If you’re even a ‘casual’ drinker, there’s a good chance you’ve experienced some alcohol withdrawal symptoms. If six to twelve hours after an episode of drinking you’ve ever experienced trouble sleeping, tremors or shakes, extreme anxiety, a craving for even more alcohol, or any of the symptoms of a hangover, (think headache, nausea, sweating, that overall ugh-I-have-to-call-out-of-work feeling), then welcome to the not-so-great club. You’ve experienced alcohol withdrawal, so be it a mild version.

For those considered alcoholics, those who drink alcohol excessively and/or problematically, withdrawal symptoms become much more severe. This is why we want to be straight-up with you and let you know right off the bat that quitting alcohol as an alcoholic is hard. The symptoms mentioned previously are all more likely to occur within the first six to twelve hours after stopping.

For example, take Phil, a casual drinker. He consumes 5-6 beverages when he drinks, acquiring drunkenness, but only does it every Saturday, and only when he’s able to do so responsibly. It’s likely that Phil is not an alcoholic. However, it’s very likely that on more than one Sunday morning, Phil has had quite a headache and perhaps has been trapped in a certain room of his abode…

Jackie drinks four nights a week on average, having 4-5 beverages, sometimes more, and never misses a party. It’s likely she’s an alcoholic. It’s also likely that if she were to stop suddenly, that Jackie would experience tremors, sweating, sleeplessness, anxiety, and an overall bodily sickness… and that’s her first six to twelve hours.

The Detox Timeline

Those six to twelve hours afterward make up phase 1 of something called a detox timeline. A full detoxification from alcohol for a heavy drinker usually takes a full week. That is NOT to say that alcoholism or the addiction to drinking is cured in that time. This is ONLY to say that the human body completely rids itself of the presence of alcohol in approximately 7 days.

Throughout the course of this detox week, different phases of alcohol withdrawal symptoms may occur. In general, there are four phases, the first of which has been briefly discussed already:

  1. 6 – 12 hours after stopping
  2. 12 – 24 hours after stopping
  3. 24 – 48 hours after stopping
  4. 2 days to 7 days after stopping

Most of the rest of this article will consider the four phases of the detox timeline, followed by some facts and thoughts to reassure you, or whoever is quitting alcohol, that the correct decision is being made. Seven days of withdrawal is well worth preventing a lifetime of alcoholism. Over 85,000 Americans die every year due to alcohol-related causes. Those seven hard days are very much worth becoming a statistic. Let’s take a look at this seven-day period, starting with a more in-depth look at phase 1 of the detox timeline. You should know what you’re getting into and why.

alcohol withdrawal timeline

Phase 1:  Six to Twelve Hours Afterward

Headache

Alcohol can lead to dehydration by causing the body to lose fluid. There are also certain chemicals in alcohol that may cause further dehydration. This lack of fluid decreases blood flow to the brain, resulting in an unpleasant head throb.

Nausea/Vomiting

Alcohol is not exactly a mild substance. Ethanol, the type of alcohol used in adult beverages, is also used as an antiseptic, in some soaps, and as an occasional rocket fuel. That being said, excessive drinking irritates your stomach/intestine walls and also increases the amount of stomach acid produced. This often leads to nausea and/or vomiting. Yuck.

Excessive Sweating

You’ve probably heard someone talk about how a shot of whiskey or rum can ‘warm up’ the body – or you may have experienced it. Well, contrary to this popular belief, alcohol does not raise your temperature. Alcohol causes your heartrate to increase, which causes your blood vessels to dilate, which oftentimes leads to sweating. Because most alcoholics finish drinking during PM hours and then fall asleep pass out, this alcohol-triggered sweating becomes the ‘night sweats.’

Trouble Sleeping

Most people think alcohol helps them sleep. Wrong. Alcohol helps people fall asleep, but actually lowers the quality of the sleep itself. See, sleep occurs in stages. There is the first stage, where you are barely asleep, the middle stage, which is the REM (rapid eye movement) stage, where dreams happen, and then there is the final stage, which is deep sleep. There is no eye movement and there is no muscle movement during deep sleep. When entered into naturally from REM sleep, it is the most restorative and beneficial stage of sleep.

Alcohol causes the first and middle stages to be skipped, and enters you directly into deep sleep. This is why falling asleep drunk is referred to as passing out – you enter directly into a deep unconsciousness. This unfortunately does not last long, and as the effects of alcohol wear off, your sleep becomes lighter and lighter until you are consciously being disrupted. (This is when you would toss and turn and punch your pillow).

Tremors/Shakes

Prolonged alcohol abuse causes overall brain function to slow down. It’s a bit more complicated and intricate than that, but essentially the brain becomes used to running in an altered state, a state with less brain activity than normal. Stopping drinking causes brain activity to pick up again and it happens in a rush. The brain enters a state of hyperactivity, increasing nerve cell activity, resulting in tremors. It can be a minor hand shake, a full body shake, or anything in between.

Anxiety

Everybody has some level of anxiety – it’s just that the majority of people do not have a problematic level of anxiety. Those who suffer from diagnosed anxiety and are alcoholics will suffer more severe anxiety when quitting drinking. However, quitting drinking exacerbates all levels of anxiety. The brain contains countless cells called neurotransmitters, which basically carry messages from the brain to the rest of the body, allowing us to do everything from eat and breathe to paint a canvas. There are many different types of neurotransmitters. Alcohol distorts the levels of these cells, along with serotonin levels, which can ultimately worsen anxiety.

