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Alcohol Detox Guide

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Symptoms, Timeline, and Effects

Alcohol is an almost universal legally obtained intoxicant inextricably linked with widespread substance abuse and several adverse short- and long-term health effects. It is a central nervous system depressant—drinking can lead to a loss of coordination, poor judgment, slower thought process, and loosening of inhibitions.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), over 15 million adults in the United States had an alcohol abuse disorder in 2015, yet only 1.3 million of them received formal alcohol addiction treatment.

treating alcoholism statistic graphic

Alcohol is the most commonly abused of any substance. The following are some reasons why2:

  • Alcohol is easy to find and legal to purchase.
  • Drinking alcohol is socially acceptable in many settings.
  • Alcohol is considerably less expensive than most drugs.
Chronic alcohol abuse can lead to the development of tolerance, which means that you require increasing amounts of alcohol in order to feel the desired effects or intoxication. Tolerance continues to increase as alcohol abuse continues, which can have deadly consequences as excessive alcohol consumption can compound already significant physical toxicity and lead to overdose.

As tolerance builds, it is likely that physical dependence will develop as well. Once you are dependent on alcohol, unpleasant and potentially fatal withdrawal symptoms will emerge if you suddenly cut back on alcohol or quit drinking altogether. Professional detoxification services are available to help you through distressing withdrawal symptoms, ensuring comfort and safety throughout the process.

What Are the Short-term Effects?

Moderate drinking is defined as up to two drinks a day for men and one drink a day for women.3 One drink is considered a 1.5-ounce shot of a distilled spirit or liquor, a 12-ounce serving of beer, an 8-ounce serving of malt liquor, or a 5-ounce glass of wine.4  Though moderate alcohol consumption has been linked with certain health benefits—such as providing some cardiovascular benefits and certain other protective effects—it’s potential drawbacks are impossible to ignore.

Excessive drinking can lead to intoxication, which may have some pleasant or desirable effects but can also be problematic. Some short-term effects of alcohol abuse may include:5

Measurement of alcoholic drink graphic

  • Reduced inhibitions.
  • Attention or memory issues.
  • Concentration problems.
  • Slurred speech.
  • Motor impairment.
  • Breathing problems.
  • Coma.

Intoxication may be intensified when alcohol is combined with other psychoactive substances, such as marijuana, cocaine, opioids, or benzodiazepines. Mixing alcohol with other drugs can be extremely dangerous and lead to overdose or other harmful consequences.

What Are the Long-term Effects?

Long-term alcohol consumption can have a devastating impact on a person’s mental and physical health. Chronic drinking may result in lasting disruptions of certain neural pathways and can lead to drastic changes in behavior and mood, as well as impaired cognitive functioning.Some potential long-term effects of alcohol abuse include:4,6

Struggling with Alcohol Addiction

Chronic and excessive consumption of alcohol can lead to alcoholism or alcohol use disorder, a progressive condition that tends to worsen without treatment.

  • Cardiovascular issues, including high blood pressure, stroke, and chronic heart disease.
  • Hepatic issues, such as alcoholic hepatitis, cirrhosis, and liver cancer.
  • Increased risk of certain cancers, such as breast cancer and cancer of the head and neck.
  • Mental health problems (including depression and anxiety).
  • Social problems (including lost productivity, family issues, unemployment).

As previously mentioned, chronic alcohol consumption causes a person’s tolerance to increase, which means that they require more alcohol to achieve intoxication.7 Tolerance to some of alcohol’s intoxicating effects does not mean protection from adverse health effects, however. In fact, the high amount of alcohol required to overcome tolerance can lead to alcohol poisoning, which could require emergent medical attention.

Long-term drinking can also lead to significant physiological alcohol dependence, which means that withdrawal symptoms are likely to emerge if you try to cut back or quit drinking. Alcohol withdrawal symptoms can be life-threatening and often require professional detox treatment.

Withdrawal Symptoms

The acute alcohol withdrawal syndrome manifests itself differently depending on various individual factors such as age, physiology, mental and physical health, the abuse of other drugs, the length of alcohol consumption, the frequency of alcohol consumption, and average amount consumed. After prolonged bouts of drinking, some people will experience at least a few of the following alcohol withdrawal symptoms; in more significant cases of alcohol dependence, others may encounter most or all of them:8

You can receive drug detox and/or alcohol addiction treatment in a safe and comfortable environment supervised by medical professionals.

  • Sleep disturbances, such as insomnia or intense nightmares.
  • Severe nausea and/or vomiting.
  • Lack of appetite.
  • Tremors.
  • Profound sweating.
  • Rapid heart rate.
  • Increased blood pressure.
  • Fever.
  • Anxiety.
  • Irritability.
  • Agitation.
  • Seizures.
  • Confusion.
  • Disorientation.
  • Impaired memory and judgment.
  • Increased sensitivity to light, sound, and tactile sensations.
  • Auditory, visual, or tactile hallucinations.
  • Delusions.

If you or someone you love has experienced symptoms of this nature when attempting to quit or cut back on alcohol use, it is time to reach out for help. You can receive drug detox and/or alcohol addiction treatment in a safe and comfortable environment supervised by medical professionals.

Withdrawal Timeline

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) indicates that alcohol withdrawal symptoms tend to emerge within 4-12 hours of the last drink. As alcohol is metabolized and cleared from the body fairly rapidly, the onset of withdrawal symptoms is often abrupt, but symptoms then resolve relatively quickly. Symptoms tend to peak around the second day and subside by the fourth or fifth day.7

Because many issues factor into the withdrawal process, any general withdrawal Symptoms of alcohol withdrawal after last drink.timeline is going to be a mere estimate of what ultimately transpires. Factors that may predict a more intense or complicated alcohol detox experience include the following:7

  • Advancing age
  • Having significant medical issues
  • Past episode of significant and/or complicated withdrawal
  • Family history of alcohol withdrawal
  • Consumption of sedatives or anti-anxiety medications

Effects of Withdrawal

As mentioned, the effects of withdrawing from alcohol are quite complex and sometimes present some serious health risks. Physical risks include cardiac complications related to blood pressure spikes, dehydration and electrolyte imbalance due to vomiting, accidents related to hallucinations or delusions, and seizures. These symptoms are best monitored and managed with medical supervision.

