How long do alcohol withdrawal symptoms last?

Answer 1

== == == == == == == == == == == == If you would like to know more about alcohol withdrawal symptoms and diagnosis, and about alcohol withdrawal treatment through alcohol detoxification (alcohol detox), read the following article for more information. Alcohol detoxification (alcohol detox) is an option if you are alcohol dependent. == == If you are alcohol dependent you have a strong desire to drink alcohol. In addition, your body becomes used to lots of alcohol. Therefore, you may start to develop 'withdrawal' symptoms 3-8 hours after your last drink as the effect of the alcohol wears off. So, even if you want to stop drinking, it is often difficult because of the withdrawal symptoms.

Withdrawal symptoms include: feeling sick, trembling, sweating, craving for alcohol, and just feeling awful. Convulsions occur in a small number of cases. As a result, you drink alcohol regularly and 'depend' on it to prevent these symptoms. If you do not have any more alcohol the withdrawal symptoms usually last 5-7 days, but a craving for alcohol may persist longer.

Delirium tremens ('DTs') is a more severe reaction after stopping alcohol. It occurs in about 1 in 20 people who have alcohol withdrawal symptoms about 2-3 days after their last drink. Symptoms include: marked tremor (the shakes) and delirium (agitation, confusion, and seeing and hearing things that are not there). Some people have convulsions. Complications can develop such as dehydration and other serious physical problems. It is fatal in some cases. Detoxification or 'detox' involves taking a short course of a medicine which helps to prevent withdrawal symptoms when you stop drinking alcohol. The most commonly used medicine for detox is chlordiazepoxide. This is a benzodiazepine medicine. Many GPs are happy to prescribe for detox from alcohol. A common plan is as follows. * A GP will prescribe a high dose of medication for the first day that you stop drinking alcohol. * You then gradually reduce the dose over the next 5-7 days. This usually prevents, or greatly reduces, the unpleasant withdrawal symptoms. * You must agree not to drink any alcohol when you are going through detox. A breathalyser may be used to confirm that you are not drinking. * Your GP or practice nurse will usually see you quite often during the time of detox. * Also during detox, support from family or friends can be of great help. Often the responsibility for getting the prescription, and giving the detox medicine is shared with a family member or friend. For example, a partner or parent of the person going through detox. Some people manage quite easily, others find it more difficult. You can expect to: * Feel quite nervous or anxious for a few days. * Have some difficulty with getting off to sleep for a few nights. * Have some mild withdrawal symptoms, but they should not be too bad, and a lot less than if you were not taking the detox medicine. The medication used for detox does not make you stop drinking. You need determination to stop. The medication simply helps you to feel better whilst your body readjusts to not having alcohol. Even after the period of detox you may still have some craving for alcohol. So you will still need willpower and coping strategies for when you feel tempted to drink. You are likely to be prescribed vitamins, particularly vitamin B1 (thiamine), if you are alcohol dependent. Especially during detox. This is because many people who are dependent on alcohol do not eat properly and can lack certain vitamins. A lack of vitamin B1 is the most common. A lack of this vitamin can cause serious brain conditions. Some people are referred to a specialist drug and alcohol unit for detox. This is usually better for people who have other physical or mental health problems and for those who have: * little home or social support * a history of severe withdrawal symptoms * a physical illness caused by alcohol * had previous attempts to stop alcohol and have failed. The medicines used to detox in specialist units are much the same as GPs prescribe. However, these units have more staff and expertise for giving support and counselling. Some people with serious alcohol related problems are admitted to hospital to detox.

Answer 2

It gets easier as time goes by. There will at some point be a day in which you do not crave it. Then at another point, a week might go by. Later a month. At a given point, it might be years that you go without a craving.

But one can hit, even years later, but if you just take that day as it comes, and don't give in, it will pass. Never be afraid to call on a friend or your sponsor.

AnswerI am a recovering alcoholic and drug addict. I haven't done drugs in 5 years, and I haven't had a drink in 3 years (literally, almost exactly 3 years today). And my experience has been that the cravings never go away.

They definitely diminish. After the first year of sobriety, it becomes much, MUCH easier to stay sober. That nagging feeling that something is missing in your brain does finally go away. You know that feeling, like something is missing in your brain, and nothing will fill it up and make you complete again except alcohol? That does go away (psychiatric medications, like antidepressants, can really help as well, as they will help restore your brain chemistry so you don't constantly feel like there's something missing from your brain).

