How To Deal With Alcohol Withdrawals
Alcohol dependence and alcohol withdrawal affect many people in the UK. Here, we explain what alcohol withdrawals are, why they happen, common symptoms, what the withdrawal timeline can look like and when professional medical help may be needed.
This page provides general information only. Alcohol withdrawal can sometimes be serious and should not be self-managed on the basis of information found online.
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 person who has become physically dependent on alcohol abruptly stops or significantly reduces their alcohol consumption.
The condition can present as a range of symptoms that vary considerably in severity. At the least severe end, symptoms can be unpleasant and uncomfortable. More serious alcohol withdrawal can involve potentially life-threatening complications requiring urgent medical treatment.
These symptoms occur because the body and brain adapt to repeated exposure to alcohol. When alcohol is substantially reduced or removed, the nervous system has to adjust to its absence.
- Alcohol Withdrawal Syndrome (AWS): A medical condition that can occur when someone who has become physically dependent on alcohol stops or significantly reduces their alcohol consumption.
- Detoxification: The process of stopping alcohol and allowing the body to adjust to its absence. Where physical dependence is present, withdrawal may require medical assessment, monitoring and treatment.
Understanding alcohol withdrawal helps explain why suddenly stopping alcohol is not always simply a matter of willpower.
Withdrawal can cause serious complications in some people, which is why anyone who may be physically dependent upon alcohol should seek appropriate medical advice before suddenly stopping.
Alcohol Dependence
Alcohol dependence is sometimes misunderstood as simply a lack of willpower.
In reality, repeated alcohol consumption can lead to biological and behavioural changes that distinguish dependence from occasional or social drinking.
A person who has developed alcohol dependence may experience cravings, difficulty controlling their drinking, tolerance and physical withdrawal when alcohol is substantially reduced or stopped.
GABA and Alcohol Dependence
The neurotransmitter gamma-aminobutyric acid — usually shortened to GABA — plays an important part in how alcohol affects the brain and nervous system.
GABA helps reduce neuronal activity throughout the nervous system.
Alcohol enhances inhibitory signalling in the brain, contributing to effects such as relaxation, reduced anxiety, sedation and impaired coordination.
With repeated heavy alcohol consumption, the brain attempts to compensate for these effects.
Our Brain Reward System
Alcohol also interacts with the brain’s reward and learning systems.
Dopamine is one of the chemicals involved in learning what is rewarding, important and worth repeating.
Initially, drinking alcohol may be associated with feelings such as pleasure, relaxation or relief from stress.
Over time, the brain can increasingly associate alcohol with reward or relief. Situations, emotions, places, people and times of day can then become linked with the urge to drink.
This helps explain why alcohol dependence is considerably more complex than simply choosing whether or not to drink.
Prolonged Exposure and Tolerance
With continued and frequent alcohol use, the body’s response can change. The same amount of alcohol may no longer produce the same effect as it previously did. This is known as tolerance. As tolerance develops, some people drink increasingly large quantities of alcohol to achieve the effect they previously experienced from smaller amounts.
Dependence and Withdrawal
With repeated heavy alcohol exposure, the nervous system adapts to alcohol’s depressant effects. When alcohol is then suddenly removed, the balance of activity in the nervous system can temporarily shift in the opposite direction. This hyper-excitable state contributes to many of the symptoms associated with alcohol withdrawal. Understanding the physiological basis of alcohol dependence helps demonstrate why withdrawal can sometimes require medical assessment and treatment.
The Onset of Withdrawal Symptoms
Alcohol withdrawal symptoms can begin within hours of the last alcoholic drink, although the timing, severity and pattern vary between individuals. Early withdrawal may involve a number of uncomfortable physical and psychological symptoms.
Symptoms Can Include
- Anxiety: Some people experience increased nervousness, restlessness or anxiety.
- Shaking: Tremor, particularly of the hands, can occur during alcohol withdrawal.
- Nausea: Withdrawal can affect the digestive system and may cause nausea or vomiting.
