How To Deal With Alcohol Withdrawals

How To Deal With Alcohol Withdrawals

Symptoms, Treatment and Timeline of Alcohol Detox

The alcohol addiction statistics in the UK show that far too many people in the country have alcohol addiction or dependency. Here, we give you the low down on what withdrawals are, how they happen, what to do about them and how to prevent them.

Alcohol Withdrawals

If you are suffering from severe alcohol withdrawal symptoms now, please dial 999 and ask for an ambulance.

What is Alcohol Withdrawal?

Alcohol withdrawal happens when a dependent drinker abruptly cuts down or stops drinking alcohol. The condition usually presents as a series of symptoms that, at the very least are unpleasant,  and at worst, can be fatal.  These symptoms manifest due to the body’s physiological adaptation to regular alcohol exposure, which, when disrupted, often leads to a range of physical and psychological effects.

  • Alcohol Withdrawal Syndrome (AWS): A medical condition that happens when a person accustomed to regular drinking stops or significantly curtails their alcohol consumption.
  • Detoxification: The process of allowing the body to eliminate the toxins accumulated from prolonged alcohol use. It often involves managing withdrawal symptoms through medical intervention.

Understanding these terms and the mechanisms behind alcohol withdrawal helps in recognising the seriousness of the condition. It highlights the need for professional intervention, as withdrawal can lead to severe complications if not properly managed. We hope that reading this article helps you understand the potential dangers associated with alcohol withdrawal, providing a notion of what to do and how to overcome them safely.

Alcohol Dependence

Alcohol dependence, often misunderstood as a lack of willpower, actually involves complex biological processes that set it apart from “normal” or social drinking. People who drink moderately usually do so without any adverse physical or psychological effects. In contrast, alcohol dependence is a chronic condition where the compulsive need to drink, usually without any control over the amount drunk, causes all kinds of problems, not least the need for alcohol itself.

GABA and Alcohol Dependence

  • The neurotransmitter gamma-aminobutyric acid (GABA) plays a pivotal role in the development of alcohol dependence. GABA’s primary function is to reduce neuronal excitability throughout the nervous system.
  • Alcohol consumption enhances the effect of GABA, leading to the sedative effects often sought by drinkers. The brain’s positive response to this sedation can contribute to the development of dependence.

Our Brain Reward System

  • Beyond GABA, the brain’s reward system, which releases dopamine during pleasurable activities, becomes engaged when consuming alcohol.
  • Initially, alcohol consumption may result in feelings of euphoria and relaxation due to heightened dopamine levels. Over time, the brain associates alcohol with these positive feelings, strengthening the compulsion to drink.

Prolonged Exposure and Tolerance

  • With continued and frequent use, the body’s response to alcohol changes. The same amount of alcohol does not elicit the same response as before — this is known as tolerance.
  • As tolerance builds, people often consume greater amounts of alcohol to achieve previous effects, which further alters brain chemistry.

Addiction Requires More

  • The brain’s adaptation to the depressant effects of alcohol means that natural GABA activity decreases, and the production of excitatory neurotransmitters increases to maintain balance.
  • When alcohol is no longer present, the brain’s chemical balance tips, leading to the hyper-excitable state characteristic of withdrawal.

It’s essential to recognise the physiological underpinnings of alcohol dependence as it underscores the condition’s seriousness and the severe need for professional intervention and support. Understanding these factors can also dispel misconceptions, providing clarity and empathy for those struggling with dependency.

The Onset of Withdrawal Symptoms

The journey away from alcohol dependence often begins with the onset of withdrawal symptoms. These symptoms can manifest as early as 6 hours after the last drink and may escalate in severity. The initial phase is typically marked by a range of discomforts that signal the body’s reaction to the absence of alcohol.

Symptoms Include

  • Anxiety: A common early sign of withdrawal, where people may experience heightened nervousness or panic attacks.
  • Shaking: Known as tremors, this involuntary shaking can occur in the hands and is often one of the first physical signs of withdrawal.
  • Nausea: With the digestive system affected, nausea can lead to vomiting, further increasing the risk of dehydration.
  • Insomnia: Despite the fatigue that may accompany withdrawal, many find it difficult to achieve restful sleep.

The NHS guidelines on detoxification recognise these initial symptoms and the importance of managing them effectively. To mitigate the discomfort and potential risks associated with early withdrawal symptoms, a medically supervised detoxification process often includes pharmacological support. One such medication is chlordiazepoxide, a benzodiazepine tranquiliser, which is often used in the UK to ease the symptoms. This medication functions by enhancing the effect of the neurotransmitter GABA, thereby calming the nervous system and providing relief from the acute symptoms of withdrawal.

