• Alcohol is a legal, depressant drug.
  • It is a liquid produced by fermentation. Further processing produces alcoholic drinks such as beer, wine, cider and spirits.
  • Pure alcohol has no colour. It has a very strong taste that feels like a burning sensation.
Onset & Duration


  • Within 24 hours and up to 48 hours 
  • (depending on Blood Alcohol Level; hours after last drink and level of neuro-adaptation)


  • 3-7 days (up to 14 days in severe withdrawal)
Clinical Features
  • Anxiety, agitation, sweating, tremor, vomiting, abdominal cramps, diarrhoea, craving, insomnia, elevated blood pressure, pulse and temperature; headache, seizures, confusion, perceptual distortions, disorientation, hallucinations, seizures, delirium tremens, arrhythmias and Wernicke’s encephalopathy
  • Potential Complications
  • Seizures - Convulsions, sensory disturbances, loss of consciousness
  • Hallucinations - Visual or tactile transient hallucinations, paranoia, psychological disturbances, abnormal affect, auditory or visual delusions
  • Delirium - Agitation, hyperactivity, tremor, confusion and disorientation.  Can occur without progressing to delirium tremens
  • Agitation - Anger, aggression, irritability, violent outbursts
  • Wernicke-Korsakoff’s Syndrome (WKS) - Cognitive impairments in memory, deficits in abstraction and problem solving, confusion, ocular and gait disturbances, apathy and amnesia
  • Dehydration - Increasing thirst, dry mouth, weakness or light-headedness, darkening of the urine or decrease in urination
  • Cardiac arrest and death - can occur in very severe alcohol withdrawal syndrome
Care & Treatment


  • Atropine Sulphate/Diphenoxylate Hydrochloride (Lomotil)
  • Loperamide Hydrochloride (Imodium) 
  • Drink plenty of fluids - 6 - 8 glasses of water a day
  • Eat regular meals


  • Paracetamol (Panadol)
  • Massage

Nausea and Vomiting

  • Metoclopramide (Maxolon)
  • Prochlorperazine (Stemetil)
  • Eat small meals and snacks often
  • Drink plenty of water
  • If vomiting, stop eating solid food and try small sips of liquid, or sucking an ice cube. Try a small amount of food once you have kept fluids down for a few hours
  • Rehydration/sports/isotonic drinks such as ‘Powerade'
  • Avoid citrus and caffeine on an empty stomach

Pronounced agitation or insomnia

  • Benzodiazepines: Diazepam, Temazepam tablets* (*Risk/benefit analysis required due to propensity for misuse and exacerbation of depressive symptoms)
  • Reduce coffee, tea, cola and energy drinks during the day and have none after 2 pm
  • Eat 3 meals a day and avoid heavy, spicy meals late at night
  • Avoid napping during the day and keep to regular bed and wake times
  • Exercise regularly (in the day, not after 6 pm)
  • Use relaxation techniques
  • Avoid doing things (i.e. tough phone calls) that might upset you before going to sleep
  • Have a bath in the evening

Stomach cramps

  • HyoscineButylbromide (Buscopan)
  • Have a bath
  • Use a heat rub/ wheat bag
  • Massage

Aches and pains

  • Ibuprofen
  • Have a bath
  • Use a heat rub/ wheat bag
  • Do gentle exercise e.g. walking
  • Massage


  • Remove ‘cues’ or reminders of use as these intensify craving.
  • Keep busy, use distractions
  • Focus on what is happening at the moment and take each hour and day as it comes. Thinking too far ahead can often be overwhelming and counterproductive.


  • Have regular showers or baths
  • Paracetamol - take as directed on the packet