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Alcohol Detox: A Guide To Detoxification & Withdrawal Symptoms

A Guide to Alcohol Detox

Detox from alcohol can be a complicated process, but before you can recover from alcohol addiction, you need to get all the alcohol out of your system. The alcohol withdrawal timeline can vary, and how long it takes to get alcohol out of your system depends on how long you’ve been drinking and your overall health.

Some people are able to recover from mild alcohol use problems without experiencing severe withdrawal symptoms, while others have symptoms that could cause permanent disability or death. 

An effective detox and alcohol addiction treatment program can help you get through this risky process safely. To be prepared for what comes next, learn more about the benefits of detoxing from alcohol and the typical withdrawal timeline after admission to an inpatient rehab program

What is alcohol detox?

People who have an alcohol use disorder often find it difficult to stop drinking. Alcohol affects the brain by raising levels of dopamine, which interrupts the brain’s natural dopamine production. It depresses natural brain functioning, which can lead to overstimulation of those systems when the person stops drinking. Frequent and heavy drinking can damage the brain in ways that make it dependent on alcohol. Withdrawal symptoms can develop when the person stops drinking.

Alcohol detox is a managed process of stopping alcohol use and letting the brain clear itself of the negative effects of alcohol. Because withdrawal symptoms can sometimes be dangerous, detox from alcohol should only be attempted under medical supervision. Alcohol self-detox isn’t recommended since some withdrawal symptoms could turn deadly.

When it comes to long-term rehabilitation from addiction, detox is only the first step. After going through detox, you still need to participate in a comprehensive rehab program that addresses the underlying causes of alcohol addiction and teaches you techniques to avoid a relapse.

What withdrawal symptoms can you experience during alcohol detox?

Not everyone experiences the same withdrawal symptoms during detox from alcohol. Symptoms range from mild to severe, and the severity is often tied to the severity of the alcohol use. Some typical alcohol withdrawal symptoms include:

  • Sweating
  • Shakiness
  • Nausea
  • Vomiting
  • Depression
  • Foggy thinking
  • Disorientation
  • Difficulty sleeping
  • Anxiety
  • Hallucinations
  • Severe agitation

For some people, the risks of alcohol withdrawal include long-term disability and death. This is particularly true for those who have been through multiple detoxification and addiction cycles. People with liver disease, older individuals, and those with a history of withdrawal seizures may also have a higher risk of dangerous withdrawal symptoms. In particularly dangerous cases, the person undergoing alcohol detox develops a condition called delirium tremens. This life-threatening condition involves confusion, restlessness, fever and seizures. Delirium tremens is potentially fatal.

Various factors can influence the type and severity of withdrawal symptoms during detox from alcohol. Factors that might increase your risk of severe symptoms include:

  • A family history of alcoholism or drug addiction
  • How long you have been addicted to alcohol
  • The amount of alcohol you typically drink in one drinking session
  • Medical history
  • Childhood trauma
  • Stress levels
  • Co-occurring mental health issues
  • Co-occurring substance abuse problems

Medically managed detox helps reduce the risks during this potentially dangerous time period. During a medically managed detox program, doctors and nurses monitor the person for a few days so they can intervene if symptoms become problematic. The individual in recovery may be prescribed medicine to ease symptoms.

Doctors and rehabilitation center staff use a scale called the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) to assess where the person is in the detoxification process. This helps them decide what interventions are appropriate at different stages of withdrawal.

What factors influence alcohol withdrawal?

Several factors influence the severity of alcohol withdrawal, making it a highly individual condition. These factors include the following:

  • medical history
  • stress levels
  • how long the individual has been drinking
  • family history of addiction
  • how much alcohol was consumed each time
  • presence of a co-occurring mental health disorder
  • childhood trauma

Another factor that can influence alcohol withdrawal symptoms is using other drugs and alcohol simultaneously. It can also increase the potential side effects and dangers.

Generally speaking, the more dependent on alcohol an individual is, the more likely the individual is to encounter severe alcohol withdrawal symptoms.

Alcohol withdrawal can be fatal since the central nervous system and brain experience a revival after being restrained by alcohol for an extended period of time. Alcohol acts as a central nervous depressant and its sudden removal can be life-threatening.