When I'm not around alcohol, I hardly ever think about it anymore. And actually, when I think about drinking now, the idea frightens and sickens me. It has been said that the human mind remembers pleasure much better than it remembers pain. People say that if a woman could remember the pain of having her first child, she would never have another.

I think it's the same with drinking and drug use. When you've just quit, you don't remember the bad parts of your drinking/drug use: passing out on the bathroom floor, vomiting all over your own floor and being too sick to clean it up, making embarrassing drunken phone calls, disappointing your friends and family with your irresponsibility, etc.

Instead, you just remember the good parts. When you're having cravings, all you can think about is how great it would be to have that drink in your hand. You imagine classy parties and posh bars/nightclubs, where you and lots of glamorous people are standing around with cocktails, making witty remarks and just being fabulous. You imagine the condensation building up on a cold beer, or the candles on the bar making your martini twinkle and glitter.

It's only after you've drank again that you remember why you quit in the first place. But, I dunno, at some point -- I'm really not sure when, or why -- I stopped remembering only the good parts, and I started remembering the bad parts, too. Now, when I think about drinking, I imagine the godawful taste of cheap vodka straight from the bottle. I think about the time my brother found me passed out on the bathroom floor. I think about the horrible anxiety that comes when you're out of booze and all the bars and liquor stores are closed.

I don't know what changed, but I'm so glad it did, because it's made it so much easier to stay sober.

However, it's not all smooth sailing, even after 3 years. When I'm not around alcohol, it's a lot easier to stay sober. But when I'm around people drinking and partying, it's still extremely hard.

Last week I went to my best friend's wedding, and everyone -- EVERYONE -- was drinking all week long. The bachelorette party and the rehearsal dinner were bad enough, but the wedding itself was an absolute nightmare.

They had 150 guests, and literally, every single one of them except me was getting drunk. They had an open bar until midnight, and everyone was just getting wasted, laughing and cracking jokes, and just generally having a grand old drunken time.

And there was me, sitting there in my pretty dress, just watching everyone. It was HELL. Pure HELL.

And then, after the open bar ended, everyone went up to the Bridal Suite to drink more! They started pulling out bottles of liquor and setting up drinking games.

Thank God I didn't have to stay for that. One of the other girls was tired, and wanted to leave, so she drove me back to the bride's apartment and we went to bed early.

But seriously, I would never want to go through that again. I don't think I'll ever be comfortable in a room full of drinking people again, not even after I've been sober for 20 years.

Being in situations where other people are drinking is unavoidable, if you want to have any kind of social life. But I would definitely recommend that you stay away from social situations where people are drinking, for AT LEAST the first year of sobriety.

This will be VERY hard, especially if you're like me, and ALL of your friends drink. I've lost touch with a lot of friends since I quit drinking, because I would usually hang out with them at bars or at parties. Since I can't go to bars or parties anymore -- except on special occasions like my best friend's wedding, where it's totally unavoidable -- I hardly ever see them anymore.

But you know what? If you have to lose friends to stay sober, then that's just what you have to do. If they can't make time to hang out with you in a sober setting, then that sucks, but, there's nothing you can do. You can't be going to bars and parties every weekend like you used to. You just CAN'T.

I would also recommend that you try this medication called Antabuse (generic name is disulfiram). Antabuse was discovered by accident; it was originally produced as a manufacturing by-product. Scientists soon discovered that, if you take this substance before drinking, you will get horribly, HORRIBLY sick if you drink.

It takes all the pleasure out of drinking, and replaces it with misery. Less than five minutes after your first drink, you'll get a pounding headache, you'll feel hot and feverish all over, your hands will itch like crazy, and you feel weak, disoriented, and very nauseous. It's horrible. You will get so sick from that first drink, that you won't be able to have another.

The other great thing about Antabuse is that it has a cumulative effect in your body. If you've been taking it every single day for a month or more, then you have to stop taking it for a week before you can drink without getting sick. If you've been taking it for many months, or years, then you have to stop taking it for at least two weeks to one month before you can drink again.

So, say you get a horrible craving for alcohol. You decide that you're going to go off your Antabuse and start drinking again. But by the time one or two weeks has gone by, usually you have come to your senses, and have started taking the Antabuse again.

Antabuse prevents you from impulsively deciding to drink. If you decide to drink, you have to wait at least a week or two, and by that time, the craving has long passed.

