Alcohol Withdrawal Timelines: PAWS & Protracted Withdrawal Lengths Are Unique to Individuals

What Is the Average Alcohol Withdrawal Timeline - Fight Addiction Now

Alcohol Withdrawal Signs, Symptoms and Warnings

Alcohol withdrawal occurs when a body’s natural detoxification process eliminates alcohol from the system. If a person is an extremely heavy drinker, as soon as his or her body begins to sense a lack of alcohol, physical symptoms will begin.

Acute alcohol withdrawal is the first stage in the detoxification process and involves mostly physical symptoms. Common signs and symptoms of acute alcohol detox include:

  • Nausea and vomiting
  • Irritability, anxiety, restlessness and confusion
  • Headaches
  • Heart palpitations
  • Seizures
  • Fever and sweating

It is important to note that alcohol withdrawal can be dangerous and produce severe symptoms. When going through alcohol withdrawal, it is best to be under some sort of professional addiction recovery support, because it is impossible to tell how severe withdrawal symptoms might become.

When a person’s symptoms become severe, withdrawal is referred to as delirium tremens and can cause:

  • Altered mental functions, disorientation
  • Deep sleep
  • Extreme fear or excitement
  • Sudden mood changes

These types of symptoms are much more dangerous than the effects listed previously. If a person goes through withdrawal too quickly, it can be extremely detrimental, which is why it is advisable to be under the care of a licensed physician or rehabilitation facility.

How Long Does Alcohol Withdrawal Last?

The alcohol withdrawal timeline varies from five days to many months. The acute phase typically lasts five to seven days. Once those symptoms have run their course, different symptoms can appear at any time. The range is dependent on many different factors, including length and amount of alcohol use, medical history and addiction history.

The Physiological Aspects of Withdrawal

Excessive alcohol use interferes with brain function by disrupting neurotransmitters. One neurotransmitter in particular, gamma-aminobutyric acid (GABA), helps produce endorphins. When you drink alcohol in excess, it causes a GABA imbalance.

Dopamine, the “feel good” chemical, stops its production when a heavy drinker suddenly stops drinking. These imbalances cause physiological differences in your system, which in turn give you unpleasant withdrawal symptoms.

Alcohol withdrawal can also induce anhedonia, a term for the brain’s lack of production of feel-good chemicals. Once the brain has stopped producing these chemicals, it takes a while for production to begin again. The brain works to fix the imbalance, but in the meantime, anhedonia will cause a severe lack of interest in most aspects of the person’s life. This can cause deeper depression and emotional issues.

In many instances, withdrawal symptoms only last five to seven days. Other times, people experience alcohol withdrawal months after they stop drinking. These long-lasting withdrawal syndromes are known as protracted or post-acute withdrawal.

Alcohol Withdrawal Timeline for Protracted/Post-Acute Withdrawal

Once the initial effects of acute withdrawal wear off, a person may experience post-acute or protracted withdrawal symptoms, typically two months or more after alcohol cessation. Other names for this withdrawal stage include chronic withdrawal, extended withdrawal, late withdrawal and long-term withdrawal. PAWS is a common acronym for post-acute withdrawal syndrome.
In contrast to acute withdrawal’s physical symptoms, these symptoms involve mood-altering episodes such as:

  • Depression
  • Obsessive-compulsive disorder
  • Emotional overreactions (crying, laughing, anger)
  • Generalized anxiety, panic disorders
  • Sleep difficulties
  • Difficulty concentrating
  • Alcohol cravings

Depression is common during the post-acute withdrawal period and many times causes a person to relapse. Symptoms in this stage can last several weeks or months. Without help from a therapist, group support or ongoing rehabilitation, this period can be exceptionally difficult to manage successfully.

How to Actively Manage Protracted/Post-Acute Syndrome

Unconditional support is needed from others during the first few months of recovery. It is important to find guidance from group therapies, rehabilitation facilities and individual therapy and counseling.
Many people struggle during this stage of the process, and understandably so. A heavy drinker has typically become accustomed to feeling numb and not having to deal with his or her feelings. Once the person is clean, the feelings come flooding back. These feelings, coupled with the lack of feel-good chemicals being produced in the brain, are a dangerous combination.
Recovery is difficult, but there is a light at the end of the tunnel. The first few months of recovery are the most challenging and will need to be actively managed. With help from friends, family and professionals, your recovery can be a success. If you feel depressed, listless, suicidal or hopeless, seek the help of a licensed professional.

Discuss Alcohol Recovery

What have your experiences been with recovery, detox, withdrawal or alcohol abuse? Do you have valuable advice or insight that would be helpful to others? Share your thoughts and experiences with us in the comment section below, or head on over to on our community forum to discuss alcoholism recovery.

See Our Alcohol Addiction Fact Sheet

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