How Long Does Alcohol Withdrawal Last?
There are a few reasons to want to give up alcohol, you may be on a health kick and want to swop the weekly drink at the pub for the gym, need to take medication that is contraindicated with alcohol (antidepressants, certain antibiotics etc) or have noticed that your social drinking has become a drink to get up, more to get through your day and a last one to go to sleep.
Whatever your reasons to start out on this journey, you may be concerned about what your experience will be like and how long the withdrawal may take. Every person’s journey to recovery is different so you may feel all of these withdrawal symptoms or only some.
The general guidelines according to the Industrial Psychiatry Journal (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/) of what you can expect to experience are:
1st Day (Stage 1 & 2):
Within 6hrs after your last drink, the first minor withdrawal symptoms may begin:
- rapid heart rate
12 – 24hrs – at this point a small percentage of people may experience hallucinations:
- tactile hallucinations, such as having a sense of itching, burning, or numbness that isn’t actually occurring
- auditory hallucinations, or hearing sounds that don’t exist
- visual hallucinations, or seeing images that don’t exist
2nd Day (Stage 3):
The minor withdrawal symptoms you have been experiencing will usually continue through the second day and may now include
- Stomach irritability
- Increased tremors
3rd Day – 1 week (Stage 4):
Between 48hrs and 72hrs since your last alcoholic drink or decrease in alcohol consumption, you may experience a severe form of withdrawal called DTs – delirium tremens or Alcohol Withdrawal delirium.
The DTs only affect heavy long term drinkers (defined as 15 drinks a week for men & 8 drinks a week for women) your risk is higher if you also have:
- a history of alcohol withdrawal
- a history of AWD
- other health problems in addition to alcoholism
- a history of seizure disorder or other brain damage
- low platelet counts
- low potassium levels
- low sodium levels
- older age at time of withdrawal
- preexisting dehydration
- presence of brain lesions
- use of other drugs
Symptoms of AWD or DRs may include all or some of the following:
- agitation or irritability
- chest pain
- delirium (an extremely disturbed state of mind)
- delusions (irrationally believing things that are untrue)
- excessive sweating
- eye and muscle movement problems
- hallucinations (seeing or hearing things that aren’t there)
- increased heart rate or breathing rate
- increased startle reflex (an exaggerated reaction to unexpected stimuli)
- involuntary muscle contractions
- sensitivity to light, sound, or touch
- stomach pain
- sudden mood changes
If your drinking habits have been heavy for a long time you may have a seizure within 6hrs of your last drink. It is advised that if you have been a long term heavy drinker or been diagnosed with an Alcohol Use Disorder that you have medical supervision during the detox and withdrawal phase of your recovery.
Minor withdrawal symptoms will usually peak between 18 to 24hrs and start to decrease after about five days. In rare cases, moderate withdrawal symptoms (rapid heart rate, illusions) can last for a month. But all symptoms will have ceased in under 6 months.
The NHS recommends that you start with a visit to your GP, or visit the NHS directory service for free services.
In some cases following an assessment, your GP may recommend that you start at an inpatient treatment centre to assist the detox period and then continue your treatment as an outpatient.
Additional counselling is recommended to deal with your addiction and any additional mental health issues (dual diagnosis) that may resurface upon cessation.
This option is recommended if you:
- Are a long term heavy drinker
- Have not been able to moderate your alcohol consumption
- Are at risk of AWD or DTs
- Live in an environment that is not conducive to your recovery
- Have underlying mental issues or a brain injury that requires treatment at the same time
You will go through a supervised medical detox to help you avoid unnecessary discomfort and or any withdrawal complications.
You will be offered 24/7 medical support to help with the withdrawal symptoms which may include:
- Benzodiazepines – to ease the mental anxiety, seizures and muscle contractions.
- Neuroleptic Medications – to depress nervous system activity.
- Nutritional Support – During detox you will require a lot of hydrating fluids (excluding all caffeine / energy drinks) and nutritious foods. If you are unable to eat or drink you will receive nutrients (folic acid, thiamine and magnesium) and be kept hydrated intravenously.
Once the immediate withdrawal symptoms have passed you may be prescribed a course of medication to reduce the likelihood of relapse:
- Disulfiram – reduces alcohol cravings and can make you violently ill if you do consume anything alcoholic (this will include any oral medication that contains alcohol and even mouthwash)
- Naltrexone – may reduce cravings and maintain abstinence by blocking opioid receptors in your brain.
- Topiramate – reduces consumption and extends abstinence periods.
You can learn more about the different alcohol treatment options here.