- Insomnia: Difficulty falling asleep or staying asleep is common.
- Sweating: Increased sweating can occur.
- Headache: Some people experience headaches during withdrawal.
- Palpitations: Heart rate may increase.
- Irritability: Mood and emotional regulation can be affected.
Not everyone experiences the same symptoms, and the presence or absence of a particular symptom cannot reliably determine how serious someone’s withdrawal will become. People who may be physically dependent upon alcohol should seek medical advice before suddenly stopping or substantially reducing their alcohol consumption.
Where medically appropriate, healthcare professionals may use prescription medication as part of the management of alcohol withdrawal. The medication used, dose, duration and level of monitoring required are clinical decisions that should be made by an appropriately qualified healthcare professional after assessment.
Alcohol Withdrawal Timeline
The alcohol withdrawal process can unfold in stages, although there is considerable variation between individuals. The following timeline provides general information rather than a prediction of what will happen to any particular person.
Early Phase — Approximately 6–12 Hours After the Last Drink
Some people may begin to experience symptoms such as:
- anxiety
- shaking or tremor
- nausea
- sweating
- headache
- difficulty sleeping
- increased heart rate or palpitations
Symptoms may begin earlier or later than this.
Acute Phase — Approximately 12–48 Hours
Withdrawal symptoms may increase during this period.
More serious complications can include:
- Hallucinations: Some people may experience visual, auditory or tactile hallucinations.
- Seizures: Alcohol withdrawal seizures can occur and require urgent medical attention.
Anyone experiencing seizures, hallucinations or significant deterioration during alcohol withdrawal should seek urgent medical help.
Approximately 48–72 Hours and Beyond
Some serious withdrawal complications can occur during this period.
One of the most serious is delirium tremens (DTs).
Symptoms can include:
- severe confusion
- agitation
- hallucinations
- fever
- sweating
- rapid heartbeat
- changes in blood pressure
Delirium tremens is a medical emergency. The intensity and duration of alcohol withdrawal vary considerably. Factors can include:
- how much alcohol someone has been drinking
- how regularly they drink
- duration of alcohol use
- previous withdrawal episodes
- previous withdrawal seizures or delirium tremens
- physical health
- mental health
- medication
- use of other substances
Someone with a history of heavy or prolonged alcohol consumption may face different risks from someone with a different pattern of drinking. For that reason, an person’s appropriate treatment cannot be determined from a withdrawal timeline alone.
Medical Treatment of Alcohol Withdrawal
Medical treatment for alcohol withdrawal is determined according to the individual’s circumstances and clinical assessment. Prescription medicines from the benzodiazepine family are commonly used by healthcare professionals in the medical management of alcohol withdrawal. These medicines affect GABA activity within the nervous system and can be used clinically to manage withdrawal symptoms and reduce the risk of certain withdrawal complications. However, they are prescription-only medicines and are not suitable for everyone.
The choice of medicine, dose, timing and duration of treatment must be determined by the appropriately qualified clinician responsible for the person’s care. People should not use somebody else’s medication or attempt to devise their own alcohol detox medication regime.
Depending upon the person’s circumstances, medically assisted withdrawal may take place:
- at home with appropriate medical arrangements
- through a community or outpatient service
- in a residential detoxification service
- in hospital
The most appropriate setting depends upon individual clinical circumstances.
Complications of Withdrawal
Some people undergoing alcohol withdrawal can develop more serious complications. These can include hallucinations, seizures and delirium tremens.
Hallucinations
Hallucinations are perceptual experiences that can be visual, auditory or tactile. Someone experiencing hallucinations during alcohol withdrawal should obtain urgent medical advice.
Seizures
Withdrawal seizures can occur after a person who has become physically dependent upon alcohol suddenly stops or significantly reduces their alcohol consumption. A seizure during alcohol withdrawal requires urgent medical attention.