I have no doubt that I would've drank at the wedding, if it hadn't been for the Antabuse I take. The ONLY thing that kept me from drinking was the knowledge that I would get horribly, violently ill.

In short, after the first year, it will get MUCH easier to stay sober. But you will most likely never get to the point where you have absolutely no cravings and no desire to drink at all. Especially when you're at a great party, watching everyone else get hammered.

Answer 3

Definition

Alcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol every day suddenly stops drinking alcohol.

Causes, incidence, and risk factors

Alcohol withdrawal usually occurs in adults, but it may occur in teenagers or children as well. It can occur when a person who often uses alcohol excessively suddenly stops drinking alcohol. Withdrawal usually occurs within 5 - 10 hours after the last drink, but it may occur days later.

The more heavily you drink every day, the more likely you will be to develop alcohol withdrawal symptoms when you stop drinking. The likelihood of developing severe withdrawal symptoms also increases if you have certain other medical problems.

Symptoms

Alcohol withdrawal may involve psychological and physical symptoms.

Mild-to-moderate psychological symptoms:

• Anxiety or nervousness
• Depression
• Difficulty thinking clearly
• Fatigue
• Irritability or easy excitability
• Jumpiness or shakiness
• Nightmares
• Rapid emotional changes

Mild-to-moderate physical symptoms:

• Clammy skin
• Enlarged (dilated) pupils
• Headache
• Insomnia(sleeping difficulty)
• Loss of appetite
• Nausea and vomiting
• Pallor
• Rapid heart rate
• Sweating
• Tremor of the hands or other body parts

Severe symptoms:

• Agitation
• Delirium tremens -- a state of severe confusion and visual hallucinations
• Fever
• Seizures

Signs and tests

When evaluating you for alcohol withdrawal, your health care provider will check for:

• Abnormal eye movements
• Abnormal heart rhythms
• Dehydration
• Elevated temperature
• General body shaking
• Liver failure
• Rapid breathing
• Rapid heart rate
• Shaky hands

A toxicology screen may be performed, as well as other blood tests.

Treatment

The goals of treatment are to reduce the immediate withdrawal symptoms, prevent complications, and begin long-term therapy to promote abstinence (no drinking at all).

INPATIENT DETOXIFICATION

People with moderate-to-severe symptoms of alcohol withdrawal may need inpatient treatment at a hospital or other facility that treats alcohol withdrawal. Others who may need inpatient treatment include those who:

• Have a mental health disorder, such as schizophrenia or bipolar disorder
• Have failed outpatient treatment for Alcoholism or alcohol withdrawal
• Have serious medical problems
• May be harmful to themselves or others

Treatment at an inpatient center will include medical monitoring and treatment of alcohol symptoms.

• Monitoring of blood pressure, body temperature, heart rate, and blood levels of different chemicals in the body will take place. The person will be watched closely for hallucinations and other signs of delirium tremens.
• Many patients are given fluids or medications through a vein (IV).
• Treatment may involve sedating the person until withdrawal is complete. A class of medications known as benzodiazepines is often used for this purpose.

OUTPATIENT DETOXIFICATION

People with mild-to-moderate alcohol withdrawal symptoms can often be treated in an outpatient setting. They should have a person who commits to staying with them throughout the process and is able to monitor them closely. Daily visits to a health care provider are needed until the patient is stable.

Blood tests are drawn periodically. Patients are given sedative drugs to help them with withdrawal symptoms.

As withdrawal symptoms become manageable:

• Patient and family counseling is begun to address the long-term issue of the patient's alcoholism. See: Alcoholism
• Testing and treatment for other medical problems associated with the use of alcohol are performed.
• Mental health disorders that are present should be treated.

It is important that the patient goes to a living situation that helps support them in staying sober. Some areas have housing that provide a supportive environment for those trying to stay sober.

Permanent and life-long abstinence from alcohol is the best treatment for those who have gone through withdrawal.

Support Groups

For additional resources, see alcoholism support group.

Expectations (prognosis)

Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition. Symptoms usually begin within 5 - 10 hours of the last drink. The symptoms peak in 48 - 72 hours and may persist for weeks.

Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink excessively may develop many medical conditions such as liver and Heart disease.

Most people who go through alcohol withdrawal make a full recovery; however, a small percentage of alcohol withdrawal cases end in death, especially if delirium tremens is present. For those who recover from alcohol withdrawal, the long-term outlook depends on how much organ damage has occurred and whether the person can stop drinking completely.

