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Alcohol Withdrawal · Clinical Guide

Alcohol Withdrawal Symptoms, Timeline & Treatment

Alcohol withdrawal symptoms begin 6–12 hours after the last drink and include anxiety, tremors (shakes), sweating, nausea, and elevated heart rate. Seizures can occur at 24–48 hours. In severe cases, delirium tremens (DTs) develops at 48–72 hours and is potentially fatal — requiring emergency medical treatment. Do not stop drinking heavily without medical supervision.

Alcohol withdrawal timeline

6–12 hours
Mild
  • Anxiety and restlessness
  • Tremors (shaking, particularly of the hands)
  • Sweating
  • Nausea and vomiting
  • Headache
  • Elevated heart rate
  • Difficulty sleeping
12–24 hours
Moderate
  • Hallucinations (visual, auditory, or tactile) — you are conscious but perceiving things that are not there
  • Worsening tremors
  • Increased anxiety and agitation
  • High blood pressure
  • Rapid heart rate
  • Fever
24–48 hours
Moderate–Severe
  • Seizures — a medical emergency: call 999 immediately
  • Continued hallucinations
  • Severe disorientation
  • Severe sweating and tremors
  • Very high blood pressure
48–72 hours
Severe — Delirium Tremens
  • Delirium tremens (DTs): profound confusion, agitation, fever, and hallucinations
  • Life-threatening cardiovascular complications
  • Fatal without medical treatment in up to 15–37% of untreated cases
  • Requires intensive medical care — ICU admission may be necessary

Alcohol withdrawal treatment

NHS outpatient alcohol detox (community detox) is the most common form of treatment — you stay at home but receive daily clinical supervision and medication. The standard medication is chlordiazepoxide (Librium), a benzodiazepine that prevents withdrawal seizures and makes the process much more manageable. This is free on the NHS.

Residential detox is available for those with severe dependency, previous seizures or DTs, or unsafe home situations. Call Frank on 0300 123 6600 (free, 24/7) to access the right level of support for your situation.

Call Frank: 0300 123 6600Find detox centres →

Frequently asked questions

What are the first signs of alcohol withdrawal?+

The first signs of alcohol withdrawal typically appear 6–12 hours after the last drink and include: anxiety, restlessness, tremors (shaking hands), sweating, nausea, vomiting, headache, and elevated heart rate. Many heavy drinkers experience these symptoms every morning before their first drink without realising they are symptoms of physical alcohol dependency.

How long do alcohol withdrawal symptoms last?+

Mild alcohol withdrawal symptoms typically peak at 24–48 hours and begin to resolve after 5–7 days. However, some symptoms — particularly anxiety, insomnia, and mood disruption — can persist for weeks or months as part of Post-Acute Withdrawal Syndrome (PAWS). Seizures typically occur 24–48 hours after the last drink. Delirium tremens (DTs) typically peaks at 48–72 hours.

What is delirium tremens (DTs)?+

Delirium tremens (DTs) is a severe, potentially fatal form of alcohol withdrawal that occurs in approximately 5% of people going through alcohol withdrawal. It is characterised by profound confusion, agitation, fever, and hallucinations, and requires emergency medical treatment. Without treatment, DTs has a mortality rate of up to 37%. Risk factors include long duration of heavy drinking, previous DTs, older age, and malnutrition.

Can alcohol withdrawal kill you?+

Yes. Severe alcohol withdrawal — particularly delirium tremens (DTs) and withdrawal seizures — can be fatal without medical treatment. This is one of very few withdrawal syndromes that can directly kill you (opioid withdrawal, by contrast, is extremely unpleasant but rarely directly fatal). Anyone with a significant alcohol dependency should seek medical supervision before stopping drinking.

Is it safe to stop drinking at home?+

For people with mild alcohol use who are not physically dependent, stopping at home is generally safe. For people who drink heavily every day, experience morning shakes or sweats, or have previously experienced withdrawal seizures or DTs, stopping at home without medical support is dangerous. NHS community alcohol detox — at home but with daily clinical supervision and detox medication — is available free across the UK.

See also
How to stop drinkingSigns of alcoholismAm I an alcoholic?Alcohol addiction helpAlcohol detox centresAlcohol rehabAA meetings near youWithdrawal timeline
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