The acute stage of alcohol withdrawal symptoms in most patients lasts five to 10 days, though some symptoms are more common in the first 48 hours following cessation. A small number of patients continue to exhibit symptoms long after the acute stage, but most alcoholics see a decrease in measurable effects after about 72 hours if early warning signs are recognized. Untreated symptoms can lead to worsening complications, some of which won't begin until after 72 hours.
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One of the early signs of alcohol withdrawal is a trembling in the extremities. It can appear in cases of prolonged alcohol abuse as soon as four hours after the last drink. Tremors are the first indicator of potentially serious withdrawal that can escalate to seizures and hallucinations. Tremors are most acute in the first four to 72 hours, but they often continue at some level of intensity until the patient is fully detoxified.
Severe alcohol withdrawal that is left untreated will develop into more serious complications. Grand mal seizures typically begin at early in the withdrawal stage peaking around the 24-hour mark, but 5 percent to 10 percent of patients continue to seize for as long as a week if acute withdrawal is not addressed medically, according to the National Institute of Alcohol Abuse and Alcoholism.
Hallucinations plague roughly 10 percent of alcoholics undergoing detoxification, according to the National Institute of Alcohol Abuse and Alcoholism. Symptoms generally present early upon cessation, but they can extend well beyond 72 hours in some cases. They are generally visual, but tactile hallucinations, such as the feeling of things crawling over the skin, are also common in affected individuals. The detoxification process can take up to ten days, but the patient should see a steady decrease of acute symptoms after the third or fourth day.
Also known as the DTs, delirium tremens often doesn’t begin until after about 72 hours of abstinence, but it can be delayed by as much as a week. It is the most serious complication of alcohol withdrawal. Untreated DTs have a morbidity rate of 5 percent, according to the National Institute of Alcohol Abuse.
Symptoms include dramatic autonomous nervous system hyperactivity which leads to rapid breathing, high blood pressure, accelerated heart rate and inconsistent body temperature. Night sweats are common as is acute dehydration. DTs also reduce the blood flow to the brain causing sufferers to become confused and disoriented. Sleep becomes difficult and hallucinations are possible.