It should be noted, that while these initial symptoms can be deeply unsettling, they represent the body’s attempt to recalibrate in the absence of alcohol. Medical support during this phase is essential, not only to alleviate symptoms but also to monitor for any complications that may arise. Those attempting to navigate this turbulent phase should do so under the guidance of healthcare professionals who can tailor the detoxification protocol to their specific needs, ensuring safety and improving comfort during this awful time.

Alcohol Withdrawal Timeline

The withdrawal process from alcohol dependence unfolds in phases, each with its own set of symptoms and timelines. The body’s adjustment to the absence of alcohol is a gradual process, with symptoms peaking at various intervals. Understanding this timeline is essential for managing expectations and preparing for the road to recovery.

  • Early Phase (6-12 hours post last drink):
    • Headaches and sweating may accompany the aforementioned symptoms as the body begins to react to the lack of alcohol.
    • Palpitations or an increased heart rate can occur, heightening the sense of discomfort.
  • Acute Phase (12-48 hours):
    • Hallucinations: Some people may experience visual, auditory, or tactile hallucinations during this stage.
    • Seizures: There is a risk of seizures, which can be of particular concern and require immediate medical attention.
  • Protracted Phase (48-72 hours and beyond):
    • Delirium Tremens (DTs): This severe form of alcohol withdrawal includes symptoms such as confusion, rapid heartbeat, and fever. DTs are considered a medical emergency.
    • Mood disturbances and irritability may persist, sometimes leading to profound changes in emotional state.

The intensity and duration of these symptoms often depend on several factors, such as the duration of alcohol abuse and the amount typically consumed. A person with a history of long-term, heavy drinking may experience more severe and prolonged symptoms compared to someone with a shorter history of alcohol use.

The UK guidelines recommend the use of benzodiazepines for managing the symptoms of acute alcohol withdrawal. This class of medications has a strong evidence base for preventing complications such as seizures and DTs, which are risks during the acute phase of withdrawal.

Symptoms can vary widely among people, highlighting the importance of a personalised approach to treatment. It’s this variation that underscores the role of medical supervision during detoxification. Close monitoring of vital signs and symptoms by healthcare professionals enables timely intervention, should severe withdrawal symptoms arise.

Given the complexities of the withdrawal timeline and the potential for life-threatening complications, people should not attempt to detoxify without medical support. The risks associated with self-detoxing can be significant, and in severe cases, hospitalisation may be necessary to ensure the safety and well-being of the person undergoing withdrawal.

Benzodiazepines and Managing Withdrawal

In the realm of alcohol withdrawal management, benzodiazepines stand as the cornerstone of medical treatment. The British National Formulary (BNF) and NICE guidelines underscore their role as the first-line treatment for withdrawal symptoms. These medications, which include agents such as chlordiazepoxide, possess a robust evidence base supporting their effectiveness in preventing severe withdrawal complications.

  • Prevention of Seizures: Benzodiazepines enhance the activity of the neurotransmitter GABA, which exerts a calming effect on the brain. This action reduces the risk of seizures, a serious and potentially life-threatening symptom of alcohol withdrawal.
  • Mitigation of Delirium Tremens: Delirium tremens (DTs) presents a significant risk during alcohol withdrawal. Benzodiazepines have been shown to mitigate the risk of DTs, which are characterised by confusion, rapid heartbeat, and fever.
  • Reduction of Withdrawal Severity: By dampening the central nervous system’s hyperactivity during withdrawal, benzodiazepines alleviate symptoms such as tremors, anxiety, and agitation.

The efficacy of benzodiazepines in reducing withdrawal severity and preventing complications is well-documented in the clinical literature, including systematic reviews such as those found in the NCBI database. Their ability to prevent seizures and DTs is very useful, as these conditions can lead to long-term neurological damage or even be fatal if not properly managed.

While benzodiazepines are effective, they must be used under strict medical supervision. The dosage and duration of treatment are tailored to the person’s needs, taking into account factors such as the severity of dependence, the presence of co-occurring medical conditions, and the risk of benzodiazepine dependency itself.

The judicious use of benzodiazepines forms a vital part of a comprehensive treatment plan for alcohol withdrawal. The goal remains not only to alleviate discomfort but also to pave the way for long-term recovery and rehabilitation.

