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Alcohol withdrawal

Alcohol withdrawal

Alcohol withdrawal is a syndrome with a set of symptoms that can occur following a reduction in alcohol consumption after a period of excessive use. This conditions symptoms typically include:

  • anxiety
  • shakiness
  • sweating
  • vomiting
  • increased heart rate
  • mild fever

More severe symptoms can include:

  • seizures
  • hallucinations
  • and delirium tremens (DTs)

Symptoms normally begin around about six hours after the last drink. They are most evident in the period of 24 to 72 hours since finishing the last alcoholic beverage, and improve by seven days.

Alcohol withdrawal may occur in those who are alcohol dependent. This may occur following a planned or unplanned decrease in alcohol intake. The underlying mechanism involves a decreased responsiveness of GABA receptors in the brain. The withdrawal process is typically followed using the Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA-Ar).

Treatment for alcohol withdrawal

The typical treatment of alcohol withdrawal is with benzodiazepines such as chlordiazepoxide or diazepam. The dosage will be based on the person’s symptoms. Thiamine is recommended routinely. Electrolyte problems and low blood sugar should also be treated. Early treatment improves the over all outcome.


In the Western world around 15% of people have problems with alcohol use disorder at some point in their lives. Around about half of all people with alcohol use disorder will develop withdrawal symptoms upon reducing their alcohol intake, with 4% developing severe symptoms. Among those with severe symptoms up to 15% die.


Symptoms of alcohol withdrawal have been described at least as early as 400 BC by Hippocrates. It is believed that alcohol abuse had not become a widespread problem up until around the 18th century.

Treating alcoholism with Benzodiazepines

Unlike other medicines used to treat alcoholism, such as disulfiram and  naltrexone, benzodiazepines can be used during the detox phase of recovery. It is during the detox period that the symptoms of alcohol withdrawal typically arise. This is when the alcohol is completely cleared out from your body. The detox process can last anywhere from just a few days and anything up to to a few weeks, depending on the severity of the alcohol use disorder (AUD).

Due to the unpredictable nature of withdrawal symptoms, it is highly recommended to only detox under the care and instructions of medical professionals. Treatment providers are able to administer prescription drugs, such as benzos, to help reduce any uncomfortable and painful withdrawal symptoms that may arise during the detox.

Some of the alcohol withdrawal symptoms that benzos can prevent and treat include:

  • Headaches
  • Nausea and vomiting
  • Insomnia
  • Aggravation and irritability
  • Chills and sweats
  • Seizures

There are several different types of benzodiazepines used in alcohol rehab facilities, including:

  • diazepam
  • chlordiazepoxide
  • oxazepam
  • and lorazepam.

Here is a breakdown of these drugs and how they are used in the treatment of alcohol withdrawal.


Diazepam (valium) is one of the most common medications used to treat alcoholism. It comes in two forms, tablet and injection. The medicine helps reduce the chance of recurrent withdrawal symptoms. Since it’s a long-acting benzo, a single dose can last up to three days. This medicine starts taking effect very quickly. Patients can sometimes even feel the effects roughly five minutes for the injectable form and 30 to 60 minutes for tablet form. This medication helps reduce withdrawal symptoms including anxiety, muscle spasms, seizures and insomnia.

Chlordiazepoxide (Librium)

This medication is administered daily by tablet to relieve unpleasant withdrawal symptoms. Similar to other long-lasting benzos, chlordiazepoxide remains in the body for about three days. Due to its prolonged effects, patients taking this medication often feel much more comfortable during the rest of the whole withdrawal process. It takes roughly around 30 minutes for the patient to feel the effects of chlordiazepoxide. The prescription lowers symptoms of anxiety and muscle spasms caused by alcohol withdrawal. Talk with a doctor or your GP about other possible uses of this drug and how it benefits recovery.

Oxazepam (Serax)

Classified as a short-to intermediate-acting benzo, the effects of oxazepam last about a day. It comes in the form of a tablet and is usually taken daily. This drug is typically administered to the patient while having them under medical supervision. This is so that a patient’s vitals and health can be monitored. After taking this drug, it takes around an hour for patients to feel relief from withdrawal symptoms. It helps relieve anxiety caused by alcohol withdrawal and detox. This allows a person’s body to relax so they can focus on sobriety and other beneficial aspects of treatment.

Lorazepam (Ativan)

Lorazepam is used by rehab facilities across the nation to help patients overcome an AUD. The medicine comes in a tablet and injection form. As an intermediate-acting drug, it has a duration of roughly around 11 to 20 hours. It is more commonly used in older patients and individuals with liver failure. The tablet form takes effect within 30 minutes, whereas the injectable form can take effect as early as just 15 minutes. The drug helps alleviate anxiety associated with alcohol withdrawal. A doctor or your GP may also prescribe Lorazepam to reduce the risk of seizures.

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