How Long Does Alcohol Detox Take?

Alcohol dependency and addiction is a common psychiatric disorder, with similar statistics to severe depression.

Over 14% of the general population will suffer from alcohol dependency at some point in their life. [1]

Those who suffer from alcoholism or alcohol dependency will have to go through alcohol detox in an attempt to treat their addiction. Detoxification (detox) is usually defined as the ‘cessation’ of, or an abrupt end to, the consumption of alcohol.

Detox then involves removing and flushing alcohol completely from the body, in order to start the healing process.

Alcohol is classed as a depressant, and your body and mind begin to rely on the alcohol you consume the more you drink. Drinking constantly increases tolerance levels of alcohol, including levels of euphoria.

This means that when you drink you will need to drink more often and at a higher quantity than usual to achieve the effects it once had.

For people that drink this regularly, the alcohol will start to affect their mental state. Many people with mental health conditions tend to self-medicate with alcohol, even though they know alcohol is a depressant.

They are then both physically and mentally reliant on your intake of alcohol, so withdrawing from drinking proves to be the biggest hurdle.

It will take time to adjust to a life without alcohol, for your body and for your mind. Withdrawal symptoms usually prevent people from even attempting detox, nervous about the symptoms and hardships this will induce.

This is why it is important that you discuss detox with professionals, or attend an inpatient centre to carry out the detox under monitored supervision.

Do I Need an Alcohol Detox?

You will be required to detox before treatment if you are physically addicted to a substance such as alcohol. The symptoms of alcohol addiction, commonly known as alcoholism, vary according to the nature of your addiction. [2]

Someone who is suffering from an alcohol abuse disorder has an impaired ability to control or stop their drinking. This usually leads to personal or social problems, such as a hindered ability to attend to responsibilities.

The behavioural signs of alcohol abuse or alcohol use disorder:

• ‘Heavy drinking’ and alcohol cravings
• Drinking at inappropriate social times, such as in the morning or at an important event
• Secretive or dishonest behaviour
• Reacting with anger or sadness when drinking
• Losing interest in all usual activities
• Placing alcohol above other responsibilities

The physical signs of alcohol abuse or alcohol use disorder:

• Built up a tolerance for alcohol
• Tired
• Headaches
• Excessive sweating
• Change in appetite
• Change in weight
• Lack of personal hygiene
• No concern for physical appearance
• Insomnia
• severe withdrawal symptoms

These signs and symptoms are accompanied by mental challenges. The most common mental health issues associated with alcoholism are anxiety and depression, both being caused by, and a cause for, alcoholism.

The severity of your alcohol addiction can be navigated by self-assessments. The most common form is through questionnaires such as the CAGE Questionnaire: [3]

CAGE Questions

1. Have you ever felt you should cut down on your drinking?
2. Have people annoyed you by criticising your drinking?
3. Have you ever felt bad or guilty about your drinking?
4. Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?

CAGE Questions Adapted to Include Drug Use (CAGE-AID)

1. Have you ever felt you ought to cut down on your drinking or drug use?
2. Have people annoyed you by criticizing your drinking or drug use?
3. Have you felt bad or guilty about your drinking or drug use?
4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?

A score of 2 or more (per set of 4 questions) is deemed clinically significant, proving that you exhibit negative drinking behaviours and possible alcohol addiction or dependency. If you answer ‘yes’, you will be scored a 1, and if you answer ‘no’, you will be scored a 0.

If you or a loved one is showing signs of alcohol addiction, follow this up with a self-assessment questionnaire, carried out at home or through a GP appointment. If you believe you would benefit from a detox, then you are taking the first steps towards sobriety and a brighter future.

Symptoms of Alcohol Detox: Withdrawals

Heavy drinkers who suddenly stop or cut down their alcohol consumption will experience alcohol withdrawal (AW). Symptoms can be both psychological and physical, manifesting as a result of alcohol-induced neurological imbalances, causing a hyperactive brain. [4]

The nature and extent of withdrawals depend on a number of factors:

• How much you drink
• How often you drink
• Your levels of tolerance
• General physical and mental health

Withdrawal symptoms can be mild or severe, which can be life-threatening.

Common and mild symptoms of alcohol withdrawal:

• Nausea and vomiting
• Headaches
• High temperature
• Chills excessive sweating
• Vivid dreaming
• Insomnia
• Fatigue
• Mild anxiety or panic

Severe symptoms of alcohol withdrawal:

• Depression and extreme anxiety
• Severe disorientation
• Confusion
• Tremors and seizures
• Hallucinations
• Fever
• High blood pressure or irregular heart rate
• rapid heart rate
• Delirium tremens

Every person will have their own unique alcohol withdrawal symptoms, manifesting in both mental and physical withdrawal symptoms. The symptoms that each drinker experiences will pose a different risk depending on your personal health and your history.

The onset of the first symptoms may occur within a few hours of your last drink, and will gradually get worse as time goes on until the detox is complete.

The Timeline of Alcohol Detox

Alcohol withdrawals are diagnosed mostly through clinical and medical examinations by medical professionals. Diagnosis requires records of alcohol intake, including amounts and frequency.

Patients are also asked about when they started, and how they reduced or cut themselves off from alcohol. To establish that you have withdrawals, it is common to fulfil these conditions: [5] [6]

1. Clear evidence of a cut-off or reduction of intake of alcohol after previously consuming a high volume
2. Symptoms of withdrawal cannot be accounted for by other medical conditions or mental disorders
3. There is evident significant distress and decline in general functioning (both mental and physical) due to these withdrawal symptoms.

How long does it take for alcohol to leave my body?

