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Withdrawal symptoms typically occur within eight hours following your last drink and peak between 24 and 72 hours.

While stopping drinking abruptly may sound like a good idea if you identify yourself as addicted to alcohol, it is vital that you do not do so without seeking medical advice. 

This is because the alcohol withdrawal process is potentially life threatening. Some symptoms can be so severe that serious and long-term damage can be caused, risking illness or even death.

The process of alcohol withdrawal

Alcohol increases the stimulation of certain receptors in the brain, causing central nervous system (CNS) depression. With repeated heavy consumption of alcohol, these receptors become desensitised and reduce in number, resulting in tolerance and physical dependence.

When alcohol consumption is stopped too abruptly, a person's nervous system suffers from uncontrolled firing. As alcohol leaves the system, someone will then experience mild, moderate or severe withdrawal symptoms. As these symptoms can change in severity within hours, caution needs to be taken.

Mild alcohol withdrawal symptoms include:

  • Nausea
  • Mild itching
  • Slight tremors
  • Sounds and light seeming to be more intense than usual
  • Feeling clammy
  • Mild headaches

Moderate alcohol withdrawal symptoms include:

  • Frequent nausea and dry retching
  • Pins and needles, burning or numbness
  • Tremor seen when arms are held outstretched
  • Startled by noises, and bright light becomes uncomfortable
  • Sweating, anxiety and restlessness
  • Mentally less alert (e.g. not knowing the day of the week)

Severe alcohol withdrawal symptoms include:

  • Constant nausea, retching and vomiting
  • Hallucinations: auditory, visual or sensations of bugs on the skin
  • A coarse tremor
  • Drenching sweats
  • Acute confusion (e.g. not being able to recognise surroundings or familiar people)

Severe withdrawal symptoms are known as delirium tremens (DTs). These can lead to seizures as alcohol is a CNS depressant, and abrupt withdrawal can lead to CNS excitability. 

The importance of medically assisted alcohol detoxification

Detoxification involves ridding your body of alcohol while managing unpleasant and dangerous withdrawal symptoms.

At Priory, our alcohol detoxification programme has been designed to help people withdraw from alcohol in a controlled and highly supportive clinical environment.

During alcohol withdrawal treatment within a Priory addiction treatment centre, your symptoms will be closely monitored and regulated by your consultant and their expert team so that you remain safe. Medical assistance can also be provided to prevent you from becoming ill or experiencing hazardous effects of the withdrawal process.

Post-acute withdrawal (PAWS)

There are two stages of withdrawal. During the first stage, you may experience physical withdrawal symptoms. The second stage of withdrawal is known as post-acute withdrawal syndrome (PAWS). During this time, you'll have fewer physical symptoms, but more emotional and psychological ones.

Most people experience PAWS, which include mood swings, anxiety, irritability, tiredness, variable energy, low enthusiasm, variable concentration and disturbed sleep

These symptoms occur as your brain chemistry gradually returns to normal. As your brain functioning improves, the levels of your brain chemicals will fluctuate as they approach the new equilibrium.

In the beginning, your symptoms will change minute to minute and hour to hour. As you recover further, they will disappear for a few weeks or months, but will return again. During your recovery journey, the good stretches you experience will get longer and longer.

Post-acute withdrawal usually lasts for two years. Once you've been in recovery for a while, you will find that each episode usually lasts for a few days. While there is no obvious trigger, your Priory rehabilitation team can provide you with strategies so that you are able to manage each post-acute withdrawal episode with confidence.

Receiving support following detoxification

We understand that withdrawing from alcohol and seeking support in the first place can be daunting. While undergoing detox is a courageous first step, but it is recommended that you follow up detoxification with an addiction treatment programme for alcohol dependence. This will give you the chance to challenge your addiction mentally and emotionally, helping you to avoid drinking in the future.

Within Priory, our inpatient rehabilitation programme typically lasts for 28 days. During this time, you will attend individual and group therapy to address the source of your addictive behaviours, increase your self-awareness and take steps towards a long-lasting recovery.

Based on the 12-Step philosophy, you will focus on identifying and changing your unhealthy behaviours and thoughts patterns to help equip you with the skills you’ll need to maintain a life without alcohol.

Blog reviewed by Dr Laurence Church (MBChB, Msc, MRCPsych), Consultant Psychiatrist at Priory Hospital Woking

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