Alcohol withdrawal begins around eight hours after your final drink. It peaks between 24 and 72 hours but can continue for weeks.
If you are considering stopping drinking, you need to be aware of the dangers of alcohol detoxification. Quitting alcohol can cause severe withdrawal symptoms.
For this reason, the safest way to go through the detox process is under medical supervision.
What happens during alcohol withdrawal?
To answer this question, let’s take a quick dive into the science behind alcohol and its effect on the brain.
Alcohol is linked to a neurotransmitter called GABA. GABA is what is known as an ‘inhibitory’ neurotransmitter, which means that it inhibits the brain’s activity. Alcohol binds to GABA receptors, which amplifies the effect of GABA. This leads to feelings of inebriation which we associate with alcohol such as loss of balance and euphoria.
When someone drinks large quantities of alcohol over a long period of time, the brain adapts to this situation. It effectively reduces the effect of GABA so that it can continue to function despite the excessive amount of alcohol it is being exposed to.
When someone stops drinking abruptly, the brain is suddenly deprived of GABA, which causes it to become less inhibited. It becomes highly stimulated instead. This causes withdrawal symptoms such as anxiety, a raised heart rate, and tremors.
What are all the withdrawal symptoms which can occur after you stop drinking?
According to Noeline Latt,
Common withdrawal symptoms include:
- Feeling anxious or nervous
- Appetite loss
- Difficulty sleeping
- Dilated pupils
- Faster heart rate
- Feeling depressed
- Feeling irritable
- Feeling tired
- Having nightmares
- Mood swings
- Nausea and/or vomiting
- Not being able to think clearly
- Pale skin
Severe withdrawal symptoms include:
- Extreme agitation
- Extreme confusion
- Hallucinations (feeling, seeing, or hearing things that aren’t there)
- High blood pressure
Severe withdrawal symptoms such as these are also known as DTs, or delirium tremens. They occur in around 3 to 5% of those who go through alcohol detox. If left untreated, DTs can be life-threatening. It is extremely important that anyone experiencing delirium tremens gets urgent medical treatment.
Why should I go through alcohol detoxification under medical supervision?
Some view medical detox as an unnecessary expense: after all, why go through detox in a rehab or clinic when you can do it at home, for free?
Or, they may feel that going to inpatient rehab is embarrassing, and they may not want to admit that they are dependent on alcohol.
The reality is that going through a home detox, without any medical care, can put your life in danger. Alcohol withdrawal symptoms are very severe, especially for those who are highly dependent on alcohol.
If you want to stop using alcohol, but you have hesitations about going through a medically-assisted detox in a rehab clinic, you need to ask yourself whether detoxing at home is worth the risk.
Even if you get through the detox, there is always the risk of relapse. Relapse rates are much lower among those who seek treatment compared to those who try to overcome their alcohol dependence on their own. 
What is post-acute withdrawal syndrome (PAWS) and how common is it?
Acute withdrawal symptoms, such as headaches, sweating and vomiting, are withdrawal symptoms which occur in the week or so after your final drink.
Post-acute withdrawal symptoms, by contrast, are withdrawal symptoms that occur for months and years after withdrawal. These symptoms are often psychological, rather than physical. They can include anxiety, tiredness, rapid changes in mood, lack of enthusiasm and insomnia.
Although post-acute withdrawal syndrome is not an official medical diagnosis, it does seem to be common among those in recovery from substance use disorders (SUDs), many of whom report experiencing the psychological symptoms listed above.
One theory put forward to explain PAWS is that it results from homeostatic adjustment, or the brain returning to normal after a period of intense substance use.
Whatever the causes, PAWS is real, and it can last for up to two years. If you decide to attend rehab, the rehab staff will be able to advise you on the best ways to combat post-acute withdrawal symptoms.
What happens after I complete alcohol withdrawal?
Once you have got through the withdrawal stage, you have the option to go through rehab. Rehab involves therapy and counselling to get to the root of your substance issues. There are lots of very good inpatient alcohol rehabs in the UK where you can receive evidence-based therapy that is tailored to your needs.
A typical stay in rehab often lasts around 28 days. During this time, you will have the opportunity to receive individual therapy, group therapy and counselling. You can also explore alternative therapy options, such as meditation, yoga and acupuncture. Finally, you will be able to attend 12-step meetings such as Alcoholics Anonymous.
 Addiction Medicine. By Noeline Latt, Katherine Conigrave, John B. Saunders, E. Jane Marshall and David Nutt, (Oxford University Press, Oxford: 2009).
 ‘Rates and predictors of relapse after natural and treated remission from alcohol use disorders’, Rudolf H. Moos and Bernice S. Moos. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1976118/