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Alcohol Withdrawal & Medical Detox: Symptoms, Timeline, What to Expect

Treatment for alcohol addiction often begins with alcohol detoxification, especially if a person has been drinking heavily for an extended period of time.1 Alcohol withdrawal can be dangerous and even life-threatening, which is why it is important to undergo detox in a safe and supervised medical setting before transitioning into formal addiction treatment.1

Alcohol detox helps individuals stop drinking under medical supervision. It can reduce withdrawal side effects and ease the transition into ongoing addiction treatment to address the root causes of alcohol misuse.1

Keep reading to learn more about alcohol detox, including what to expect during withdrawal, common symptoms, the alcohol withdrawal timeline, and how to find alcohol detox near you.

What Is Alcohol Detox and Withdrawal?

Alcohol withdrawal occurs when someone who has been drinking heavily and regularly abruptly reduces or stops their alcohol use.2 The resulting alcohol withdrawal symptoms can range from mild to severe and may significantly impact a person’s ability to function.2 In some cases, alcohol withdrawal can be dangerous and even deadly if not managed properly.1

To reduce the risks, healthcare providers may recommend medical detox for alcohol. Patients receive supervision, support, and often alcohol detox medications to manage symptoms and keep them as comfortable and safe as possible during the process.1

While only a physician or other professional can determine whether detox is necessary, people who may benefit from alcohol detox include individuals who:1

  • Have a history of severe withdrawal symptoms, such as delirium tremens (DTs) or seizures.
  • Are already experiencing moderate alcohol detox symptoms.
  • Are still intoxicated and haven’t yet developed withdrawal symptoms, or who have been abstinent for a short time but are expected to develop symptoms soon.

Detox typically involves three components:1

  • Evaluation: A comprehensive assessment of a person’s current situation and needs, their history with alcohol and other substances, blood testing, and screening for co-occurring mental and physical conditions.
  • Stabilization: The core phase of alcohol detoxification, during which a person receives medications, monitoring, and supportive care as their body adjusts to functioning without alcohol.
  • Fostering patient readiness for substance use treatment: Once withdrawal is complete, individuals are encouraged and supported in transitioning to a formal addiction treatment program.

Alcohol Withdrawal Symptoms and Timeline

Withdrawal symptoms usually begin 4-12 hours after a person stops or reduces drinking after heavy, prolonged use.2 Because alcohol is processed quickly by the body, symptoms typically peak around the second day after a person stops drinking. Many symptoms begin to ease by days four or five, but in some cases, certain symptoms may persist for several months.2

The severity of alcohol withdrawal symptoms can vary from person to person, but they often include:1,2

  • Increased heart rate and blood pressure.
  • Tremors.
  • Decreased appetite.
  • Nausea or vomiting.
  • Impaired concentration, judgment, and memory.
  • Hallucinations (auditory, tactile, visual).
  • Increase sensitivity to light and sound.
  • Agitation and irritability.
  • Anxiety.
  • Restlessness.
  • Insomnia, intense dreams, or nightmares.
  • Delirium.
  • Seizures.

What Causes Alcohol Withdrawal?

People who drink alcohol regularly can develop dependence, which is a physiological adaptation that occurs when the body becomes accustomed to the presence of alcohol.3 When someone dependent on alcohol cuts back on their alcohol intake or quits altogether, they can experience withdrawal symptoms.3

As alcohol withdrawal can be very uncomfortable, people may continue drinking to alleviate withdrawal symptoms, which perpetuates the cycle.2

The severity of alcohol withdrawal can be impacted by several factors, such as:1,2

  • Age.
  • Overall physical health.
  • Nutritional factors.
  • How much and how often they drink.
  • The presence of co-occurring medical or psychiatric conditions.
  • Family history of alcohol withdrawal.
  • Prior alcohol withdrawal.
  • The use of sedative, hypnotic, or anxiolytic drugs (like benzodiazepines).

Is Alcohol Withdrawal Dangerous?

Yes, alcohol withdrawal can be dangerous, and in some cases, life-threatening.1

Although symptoms can range from mild to severe, the course of these symptoms is extremely variable. Even mild withdrawal can be unpleasant, while severe withdrawal can lead to potentially life-threatening symptoms, including delirium tremens (DTs), seizures, and dysregulated blood pressure, body temperature, and pulse.1

These risks are why you should not detox from alcohol at home. It is never recommended to attempt detoxing “cold turkey” without medical support. Professional, medical detox programs can immediately address the risks of alcohol detox and help people remain as comfortable and safe as possible.1

Alcohol Detox Programs & Treatment

An alcohol detox program provides structured support to help people withdraw from alcohol and typically involves a combination of interventions, including medication, support, and supervision.1

Alcohol detox can take place in a variety of settings, depending on a person’s needs and the severity of their withdrawal symptoms. Levels of care may include:1

  • Residential detox settings with minimal medical oversight.
  • Outpatient detox in a doctor’s office or clinic.
  • Medically supervised detox at freestanding detox centers or hospitals.

