Alcohol Detox: Timeline, Safety, and Treatment

What Is Alcohol Detoxification?

Detoxification, also known as detox, is a term that describes a set of interventions used by healthcare providers to manage the symptoms of acute intoxication and withdrawal.¹

Many people enter detoxification as the first step in alcohol addiction treatment. Without medical supervision, moderate to severe alcohol withdrawal can be dangerous; medical detox makes the withdrawal process for these patients safe and more comfortable.¹

There are 3 main phases of detoxification: evaluation, stabilization, and entry into continued treatment.¹

1. Evaluation involves determining the substances you are withdrawing from, how much is present in your body, and what interventions may be necessary during detoxification.
2. Stabilization encompasses all medical and psychosocial processes needed to become substance-free, which can include medication, counseling, and leaning on social and familial support.
3. Lastly, detox involves facilitating entry into treatment, meaning that once you are medically stable, you will be referred to a treatment program to help you understand the psychological, behavioral, and social aspects of alcohol addiction.

Symptoms of Alcohol Detox

Alcohol withdrawal occurs as a result of physical dependence, which refers to adaptations the body makes when chronically drinks for a prolonged period.² Once someone quits or reduces their use, they often experience physical and psychological symptoms as their body adjusts to the absence of alcohol.² These symptoms can be dangerous without medical intervention.

Some of the symptoms of alcohol withdrawal include:¹

• Behavioral changes, such as restlessness, irritability, anxiety, or agitation.
• Increased sensitivity to light, sound, and other sensations.
• Poor concentration, memory, and judgment.
• Gastrointestinal symptoms such as nausea, vomiting, or lack of appetite.
• Tremors, elevated heart rate, and increased blood pressure.
• Sleep disturbance, such as insomnia or nightmares.
• Hallucinations and delusions.
• High fever.
• Grand mal seizures.

Seizures associated with alcohol-induced delirium known as delirium tremens are  caused by severe alcohol withdrawal syndrome and are life threatening and require medical intervention.¹

The course and severity of alcohol withdrawal symptoms can vary widely from person to person based on several factors.¹ Such factors can include:¹

• How much the patient has been drinking and for how long.
• The patient’s general health status, age, and nutrition.
• Whether they have experienced withdrawal before. If someone has gone through several previous withdrawals, they are at a greater risk for severe withdrawal symptoms the next time around.

Alcohol Detox Timeline—How Long Does Detoxing Take?

Much like withdrawal symptoms, detox timelines also vary. Withdrawal can begin 6-24 hours after the last drink and may last several days.¹

Seizures typically occur within the first 48 hours after the patient’s last drink, with the highest incidence risk being around 24 hours.¹ 

Patients will remain in detox until they are medically stable and ready to be discharged to the next stage of clinical treatment.

First 6-12 Hours

Initial symptoms of alcohol withdrawal typically begin 6 to 12 hours after the patient stops drinking.³ These symptoms may be somewhat mild and can affect various body systems. Minor withdrawal symptoms can include:³

• Insomnia.
• Tremors.
• Mild anxiety. 
• Stomach upset.
• Headaches.
• Heart palpitations.
• Loss of appetite.
• Diaphoresis, also known as heavy sweating.

12-24 Hours

Within the first 24 hours of alcohol withdrawal, initial symptoms will likely persist with other, more intense symptoms emerging. Visual, auditory, or tactile hallucinations, for example, are typically present within the first 12 to 24 hours of alcohol withdrawal.³ Hallucinations typically resolve within 48 hours.³

24-72 Hours

In cases of severe withdrawal, symptoms are much more intense and typically occur by the second or third day of detox. Most notably, within 48 to 72 hours, delirium tremens (DTs) may occur.³ Delirium tremens is a syndrome characterized by:³

• Sweating.
• Agitation.
• Rapid heart rate.
• Hypertension.
• Fever.
• Hallucinations.
• Disorientation.