Complications of Withdrawal

As people navigate alcohol withdrawal, they may encounter severe symptoms that signify a complicated withdrawal phase, a condition that demands immediate medical intervention. The term “complicated alcohol withdrawal” encompasses a spectrum of serious manifestations, including hallucinations, seizures, and the potentially fatal condition known as delirium tremens. The gravity of these symptoms warrants a detailed exploration.

Hallucinations during withdrawal are perceptual disturbances that can be visual, auditory, or tactile. These sensory misinterpretations can lead to significant distress and are often accompanied by other withdrawal symptoms.

Seizures, another alarming complication, occur due to the abrupt cessation of alcohol intake after prolonged use. This sudden withdrawal can trigger abnormal electrical activity in the brain, leading to convulsions. Such events require urgent attention to prevent further neurological damage.

Delirium Tremens (DTs) represent the most severe form of alcohol withdrawal, characterised by profound confusion, autonomic hyperactivity, and cardiovascular disturbances. This state of altered mental status can lead to fatal outcomes if not addressed promptly.

The comprehensive review provided by the NCBI elucidates the need for immediate medical attention when these severe symptoms appear. The absence of timely care might lead to irreversible harm or fatal consequences. Complicated alcohol withdrawal is a medical emergency, and the presence of these symptoms signifies a threshold that necessitates professional medical support.

In the context of complicated alcohol withdrawal, the role of the treatment provider becomes indispensable. They assess the severity of the condition, administer appropriate medications, and closely monitor the patient’s vital signs to mitigate risks. Knowledge of these potential complications is vital for those seeking to understand the full spectrum of alcohol withdrawal and underscores the importance of medical guidance during the detoxification process.

Detoxification Process and Medical Support

Detoxification, the process of allowing the body to rid itself of alcohol, marks the first step toward recovery for those with alcohol dependency. According to Medical News Today, this period can be fraught with danger and discomfort, hence the necessity of medical supervision can’t be overstated.

  • Commencement and Duration: Detox typically begins within 6 to 24 hours post the last alcohol consumption, with symptoms potentially intensifying over the subsequent days. While most acute symptoms tend to subside after approximately a week, some may persist for a longer duration.
  • Vital Signs Monitoring: Healthcare professionals meticulously monitor vital signs, including heart rate, blood pressure, and temperature. Such vigilance helps in detecting and addressing any abrupt changes that might indicate severe withdrawal or the onset of complications.
  • Symptom Management: The administration of medications is a key aspect of the detoxification process. For instance, to alleviate withdrawal symptoms, benzodiazepines are commonly prescribed, as they aid in reducing anxiety and the risk of seizures—a protocol in line with the NHS guidelines.
  • Medical Interventions: In severe cases, such as when a patient exhibits signs of delirium tremens or seizures, hospitalisation may become imperative. This level of care allows for the administration of immediate interventions and the managing of symptoms under close medical scrutiny.
  • Ongoing Support: Beyond the physical aspect of detoxification, healthcare providers offer psychological support and advice on post-detoxification care. They play a vital role in planning long-term treatment strategies, which may include therapy and support groups, as suggested by the NHS.

The role of healthcare professionals extends beyond mere prescription and monitoring; they offer a lifeline during a period that can be overwhelming and, at times, life-threatening. Their expertise and the support they provide form the bedrock upon which addicts can build towards lasting recovery. It’s this comprehensive approach to detoxification, where medical support harmonises with therapeutic care, that fosters an environment conducive to healing and rehabilitation from alcohol dependence.

Adjunct Treatments to Benzodiazepines

While benzodiazepines stand as the main treatment for alcohol withdrawal symptoms, adjunctive medications – that is, medications given in addition to the main medicine – may offer additional benefits, targeting symptoms that benzodiazepines alone may not sufficiently control. The American Family Physician journal indicates that a multifaceted pharmacological approach may be necessary for a comprehensive management of withdrawal.

  • Haloperidol: This antipsychotic medication serves to alleviate hallucinations and agitation. Its use, however, requires careful consideration due to potential side effects like sedation and extrapyramidal symptoms.
  • Beta Blockers: These agents can effectively reduce the autonomic symptoms associated with withdrawal, such as tachycardia and hypertension. Yet, they should not be used as monotherapy due to their inability to prevent seizures.
  • Clonidine: As an alpha-2 agonist, clonidine addresses the sympathetic overactivity that accompanies withdrawal. It provides a calming effect without the risk of respiratory depression, which makes it a suitable adjunct in specific circumstances.