Calling your health care provider

Alcohol withdrawal is a serious condition that may rapidly become life threatening.

Call your health care provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Call for an appointment with your health care provider if symptoms persist after treatment.

Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur.

Prevention

Minimize or avoid the use of alcohol. In people with alcoholism, total abstinence from alcohol may be necessary.

References

O'Connor PG. Alcohol abuse and dependence. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 31.

In the clinic. Alcohol use. Ann Intern Med. 2009;150:ITC3-1-ITC3-15.

Schuckit MA. Alcohol-use disorders. Lancet. 2009;373:492-501.

Answer 4

Definition

Alcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol every day suddenly stops drinking alcohol.

Alternative Names

Detoxification - alcohol; Detox - alcohol

Causes, incidence, and risk factors

Alcohol withdrawal occurs most often in adults, but it may occur in teenagers or children.

The more you drink every day, the more likely you are to develop alcohol withdrawal symptoms when you stop drinking.

You may have more severe withdrawal symptoms if you have certain other medical problems.

Symptoms

Alcohol withdrawal symptoms usually occur within 5 - 10 hours after the last drink, but can occur days later. Symptoms get worse in 48 - 72 hours, and may persist for weeks.

Common symptoms include:

• Anxiety or nervousness
• Depression
• Not thinking clearly
• Fatigue
• Irritability
• Jumpiness or shakiness
• Mood swings
• Nightmares

Other symptoms may include:

• Clammy skin
• Enlarged (dilated) pupils
• Headache
• Insomnia(sleeping difficulty)
• Loss of appetite
• Nausea and vomiting
• Pallor
• Rapid heart rate
• Sweating
• Tremor of the hands or other body parts

A severe form of alcohol withdrawal called delirium tremens can cause:

• Agitation
• Severe confusion
• Seeing or feeling things that aren't there (hallucinations)
• Fever
• Seizures

For more information on this severe form of alcohol withdrawal, see: Delirium tremens.

Signs and tests

Your health care provider will perform a physical exam. This may reveal:

• Abnormal eye movements
• Abnormal heart rhythms
• Not enough fluids in the body (dehydration)
• Fever
• Rapid breathing
• Rapid heart rate
• Shaky hands

Blood and urine tests, including a toxicology screen, may be done.

Treatment

The goal of treatment includes:

• Reducing withdrawal symptoms
• Prevent complications,
• Therapy to get you to stop drinking (abstinence)

INPATIENT TREATMENT

People with moderate-to-severe symptoms of alcohol withdrawal may need inpatient treatment at a hospital or other facility that treats alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens.

Treatment may include:

• Monitoring of blood pressure, body temperature, heart rate, and blood levels of different chemicals in the body
• Fluids or medications through a vein (by IV)
• Sedation using medication called benzodiazepines until withdrawal is complete

OUTPATIENT TREATMENT

If you have mild-to-moderate alcohol withdrawal symptoms, you can often be treated in an outpatient setting. You will need someone to commit to staying with you during this process,k and who can keep an eye on you. Daily visits to your health care provider are needed until you are stable.

Treatment usually includes:

• Sedative drugs to help ease withdrawal symptoms
• Routine blood tests
• Patient and family counseling to discuss the long-term issue of alcoholism. See: Alcoholism
• Testing and treatment for other medical problems linked to alcohol use

It is important that the patient goes to a living situation that helps support them in staying sober. Some areas have housing options that provide a supportive environment for those trying to stay sober.

Permanent and life-long abstinence from alcohol is the best treatment for those who have gone through withdrawal.

Support Groups

See: Alcoholism support group

Expectations (prognosis)

How well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.

Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver and heart disease.

Most people who go through alcohol withdrawal make a full recovery. However, death is possible, especially if delirium tremens occurs.

Calling your health care provider

Alcohol withdrawal is a serious condition that may rapidly become life threatening.

Call your health care provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Call for an appointment with your health care provider if symptoms persist after treatment.

Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur.

Prevention

Reduce or avoid alcohol. If you have alcoholism, you should stop drinking completely.

References

O'Connor PG. Alcohol abuse and dependence. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 31.

In the clinic. Alcohol use. Ann Intern Med. 2009 Mar 3;150(5).

Schuckit MA. Alcohol-use disorders. Lancet. 2009;373:492-501.

Reviewed By

Review Date: 03/20/2011

David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine.

Answer 5

On average, two to five days. It varies with individuals and their physical condition.