What to Expect with Alcohol Detox
When a person seeks treatment for alcohol addiction, usually the first step in the recovery process is alcohol detoxification. Alcohol detox happens when the body removes any remaining alcohol from the system.
However, when someone who has developed an alcohol dependence stops drinking alcohol, they may experience symptoms of withdrawal during detox. Withdrawal symptoms can range from mild to severe, depending on previous alcohol consumption.
A person who was a heavy drinker is more at risk for severe withdrawal symptoms whereas a less serious drinker may only experience mild symptoms.
Symptoms of Alcohol Withdrawal
For some individuals who have quit drinking after a period of alcohol abuse, the withdrawal symptoms may be relatively minor.
Some of the more common symptoms of alcohol withdrawal include:
- Anxiety
- Feeling irritable
- Insomnia
- Decreased appetite
- Cravings for alcohol
Individuals who experience more serious acute withdrawal symptoms are more likely to have been heavy drinkers than those who only experience mild symptoms.
Some of the more severe alcohol withdrawal symptoms include:
- Increased body temperature (fever)
- Tremors in hands and arms
- Disorientation or confusion
- Sweating
- Nausea, possible vomiting
- Increased blood pressure
- Increased heart rate
Many of the more severe withdrawal symptoms won’t show up until 48-72 hours after the last drink. For the most extreme cases of withdrawal, delirium tremens may be present. Individuals showing more severe side effects should seek medical care immediately.
Delirium Tremens (DTs)
Delirium tremens is a condition that can occur for individuals with the most severe form of alcohol withdrawal syndrome. The symptoms of delirium tremens can be fatal.
Side effects of delirium tremens can include:
- Hallucinations (visual and auditory)*
- Withdrawal seizures
- Severe disorientation
- Extreme tremors
- Inability to regulate blood pressure or heart rate
- Organ failure
- Impaired brain function
By seeking medical detox for the management of alcohol withdrawal syndrome, patients gain access to medical care during the entire withdrawal process.
Alcohol Detox Timeline
Individuals who go through alcohol detox may have varying experiences, depending on age, addiction level, other health conditions, and so on. However, you can expect the detox process to follow a general timeline.
First 6–12 Hours (Stage 1)
Most people will begin to experience alcohol withdrawal symptoms in the first 6-12 hours following their last drink. During this early stage, your central nervous system is beginning to feel the impact of no longer getting the sedative effects of alcohol that it had become used to.
Within the first 6-12 hour period, symptoms may include:
- Nausea
- Tremors (aka “the shakes”)
- Anxiety
- Trouble sleeping
- Irritability
Days 1–3 (Stage 2)
Stage two of alcohol detox occurs within the 24 to 72-hour mark. During this phase of withdrawals, symptoms will begin to peak. In addition, some of the more severe withdrawal symptoms can begin to appear.
Seizure risks are the highest during stage two. In addition to seizures, prolonged sleep disturbances, mood changes, and fatigue can also be present.
Stage two possible symptoms:
- Nausea
- Stronger tremors
- Fatigue
- Changes in mood (anxious, irritable)
- Brain fog
- Hallucinations
- Seizures
- Delirium tremens (DTs)
One Week (Stage 3)
For some individuals, the next week or more may also present some symptoms. As the central nervous system returns to its normal functioning, severe side effects are likely to wane. However, people recovering from alcohol use disorder, in particular, should try to manage expectations during stage three.
Sometimes, mild symptoms may continue to present over this time period. While these symptoms will not be serious, they can be disruptive and feel discouraging. Whether or not symptoms continue during stage three will rely upon the individual, their history with alcohol use (length of time, amount consumed, etc.), and any additional health factors.
Home Detox vs Medically Supervised Detox
When going through detox from any type of substance use, your safest option is to consult with a healthcare professional beforehand. Some withdrawal symptoms—including those that appear for alcohol—can be dangerous or even deadly.
Choosing a Home Detox
Mild alcohol addiction can usually mean mild withdrawals, and would therefore be safe to go through at home. However, it is best to seek medical advice from a healthcare professional about the risks involved with your individual situation.
If approved by a healthcare professional for at-home detoxification, you can anticipate experiencing mild symptoms of withdrawal as listed above.
During a home detox, the following practices may:
- Hydration: Keeping yourself hydrated during alcohol detox will assist your body with naturally flushing out any relevant chemicals.
- Balanced Diet: Eating healthy, nutrient-rich foods will support your body’s healing and fuel you as your body adjusts to the lack of alcohol it had fotten used to.
- Rest: Be sure to get plenty of rest and try to maintain a normal sleep schedule, which will allow your body to continue to heal.
If you choose to do a home detox, it is ideal to check with a medical professional to ensure that it is safe for you to do without medical supervision. During the detox process, if you begin to experience more severe symptoms, seek medical attention as soon as possible.
Choosing a Medically Supervised Detox
In some cases, medical detox is the safer choice when detoxing from alcohol use—especially when heavy drinking was the case beforehand. Medical detox allows the recovering individual to go through alcohol withdrawals under medical supervision to ensure their safety.
As mentioned above, more acute withdrawal symptoms can be life-threatening. Having access to medical personnel can be critical.
Medically-supervised detox can be provided on either an inpatient or an outpatient level, depending on the severity of previous alcohol use. There are a variety of treatment programs available to assist you through the detox process and provide you with peace of mind.
Besides monitoring your vitals and working to keep you safe, your medical detox team may also prescribe you certain medications to assist you through the withdrawal process. Some of these medications are designed to lessen the alcohol withdrawal symptoms, while others are meant to help you resist the urge to relapse and return to drinking.
Medications Used During Alcohol Detox
Here are some of the most common medications utilized to treat alcohol use disorder during the detoxification process:
- Benzodiazepines: Can be used for their sedative effects to prevent withdrawal seizures. Such benzodiazepines may include: chlordiazepoxide (Librium®), diazepam (Valium®), and lorazepam (Ativan®).
- Naltrexone: More commonly prescribed during the late withdrawal stage to prevent relapse.
- Acamprosate: Another common choice for preventing relapse, usually after the main withdrawal symptoms have subsided.
- Disulfiram: Helpful for relapse prevention by causing an unpleasant reaction to drinking alcohol.
Continuing Support for Alcohol Use Disorder
In many cases, aftercare for alcohol use disorder can be just as important as the detox process.
After the symptoms of withdrawal have subsided, many individuals seek mental health treatment. Alcohol use disorder takes a toll on the individual mentally and emotionally, not just physically.
Support groups and individual counseling via psychiatry can provide separate but similar benefits to help you or your loved one continue their overall healing.
Additionally, you or your loved one may already be enrolled in an alcohol rehabilitation program (inpatient or outpatient), and the detox process was just the first step in your journey. Whatever the case may be, once detox is complete you have finished one of the most critical steps in alcohol addiction treatment.
Ready to Tackle Alcohol Detox?
Not sure what alcohol detox treatment options are available to you? You can talk to your doctor or you can visit the Substance Abuse and Mental Health Services Administration (SAMHSA) program locator to see what kinds of treatment facilities are near you.