• 6 hours in your blood
• 12 to 24 hours in your urine
• 12 -24 hours on your breath
• 12-24 hours in your saliva
• Up to 90 days in your hair

Mild symptoms of alcohol withdrawal during the detox process start after 6 hours after the last drink is consumed. This is when seizures are likely to occur if the person is a very heavy drinker.

Hallucinations may start between hours 12 and 24 when people see things or hear things that are not there or true.

During this whole period, minor and common withdrawal symptoms such as nausea or diarrhoea persist. Between days 1 and 2, these minor symptoms such as headaches and anxiety are at their peak.

Symptoms of withdrawals usually start to ease after 4 or 5 days, depending on the person.

There have always been 3 main goals of the alcohol detox process, set by the American Society of Addiction Medicine (ASAM): [7]

1. To provide a safe withdrawal from the drug(s) of dependence and enable the patient to become drug-free.
2. To provide a withdrawal that is humane and thus protects the patient’s dignity.
3. To prepare the patient for ongoing treatment of his or her dependence on alcohol or other drugs.

Management of Alcohol Detox: Medication

Detox is the first stage of changing your relationship with alcohol. Severe alcohol withdrawal symptoms will usually subside after a couple of weeks, depending on the severity and nature of your alcohol addiction.

The worst alcohol withdrawal symptoms often present as hallucinations, seizures and delirium tremens. These are potentially life-threatening, and medication has been utilised to help overcome the first waves of symptoms. Benzodiazepines have proven to be the most efficient treatment for alcohol withdrawals, considered to be the ‘gold standard’. [8]

Alcohol negatively impacts the GABA neurotransmitters in the brain, preventing them from working properly. Benzodiazepines (‘Benzos’) are both safe and effective, stimulating the GABA-A receptors and serving as a substitute.

This has proven to reduce the presence of both seizures and delirium tremens massively. [9]

The main advantages of Benzodiazepines are:

• Preventing agitation
• Reducing the feelings of anxiety
• Reducing the risk of seizures
• Reducing the risk of delirium tremens

Librium is one of the most commonly used benzodiazepines, a brand name for the general chlordiazepoxide.

Librium is administered to those going through withdrawal for its sedative effect. Detox tends to increase feelings of anxiety, so Librium is used to hamper this feeling and overall agitation.

Librium also helps regulate the broken communication between transmitters that have been affected by alcohol, compensating for the sudden brain imbalance the detox is causing.

Librium is only used for the initial waves of withdrawals, and it is administered for up to a week. The dosage you will require will depend entirely on the severity and extent of withdrawal symptoms, but its administration will always be monitored.

Your mental and physical health is tested during alcohol withdrawals on your quest for long-term sobriety.

Throughout the detoxification process, you will have medical supervision and be looked after by healthcare professionals. This detox from alcohol can be successful in both outpatient and inpatient medical facilities.

Treatment for Alcohol Detox

Following detox in inpatient or outpatient rehab centres, patients can take part in a process of therapies such as counselling or 12-step support programmes. Supportive care from a rehab facility along with detox medication provides people with the best chance of recovery.

There are different forms of alcohol withdrawal, all manifesting through different alcohol detox symptoms. This is acknowledged by medical professionals, and there will be both treatment and medication suitable to help you on your recovery journey and abstinence from alcohol.

In its most severe form, alcohol detox warrants constant medical attention in the form of inpatient treatment.

This residential programme treats severe alcoholism and alcohol withdrawal symptoms. Mild alcohol withdrawal symptoms are easily treatable via outpatient medical facilities, with more flexible detox programmes.

Both inpatient and outpatient rehab facilities provide expert therapy and medical assessments through different forms of alcohol treatment:

• Family therapy
• Individual therapy
• 12-step programmes (e.g. alcoholics anonymous)
• Mental health counselling
• Addiction education
• Behavioural therapies
• Holistic therapy

This is a general alcohol withdrawal timeline, with suggested alcohol withdrawal treatment. The treatment you ought to receive will be entirely based on previous and current levels of alcohol, mental health issues, and medical history.

We have expert teams of professionals that will provide a medical assessment for both mild detox and minor symptoms, along with those suffering from life-threatening symptoms.

The recovery from addiction is never linear, nor is it easy. We are here to ease this phase of recovery, and guide you every step of the way.

Get Help Today

For more information and advice, please contact Rehab 4 Alcoholism today on 0800 111 4108.

References

[1] Kessler RC, Nelson CB, McGonagle KA, Liu J, Scwartz M, Blazer DG. Co-morbidity of DSM- III- R major depressive disorder in the general population: Results from the US National Co-morbidity Survey. Br J Psychiatry. 1996;168:17–30.

[2] https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder

[3] https://www.mdcalc.com/calc/1729/cage-questions-alcohol-use

[4] Saitz R. Introduction to alcohol withdrawal. Alcohol Health Res World. 1998;22(1):5-12. PMID: 15706727; PMCID: PMC6761824.

[5] Miller NS, Gold MS. Management of withdrawal syndromes and relapse prevention in drug and alcohol dependence. Am Fam Physician. 1998;58:139–46.

[6]  American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000.

[7] Kasser C, Geller A, Howell E, Wartenberg A. Detoxification: principles and protocols. American Society of Addiction and Medicine. [cited 2010 Sept 7] Available from: http://www.asam.org/pub1/detoxification.htm

[8] Sachdeva A, Choudhary M, Chandra M. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. J Clin Diagn Res. 2015 Sep;9(9):VE01-VE07. doi: 10.7860/JCDR/2015/13407.6538. Epub 2015 Sep 1. PMID: 26500991; PMCID: PMC4606320.

[9] chatzberg AF, Cole JO, DeBattista C. Manual of Clinical Psychopharmacology. 4th ed. New York: American Psychiatric Publishing Inc; 2003.