There are some potential long-term effects related to alcohol withdrawal, referred to as protracted or post-acute withdrawal. These symptoms can persist for weeks, months, or years once acute withdrawal symptoms have been resolved.9 They can be particularly distressing and can interfere with the recovery process. Some examples of common protracted withdrawal symptoms associated with chronic alcohol abuse include:3,8,9

  • Depression.
  • Anxiety.
  • Irritability.
  • Hostility.
  • Unstable moods.
  • Insomnia.
  • Sleep apnea.
  • Fatigue.
  • Problems with concentrating and thinking.
  • Decreased interest in sex.
  • Unexplainable pain.

Transitioning into a comprehensive alcohol abuse treatment program once you complete detox can help to mitigate some of these protracted withdrawal symptoms and can provide you with the foundation you need to begin on the road to sobriety.

Woman experiencing alcohol withdrawal symptoms

What is Detox?

You may be apprehensive or scared about entering a detox program, particularly if you aren’t acquainted with the detoxification process. A professional alcohol detox provides the medical supervision and support needed for you to safely clear alcohol and other substances from your system.5,8 Trained medical and psychiatric staff members provide around-the-clock support and are available to intervene if the patient experiences medical complications related to withdrawal.8

Detox is a safe, medically supervised method designed to clear your system of alcohol and other substances.

The objective of an alcohol detox program is to help patients withdraw from alcohol comfortably and safely and prepare them to transition into an alcohol abuse recovery program. Detoxification typically has 3 key components, including:8

  • Evaluation: A mental health professional administers an intake evaluation, which assesses the severity of your addiction, as well as your mental and physical health condition. This information will be used to create an individualized detox treatment plan for you.
  • Stabilization: Staff members provide monitoring and support throughout the withdrawal process with the goal of identifying potential complications and intervening appropriately.
  • Helping the patient transition into treatment: Once you are medically stabilized, the staff members will create a plan for you to transition into a recovery program that can equip you with relapse prevention skills that will help you maintain sobriety in the long run.

If you are already experiencing withdrawal when you enter the detox program or hospital, the doctor or mental health professional will likely use the Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) to evaluate the severity of your alcohol withdrawal symptoms, which can be categorized into 3 stages. These stages increase in severity and include:10

Patient struggling with alcohol withdrawal symptoms.

  • Stage 1 (mild): Mild symptoms, such as headache, tremors, anxiety, and insomnia.
  • Stage 2 (moderate): Mild symptoms plus rapid breathing, rapid pulse, profound sweating, fever, and confusion.
  • Stage 3 (severe): Moderate symptoms plus impaired attention, disorientation, auditory or visual hallucinations, and seizures.

Without appropriate treatment, an individual can progress from the first stage to the second and third rather quickly, which is why alcohol detox is so vital.10 Alcohol detox programs provide a structured environment for those detoxing from alcohol while addiction treatment programs provide an intensive and thorough approach to recovery by addressing the underlying issues driving substance abuse.

Detox Options

Withdrawing from alcohol can be uncomfortable and, in some cases, presents serious health risks, but programs are available to help you get though the process safely with minimal emotional or physical trauma. A thorough evaluation of your risks for withdrawal complications will help to determine the most appropriate level of care. Medical detox options include:

  • Hospital setting: Many hospitals have detox units where medical professionals are trained to closely monitor your condition and keep you safe. Oftentimes people receive detoxification services at a hospital after experiencing a medical emergency, such as alcohol poisoning or severe, prolonged seizures.
  • Inpatient treatment: You live at the residential detox facility for the duration of detox, receiving 24-hour monitoring and care. Medications, such as benzodiazepines, may be utilized to increase safety by minimizing agitation and lowering the risk of seizure.
  • Outpatient detox: Some clinics and private physicians offer outpatient detox programs in which you live at home but attend the program or visit your doctor’s office on a daily schedule. As alcohol withdrawal can be quite severe, outpatient detox options are reserved for those who have been thoroughly evaluated by a physician or other substance abuse treating professional and found to be at minimal risk of experiencing a complicated withdrawal.

Detoxification is only the first step in treating alcoholism. Many have failed to maintain sobriety because they tried to return to their old lives once they detoxed from alcohol. Relapse is a very real possibility unless one is armed with the tools to stay on the path of recovery. Alcohol and drug detox are step one; additional treatment helps provide these relapse prevention tools.

Sources

    1. National Institute on Alcohol Abuse and Alcoholism. (2018). Alcohol Facts and Statistics.
    2. National Institute on Drug Abuse. (2018). Commonly Abused Drug Charts.
    3. Harvard of Public Health. (n.d.). Alcohol: Balancing Risks and Benefits.
    4. Centers for Disease Control and Prevention. (2018). Facts Sheets-Alcohol Use and Your Health.
    5. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Overview of Alcohol Consumption.
    6. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol’s Effects on the Body.
    7. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Edition). Arlington, VA: American Psychiatric Publishing.
    1. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
    2. University of Wisconsin Health. (2018). Post-Acute Withdrawal Syndrome (PAWS)
    3. Muncie, H.L., Jr., Yasinian, Y., & Oge’, L. (2013). Outpatient Management of Alcohol Withdrawal SyndromeAmerican Family Physician, 88 (9), 589-595.

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