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Alcohol withdrawal symptoms: A timeline & what to expect

Alcohol withdrawal symptoms are something many dependent drinkers fear and those concerns can be a factor that results in people continuing to drink.

However, symptoms of alcohol withdrawal can be very successfully eased and reduced with the right medical support and they are relatively short-lived.

Withdrawal from alcohol must be properly managed for those who have become dependent drinkers as sudden unmanaged cold turkey can result in dangerous, even life-threatening symptoms. 

Whilst alcohol withdrawal must be done with thought, planning and medical oversight, worry over withdrawal symptoms should never be a reason to continue drinking. Continuing to drink heavily is far more harmful to the individual, their families and wider society. 

The presence of alcohol withdrawal symptoms between drinks or when alcohol intake is reduced are an indication of alcohol dependency. Early alcohol withdrawal symptoms include sweats, shakes, headache and nausea or retching.

The first 24 – 48 hours – alcohol withdrawal symptoms

young man suffering with a headache from a hangover and holding a glass of water

Alcohol withdrawal symptoms are a response of the central nervous system to the reduction of the sedative effect of alcohol in the system. They occur after long term exposure to excessive drinking.

Initial symptoms of alcohol withdrawal usually emerge between six and 24 hours after the individual’s last drink and mimic a hangover. These can escalate into more severe and dangerous symptoms in some cases.

Symptoms are likely to be worst in the first 48 hours, but these can be substantially eased with the right clinical support.

Initial withdrawal symptoms may include:

  • Hand tremors/the shakes
  • Excessive sweating and/or clammy skin
  • Retching, vomiting, feeling sick or an unsettled stomach
  • Reduced appetite
  • Retching, vomiting, feeling sick or an unsettled stomach
  • Headache
  • A general sense of restlessness and anxiety
  • Insomnia or restless sleep
  • Reduced energy
  • Low mood or depression
  • Craving alcohol
  • Hallucinations

Between 12 hours and 72 hours after alcohol withdrawal

More severe symptoms may occur in some people and are likely to begin between 12 hours and 72 hours after the individual’s last drink.

Raised heart rate and increased blood pressure can be an issue.

Between one and two in ten dependent drinkers withdrawing from alcohol will be at risk of seizures. When they do occur it is usually one to three days after an individual’s last drink. With medical oversight, the risk can be reduced and managed.

For many people, the 48 hour to 72-hour mark will see a dramatic improvement and reduction in withdrawal symptoms.

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Three to seven days into alcohol withdrawal

Most people feel substantially better and may have stopped experiencing alcohol withdrawal symptoms at the three to seven-day mark.

Worsened withdrawal symptoms three to 10 days after an individual’s last drink can happen in a few cases and can be a sign of delirium tremens (DTs), which is a medical emergency. If someone is not already in a residential recovery setting or hospital at this point, it can be a 999 situation. It is part of the reason that withdrawing from alcohol should be done with medical support.

Delirium tremens is characterised by severe agitation alongside disorientation, confused thinking and reduced environmental awareness, profuse sweating and fever.

Most people will feel much better seven days after their last drink and withdrawal symptoms will be dramatically reduced or gone altogether.

Who is likely to suffer alcohol withdrawal symptoms? 

People aged under 30 are less likely to experience alcohol withdrawal symptoms than older people.

Significant alcohol withdrawal symptoms are most likely in:

  • People who are used to having their first drink of the day early in the morning
  • Those who have had their last drink in the past six to 24 hours
  • Someone who drinks heavily every day or those who drink eight or more units of alcohol five days of the week.
  • Individuals who have previously experienced withdrawal symptoms

What can be done to manage withdrawal symptoms?

It’s vital to have clinical support and management when withdrawing from alcohol due to the risk of fitting and other complications and the permanent damage that can cause.

During withdrawal from alcohol, people will be kept under close watch and their vital signs monitored to ensure their safety. 

Medications to help reduce and manage withdrawal symptoms may be given. These may include benzodiazepines and thiamine.

A managed detox from alcohol is the first stage to recovery from alcoholism. It’s vital to understand what led you to become a dependent drinker. There are almost always underlying issues that lead people to self medicate or seek escape via alcohol.

People are far more likely to remain alcohol-free if they have support to recover from alcoholism and alcohol dependency. 

Recovery is possible and help is out there.

Call today for free & confidential advice on 08000029010 (International: +44 161 674 9049)

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About the author: Martin Preston

Martin is our Founder and Chief Executive. Martin is himself in long term recovery and started Port of Call to help families navigate treatment options. In 2020 Martin will open Delamere Health Ltd, the UK’s first purpose built addiction treatment clinic.

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