Alcohol Withdrawal Timeline: What to Expect Hour by Hour (And When to Get Help)

You’ve made the decision. You’re done. But now your body has something to say about it.

Alcohol withdrawal is real, it’s physical, and it can range from uncomfortable to dangerous. I’m not going to sugarcoat it. But I am going to walk you through exactly what happens, hour by hour, so you know what’s coming.

Knowledge kills fear. The Stoics knew this. Seneca wrote, “We suffer more in imagination than in reality.” When you know what to expect, the unknown loses its power.

Key Takeaways

• Alcohol withdrawal symptoms typically begin 6-12 hours after your last drink
• Most physical symptoms peak between 24-72 hours
• The timeline varies based on drinking history, health, and individual factors
• Severe withdrawal (delirium tremens) can be life-threatening. Seek medical help if symptoms are severe
• Most people feel significantly better by days 5-7
• The psychological benefits continue improving for months

What I Wish Someone Had Told Me

Before we get into the medical timeline, here’s what I want you to know. The stuff no doctor will tell you.

The moment that changed everything for me wasn’t physical. It wasn’t the shaking hands or the sleepless nights. It was the moment I saw my family’s faces and realized they were done. Not angry. Not disappointed. Done. The people who had stood by me through everything had finally hit their limit.

That pain was worse than any withdrawal symptom. And it was the pain I needed.

Because withdrawal isn’t just your body detoxing from alcohol. It’s your whole life detoxing from the lies you told yourself. “I can control it.” “It’s not that bad.” “I’ll quit tomorrow.” All of those lies die in withdrawal, and what’s left is the raw, uncomfortable truth: it went too far.

But here’s the thing nobody tells you: that truth is the foundation of everything good that comes next. The pain of withdrawal is the price of admission to a life you can’t even imagine right now. And it’s worth every second.

The Alcohol Withdrawal Timeline: What Actually Happens

Hours 6-12: The First Signs

This is when your body first notices the alcohol is gone. You might experience:

• Anxiety. Your brain has been suppressed by alcohol. Now it’s firing on all cylinders with no brake pedal
• Insomnia. Despite being exhausted, sleep feels impossible
• Nausea. Your stomach has been dealing with a toxin for years. It needs time
• Shaky hands. The nervous system is recalibrating
• Sweating. Your body is literally flushing out poison
• Headache. Dehydration and neural readjustment

What helped me: Water. Lots of it. And sitting with the discomfort instead of running from it. Running is what got us here.

Hours 12-24: The Peak Begins

Symptoms intensify. This is the stretch that makes most people think, “Maybe I’ll just have one to take the edge off.”

Don’t. That voice is the addiction talking. It’s not your voice.

• Increased heart rate. Your heart is adjusting to functioning without a depressant
• Elevated blood pressure. Temporary but real
• Irritability. Everything and everyone is annoying. This is normal
• Tremors. More pronounced shaking
• Brain fog. Can’t think straight? Your brain is rebooting

The HALT check matters here. Are you Hungry? Angry? Lonely? Tired? Address those four things, and half your symptoms become manageable. Read more about the HALT method →

Hours 24-48: The Storm

This is the hardest window for most people. If you’re going to feel terrible, this is when it peaks.

• Possible hallucinations. Some people experience visual or auditory disturbances
• Severe anxiety. Bordering on panic
• Confusion. Difficulty concentrating or making decisions
• Continued tremors. Usually at their worst
• Loss of appetite. Your body is focused on healing, not eating

What helped me: Having a plan for the 2 AM hours when everything feels worst. Breathing exercises. And remembering my family’s faces. That image was my anchor. The pain of withdrawal was temporary. Losing them would have been permanent.

Hours 48-72: The Turn

For most people, this is where the tide starts to turn. You’re not out of the woods, but you can see the tree line.

• Symptoms begin to decrease. Slowly but noticeably
• Sleep may return. Fragmented, but it’s coming
• Appetite starts returning. Your body is hungry for nutrients
• Emotional swings. Crying for no reason? Laughing at nothing? Both normal
• Mental clarity begins. Brief moments of “Oh, so THIS is how thinking is supposed to feel”

This is the moment to hold onto. That first flash of clarity. Write it down. You’ll need it later.

Days 3-7: The Clearing

The physical worst is behind you. Now the psychological healing begins.

• Energy fluctuations. Some hours you feel great, others you’re exhausted
• Improved sleep. Getting longer and more restorative each night
• Reduced anxiety. Still present but no longer overwhelming
• Emotional processing. Feelings you’ve been numbing start surfacing
• Sugar cravings. Your body is looking for the glucose alcohol used to provide. This is completely normal

The Stoic approach: Marcus Aurelius wrote, “The impediment to action advances action. What stands in the way becomes the way.” Every uncomfortable symptom is your body healing. The obstacle IS the way.

Days 7-14: The New Normal Emerges

By now, most physical withdrawal symptoms have resolved. What remains is mostly psychological:

• Better sleep quality. Often better than you’ve had in years
• Clearer skin. Dehydration and inflammation are subsiding
• Improved digestion. Your gut is healing
• Emotional sensitivity. Things hit harder. This is actually good. You’re feeling again
• The “pink cloud”. Some people experience a euphoric period. Enjoy it, but don’t let your guard down

Days 14-30: The Rebuild

This is where the magic starts. The first 30 days are transformative in ways that are hard to describe until you live them.

