Substance guides

Alcohol withdrawal timeline: Hour by hour, day by day

Published August 1, 2025 · 8 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Alcohol withdrawal follows a predictable timeline, though individual experiences vary. Understanding the stages helps you prepare and know when medical help is essential.

6-12 hours

Anxiety, insomnia, nausea, abdominal pain, tremors (the shakes), sweating, and elevated heart rate. These early symptoms resemble a severe hangover but escalate rather than improve.

12-24 hours

Symptoms intensify. Hallucinations may begin (visual, auditory, or tactile). The person may see or feel things that are not there while remaining oriented. Blood pressure and heart rate continue rising.

24-48 hours

Peak seizure risk. Grand mal seizures can occur without warning. This is when withdrawal becomes most medically dangerous. Confusion and agitation increase. Medical supervision is critical during this window.

48-96 hours

Delirium tremens (DTs) risk peaks. Severe disorientation, agitation, hallucinations with total confusion, fever, and dangerous cardiovascular instability. DTs occurs in 3-5% of heavy drinkers and has 1-5% mortality even with treatment.

5-7 days

Acute symptoms typically resolve. Residual anxiety, insomnia, and mood disturbance may persist for weeks (post-acute withdrawal). Most medical detox programs last 5-7 days.

Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC

Frequently asked questions

How long does alcohol withdrawal last?

Acute withdrawal lasts 5-7 days. Residual symptoms (anxiety, insomnia) may persist for weeks to months.

When do alcohol withdrawal seizures happen?

Seizure risk peaks at 24-48 hours after the last drink.

Can you die from alcohol withdrawal?

Yes. Seizures and delirium tremens can be fatal. Medical detox is strongly recommended for heavy daily drinkers.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.