Each of these medications brings a unique mechanism of action to the table, addressing the complex pathophysiology of AWS. They serve to complement the effects of benzodiazepines, potentially leading to improved symptom control and a reduction in the risk of severe complications.

Addiction treatment professionals tailor the combination of these treatments based on the severity and progression of the person’s withdrawal symptoms. The goal remains to mitigate discomfort, prevent acute withdrawal complications, and pave the path towards recovery. These adjunct medications must be administered under strict medical supervision, as the interplay between different drugs requires careful management to avoid adverse effects.

In essence, the judicious use of adjunctive therapies alongside benzodiazepines may enhance the efficacy of AWS treatment protocols, providing a more stabilised transition away from alcohol dependence. This approach underscores the importance of a personalised treatment plan, one that responds dynamically to the evolving needs of the person during the withdrawal process.

Preventing Relapse and Helping Long-term Recovery

The successful navigation of alcohol detoxification marks a pivotal step in recovery; however, it represents the commencement, not the completion, of a journey towards sustained sobriety. Preventing relapse post-detoxification involves a strategic and multifaceted approach that integrates ongoing treatment, support mechanisms, and counselling. These components work synergistically to fortify a person’s resolve and equip them with the necessary tools to maintain long-term recovery.

  • Ongoing Treatment: Continuing care typically involves structured treatment programmes that may include pharmacotherapy to manage cravings and support abstinence. Engagement in such programmes proves essential in reinforcing the gains achieved during detoxification.
  • Support Groups: Fellowships such as Alcoholics Anonymous (AA) provide a community of people who share experiences and strength. The solidarity found in support groups offers a unique form of accountability and encouragement, which is vital for enduring recovery.
  • Counselling: Evidence supports the efficacy of psychotherapy in addressing the psychological aspects of alcohol dependence. Techniques such as Cognitive Behavioural Therapy (CBT) can prove particularly effective, enabling people to develop coping strategies to deal with triggers and stressors.

The National Health Service (NHS) provides an array of resources designed to aid people in recovery from alcohol dependence. The NHS recommends various treatment options and support pathways, ensuring that those in recovery have access to comprehensive care suited to their specific needs. This level of personalised attention underpins the prevention of relapse.

Moreover, numerous treatment centres specialise in safe alcohol detoxification, offering ongoing support post-detox. These centres understand that the detoxification process is merely the first step and that the real work begins with the maintenance of sobriety. They offer continued medical care, therapy sessions, and support group meetings to help prevent relapse. Detox Today can help you find the most appropriate and best-value treatment available in the UK. We also offer home alcohol detox, where you get remote treatment and do not have to attend a clinic.

Recovery is not a linear process; it entails perseverance, support, and a willingness to seek help when faced with challenges. Strategies to prevent relapse after detoxification are indispensable, and when implemented effectively, they enhance the prospects for long-term recovery.

When to Seek Medical Help

Embarking on the journey to sobriety is a commendable decision, yet it’s imperative to approach it with caution and professional guidance. The complexity of alcohol use disorder necessitates medical oversight, particularly when one is considering treatment options. The importance of seeking medical advice can’t be overstated, as the risks associated with self-detoxing are significant and, in some cases, life-threatening. If you are suffering from severe alcohol withdrawal symptoms now, please dial 999 and ask for an ambulance.

Medical Supervision: Professional healthcare providers are equipped to assess the severity of alcohol dependence and offer a safe detox plan. They can monitor vital signs, administer medications, and provide immediate intervention in case of complications.

Risks of Self-detoxing: Without medical supervision, those attempting to detox on their own may experience severe withdrawal symptoms, such as seizures, hallucinations, or delirium tremens. These symptoms can escalate rapidly and require hospitalisation.

Access to Medication: In a medically supervised setting, medications such as benzodiazepines may be prescribed to mitigate withdrawal symptoms safely. These medications help manage anxiety, prevent seizures, and ensure a more comfortable detoxification process.

Those experiencing withdrawal symptoms should seek professional advice, as withdrawal can range from mild to severe. A treatment professional can inform people about the detox process and the potential need for medication to alleviate withdrawal symptoms.

Hospitalisation might become necessary during severe withdrawal to safeguard the peson’s health. Medical professionals closely monitor the patient’s blood pressure, breathing, and heart rate, providing medications to ease the process and reduce the risk of severe complications.

In summary, while the desire to overcome alcohol dependency is a pivotal step, undertaking the process without medical support poses grave risks. Always seek medical help to ensure safety and efficacy during the detoxification process, thereby laying a solid foundation for recovery.

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