It is never recommended that an individual stops drinking completely without professional supervision since symptoms can occur and magnify at a rapid rate. Even after the physical side effects of alcohol withdrawal have subdued, cravings and emotional symptoms can continue without the proper treatment and support.

How long is alcohol detox?

An alcohol detox program takes from three to ten days. During this time, you stay onsite at the rehab facility and receive 24-hour monitoring for withdrawal symptoms.

The alcohol withdrawal timeline typically occurs over 12 to 72 hours and progresses in stages. The first symptoms usually begin to show up about 12 hours after the last drink. Depending on the severity of the addiction, withdrawal symptoms can start even before all the alcohol has left your system.

The symptoms of alcohol withdrawal may last up to a week. Most people going through detox experience the worst symptoms around 24 to 72 hours after the last drink. If hallucinations occur during withdrawal and detox, these typically start 12 to 24 hours after the final drink and dissipate by 48 hours after the last drink. Delirium tremens begins around 48 to 72 hours after halting all drinking. If someone in detox doesn’t progress to severe symptoms by 24 to 48 hours after the last drink, they are unlikely to have a significant increase in symptoms after this point.

Once you’ve gone through alcohol detox, rehab from addiction can begin. A typical addiction rehabilitation program takes around 7 weeks, but the program can be tailored to your specific needs. Some people require more time in rehab before they are ready to live a sober life and deal with regular activities using the techniques they learned in therapy. If you are dealing with other substance abuse issues or mental health problems, you may need a longer rehab program to address these issues alongside the addiction.

After completing a rehab program, you may remain in an aftercare program for a year or more. These therapy sessions, peer group meetings and check-ins help you assess your progress and reduce the chances of a relapse into addiction.

What are the stages of alcohol withdrawal?

There are three stages of severity when it comes to alcohol withdrawal side effects ranging from mild to severe.

Stage 1: MildStage 2: ModerateStage 3: Severe/delirium tremens
Loss of appetiteIncreased mood disturbancesFever
NauseaIrregular heart rateAgitation
DepressionRespiration and body temperatureSeizures
Heart palpitationsIrritabilityHallucinations
AnxietyIncrease blood pressureSevere confusion
TremorsSweating
Mood swingsMental confusion
Abdominal pain
Insomnia
Foggy thinking

How long before symptoms start showing up?

Between 12 and 24 hours, after individuals stop drinking, some people may experience tactile, auditory or visual hallucinations. These typically end within 48 hours.

Withdrawal seizures usually happen between 24 and 48 hours after an individual stops drinking. But in rare cases, seizures can occur as early as 2 hours after drinking stops and up to 10 days after cessation of alcohol. There is an increased risk of seizures for people who have gone through numerous detoxifications or have had previous seizures.

Delirium tremens typically start between 48 and 72 hours after an individual’s last drink. Individuals most at risk of delirium tremens have acute medical illness, a history of withdrawal seizures, abnormal liver function, or are of an older age.

Are there medications that can help during alcohol detox?

In some cases, medication is required to reduce withdrawal symptoms to manageable levels. Alcohol detox medications are administered by the doctor monitoring the withdrawal process. 

There are a few different medicines used in detox, and what works for one person may not work for another. The type and amount of medication may be adjusted during detox as the client’s needs change.

Benzodiazepines

Benzodiazepines include short-acting and long-acting versions, both of which can be used in a detox program. These medicines treat anxiety, insomnia and muscle spasms that occur during withdrawal.

Naltrexone

This medication reduces alcohol cravings. Because it can cause an increase in withdrawal symptoms, naltrexone is not usually prescribed or administered until a few days into the detox process. Naltrexone is available in pill and injectable forms, and the doctor managing your detox and rehabilitation can determine which version is right for you.

Anticonvulsants

Individuals with a history of withdrawal-induced seizures may be given anticonvulsant drugs during detox. Common anticonvulsant drugs used to manage convulsions during withdrawal include carbamazepine, divalproex sodium, phenobarbital, levetiracetam, and clonazepam.