These symptoms can be uncomfortable and intense, and peak at around 5 days before resolving.³

How to Safely Detox from Alcohol

Only a medical professional can determine the appropriate level of support needed to monitor someone’s symptoms during detoxification. There are different levels of detox services, which a medical professional will evaluate based on various factors unique to the patient’s health and situation.¹

Many people benefit from 24/7 medical support and monitoring during alcohol detox because of the serious health risks posed by acute alcohol withdrawal. Detoxification settings can vary in intensity based on patient’s needs, from medically managed intensive inpatient detoxification (the highest level of care) to ambulatory detox, where the patient visits a physician’s office or have home health visits while residing at home.¹

Medications Used During Alcohol Detox

Certain medications may be used to manage the effects of alcohol withdrawal. Benzodiazepines are the most common and are used to prevent withdrawal symptoms from intensifying.1, “benzodiazepine treatment of alcohol withdrawal,” pg. 58 Some benzodiazepines commonly used for alcohol withdrawal symptoms include:¹

• Diazepam (Valium).
• Chlordiazepoxide (Librium).
• Lorazepam (Ativan).
• Oxazepam (Serax).

Other types of medications that may be used for alcohol withdrawal symptoms include:¹

• Barbiturates, such as phenobarbital.
• Anticonvulsants, including carbamazepine (known as Atretol or Tegretol).
• Antipsychotics, such as the drug haloperidol (Haldol), may be used for agitation, hallucinations, or delirium during alcohol withdrawal.
• Beta-blockers and alpha-adrenergic agonists, like clonidine.

Alcohol Addiction Treatment Options

Detox by itself is rarely effective as a treatment modality for alcohol addiction. Most people will need continued treatment to address contributing factors to their addiction, and not just the symptoms of their physical alcohol dependence. This is why one of the main aims of detox is to facilitate entry into ongoing treatment.¹

Some of the treatment approaches commonly used in alcohol addiction treatment include:⁴

• Behavioral therapy. Among the most commonly used forms of clinical treatment for substance abuse, behavioral counseling helps people to understand their substance use, change their attitudes and behaviors, and implement new strategies to maintain lasting change in recovery. Some commonly used approaches to behavioral therapy for alcohol addiction treatment include cognitive-behavioral therapy, contingency management, community reinforcement, and motivational enhancement.
• Medications for alcohol use disorder. Alcohol addiction treatment may incorporate the use of medication management for alcohol dependence, such as acamprosate, disulfiram, or naltrexone. These medications are different than those used to treat withdrawal symptoms, and instead, address cravings for alcohol that may present during the recovery period.
• Peer support. Some treatment programs may also offer peer support opportunities, such as participating in a 12-Step program or other self-help groups facilitated by those who are also in recovery. These groups offer community support and allow patients to meet other people with whom they have mutual understanding and experiences.

Inpatient and Residential Treatment

Inpatient or residential treatment requires the patient to reside at the facility while receiving around-the-clock care and support. The treatment center may be housed within a hospital or clinic or have more of a hotel-like quality, but it is always staffed by addiction experts 24 hours a day.⁴

Some of the benefits of an inpatient treatment center can include having access to 24/7 support from medical staff and safely beginning recovery surrounded by peers and mentors in a community setting.

Outpatient Treatment

Outpatient treatment programs allow participants to live at home while they seek care during certain hours of the day. Care options vary widely based on the type of services offered and the intensity of treatment:⁴

• Partial hospitalization programs (PHPs) typically require attendance around 5 days per week with a minimum weekly time commitment of 20 hours.⁶
• Intensive outpatient programs (IOPs) may require attendance 3 to 5 days per week with a time commitment of a weekly minimum of 9 hours.⁷ 
• Standard outpatient programs may allow even more flexibility in scheduling.

Treatment for Alcohol Addiction

If you or someone you love is struggling with alcohol addiction, help is available today through American Addiction Centers (AAC). Our facilities offer evidence-based treatment, several alumni programs for continuing care in your recovery journey, and a 90-day brand promise. This means that if you complete 90 consecutive days at an AAC facility and experience a relapse after graduation, you are welcome back for a complimentary 30 days of treatment.

For more information, contact an admissions navigator at AAC today by calling any time, 24/7. We are here for you as you take the first step towards sobriety.

Frequently Asked Questions