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The Stages of Alcohol Withdrawal

Alcohol detox can be just as frightening as alcoholism. For those who suffer from severe alcohol use disorders and alcohol dependency, getting sober can seem like an up-hill battle. Alcohol detox is an intense and often uncomfortable process, and withdrawal symptoms can range from mild to severe. However, making the decision to stop drinking is a great first step towards recovery.

While alcohol withdrawal can be dangerous, it is possible to safely detox from alcohol. The timeline and symptoms of alcohol detox vary by individual, but there are three common stages of withdrawal. Detoxing from alcohol in a medically-supervised environment can be a safe and effective way to get sober and avoid deadly withdrawal symptoms. Keep reading to learn more about the stages of alcohol detox and how to safely maneuver through alcohol withdrawal syndrome.


What is alcohol detox?

Alcohol detox is the first step in the journey of overcoming an alcohol addiction. Alcohol use disorders include binge drinking, alcohol abuse, and alcohol dependence. Alcohol abuse can be dangerous for both the mind and body, causing severe damage throughout a person’s life. When someone makes the decision to stop abusing alcohol, they must go through alcohol detox.

The detox process is the body’s way of removing toxins and waste products. Long-term heavy drinking can cause an excess of toxins in the body. Through alcohol detox, a person can begin to overcome their physical dependence on alcohol. Unfortunately, prolonged alcohol abuse can cause a buildup of tolerance for alcohol as well as biological changes. Alcohol causes the body to create a false balance, and that balance is disrupted whenever someone stops drinking. This disruption can lead to alcohol withdrawal syndrome.


Diagnosing alcohol withdrawal

A doctor or caregiver can complete the necessary assessments to diagnose alcohol dependence and withdrawal. Medical professionals look for a variety of alcohol withdrawal symptoms, including how they impact a person’s daily activities.

Typically, at least two of the following symptoms must be present to diagnose alcohol withdrawal:

No two people will experience alcohol detox and withdrawal the same. It is important to seek medical care because a doctor can properly diagnose alcohol withdrawal and provide the right course of action to detox from alcohol. The alcohol detox process is not predictable, and it is important to have medical supervision to ensure safety.


Who experiences alcohol withdrawal?

Not everyone will experience alcohol withdrawal symptoms, but heavy drinkers who stop using alcohol are likely to experience some level of withdrawal. Some people recovering from an alcohol use disorder may experience mild to moderate symptoms, while those with more severe addictions or long-term addictions can experience worsened symptoms.

There are some conditions that can increase the severity of alcohol withdrawal, including:

  • Drinking heavily every day
  • Drinking heavily for more than five years
  • Previous alcohol withdrawal symptoms
  • Poor nutrition
  • Poor physical condition
  • Decreased liver function
  • Simultaneous drug use

Alcohol Detox Stages FAQs

How long does it take to detox from alcohol?

The timeline for alcohol detox typically begins about six hours after the last drink and lasts for several days. Detox is not the same for everyone, so some people may experience symptoms later. Also, some people may experience alcohol withdrawal symptoms for several weeks depending on personal factors.

What are the stages of alcohol withdrawal?

Alcohol withdrawal is typically broken down into 3 stages; stage 1, stage 2 and stage 3. ‘Stage 1’ typically includes symptoms like anxiety, depression, anger, fatigue and insomnia while ‘stage 2’ includes symptoms like fever, high blood pressure, confusion, increased heart rate, sweating and trouble breathing. ‘Stage 3’ is the most dangerous stage and can include more severe symptoms like high fever, seizures, hallucinations and others.


Alcohol Withdrawal Stages

Alcohol Detox Stages
Alcohol Detox Stages / Compass Detox

When discussing alcohol detox, there are three stages of alcohol withdrawal. While some people may experience all three stages of withdrawal symptoms, others may experience some or none. It is impossible to fully understand how a person will experience alcohol detox before they begin the process due to the wide range of factors that contribute to the severity and duration of withdrawal symptoms.

The unpredictable nature of alcohol detox makes it imperative to seek medical care. The general outline of detox may be what is most common, but the process will not be the same for everyone. In general, the three stages of alcohol detox move from the least severe to the most severe, with symptoms worsening over the first few days. By day 5 of alcohol withdrawal, most people experience significantly reduced symptoms.

Stage 1: Least Severe

The first stage of alcohol detox features symptoms that can range from annoying or uncomfortable to moderately severe. Symptoms can begin within six to eight hours after the last drink. However, some people may not experience withdrawal symptoms for 24 hours after last drink.

