Trust SoCal Treatment Center

Alcohol Withdrawal Timeline

Alcohol withdrawal is one of the most medically serious forms of substance withdrawal, and understanding its timeline is essential for anyone considering sobrie...

Medically reviewed by Rachel Handa, Clinical Director — Updated February 1, 2026

Overview

Alcohol withdrawal is one of the most medically serious forms of substance withdrawal, and understanding its timeline is essential for anyone considering sobriety after prolonged or heavy drinking. When someone who has been drinking heavily for weeks, months, or years suddenly stops or significantly reduces their intake, the central nervous system, which has adapted to the constant presence of alcohol, becomes hyperexcitable. This neurological rebound produces a range of symptoms that can begin within just six hours of the last drink and may progress to life-threatening complications without proper medical oversight. At Trust SoCal, our JCAHO-accredited medical detox program provides around-the-clock monitoring and evidence-based interventions to ensure that every client navigates alcohol withdrawal safely and as comfortably as possible. The severity and duration of alcohol withdrawal depend on several individual factors, including the length and quantity of alcohol use, previous withdrawal episodes, co-occurring mental health conditions, overall physical health, and age. A phenomenon known as kindling means that each successive withdrawal episode tends to be more severe than the last, making professional medical detox increasingly important for individuals who have attempted to quit before. Our clinical team at Trust SoCal uses validated assessment tools such as the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) to continuously monitor symptom severity and adjust treatment protocols in real time. If you or someone you love is struggling with alcohol dependence, please call us at (949) 280-8360 to learn about our comprehensive withdrawal management and treatment programs. Understanding what to expect during each phase of alcohol withdrawal can help alleviate fear and empower individuals to seek the help they need.

Phase 1: Early Withdrawal (6-24 Hours)

The first symptoms of alcohol withdrawal typically appear within six to twelve hours after the last drink, though they can begin as early as four hours in individuals with severe dependence. During this initial phase, the body is beginning to recognize the absence of alcohol and the central nervous system starts to become overactive. Symptoms during this stage are generally mild to moderate but can still be uncomfortable enough to drive a person back to drinking if they are attempting to quit without support.

Common symptoms during early withdrawal include anxiety, restlessness, irritability, insomnia, mild tremors in the hands, nausea, loss of appetite, headache, sweating, and elevated heart rate. Some individuals may also experience mild auditory or visual disturbances. While these symptoms are rarely dangerous on their own, they represent the beginning of a process that can escalate quickly, which is why medical supervision from the outset is strongly recommended.

At Trust SoCal, clients entering our detox program receive a comprehensive medical evaluation upon admission, including blood work, vital sign monitoring, and a thorough assessment of their drinking history. This allows our physicians to anticipate the likely severity of withdrawal and implement preventive protocols, including the administration of benzodiazepines or other medications when clinically indicated.

Anxiety and restlessness
Mild hand tremors
Nausea and loss of appetite
Insomnia and disturbed sleep
Sweating and elevated heart rate
Headache and irritability

Phase 2: Peak Withdrawal (24-72 Hours)

The period between 24 and 72 hours after the last drink is considered the peak danger zone for alcohol withdrawal. During this phase, symptoms intensify significantly and the risk of serious medical complications is at its highest. This is the window in which seizures are most likely to occur, typically between 24 and 48 hours, and when delirium tremens (DTs) may develop, usually between 48 and 72 hours. Delirium tremens is a medical emergency characterized by severe confusion, agitation, hallucinations, fever, and cardiovascular instability, and it carries a mortality rate of up to five percent without treatment.

Other symptoms during peak withdrawal can include pronounced tremors, profuse sweating, rapid heartbeat, high blood pressure, severe anxiety or panic, vivid nightmares, and in some cases, auditory or visual hallucinations even without the full syndrome of delirium tremens. The autonomic nervous system is in overdrive during this phase, and the body is under significant physiological stress.

Medical detox during this critical window involves frequent vital sign monitoring, symptom-triggered medication administration, intravenous fluids and electrolyte replacement, nutritional support including thiamine supplementation to prevent Wernicke encephalopathy, and continuous clinical observation. Our JCAHO-accredited facility is equipped to manage even the most complex withdrawal presentations safely.

Risk of withdrawal seizures (24-48 hours)
Possible delirium tremens onset (48-72 hours)
Severe tremors and agitation
Hallucinations (visual, auditory, or tactile)
Significant autonomic instability (blood pressure, heart rate)
Profuse sweating and fever

Phase 3: Subacute Withdrawal (72 Hours to 7 Days)

After the 72-hour mark, the most dangerous acute symptoms of alcohol withdrawal typically begin to subside for most individuals. However, this does not mean that the withdrawal process is complete. During the subacute phase, which generally extends from day three through day seven, many clients continue to experience significant symptoms that require ongoing medical management and clinical support.

Common symptoms during this phase include persistent anxiety, mood swings, difficulty concentrating, fatigue, mild tremors, insomnia or disrupted sleep patterns, and general physical discomfort. Some individuals may experience lingering gastrointestinal symptoms or a persistent sense of unease. The risk of seizures diminishes significantly after 72 hours but does not disappear entirely, particularly in individuals with a history of complicated withdrawal.

This is also the phase during which our clinical team begins to assess readiness for transition to the next level of care, whether that is residential treatment, partial hospitalization (PHP), or intensive outpatient programming (IOP). Treatment planning discussions, therapeutic engagement, and psychoeducation become increasingly important as acute symptoms resolve.