What to Expect in Alcohol Detox

Before beginning alcohol detoxification, you’ll meet with a team of professionals for a thorough evaluation.1 This assessment helps determine the most appropriate treatment setting and considers factors such as your alcohol consumption, history of withdrawal symptoms, and any co-occurring medical or mental health conditions.4

What happens in an alcohol detox program can vary based on the type of program. Outpatient detox programs, such as those in a home health care setting or a physician’s office, often provide scheduled monitoring but not continuous supervision.1,4 Some outpatient programs offer more frequent monitoring by licensed nurses in settings like day hospitals.1

In residential or inpatient programs, care is more intensive, ranging from social detox settings that provide peer and social support to medically monitored or managed detox facilities where patients receive 24-hour care and medication management.1

In cases of severe withdrawal or complex medical conditions, detox may occur in a psychiatric hospital or acute care setting with intensive medical supervision.1

Regardless of the setting, a quality alcohol detox program will offer continuous support and clinical oversight to manage symptoms, reduce discomfort, and help ensure your safety throughout the process.1

Medications Used in Alcohol Detox

Medications for alcohol detox are often used to reduce the severity of withdrawal symptoms, prevent complications, and manage any co-occurring medical or psychiatric issues.1

Benzodiazepines are commonly used for alcohol withdrawal and can help prevent symptoms from progressing into more serious or life-threatening complications.1

Depending on a person’s individual needs, other medications may also be used, including:1,4

  • Anticonvulsants like gabapentin to reduce the risk of seizures.
  • Antipsychotics to manage severe agitation, hallucinations, or other psychiatric symptoms.
  • Clonidine to help control elevated blood pressure related to withdrawal.

What Happens After Alcohol Detox?

Alcohol detox is an important first step, but it’s only the beginning of the recovery process. A quality detox program should help individuals transition to ongoing treatment for alcohol misuse or addiction, which can help build a strong foundation for long-term recovery.1

Ongoing treatment helps address the underlying factors that contribute to alcohol misuse and provides tools and strategies to support recovery.5 This care may include a combination of behavioral therapies, counseling, medications for alcohol use disorder, and support groups.5

Common behavioral therapies include:5

  • Cognitive-behavioral therapy (CBT): Helps people recognize and avoid triggers for relapse and teaches coping skills to avoid alcohol misuse.
  • Contingency management (CM): Uses positive reinforcement to promote desired behavioral changes.
  • Motivational interviewing (MI): Helps people increase their motivation to make positive life changes.
  • 12-step facilitation: Provides familiarization with and encourages participation in 12-step-based mutual-support groups, such as Alcoholics Anonymous (AA).

Depending on a person’s needs and preferences, treatment can take place in various settings, such as:6

  • Inpatient drug and alcohol rehab: Individuals live at a facility where they receive 24/7 care, therapy, and medications as needed.
  • Outpatient addiction treatment programs: Individuals live at home and attend treatment at a rehab on a regular schedule.
  • Intensive outpatient programs: These are supportive outpatient programs offering 9-20 hours of treatment each week.
  • Partial hospitalization programs: These are highly supportive outpatient programs offering 4-8 hours of treatment most days of the week.
  • Addiction treatment aftercare: This is designed to provide continuing recovery support after a person completes a more formal treatment program, and can include various interventions like support groups, sober living, or individual counseling.

Does Health Insurance Cover Alcohol Detox Centers?

Yes, many health insurance plans cover alcohol detox centers, especially when detox is considered medically necessary. Under the Affordable Care Act (ACA), most Marketplace insurance plans are required to provide coverage for mental health and substance use disorder (SUD) treatment, which includes services like medical detox for alcohol.7

The specifics regarding coverage can vary depending on your plan and the type of treatment you choose, so it’s important to verify your benefits with your provider.7 We can also help you understand how to use health insurance coverage for rehab and verify your insurance.

While certain plans may not cover treatments not deemed medically necessary, such as holistic or alternative therapies, they generally include coverage for essential services like detox, residential/inpatient rehab, outpatient treatment, aftercare, and medications.8 Again, it’s important to check the specifics of your plan so you know exactly what’s covered before you start treatment.

Get Admitted to Alcohol Detox

Getting admitted to alcohol detox can be one of the most important steps you take for your health and well-being. American Addiction Centers is a leading provider of addiction treatment, with rehabs located across the U.S. In many cases, you can get admitted on the same day by calling us at to speak to an admissions navigator. We can quickly verify your insurance and help you start the admissions process right away.

Start the Recovery Journey

Facing alcohol withdrawal might seem challenging right now, but there is always hope. Call us at and start your recovery journey today. People can and do recover from alcohol misuse and addiction, and treatment can help you or a loved one start the path to a happier, healthier life.

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