• Mental clarity that surprises you. Decisions become easier
• Physical changes become visible. Weight loss, better skin, brighter eyes
• Relationships begin improving. People notice the change
• Confidence that’s actually yours. Not borrowed from a bottle
• New habits start forming. The foundation of your sober life

For me, this was when I started walking. Not running, not exercising. Just walking. No bottle in hand, just loving life. Living the proof of my own work. That feeling is worth everything you’re going through right now.

When to Seek Medical Help

Alcohol withdrawal can be medically dangerous. Seek immediate help if you experience:

• Seizures of any kind
• Severe confusion or disorientation
• Hallucinations (visual, auditory, or tactile)
• Fever above 101°F (38.3°C)
• Severe vomiting that prevents hydration
• Rapid, irregular heartbeat

You should consider medically supervised detox if:

• You’ve been drinking heavily for years
• You’ve had withdrawal seizures before
• You have other medical conditions
• You’ve attempted to quit and experienced severe symptoms

There is no shame in getting medical help. It’s not weakness. It’s wisdom. The bravest thing you can do is admit you need help.

What Nobody Tells You About Withdrawal

1. The Emotional Pain Hits Harder Than the Physical

Your body heals in days. But the moment you stop numbing yourself, every feeling you’ve been avoiding shows up at once. Guilt. Shame. Grief for lost time. The faces of people you’ve hurt. Let it come. That pain is the beginning of healing.

2. It’s Not Linear

You’ll have good hours and bad hours, sometimes in the same day. Progress isn’t a straight line. It’s a zigzag that trends upward.

3. PAWS Is Real

Post-Acute Withdrawal Syndrome (PAWS) can cause intermittent symptoms (anxiety, mood swings, sleep issues, cravings) for weeks or months after quitting. Knowing this prevents the “I should be fine by now” trap.

4. The Cravings Change Shape

Early cravings are physical and intense. Later cravings are psychological and sneaky. “Just one drink” is the most dangerous thought in recovery. Here’s why it never works →

5. Your Body Heals Faster Than You Think

Within 72 hours, your body has already begun remarkable healing. Within 30 days, you’ll barely recognize the person in the mirror. Within 90 days, people will ask what changed. The answer is everything.

6. The Relationships You Think Are Gone Might Come Back

The family that was “done” with me? They watched. They waited. They saw the change before I could even articulate it. Actions speak when words have lost all credibility. Not every relationship survives addiction. But more survive recovery than you’d expect.

Tools for Getting Through It

Here’s what’s helped thousands of people (including me):

1. The HALT method. Check if you’re Hungry, Angry, Lonely, or Tired before assuming it’s a craving
2. Breathing exercises. 4-7-8 breathing works: inhale 4 seconds, hold 7, exhale 8
3. Movement. Even a 10-minute walk changes your brain chemistry
4. Sugar. Seriously. Your body is craving glucose. Fruit, chocolate, whatever helps
5. Community. AA meetings, online support groups, the #RecoveryPosse on Twitter
6. Philosophy. Stoic practices for sobriety gave me a framework that willpower alone couldn’t
7. Write it down. Journal everything. The pain, the progress, the random 3am thoughts. You’ll want to read it later
8. Our free sobriety app. Built for exactly these moments: thesurvivalherbalist.com/app/. Crisis Mode, HALT checks, virtual sponsor, breathing exercises, Stoic wisdom. All free, no download required

Frequently Asked Questions

How long does alcohol withdrawal last?

Physical symptoms typically last 5-7 days, with the worst occurring in the first 72 hours. Psychological symptoms (PAWS) can persist for weeks to months but gradually improve.

Can you die from alcohol withdrawal?

In severe cases, yes. Delirium tremens (DTs) can be fatal if untreated. This is why medical supervision is recommended for heavy, long-term drinkers. Always err on the side of caution.

Is it safe to quit alcohol cold turkey?

For light to moderate drinkers, cold turkey is usually safe. For heavy, long-term drinkers, medical supervision is strongly recommended. When in doubt, consult a doctor.

What helps with alcohol withdrawal insomnia?

Avoid caffeine after noon, maintain a consistent sleep schedule, try magnesium supplements (consult your doctor), practice deep breathing, and avoid screens before bed. Sleep typically improves significantly within 1-2 weeks.

When do alcohol withdrawal cravings stop?

Physical cravings typically subside within 1-2 weeks. Psychological cravings can persist for months but become less frequent and less intense over time. Having strategies ready (HALT checks, breathing exercises, distraction techniques) is essential.

What does alcohol withdrawal feel like?

The best description: imagine the worst flu you’ve ever had, combined with the worst anxiety. Your body aches, your mind races, and everything feels wrong. But unlike the flu, you know exactly why it’s happening. And unlike the flu, what comes after isn’t just “normal.” It’s better than normal. It’s freedom.

If you’re going through withdrawal right now, remember: every uncomfortable moment is your body healing. The pain you’re feeling? That’s the old life leaving. Let it go.

The person you’re becoming on the other side of this is someone worth fighting for.

Need support right now? Try our free sobriety app with Crisis Mode, breathing exercises, and a virtual sponsor who’s available 24/7: thesurvivalherbalist.com/app/

Related Posts

• The First 30 Days: What Actually Happens When You Quit Drinking
• What to Do at 2 AM When You Want to Drink
• HALT: The Recovery Acronym That Actually Works
• Why “Just One Drink” Never Works
• What Is Stoic Sobriety?
• How Philosophy Helped Me Quit Drinking