Phase 4: Post-Acute Withdrawal Syndrome (Weeks to Months)

A significant percentage of individuals recovering from alcohol dependence experience post-acute withdrawal syndrome (PAWS), a collection of protracted symptoms that can persist for weeks, months, or in some cases, over a year after the last drink. PAWS is believed to result from the brain slowly recalibrating its neurochemistry after prolonged alcohol exposure, and its symptoms are primarily psychological and cognitive rather than physical.

Common PAWS symptoms include persistent anxiety, depression, irritability, difficulty with memory and concentration, sleep disturbances, reduced stress tolerance, and intermittent cravings. These symptoms tend to come and go in waves and can be a significant relapse trigger if not properly addressed through ongoing treatment and support.

At Trust SoCal, our comprehensive continuum of care is designed to support clients through every stage of recovery, including PAWS management. Through individual therapy, group counseling, medication management when appropriate, and robust aftercare planning, we help clients develop the coping skills and support networks necessary to navigate this extended recovery phase successfully.

Medical Detox: Why Professional Support Is Essential

Alcohol withdrawal is one of the few substance withdrawal syndromes that can be fatal without medical intervention. The risks of seizures, delirium tremens, and cardiovascular complications make unsupervised withdrawal not only uncomfortable but genuinely dangerous. Attempting to detox from alcohol at home, commonly referred to as going cold turkey, is strongly discouraged by medical professionals, particularly for individuals with a history of heavy or prolonged use.

Medical detox at Trust SoCal provides a controlled, comfortable environment in which withdrawal can be managed safely using evidence-based protocols. Our medical team uses a combination of benzodiazepines, anticonvulsants, and supportive medications tailored to each client's needs. Nutritional support, including thiamine and folate supplementation, is provided to address the nutritional deficiencies common in chronic alcohol use. Continuous monitoring allows for rapid response to any changes in clinical status.

If you or a loved one is considering stopping drinking after a period of heavy use, please reach out to Trust SoCal at (949) 280-8360. Our admissions team is available around the clock to answer your questions and help you take the first step toward safe, supported recovery.

Key Takeaways

Alcohol withdrawal symptoms can begin within 6 hours of the last drink and peak between 24 and 72 hours.
Seizures and delirium tremens are the most serious risks and require immediate medical attention.
Medical detox with benzodiazepines and supportive care is the safest approach to alcohol withdrawal.
Post-acute withdrawal syndrome (PAWS) can persist for months and requires ongoing therapeutic support.
Trust SoCal's JCAHO-accredited detox program provides 24/7 monitoring and individualized withdrawal management.

Frequently Asked Questions

How long does alcohol withdrawal last?

Acute alcohol withdrawal symptoms typically last five to seven days, with the most severe symptoms occurring between 24 and 72 hours after the last drink. However, post-acute withdrawal symptoms such as anxiety, sleep disturbances, and cravings can persist for weeks or months. The exact timeline varies based on individual factors including the duration and severity of alcohol use, previous withdrawal history, and overall health.

Can alcohol withdrawal be fatal?

Yes. Alcohol withdrawal can be life-threatening, particularly in cases involving seizures or delirium tremens (DTs). Without medical treatment, the mortality rate for delirium tremens can be as high as 15 to 20 percent. With proper medical management in a supervised detox setting like Trust SoCal, the risks are dramatically reduced and the process is made as safe and comfortable as possible.

What medications are used during alcohol detox?

The most commonly used medications during alcohol detox are benzodiazepines such as diazepam, chlordiazepoxide, or lorazepam, which help prevent seizures and reduce anxiety. Anticonvulsants, beta-blockers, and anti-nausea medications may also be used. Thiamine (vitamin B1) is routinely administered to prevent Wernicke encephalopathy. Our medical team tailors medication protocols to each individual client.

Should I detox from alcohol at home?

Medical professionals strongly advise against detoxing from alcohol at home, especially for individuals with a history of heavy or prolonged use. The risk of seizures, delirium tremens, and other complications makes unsupervised withdrawal potentially dangerous. At Trust SoCal, our medically supervised detox program provides 24/7 monitoring and evidence-based care. Call (949) 280-8360 to discuss safe detox options.

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Alcohol Withdrawal Timeline

Overview

Phase 1: Early Withdrawal (6-24 Hours)

Phase 2: Peak Withdrawal (24-72 Hours)

Phase 3: Subacute Withdrawal (72 Hours to 7 Days)

Phase 4: Post-Acute Withdrawal Syndrome (Weeks to Months)

Medical Detox: Why Professional Support Is Essential

Key Takeaways

Frequently Asked Questions

Related Resources

Opioid Withdrawal Timeline

Medical Detox vs. Cold Turkey

What to Expect at Rehab

Ready to Start Your Journey?

Alcohol Withdrawal Timeline

Overview

Phase 1: Early Withdrawal (6-24 Hours)

Phase 2: Peak Withdrawal (24-72 Hours)

Phase 3: Subacute Withdrawal (72 Hours to 7 Days)

Phase 4: Post-Acute Withdrawal Syndrome (Weeks to Months)

Medical Detox: Why Professional Support Is Essential

Key Takeaways

Frequently Asked Questions

Related Resources

Opioid Withdrawal Timeline

Medical Detox vs. Cold Turkey

What to Expect at Rehab

Ready to Start Your Journey?