Within the first 6 to 24 hours of alcohol withdrawal, symptoms may be less severe. The exact symptoms experienced will differ by person, but common withdrawal symptoms in the first stage of alcohol detox include:

  • Anxiety
  • Depression
  • Anger
  • Fatigue
  • Insomnia
  • Foggy brain or confusion
  • Mood swings
  • Loss of appetite
  • Stomach pain
  • Nausea or vomiting
  • Heart palpitations
  • Tremors

It is impossible to predict exactly what will happen when someone with an alcohol use disorder stops drinking. For some, symptoms in stage one of detox may be minor. For others, symptoms may be severe. While not everyone will experience the full first stage of alcohol detox, symptoms from this stage are common at some point during withdrawal.

Staying hydrated is key during the first stage of detox. Vomiting, nausea, and diarrhea can make it difficult to keep liquids down. Medical care during detox can ensure a person receives the fluids they need to stay hydrated throughout their withdrawal symptoms.

Stage 2: More Serious

The second stage of alcohol detox can begin one day after the last drink and last for multiple days. Symptoms are likely to worsen during this time, and it can be difficult for people to continue through the detox process. In a treatment facility, support systems are in place to help provide the motivation necessary to push through uncomfortable and painful withdrawal symptoms. For people detoxing at home, it can be very tempting to give up during this stage of the process.

Common withdrawal symptoms during this stage include:

  • Fever
  • High blood pressure
  • Confusion
  • Increased heart rate
  • Sweating
  • Trouble breathing
  • Mood swings
  • Irritability
  • Restlessness
  • Loss of appetite
  • Depression

As with the first stage of alcohol detox, staying hydrated is important. Sweating can cause dehydration and further health issues. A person going through the detox process may experience some or all of these symptoms. In a professional treatment facility, doctors and nurses can monitor heart rate, blood pressure, and body temperature to ensure that levels stay safe.

Stage 3: Most Dangerous

The final stage of alcohol detox can be the most dangerous. During this stage, serious symptoms are possible for some people, including potentially fatal symptoms. The third stage of detox typically begins about three days after the last drink. For some, this stage may last only a day or two. For others, alcohol withdrawal symptoms can last for 3 weeks or more.

Common symptoms for the third stage of alcohol detox include:

  • High fever
  • Seizures
  • Hallucinations

Some people may not experience severe symptoms. Instead, they may notice their symptoms lessen after the third day. However, seizures, high fever, and hallucinations are all serious health concerns at this stage. Seizures can be potentially fatal, involving head injuries or choking that leads to death.


Should you stop drinking cold-turkey?

Alcohol detox can occur all at once or gradually through tapering. The best method for detox depends on a variety of personal factors, and a doctor can recommend the right course of action for an individual based on their professional assessment. For some, quitting cold-turkey under medical supervision works well. For others, tapering alcohol usage might be the right plan.

Professional Medical Detox

Detoxing at home is dangerous for a number of reasons. There is no set timeline for alcohol detox, and symptoms of withdrawal can vary greatly from person to person. The safest way to detox from alcohol is under medical supervision. Depending on the severity of the alcohol use disorder, a doctor may recommend inpatient or outpatient treatment programs. These programs are designed to monitor the symptoms of withdrawal and offer as much comfort as possible during a difficult time.

Medical professionals can monitor a patient throughout the stages of alcohol detox to ensure they are safe. A doctor may choose to prescribe medication at certain points in the process to reduce the severity of withdrawal symptoms, and medical staff is on-hand to handle any issues that arise. While it may be tempting to detox at home, seeking professional medical help is the safest way to move through the stages of alcohol detox.

Sources

Additional Resources

  1. https://www.samhsa.gov/find-help/national-helpline
  2. https://www.webmd.com/mental-health/addiction/alcohol-withdrawal-symptoms-treatments#1
  3. https://www.health.harvard.edu/a_to_z/alcohol-withdrawal-a-to-z
  4. https://www.google.com/search?q=Stages+of+Alcohol+Withdrawal
Brooks V.
Brooks V.
Brooks has been a freelance journalist for the better part of two decades, as well as spending a decade as a crisis intervention counselor. Through his own work and researching the work of others throughout the many facets of the detox, crisis intervention, and mental health worlds he has been able to tell the stories of those worlds in an effort to help addicts and those with mental illnesses understand and navigate them.