Delirium Tremens
Delirium tremens — commonly referred to as DTs — is one of the most serious complications of alcohol withdrawal. It may involve severe confusion, agitation, hallucinations and significant changes in the body’s autonomic functions.
Delirium tremens is a medical emergency.
Anyone experiencing severe confusion, seizures, hallucinations, loss of consciousness or another medical emergency should call 999.
Knowledge of these complications is important because alcohol withdrawal should not automatically be regarded as something that can safely be managed alone.
Detoxification Process and Medical Support
Alcohol detoxification refers to stopping alcohol and allowing the body to adjust to its absence. For someone who has developed physical dependence, this can involve withdrawal symptoms and may require medical assessment and treatment. The detoxification process varies between individuals.
Assessment
A healthcare professional may consider factors such as:
- current alcohol consumption
- duration of drinking
- previous withdrawal
- previous seizures or DTs
- physical health
- mental health
- prescribed medicines
- other substance use
- living circumstances
- available support
Monitoring
Depending upon the type of treatment being provided, healthcare professionals may monitor symptoms and observations such as:
- pulse
- blood pressure
- temperature
- withdrawal symptoms
- mental state
The amount of monitoring required depends upon the person’s circumstances and the clinical setting.
Symptom Management
Prescription medication may be used as part of medically assisted alcohol withdrawal where a qualified healthcare professional considers it clinically appropriate. The treatment required varies considerably between individuals.
Hospital Treatment
More serious alcohol withdrawal may require hospital treatment. This may be particularly important when complications such as seizures, delirium, significant physical illness or other medical concerns are present.
Ongoing Support
Detoxification deals primarily with the immediate process of withdrawing from alcohol. It does not necessarily address the behaviours, triggers, psychological factors or circumstances that contributed to someone’s drinking. For this reason, planning what happens after detox can be just as important as the withdrawal period itself.
Other Treatments During Alcohol Withdrawal
Healthcare professionals may sometimes use additional medication or treatment to address particular symptoms or medical problems occurring alongside alcohol withdrawal. These decisions depend upon the person’s clinical circumstances.
There is no single combination of medicines that is appropriate for everybody, and additional medication should not be self-selected or used as a substitute for medical assessment. If medication is required during withdrawal, it should be prescribed and monitored by an appropriately qualified healthcare professional.
Preventing Relapse and Supporting Long-Term Recovery
Completing alcohol detoxification can be an important step, but detox is usually the beginning rather than the end of changing someone’s relationship with alcohol. Preventing a return to problematic drinking can involve addressing the habits, thoughts, triggers and circumstances associated with alcohol. Different people use different combinations of support.
Ongoing Treatment and Recovery Planning
A longer-term recovery plan can consider:
- triggers
- cravings
- routines
- stress
- sleep
- relationships
- mental health
- physical health
- social situations
- what to do when the urge to drink appears
- what support is available if things become difficult
Some people may also discuss longer-term medication options with an appropriate healthcare professional.
Support Groups
Peer and mutual-aid groups can provide support from people with experience of alcohol problems and recovery.
Options include organisations such as:
- Alcoholics Anonymous
- SMART Recovery
- other local or online recovery communities
Different approaches work for different people.
Counselling and Psychological Support
Counselling and psychological approaches can help people understand patterns associated with their drinking and develop alternative ways of responding to stress, emotions, thoughts and triggers. Approaches such as Cognitive Behavioural Therapy may be used within alcohol treatment and recovery services. The particular approach most appropriate for an individual will depend upon their circumstances and preferences.
Behavioural Change
Long-term change is rarely just about removing alcohol. It can involve changing what happens at the times and in the situations where drinking previously occurred. That can mean developing new routines, finding different ways of responding to stress and anxiety, changing environmental triggers and building activities that provide reward or connection without alcohol.
The NHS, charities, mutual-aid organisations and independent services all provide different forms of support. Detox Today can help you understand these different options and signpost you towards appropriate NHS, charitable and independent services. We can also provide behavioural recovery support and sober coaching.
