Alcohol Detox: How Long Does It Take and What Happens?

What factors influence how long alcohol detox takes? Read about potential withdrawal symptoms and long-term effects of alcohol abuse. Learn why attending alcohol rehab after detox is important.

An estimated 15 million Americans aged 12 and older currently have an alcohol use disorder (AUD), but only a fraction of the people with alcohol problems seek professional help. Regardless of the degree of alcohol abuse, most people with alcoholism can benefit from some type of treatment.1 When alcohol is a daily habit, it may feel impossible to imagine life without it, but you can stop drinking and get your life back.

How Long Does It Take to Detox From Alcohol?

Detox is the period in which you stop drinking and give your body the necessary time and support to cleanse itself of alcohol. For heavy drinkers the detox process may begin as soon as six to eight hours after the last drink, with symptoms at their worst around 24-48 hours. In general, it takes three to 10 days to safely detox from alcohol under medical supervision. It is common, however, for people to have persistent mild symptoms for several weeks.

The length of time needed for detox varies from person to person and depends on the following:

  • How long you’ve been drinking
  • How much you’ve been drinking
  • The presence of other medical, mental or behavioral health conditions (known as a co-occurring diagnosis)
  • Abuse of other drugs (e.g., benzodiazepines, marijuana, cocaine or painkillers)
  • Previous episodes of alcohol withdrawal
  • Your physical, mental, emotional and social needsIt’s important to keep in mind that alcohol detox is just the initial step on the journey of recovery. Although you may start to feel better physically after detox, the mental symptoms of alcohol withdrawal can persist for a long time. The next step after alcohol detox is rehab. Programs vary but most range from 30 to 45 days. Some clients benefit from 60- to 90-day stays at residential alcohol treatment centers to build a strong foundation for long-term recovery.

What Happens During Alcohol Detox?

Evaluations & Assessments

Alcohol detox typically begins with a complete medical evaluation and a comprehensive psychological examination. These assessments help your treatment team understand any physical or mental health conditions you may have and medications you’re taking. Bloodwork and various medical tests are given and fluids may be administered to prevent dehydration.


Medication & Support

Using the findings from the assessments, the medical team will create a detox plan, which includes the best medications to help you detox as comfortably as possible. Benzodiazepines, anti-seizure medications and antipsychotics are a few of the medications commonly used in alcohol detox. Medical staff will regularly check your vital signs and do other tests to make sure you’re progressing through detox safely. Depending on the treatment center, if you feel well enough you may begin participating in group therapy or complementary approaches for pain management such as acupuncture or massage.


Transition into Treatment

Once you’re stable, you should immediately transition into treatment. Detox helps you function physically without alcohol, but it is in treatment that you’ll dig into the reasons why you abused alcohol and learn coping skills and relapse prevention strategies to stay sober.  

Alcohol Addiction with Dr. David Sack

What Are the Phases of Alcohol Withdrawal?

Alcohol withdrawal follows a characteristic course consisting of three relatively distinct phases.2 These phases are as follows:

1. Acute withdrawal:

  • This period is characterized by tremors (shakes) and the risk for delirium tremens and seizures.
  • Seizures and tremors typically occur within the first 48 hours following discontinued consumption and peak around 24 hours.
  • DTs typically peak around 72 hours.
  • Physiological symptoms commonly experienced during acute alcohol withdrawal include increased heart rate, increased blood pressure, profuse sweating, body temperature changes, and nausea and vomiting.

2. Early abstinence:

  • Anxiety, mood swings and disturbed sleep patterns continue, but manifest without acute physical symptoms.
  • Elevated anxiety usually resolves within three to six weeks after alcohol use ends.
  • Women take slightly longer than men to move through this phase.

3. Protracted abstinence:

  • Anxiety and dysphoria (a profound state of unease or dissatisfaction) are less intense.
  • Normally insignificant challenges can provoke negativity, alcohol cravings and relapse.

