Alcohol withdrawal affects those individuals who have a physical dependence on alcohol. When a person stops drinking entirely or cuts back on drinking, the withdrawal will occur. Alcohol withdrawal can produce many symptoms, which typically occur on a timeline. This timeline will vary by person and is influenced by many factors. There are stages of withdrawal including early-stage withdrawal, second-stage withdrawal, and third-stage withdrawal.
Early Stage Withdrawal
This period of withdrawal typically begins within eight hours after a person has their last drink. During this stage, individuals may experience tremors, which can begin eight to 12 hours after the last drink. Other symptoms that might present during the early stages are anxiety, depression, headaches, rapid heartbeat, insomnia, irritability, or lack of focus and energy. The severity of these symptoms will depend on the individual but will generally begin to diminish after 24 hours. If the symptoms are not treated, they will continue to get worse and reach maximum severity within one to three days. Some people will experience these symptoms for longer periods of time.
Second-Stage Withdrawal
There are people who go through detox and may experience a second-stage withdrawal. The symptoms associated with second-stage withdrawal are more severe and are usually seen in those who drank for prolonged periods of time or who were heavy drinkers. A person may also experience second-stage withdrawal if they have tried to stop drinking prior. The symptoms associated with second-stage withdrawal include high blood pressure and hallucinations and will present beginning 12 to 24 hours after the last drink. During this stage, a person may see or hear things that are not there but these are generally short-lived. Many can also experience the symptoms from early-stage withdrawal; however, those symptoms might get worse during this stage. Other symptoms of second-stage withdrawal include muscle rigidity, breathing difficulties, loss of bowel or bladder control, and teeth clenching.
Third-Stage Withdrawal
This stage of withdrawal is experienced by 30% of individuals and can begin three to four days after the last drink. These symptoms can also last as long as two weeks after the last drink. The severity of third-stage withdrawal can be seen in those who experience delirium tremens or DTs. Symptoms of DTs include seizures, confusion, hallucinations, mood changes, episodes of long periods of sleep, and changes in heart rhythms. There are also associated injuries to self and others with DTs.
Any person who exhibits any of the symptoms listed in early-stage, second-stage, or third-stage periods of withdrawal should seek medical care. Under the direct supervision of medical staff, the person can remain safe and get the appropriate care they need.
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