur while the central nervous system is trying to recalibrate. Medical detox may entail a supervised tapering of alcohol use to gradually acclimate the body to become less dependent on it.

Other advisable steps to take during alcohol withdrawal include the use of health supplements, the adoption of a healthier diet, and the reintroduction of a regular sleep schedule to help the body return to its natural state and minimize side effects. To help prevent relapse, addiction treatment professionals often recommend ongoing therapy and counseling sessions and participation in 12-step programs — because even after the physical symptoms of alcohol withdrawal go away, many people will still have to contend with emotional cravings and other mental health challenges.

By participating in a qualified medical detox program followed by a treatment plan, those who struggle with alcohol addiction can get the full continuum of care required to endure the stages of alcohol withdrawal and successfully return to a healthy, sober lifestyle.