The psychological discomfort and anxiety during early alcohol recovery can be overwhelming, even after the majority of physical symptoms have subsided. Without support and continued treatment, alcohol withdrawal symptoms make you more likely to relapse and go back to drinking.2

alcohol and society infographic

What Are the Symptoms of Alcohol Withdrawal?

Alcohol withdrawal symptoms can range from mild to life-threatening. They may be as mild as a headache, shakiness or nausea, but people who drink heavily or for a long period of time may experience more severe symptoms such:

  • High blood pressure
  • Seizures
  • Hallucinations
  • Delirium tremens (DTs), which involves seizures and/or hallucinations
  • Mood swings
  • Anxiety
  • Profuse sweating
  • Breathing problems
  • Fever
  • Abnormal heart rate


Medical supervision and support is crucial. Stopping cold turkey on your own is never advised due to potentially fatal withdrawal symptoms. Around-the-clock access to a physician and a team of health professionals can minimize the dangers posed by the body’s physical reaction to alcohol withdrawal symptoms.

How Alcohol Rehab Restores Health

In order to stay sober, both the physical and emotional aspects of a person’s life must be addressed. After completing alcohol detox, rehab begins. Treatment delves into the underlying issues that drove you to abuse alcohol and continues repairing the damage done by alcohol. Some of the goals are:

Repairing nutritional deficiencies. Some rehab programs serve nutritious, balanced meals and may use vitamin supplements, along with folic acid and iron supplements, to boost overall health. Herbal teas and broths may be served to gently maintain hydration.

Easing cravings. Doctors overseeing the detox and rehab process may prescribe medications that can help reduce cravings and diminish the perceived pleasure of drinking alcohol.3

Education and healthy coping skills. In order to overcome addiction to alcohol, you need to heal emotionally, which requires education and therapy. In treatment you’ll learn what triggers your urges to drink and find healthier ways of coping with these triggers.4

Addressing emotional needs and spirituality. Fatigue, depression, anxiety, nightmares and mood swings are common in early recovery as you learn new ways to handle stress. For some, working on spiritual needs is an important part of recovery.4

Developing healthy relationships. You’ll work on developing healthier relationships and social skills so you can receive support in your recovery and eventually help others in their recovery. People who have abused alcohol for a long time often have burned bridges with friends and family that need to be rebuilt. Rehab also focuses on helping you develop a sober support network, as well as practical strategies for avoiding situations that can trigger relapse.

Staying Sober and Preventing Relapse

Your chances of serious health consequences and/or going back to drinking are extremely high if you detox on your own or do not continue on with treatment following alcohol detox.5  But with proper supervision and support, you can join the millions of people who live rewarding lives in recovery. 

 

Stop Drinking. Start Living.

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Sources

 

1.     Reports and Detailed Tables From the 2016 National Survey on Drug Use and Health (NSDUH). Substance Abuse and Mental Health Services Administration website. https://www.samhsa.gov/samhsa-data-outcomes-quality/major-data-collections/reports-detailed-tables-2016-NSDUHUpdated May 17, 2018. Accessed July 19, 2018.

2.     Heilig M, Egli M, Crabbe JC, Becker HC. Acute withdrawal, protracted abstinence and negative affect in alcoholism: Are they linked? Addict Biol. 2010 Apr; 15(2): 169–184. doi: 10.1111/j.1369-1600.2009.00194.x.

3.     Alcohol’s Effects on the Body. National Institute on Alcohol Abuse and Alcoholism website. http://www.niaaa.nih.gov/alcohol-health/alcohols-effects-body Accessed July 19, 2018.

4.     Alcohol Withdrawal Symptoms + How Long Do They Last? Mental Health Daily. http://mentalhealthdaily.com/2014/07/17/alcohol-withdrawal-symptoms-how-long-do-they-last/ Accessed July 19, 2018.

5.     Spear SE. Reducing Readmissions to Detoxification: An Interorganizational Network Perspective. Drug Alcohol Depend. 2014 Apr 1;137:76-82. doi: 10.1016/j.drugalcdep.2014.01.006. Epub 2014 Jan 25.

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