Home Alcohol Detox
For some people who have been appropriately medically assessed, alcohol withdrawal treatment may be possible at home rather than requiring attendance at a residential facility.
Whether home alcohol detox is suitable is a clinical decision.
Factors such as drinking history, previous withdrawal, overall health, medication, other substance use and the person’s home environment may need to be considered.
Detox Today provides information about home alcohol detox and can help people understand and access independent medical services.
Medical assessment, prescribing and medical treatment are provided by appropriately qualified independent healthcare professionals.
Detox Today does not independently prescribe alcohol detoxification medication.
When to Seek Medical Help
If you think you may be physically dependent upon alcohol, it is sensible to obtain medical advice before suddenly stopping.
Alcohol withdrawal can range from relatively mild symptoms to serious medical complications.
Seek urgent medical help if symptoms include:
- seizures
- severe confusion
- hallucinations
- loss of consciousness
- severe agitation
- significant deterioration in physical condition
If you are experiencing severe alcohol withdrawal symptoms or believe there is a medical emergency, call 999.
Healthcare professionals can assess alcohol consumption, withdrawal history, physical health and other risk factors and advise on an appropriate treatment setting. Depending upon individual circumstances, that might involve community treatment, outpatient care, home treatment, residential detoxification or hospital care. The important point is that the appropriate approach should be based upon clinical assessment rather than simply trying to predict withdrawal from an online timeline. If you or somebody you care about wants information about alcohol withdrawal, stopping drinking or the different treatment options available, you can use the live chat on this website, call 0800 009 6675 or email info@detoxtoday.co.uk.
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Private and confidential information, guidance and alcohol recovery support.
Help Accessing Detox
We can provide information about the different alcohol detox options and help you access appropriately qualified independent healthcare professionals where medical treatment is required.
Home & Remote Options
Depending upon medical assessment and individual circumstances, alcohol withdrawal treatment may sometimes be provided without admission to residential treatment.
Support Throughout
Detox Today can provide telephone and online recovery support alongside independently provided medical treatment.
Having someone available to talk to can provide practical and emotional support during what can be a difficult period.
Need Help With Alcohol Detox?
Call 0800 009 6675 or Use Live Chat
Speak to James at Detox Today
Alcohol treatment does not have to begin with knowing exactly which service you need.
Get in touch and we can help you understand the options available, including NHS and community alcohol services, outpatient detox, home alcohol detox and residential treatment.
Where private medical treatment is chosen, Detox Today can help with practical arrangements such as accessing an independent medical assessment and treatment provider.
Medical assessment, prescribing and treatment are carried out by appropriately qualified independent healthcare professionals.
We can also provide support with recovery planning and what happens after detox.
Help Arranging Home Alcohol Detox
Depending upon your circumstances, we can help with home alcohol detox treatment options:
- Accessing an Independent Medical Assessment
- Arranging an Independent Doctor Consultation
- Practical Information About Prescribed Treatment
- Support During the Detox Period
- Recovery Planning
- Aftercare and Ongoing Support
Whether home detoxification is clinically appropriate, and any decision to prescribe medication, is determined by the independent healthcare professional responsible for the medical treatment.
Important Information
This page provides general information about alcohol withdrawal and detoxification.
It is not a substitute for individual medical advice, diagnosis or treatment, and the withdrawal timeline described above should not be used to plan a self-detox.
If you drink heavily or regularly, or experience withdrawal symptoms when you reduce or stop drinking, seek advice from your GP, local alcohol service or another appropriately qualified healthcare professional before suddenly stopping.
If you experience seizures, severe confusion, hallucinations, loss of consciousness or another medical emergency, call 999.
About Detox Today
Detox Today with James McInally provides alcohol recovery guidance, sober coaching and information about detox, medications and treatment options. We help people access NHS, charitable and independent private services.
Medical treatment and prescribing are provided by appropriately qualified independent healthcare professionals.
We may receive commission for introductions to certain private medical services. Advice and signposting to NHS and charitable services is free.