Anti-Nausea Medication

Because nausea is a common symptom during detox, anti-nausea medication is sometimes used during the withdrawal phase of addiction recovery. Some commonly prescribed anti-nausea medications during detox include ondansetron and metoclopramide.

Antipsychotics

These drugs reduce psychotic episodes, such as hallucinations, delusions, and paranoia. Individuals experiencing these symptoms as part of their withdrawal from alcohol may be prescribed antipsychotics such as olanzapine and risperidone. These drugs are also used to treat conditions such as schizophrenia and bipolar disorder, so individuals with these conditions who are going through detox may continue taking these medications during and after rehab.

Antidepressants

Individuals with clinically diagnosed depression who are going through detox may be prescribed antidepressants. These medicines also help reduce anxiety, another potential symptom of alcohol withdrawal. In some cases, those with a co-occurring mental health disorder may continue taking medication for depression or anxiety after rehab in order to manage those symptoms. Treating mental health issues is part of rehabilitation because these conditions can increase the risk of a relapse later if left untreated.

Disulfiram

Disulfiram is typically used during the later stages of rehabilitation, not during the detoxification process. This drug causes negative side effects when alcohol is consumed. The intended use of disulfiram is to make alcohol use so unpleasant that you don’t want to drink anymore. Someone who drinks alcohol while on disulfiram may experience nausea, headache, body weakness, face flushing and low blood pressure.

Acamprosate

Individuals who have been drinking heavily for years may be prescribed acamprosate. This drug helps reduce alcohol cravings and assists the brain in returning to normal functioning after experiencing the effects of long-term alcohol addiction.

Find help at an alcohol detox facility

Recovery in a controlled environment greatly increases the chances of long-term success. Alcohol detox centres provide a safe, calm setting for recovery along with evidence-based treatment to help reduce the risk of future relapses.

The first step to a successful detox and rehabilitation from alcohol abuse or alcoholism is checking into a facility qualified to guide you through the alcohol detox process. The admissions process for alcohol detox includes a personal evaluation and intake exam, during which you may be asked about your alcohol consumption habits and your health history. Doctors may take blood or administer tests to evaluate your physical and mental health before beginning rehab.

The detox process takes place at the inpatient facility, and a doctor monitors the entire process to watch for potential problems. After detox is over, you start working with counselors and peer groups. Individual therapy helps you determine why you started drinking and what your triggers are that lead you to drink. You learn ways to cope with situations without drinking and develop techniques for avoiding alcohol in real-world settings.

One advantage of completing detox and rehab at an inpatient facility is the availability of professional support 24 hours a day. During medically managed detox, this is essential because dangerous symptoms can develop quickly.

Completing rehab in a safe, comfortable setting also helps you concentrate on your recovery without distractions. Access to calm spaces, areas for physical exercise and scheduled activities help you heal from alcohol addiction and develop healthier habits. During an inpatient program, housing and meals are provided, so you don’t have to worry about cooking healthy foods or finding a safe space to sleep.

Follow-up care takes place after your release from inpatient rehab. This might include outpatient counseling and participation in a 12-step program. These sessions help you stay on track and reduce the risk of a relapse..

Seek professional help.

Self-detox generally isn’t advised, and often isn’t effective. Willpower can only take you so far, and it may not be enough to counter the physical changes that alcohol has caused in your system.

For managed detox that helps you get through withdrawal symptoms as comfortably as possible and a rehab program that maximizes your chances of long-term success, you’re likely to need professional help. 

If you’re looking for alcohol detox in Ontario, Bellwood Health Services in Toronto provides medically managed detox and evidence-based rehabilitation from addiction.

Our lines are open 24/7 to get you the help you need. Give us a call at one of the numbers listed below to learn more:


EHN Canada has locations across Canada that specialize in addiction and mental health treatment. If and when you’re ready, please reach out to begin your recovery journey. 

Bellwood
Toronto, ON
1-800-387-6198

Edgewood
Vancouver Island, BC
1-800-683-0111

Gateway
Peterborough, Ontario
1-705-535-0636

Nouveau Depart
Montreal, Quebec
1-888-488-2611

Outpatient Services (Multiple locations): 1-888-767-3711

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