Alcohol is a commonly abused substance that can easily lead to dependence and addiction over time. When someone with an alcohol dependence tries to quit drinking, they’ll experience a variety of uncomfortable withdrawal symptoms. However, unlike many other addictive substances, alcohol withdrawal can result in severe, life-threatening complications that require medical treatment. 

Since alcohol withdrawal can be deadly, it’s important to speak with a health professional before quitting. A doctor or addiction treatment specialist can help you find a safe, effective way to detox from alcohol while avoiding dangerous withdrawal symptoms. However, it’s important to keep in mind that the intensity and length of detox can vary widely depending on many different factors. 

What Happens During Alcohol Detox?

Alcohol is a central nervous system (CNS) depressant, meaning this substance slows the transmission of signals between the brain and the body. More specifically, alcohol enhances the effects of a neurotransmitter called GABA, which results in suppressed activity within neurons in the brain. If you drink large amounts or for an extended duration of time, your body becomes used to having this type of response. You’ll begin needing more alcohol in order to feel the same effects, which is known as tolerance.

If you suddenly stop drinking alcohol or dramatically decrease how much you drink, the balance of neurotransmitters in your brain suddenly changes, leading to symptoms of withdrawal. In severe cases, the imbalance can cause hallucinations or seizures, which may be life-threatening. To avoid this, it is important to always speak with your health care provider if you want to stop drinking. They can help you to determine a safe and effective plan to stop drinking. 

Common Alcohol Detox and Withdrawal Symptoms

Alcohol withdrawal symptoms are more likely to occur in heavy users of alcohol. Most often, symptoms start eight hours after the last drink and can continue for weeks. Common withdrawal symptoms include:

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

Severe Alcohol Withdrawal Symptoms

More severe symptoms of alcohol withdrawal may include:

  • Sweaty, clammy skin
  • Enlarged (dilated) pupils
  • Headache
  • Insomnia (difficulty sleeping)
  • Loss of appetite
  • Nausea and vomiting
  • Pale appearance
  • Rapid heart rate
  • Tremor (hands or other body parts)
  • Seizure

Delirium Tremens

Delirium tremens is a severe form of alcohol withdrawal involving sudden mental or nervous system changes. This can happen after a period of heavy drinking and may be more likely to occur if you do not eat enough food while drinking. Most often, delirium tremens happens in people with a history of alcohol withdrawal. It’s more common among people who drink four to five pints of wine, seven to eight pints of beer or one pint of “hard” alcohol daily for several months. Delirium tremens is also more likely to occur in people who have been drinking heavily for many years. 

Symptoms most often occur 48 to 96 hours after drinking, but they can begin as long as 10 days after the last drink. These symptoms can include irritability, tremors, hallucinations and very severe symptoms like seizures. 

Stages of Alcohol Withdrawal

While each person’s situation is unique, most people experience alcohol withdrawal in three stages. The severity and length of withdrawal can vary widely based on how much you drink and how long you have been drinking. Always discuss your willingness to stop drinking with your health care provider, as they can create a plan that is both safe and effective.

The first stage of alcohol withdrawal is typically mild and can happen within hours of your last drink. Usually, this includes symptoms like nausea, tremors (often referred to as “the shakes”), changes in blood pressure and problems sleeping. 

The second stage can begin within 48 hours of your last drink, and it is when serious symptoms such as seizures can occur. It is estimated that around 5% of people will go through this phase of alcohol withdrawal. 

The final stage of alcohol withdrawal typically begins 48 to 96 hours after you stop drinking. During this stage, around 50% of people who have experienced withdrawal seizures will develop delirium tremens. It is important to seek medical care during this time, especially if you are experiencing symptoms of delirium tremens. 

Sometimes, people who undergo alcohol withdrawal experience a fourth stage that lasts weeks or months. This is known as post-acute withdrawal syndrome (PAWS). During this stage, you may experience trouble sleeping or mood changes. 

Alcohol Detox Timeline

Often, alcohol detox follows a general timeline

  • Within eight hours of your last drink, the more common and mild symptoms of withdrawal are likely to occur. These may include clammy skin, tremors, headaches, insomnia and mood swings. 
  • About 48 hours after you stop drinking, symptoms like alcohol withdrawal seizures and seeing, hearing or feeling things that are not there (hallucinations) can happen. 
  • Between 48 and 96 hours after your last drink, symptoms of delirium tremens are most likely to occur. These symptoms include tremors, visual hallucinations or seizures. It is important to seek medical care if delirium tremens occurs.
  • Weeks to months following your last drink, trouble sleeping or mood changes can persist. 

Factors That Influence the Alcohol Detox Timeline

Some of the factors that influence the alcohol detox timeline include:

  • Previous alcohol withdrawal
  • Larger amounts of alcohol use
  • Longer duration of alcoholism
  • Abnormal liver function
  • Previous seizures or delirium tremens
  • Intense craving for alcohol
  • Older age
  • Use of other drugs in addition to alcohol
  • Severe symptoms when arriving for treatment

Treatment for Alcohol Withdrawal Symptoms During Detox

After you decide to stop drinking, your health care provider will conduct an assessment that asks a variety of questions. This may include asking about how much you have been drinking, how long you have been drinking and what medications you take. It is important to be honest about this information so your provider can accurately assess your risk for severe withdrawal and delirium tremens. Based on your answers, they will recommend a treatment plan that may include medical detox, inpatient care and outpatient programming.

Professional treatment for alcohol withdrawal can make you more comfortable, keep you safe and help prevent relapse. For people with moderate to severe alcohol withdrawal, medical detox is typically recommended. In this program, you will be closely monitored for hallucinations and other signs of delirium tremens. Outpatient detox can be an option if you have mild to moderate symptoms of alcohol withdrawal. In this treatment setting, you would typically visit your health care provider each day and return to a safe, supportive environment between appointments. 

In either treatment setting, long-acting benzodiazepines like chlordiazepoxide or diazepam are often used to reduce the risk of seizures and delirium tremens. Clonidine, which can lower heart rate and blood pressure, is also sometimes used for alcohol withdrawal. Many other medications can also be incorporated, depending on the symptoms present. For example, beta blockers may help with high blood pressure, heart rate and anxiety. Haloperidol, an antipsychotic medication, can help with treating hallucinations or agitation. 

Following detox, your doctor may recommend that you begin an inpatient or outpatient rehab treatment program. Rehab programs help you to address the underlying causes of your addiction, practice healthier coping techniques and learn strategies for avoiding alcohol use in the future.

Finding an Alcohol Detox Center in Orlando

Orlando Recovery Center offers a wide variety of professional rehab services to those seeking effective addiction treatment in Florida. Our full continuum of care is individualized to meet each client’s unique needs, with treatment programs that include: 

If you or someone you love is struggling with alcohol addiction, Orlando Recovery Center can help. Contact us today to learn more about comprehension addiction treatment options that can work well for your situation. 

Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
Medically Reviewed By – Leila Khurshid, BCPS, PharmD
Leila Khurshid is a clinical pharmacist based in Denver, CO. Her writing and editing focuses on making medical information more accessible to the general population. Read more

U.S. National Library of Medicine. “Alcohol withdrawal.” MedlinePlus, January 17, 2021. Accessed April 30, 2022.

U.S. National Library of Medicine. “Delirium tremens.” MedlinePlus, January 17, 2021. Accessed April 30, 2022.

GoodRx. “Alcohol Withdrawal Timeline: How Long Does Withdrawal Last?” August 20, 2021. Accessed April 30, 2022.

Saitz, R. “Introduction to alcohol withdrawal.” Alcohol Health and Research World, 1998. Accessed April 30, 2022.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.