Alcohol is one of the most frequently used and misused substances in America. Approximately 15.1 million adults live with alcohol use disorder, and every year 88,000 preventable deaths are linked to alcohol. Alcohol withdrawal symptoms are profoundly uncomfortable and can be dangerous and even lethal.
For all but the mildest cases of alcohol use disorders, it is recommended that alcohol detox and acute withdrawal be done under the care of medical professionals who can provide pharmacological therapies to mitigate symptom severity and intervene in the case of complications.
Symptoms of Alcohol Withdrawal
Symptoms of alcohol withdrawal generally set in about 6 hours after the last drink and include anxiety, tremors, sweating, nausea, and insomnia. The peak of symptom severity is typically between 24 and 48 hours, and symptoms usually subside within a few days. Symptom severity is correlated with the degree of alcohol use; chronic, heavy alcohol use is associated with substantially more debilitating symptoms.
More serious symptoms include pronounced tremors, low-grade fever, rapid respiration, profuse sweating, vomiting, and diarrhea that are apparent within 24 hours of the last drink and persist for up to a week. Although relatively rare, the most serious cases of alcohol withdrawal include potentially life-threatening delirium tremens, seizures, and heart attack.
If these symptoms are left untreated, mortality rates are estimated to be as high as 37%; even with treatment, approximately 4% of people suffering from the most severe symptoms will die.
Alcohol Detox and Withdrawal Timeline
Although the alcohol detox and acute withdrawal timeline can vary quite a bit between people, most mild to moderate cases of alcohol detox will resolve within a week. More serious cases of detox and acute withdrawal may persist for two or more weeks. However, resolution of acute withdrawal is often the beginning of an incredibly frustrating period called “post-acute withdrawal syndrome” (PAWS), which shares many of the symptoms of acute withdrawal.
Alcohol-related PAWS can persist for months, even years, and for the most serious alcohol use disorders, PAWS may be a lifelong condition. PAWS is associated with the same constellation of withdrawal symptoms and cravings that are experienced during acute withdrawal, with fluctuating levels of severity. PAWS symptoms will subside as time goes on.
Experiencing PAWS does not mean recovery has failed; in fact, experiencing PAWS indicates that recovery is progressing normally.
Home Remedies for Alcohol Withdrawal
For anyone who intends to undergo alcohol detox and withdrawal at home, it is recommended that they undergo an evaluation with a medical professional before they begin. There are no shortcuts to alcohol withdrawal remedies, but knowing what to expect and what to look out for can be helpful for someone who is managing alcohol withdrawal symptoms at home.
For people with mild alcohol use disorder, alcohol withdrawal treatment at home can be successful. Anyone attempting a home withdrawal should enlist the support of a trusted friend or family member who will periodically check in and make sure symptoms are progressing as expected and that no alarming signs have emerged.
Tips that may make home withdrawal somewhat less uncomfortable include to:
- Have sports drinks on-hand to restore electrolyte imbalances
- Drink lots of water
- Try to eat light, healthy meals
- Supplement with a multivitamin, thiamine (vitamin B) and magnesium
If there are any symptoms at all that are even slightly concerning, the best thing to do is to seek professional help.
Dangers of Alcohol Detox at Home
Dangers associated with alcohol detox and withdrawal generally stem from substantially altered brain chemistry that is caused by chronic alcohol misuse or abuse. Alcohol particularly affects two neurotransmitters, GABA and NMDA, which are responsible for cooperatively maintaining appropriate levels of brain activity: GABA inhibits activity and NMDA potentiates activity.
Chronic, heavy alcohol use increases GABA signaling and reduces NMDA signaling, resulting in a persistent reduction in brain activity for as long as alcohol is present. However, when alcohol use is stopped suddenly, GABA and NMDA levels rapidly swing back towards normal levels as the brain tries to restore homeostasis. Because the brain has been in a state of chronic inhibition, it is unprepared for the sudden transition into a more excitable state. This restoration process is the cause of withdrawal symptoms. In severe cases, potentially lethal seizures and heart attack can occur.
Delirium Tremens
Another dangerous consequence of severe alcohol withdrawal is delirium tremens (DTs). DTs affect 3-5% of people experiencing withdrawal and, in addition to the more common withdrawal symptoms, can include:
- Delirium
- Lack of awareness
- Confusion
- Hallucinations
- Nightmares
DTs generally manifest about three days after withdrawal begins and persist for two to three days. In some cases, DTs may persist for seven to eight days. DTs are an extremely dangerous complication that is a medical emergency; by some estimates, the mortality rate of untreated DTs is as high as 37%.
Anyone who is considering undergoing alcohol detox and withdrawal at home is urged to consult with a medical professional before beginning the process. Even mild withdrawal is not without risk.
Recovering from alcohol use disorders is difficult, especially when done alone. The Recovery Village at Palmer Lake offers full-service rehab programs that are tailored to suit the needs of our clients. Our team of experts will address each aspect of your recovery and help you get on the road to lifelong recovery. Call us today.
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National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” August 2018. Accessed August 18, 2019.
Bayard, Max, et al. “Alcohol Withdrawal Syndrome.” American Family Physician, March 2004. Accessed August 18, 2019.
Rahman, Abdul; Paul, Manju. “Delirium Tremens (DT).” NCBI StatPearls, updated November 2018. Accessed August 18, 2019.
Schuckit, Marc A. “Recognition and Management of Withdrawal[…]m (Delirium Tremens).” The New England Journal of Medicine, November 2014. Accessed August 18, 2019.
Mager, Dan. “Detoxing After Detox: The Perils of Post-Acute Withdrawal.” Psychology Today, May 2015. Accessed Accessed August 29, 2019.
The Recovery Village at Palmer Lake aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.