How Long Do Alcohol Withdrawal Symptoms Last?

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Alcohol withdrawal symptoms (AWS) may occur within six hours and may hit the highest from 24 to 72 hours. For post-acute alcohol withdrawal symptoms (PAWS), it’ll take from two weeks to two years in most cases.  

AWS vary from one person to another, but the timeline of symptoms normally starts within a couple of hours. It can be divided into three stages.

Stage one (6 to 12 hours)

Mild symptoms may start as much as six hours after taking his or her last alcohol.

Symptoms may include:

  • Shaky hands
  • Sweating
  • Racing thoughts
  • Headache
  • Anxiety
  • Insomnia
  • Upset stomach

Stage two (12 to 48 hours)

After 12 to 24 hours, some people might experience hallucinations. They might hear or see things that do not exist at that moment.

Symptoms may include:

  • Disorientation
  • Seizures
  • Hallucinations
  • Sweating
  • Palpitations

Stage Three (48 to 72 hours)

People often suffer delirium tremens (DT) or alcohol withdrawal delirium after alcohol cessation.

People with DT suffer from the following:

  • Fever
  • High blood pressure
  • Hallucinations (auditory and visual)
  • Palpitations
  • Paranoia

Severe AWS can be life-threatening if left untreated. These timelines of symptoms represent physical withdrawal symptoms.

The second phase of withdrawal is known as PAWS and may last two years for heavy drinkers.

When will PAWS lasts?

During AWS, your symptoms vary within six to 72 hours. Within a week or two, your symptoms will ease.

Since PAWS affects the person emotionally and psychologically, these symptoms will appear from time to time within a year or two.

These emotions and psychological responses happen because of certain triggers in the person’s environment.

Even months after rehabilitation, PAWS might appear at home, work, or social gatherings if these triggers arise.

These triggers conclude that AWS and PAWS have internal and external dynamics that may affect how these symptoms last.

Factors that may affect alcohol withdrawal symptoms and their duration are:

1. Physiological makeup and body composition

Women are quicker to experience AWS as much as five hours after quitting alcohol, but symptoms last shorter.

However, women are found to have co-occurring alcohol-induced disorders.

Meanwhile, men likely experience intense AWS with symptoms lasting to a couple of days. There’s also a higher risk for relapse after withdrawal from alcohol addiction.

2. Severity of alcoholism

If a person has mild alcoholism disorder, expect the symptoms to show up mildly within 12 hours.

However, an individual showing mild to severe alcoholism may have AWS within four to five hours of cessation.

The more severe the disorder the quicker will the person experience AWS. The criteria for the severity of the disorder consist of lifestyle changes and accumulation of medical conditions.

3. How long and much is a person’s drinking habit

If the person started his or her excessive drinking habits at a young age, they’re likely to experience the symptoms longer.

People with acute alcohol independence might experience AWS as early as four to five hours.

These aspects affect how a person reacts when withdrawing from alcohol. People with alcohol addiction or who are looking for post-rehab should work with a therapist or counsellor to deal with AWS.

Such programs and professionals may help improve AWS within a given timeframe.

How does alcohol affect your mood?

Alcohol affects your mood by damaging the frontal lobe of the brain responsible for memory, learning, and emotions.

It contains a chemical called ethanol, which causes a depressing effect.

Similarly, alcohol boosts the effects of or gamma-aminobutyric acid (GABA) which is responsible for creating emotions such as calmness and relaxation.

Nonetheless, the more you consume alcohol the more difficult it is for your brain to reproduce neurotransmitters in releasing and relaying these emotions.

In the long run, it will create disorientation, confusion, and aggression in some individuals.

How does alcohol make you feel?

1. Alcohol makes you feel good temporarily

Alcohol consumption promotes the production of endorphins, the "feel-good" hormones, to be released in certain parts of the brain.

Such chemical compounds found in alcohol will trigger feel-good emotions.

The higher these endorphins are produced, the more the person becomes highly intoxicated.

The orbitofrontal cortex, a frontal area involved in reasoning and decision-making, and the nucleus accumbens, often known as the "pleasure centre," both boosted endorphin activity.

Endorphins are naturally created by brain cells. They provide sensations of pleasure and reward when they are released, signalling to the brain that it like what you're doing and wants you to do it again.

In the short run, alcohol makes you feel good just within a couple of hours after drinking.

Alcohol dependence may alleviate tension that leads to an increased consumption on it to feel calm and relaxed. This, in turn, leads to addiction.

