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The symptoms of withdrawal are a reflection of your body’s physiological dependence on the booze. How bad it gets depends on a number of factors that vary among individuals.
What Causes Alcohol Withdrawal?
Essentially, drinking every day causes your body to ‘expect’ the depressive effects of alcohol. This adjustment of the body’s norm must be continually fed by more and more alcohol to be sustained. With the abrupt discontinuation of alcohol intake, the body cannot relax in the same way. Without the alcohol to ‘steady’ the central nervous system, the body undergoes a period of overactivity. This is the source of the withdrawal syndrome.
There are several types of alcohol withdrawal syndromes, classified by the degree of severity and complications. In general, the more intensive, daily drinking – as opposed to periodic “binge” drinking – you do, the worse the withdrawal syndrome.
Withdrawal phenomena can generally be divided into minor withdrawals and severe withdrawals, a.k.a. delirium tremens or the “DTs.” Let’s look at each in turn.
How Long To Detox From Alcohol: Minor Alcohol Withdrawal Duration and Symptoms
How long do alcohol withdrawal symptoms last? When a patient is in for a mild case of withdrawal, he or she can expect approximately one week of noticeable symptoms, with peak severity occurring within the first few days.
If your drinking problem is complicated by other medical or psychiatric issues, be aware that the withdrawal syndrome for alcohol can take longer and, in some cases, be much more dramatic.
You can begin experiencing symptoms of withdrawal as soon as the normative level of alcohol in your blood drops, within hours of your last drink. Paradoxically, you can experience mild withdrawals even while still tipsy or drunk.
During the first 24-48 hours, minor symptoms of withdrawal occur, including anxiety and depression, fatigue, and mild confusion. The detoxifying individual may also have nightmares by night, and mood swings by day. Many people find they are unusually jumpy or irritable.
These minor symptoms are fairly common, but patients should remain conscious of the possibility of escalation. The next level of symptoms is a bit more harrowing, and may indicate your withdrawals have not yet peaked. They include:
- Pale, clammy skin
- The “sweats”
- Dilated pupils
- Poor appetite
- Nausea, possibly vomiting
- Heart palpitations
- Physical tremors
These symptoms represent an intermediate stage between mild and severe withdrawal, and can be useful from a diagnostic perspective. They offer a final chance to seek medical attention before a full-blown case of the DTs develops.
When detoxification is medically supervised, as it generally should be, addicted patients may receive either inpatient or outpatient treatment. Outpatient, or “ambulatory,” treatment is the norm for less serious cases because there are readily available ways to minimize the harm potential of withdrawals. However, even outpatient detox patients need to be accompanied by a friend or family member who can keep an eye out and take action if things get bad.
How Long Does It Take To Detox From Alcohol: Severe Cases
Severe withdrawals occur in approximately one in four long-term heavy drinkers, most of whom are over age 30 and drink at least half a 750ml bottle of hard liquor a day. Severe alcoholic withdrawal resembles a kind of psychosis, with both physical and mental symptoms. Collectively, the worst of it is known as “delirium tremens,” from the Latin for ‘shaking madness.’
Delirium tremens may develop any time between 12 hours and 4 days after the last drink. The range of onset is fairly wide. There is, however, usually a window of opportunity consisting of the first 24 to 48 hours of detoxification. So even if your body is gearing up for a horrific case of the DTs, it will likely take at least a day to get to that point.
How long does alcohol withdrawal last in cases of delirium tremens? It can last for minutes, hours, days, even weeks. Most acute episodes are resolved within five days. Each case is different, however, making it difficult to predict precisely when and for how long the DTs will last, if they occur at all.
When overtaken by the DTs, you may experience severe agitation or anxiety. Some patients break out in fever. Trembling is common, but could escalate to a point of seizures. Major confusion develops – a kind of dense mental cloud that makes it hard to discern what’s going on. Visual or auditory hallucinations can further complicate a bad situation.
Delirium tremens is a very serious medical disorder. Not only can it be terrifying and traumatic, it can also be fatal if left untreated. Although most people who face alcohol withdrawal make a full recovery, it’s important to take the possibility of death seriously. Even with hospitalization, it is possible to perish in the wake of the DTs.
Inpatient detoxification may be necessary to calm the body’s hyperactivity with benzodiazepine sedatives until detoxification is complete. If you are experiencing seizures, high fever, severe confusion, rapid heartbeats, or hallucinations, get to an emergency room fast. It could save your life.
The Many Faces of Alcoholic Toxicity
The above section delineates the first and most immediate stage of alcohol detoxification. But keep in mind that alcohol is an invasive drug that infiltrates every system in the body. It’s toxifying effects are cumulative and enduring, particularly for longtime, everyday drinkers. This fact matters for both the middle term and long term of recovery.
In the middle term, minor withdrawal symptoms can persist for weeks or months after your initial detoxification. Most commonly, you’re looking at some level of sleep disturbances, mood swings and fatigue as your body readjusts to life without a heavy daily nervous system depressant. Alcoholics commonly report at least two to four weeks of generalized anxiety – a feeling of uneasiness and the world being much too bright or loud.
Depending on how long you have been drinking heavily, there could also be serious long-term consequences of alcoholic toxicity. If you drink heavily for enough years, your body will begin to lose its ability to self-detoxify. The worst alcoholics may experience this eventuality as one or more chronic diseases of the liver, heart and brain – although nearly any physical system can be impacted.
Worried about withdrawals? Don’t panic. If you have proper medical oversight, know what to expect ahead of time, remain calm, and proceed conscientiously, you will likely make it through alcohol withdrawal.
Remember, detoxification is only the first step in the recovery process. When you emerge on the other side, however scathed – that’s when recovery really begins.