In fact, twenty percent of those with social anxiety disorder also suffer from an alcohol abuse problem. Furthermore, seven percent of all Americans use alcohol to cope with some form of anxiety. It’s obvious the two are related beyond both starting with the letter ‘a’.

A Craving for More

You’re quitting an addictive substance. It makes sense that part of the first phase of detox is a want for more. However, with alcohol it goes beyond needing a fix. Alcohol is unique in the sense that we do not become addicted to beer or wine or liquor itself; we become addicted to the changes in the brain that ethanol causes. This is why you’ve heard about people chugging mouthwash in times of desperation. There is usually a high ethanol content. The chances are that a desire for more alcohol 6 – 12 hours after stopping is in reality one of two things: a drunken plea for more unneeded booze or a coping method for one of the other symptoms mentioned prior. Either way, drinking more at this point, even a half a shot, sets you back to square one.

* * *

The first phase of your detox timeline may seem like it has to be the worst, but it is definitely not the most dangerous. In fact, the next phase is not even the most dangerous. It is phase 3, between a day and two days, during which fatality is actually a real possibility. This makes phases 1 and 2 very important – they are the prep for the really tough stuff.

Phase 2:  Twelve to Twenty-four Hours Afterward

Note that along with the symptoms mentioned next, a continuation of the previous phase’s symptoms may also occur/be occurring during this phase. The same goes for each phase transition.

Loss of Appetite and/or Malnutrition

The reason quitting can cause a loss of appetite and/or malnutrition 12 – 24 hours later is really quite simple. Most alcoholics either don’t eat enough, or eat extremely unhealthily. These tend to become habits, just like the drinking itself. After stopping, if you were someone who didn’t eat much, you will likely experience loss of appetite, and if you were someone who ate unhealthily, you may begin to experience malnutrition. These symptoms can be a result of past eating habits and/or a continuation of the habits.

Dehydration

An insufficient amount of water in the body occurs not too long after drinking begins, actually, but the worst of the effects of dehydration will likely occur 12 – 24 hours after stopping. Essentially, take all of the aforementioned symptoms related to dehydration and worsen them. [Trust us; this process of detoxification is still 100% worth the fight.]

Hallucinations

A combination of the release of extra dopamine, (a neurotransmitter associated with reward), and the fact that alcohol causes vitamin deficiency and low blood sugar means hallucinations may occur as part of the withdrawal process. This is known as alcoholic hallucinosis, usually has a sudden onset, but is never fatal, although highly unpleasant.

Phase 3: Twenty-four to Forty-eight Hours Afterward

This is by far the most dangerous and most crucial part of the detox timeline. One to days removed from heavy drinking, the body and brain begin to do some pretty funky things. This is no laughing matter, though. Both Amy Winehouse and Nelsan Ellis died of alcohol withdrawal, and many more do every year. Please remember though that the path to recovery, although hard to travel, is the most rewarding thing you can possibly do as an addict.

Mood Swings

Let’s start with something relatively benign, and purely psychological. Quitting anything can make someone irritable and go through mood swings, and with alcohol there’s no exception. One second you may be cooperative and the next you may be cursing at the gods. One minute you might be telling your significant other how much you love them, and the next you might kick them out of your place. This up-and-down is just an effect of your brain healing itself back to a normal emotional stasis. Your mood will level out, and hopefully no lasting damage will be done to any relationships in the meantime.

Low Blood Sugar

Not only do most alcoholic beverages contain lots of sugar, but also alcohol causes the liver to malfunction and not release glucose into the bloodstream. This results in low blood sugar, AKA hypoglycemia.

Grand mal Seizures

OK, here is the precursor to the most dangerous aspect of alcohol withdrawal. Approximately 4% of those withdrawing from alcohol addiction experience grand mal seizures 1 – 2 days after quitting. The seizures occur as a result of being deprived of nutrients, water and rest. A grand mal seizure can also occur due to exhaustion, sleep deprivation, or a caffeine overload.

The next symptom can be fatal. It’s by far the worst outcome of quitting drinking. Phase 4 is mostly physiological, but this last symptom in phase 3 is not to be taken lightly.

Delirium Tremens

Again, about 4% of those quitting alcohol with experience delirium tremens. It consists of a rapid arrival of extreme confusion, and often includes intense seizing, shivering, sweating, increased heartrate, overheating, hallucinations, and death about three percent of the time.

The ‘DTs’ occur because the body is undergoing something called a biochemical cascade, during which essentially the brain is responding and reacting in a haphazard manner, causing the plethora of uncomfortable symptoms.

Phase 4: Forty-eight Hours to Seven Days Afterward

We’re going to break style here, and instead just list the five major components of this phase of the detox timeline. During the 2 – 7 days after quitting, you’ll likely experience one or more of the following: confusion, depression, anger, restlessness, and general discomfort. The reason for each of these feelings is the same, and it’s not at all scientific… You just underwent a MAJOR change, and your body/brain needs some time to adjust. You’re confused about what happened, depressed that it happened, angry that you feel weird, restless because you haven’t rested much anyway in however long, and you feel generally crappy because, well, you just got done abusing alcohol.

The thing is this: There is a PHASE FIVE, and here’s what it entails: happiness, sobriety, a clear mind, a healthy body, renewed/restored relationships with loved ones, a fatter wallet, more time for productivity, a better diet, more sleep, and best of all, a reason to drink nothing but water when that ball drops for 2018 and you’ve been sober for months.

We’re here for you.