There is also a greater chance of developing high alcohol tolerance in the long run, thereby, increasing alcohol consumption intakes. Excessive drinking, though, will lead to alcohol anxiety.

2. Alcohol makes you feel anxious and depressed

The acetaldehyde compound found in alcohol affects the brain and causes problems that affect emotions – particularly, negative feelings.

Acetaldehyde increases cortisol or the stress hormone in the body, therefore, escalates feelings of anxiety and worries.

Since acetaldehyde in alcohol exacerbates negative emotions, there’s a likely chance it will increase feelings of depression. In severe instances, alcohol may induce suicidal thoughts and actions.

For people diagnosed with depression, it’ll only worsen the condition.

3. Alcohol makes you aggressive and impulsive

Disinhibiting, or the inability to control your impulses or emotions after drinking, is one of the numerous physiological and behavioural consequences of consuming alcohol.

Alcohol abuse also impairs prefrontal brain function, which is important for impulse control.

You're more prone to misinterpret a scenario and exaggerate if your cognitive function is impaired.

4. Alcohol makes you feel more confident

Our brain releases a surge of the hormone dopamine when we drink alcohol.

This hormone is linked to delight and can make you feel confident by lowering your inhibitions, making you more prone to make rash decisions before considering the consequences.

Your brain produces more chemicals than usual to combat the inhibitory effects of alcohol. That’s why when a heavy drinker stops, their mood is affected.

The system of the excitatory neurotransmitters is undergoing excessive activities, which is what causes the mood swings and changes associated with alcohol consumption.

Who is at risk for alcohol withdrawal?

The people at risk for alcohol withdrawal are usually heavy drinkers or individuals with high alcohol dependencies.

An alcoholic might be able to function normally for a long period, and eventually, drinking alcohol may become problematic.

Then withdrawal symptoms can arise and can become difficult for the individual and require medical attention.

Here is one of the known risk factors for alcohol dependency that increases the chances of alcohol withdrawal:

  • If you're a man who consumed more than 15 drinks every week.
  • If you're a woman who consumed more than 8 drinks a week.
  • If you're an individual consuming more than 5 drinks a day.

These risk variables respond differently in each person, resulting in the varying intensity of alcohol withdrawal in some people.

The chance of alcohol withdrawal is influenced by both internal and external factors.

Other factors that increase the risk for alcohol withdrawal are:

Factors that increase the risk for alcohol withdrawal

Age and drinking history

If a person started drinking young, there’s a likelihood of him or her becoming dependent on alcohol when adult. This means the greater will the risk and intensity be for alcohol withdrawal.

Self-medication

Some people would rather end their drinking habits abruptly, thus, risking the chance of entering into an alcohol withdrawal state. 

Most individuals make the mistake of remedying their symptoms without medical professionals. However, this could only increase the risk for alcohol withdrawal.

Psychological factors

People who turn to alcohol to ease their stressors will likely develop alcohol withdrawal, especially when they start feeling anxious and stressed upon cessation. 

This could make them crave the drink more and display symptoms of shakiness, sweating, and disorientation.

Environmental factors

If your home, workplace, or location is on the onset of having too much alcohol, the person may lapse into alcohol withdrawal.

The constant reminder to drink in your environment will result in an increased chance of withdrawal.

Sociological factors

If your family, friends, or co-workers are drinking, it’ll trigger symptoms of AWS in you upon cessation of drinking. 

Alcohol withdrawal problems are more prone to emerge in social situations where drinking is tolerated or encouraged. Treatment for AWS is also influenced by social and cultural variables.

The extent of drinking habits

People with grave alcohol addiction are likely at risk for AWS within four to five hours upon cessation. The severity of their alcoholism will lead to the likelihood of increased AWS.

Physiological composition

Women who have lower body water percentages and higher alcohol content will lead to quicker AWS. However, men have higher water concentration, making them experience intense AWS than women.

Because alcohol is stored in fat cells, women absorb more alcohol than men, resulting in longer alcohol effects and withdrawal symptoms.

Men have higher levels of the alcohol dehydrogenase enzyme, which aids in the dissolution before it enters the blood.

Final Thoughts

Every day, people are seeking treatment to fight their alcohol addiction and ease their withdrawal symptoms.

There are several rehabilitation services you can find at Abbeycare Scotland or Abbeycare Gloucester as well as many people who have achieved success.

Call Abbeycare Scotland or Abbeycare Gloucester now to learn about your alternatives if you're ready to reclaim your life from alcohol.

Last Updated: June 21, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.