Stopping alcohol suddenly after heavy daily drinking can be dangerous. If you drink heavily every day, do not stop suddenly before talking with a medical provider. Alcohol withdrawal can cause seizures and delirium tremens, which can be fatal. Call 911 for a seizure, confusion, hallucinations, or fever with shaking and a racing heart. Knowing the warning signs, and where withdrawal can be managed safely, can save a life.
The timeline
- 6 to 24 hours: shakiness, sweating, anxiety, nausea, fast heartbeat, poor sleep
- 12 to 48 hours: seizures can occur in some people
- 48 to 96 hours: delirium tremens (DTs) in a small number: confusion, hallucinations, fever and a racing heart. DTs are a medical emergency.
Where withdrawal can be managed
Some people with mild symptoms, no history of withdrawal seizures or DTs, and no serious medical or psychiatric illness can be treated as outpatients by a withdrawal management program that checks on them every day, with a sober adult staying with them. Many others need a hospital or a detox unit. That decision is made by a clinician who examines you, not by you alone.
Hope Addiction Medicine does not provide withdrawal management (detox). If you need it, we help you find the right setting and plan to start your longer-term alcohol treatment once you are through it.
Ready to Start Treatment?
Confidential, evidence-based care in West Ashley. New patients are often able to be scheduled within a week of requesting an appointment.
How it is managed
Withdrawal teams often use a long-acting benzodiazepine such as chlordiazepoxide (Librium) or diazepam (Valium) on a schedule that steps down over several days. For milder withdrawal, gabapentin or carbamazepine are sometimes used. Thiamine (vitamin B1) protects the brain. Symptoms are tracked with a withdrawal scale.
These medicines are prescribed only by the clinician managing your withdrawal. Never take them with alcohol, never take someone else's pills, and do not drive or operate machinery while taking them.
Call 911 for
- A seizure, confusion or hallucinations
- Fever, a very fast heartbeat or chest pain
- Vomiting that keeps you from holding down fluids or medicine
Learn more about alcohol use disorder treatment in Charleston.
Help at Hope Addiction Medicine
Our team combines medication with counseling and behavioral therapies, in person at our West Ashley office in Charleston and by telehealth when appropriate. New patients are often able to be scheduled within a week of requesting an appointment. Request an appointment or call our office.
This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber. If someone may be overdosing, call 911 and give naloxone if you have it.
Frequently Asked Questions
Only for some people with mild symptoms and no history of seizures or DTs, when a withdrawal management program checks on them every day and a sober adult stays with them. Many people need a hospital or detox unit, and a clinician who examines you decides. Do not stop heavy daily drinking suddenly without medical advice. Hope Addiction Medicine does not provide detox but can help you find the right setting.
Symptoms usually start within 6 to 24 hours, peak around days one to three and ease within about a week. Seizures can occur at 12 to 48 hours and DTs at 48 to 96 hours. Call 911 for a seizure, confusion or hallucinations.
Withdrawal teams often use a long-acting benzodiazepine such as chlordiazepoxide (Librium) or diazepam (Valium) on a step-down schedule, and sometimes gabapentin or carbamazepine for milder cases, along with thiamine. They are prescribed only by the clinician managing withdrawal and must never be combined with alcohol.