Alcohol Withdrawal

What is alcohol abuse?

The contemporary understanding of alcohol misuse has expanded from a once narrow definition to a larger categorization of various unhealthy drinking behaviours. This spectrum covers a range of activities, from binge drinking – the practice of consuming substantial amounts of alcohol in a short time frame, often leading to acute intoxication – to more chronic forms like alcohol addiction and dependence in non-clinical settings.

Alcohol addiction refers to a pattern where individuals continue to consume alcohol despite experiencing adverse consequences, often driven by an uncontrollable craving for alcohol. This is distinct from, yet sometimes intertwined with, alcohol dependence. Alcohol dependence is characterised by the body’s physical or psychological need for alcohol. It is the result of prolonged, heavy alcohol use, leading to the body’s adjustment to functioning with a certain level of alcohol. This adaptation becomes so ingrained that the absence of alcohol triggers withdrawal symptoms, which can vary in intensity.

These withdrawal symptoms are key indicators of dependence and can include a range of physiological and psychological effects, from mild anxiety and restlessness to severe complications like seizures. The severity of these symptoms is often a reflection of the extent and duration of alcohol use.

Alcohol withdrawal timeline

The timeline of alcohol withdrawal typically unfolds as follows:

1. 6-12 hours after the last drink:

– Initial symptoms begin, which can include anxiety, headaches, shaking, nausea, and irritability.

2. 12-24 hours after the last drink:

   – Symptoms may progress to more severe issues like hand tremors, disorientation, and seizures in some cases.

3. 24-48 hours after the last drink:

   – This period may see the continuation of earlier symptoms, with the possible addition of increased heart rate, high blood pressure, and hyperthermia.

4. 48-72 hours after the last drink:

   – The risk for the most severe form of withdrawal, delirium tremens (DTs), peaks during this period. DTs can include hallucinations, severe confusion, fever, and seizures.

5. 72+ hours after the last drink:

   – Symptoms typically begin to lessen after 72 hours. However, some individuals may experience prolonged withdrawal symptoms, known as Post-Acute Withdrawal Syndrome (PAWS), which can last for weeks, months, or even longer. PAWS includes ongoing mood swings, sleep disturbances, and reduced energy levels.

What exactly is alcohol withdrawal?

Alcohol withdrawal syndrome (AWS) represents a physiological process that the body undergoes when it is suddenly deprived of alcohol after a period of sustained consumption. This condition can be triggered either by an individual’s decision to abstain from alcohol or by circumstances that prevent access to alcohol. The body’s adaptation to regular alcohol exposure means that abrupt cessation can precipitate a range of withdrawal symptoms, varying in intensity from mild discomfort to severe, life-threatening conditions.

The physical alterations induced by long-term alcohol consumption significantly impair the body’s ability to regulate alcohol intake, creating a challenging barrier to reducing or discontinuing use. This leads to a state of dependency, where the body and brain function under the influence of alcohol, and its absence triggers withdrawal.

An in-depth exploration of alcohol withdrawal reveals a spectrum of symptoms that can manifest in different stages following the last alcohol intake. Initially, individuals might experience symptoms like anxiety, headaches, nausea, and insomnia. As withdrawal progresses, these symptoms can intensify, leading to more severe manifestations such as tremors, heightened agitation, and in some cases, hallucinations.

One of the most severe forms of alcohol withdrawal is delirium tremens (DTs), which can occur in a small percentage of individuals undergoing withdrawal. DTs are characterised by profound confusion, vivid hallucinations, and severe tremors, often accompanied by seizures. This condition is considered a medical emergency due to its potential to cause life-threatening complications.

The management of alcohol withdrawal is critical and typically involves medical supervision. Treatment strategies often include the use of medications such as benzodiazepines, which help to reduce the severity of withdrawal symptoms and prevent complications like seizures. In addition to medication, supportive care – including hydration, nutrition, and monitoring of vital signs – is essential in managing withdrawal safely.

Psychological support plays a pivotal role in addressing the mental and emotional challenges associated with withdrawal. Counselling and therapy can provide individuals with coping strategies and emotional support, aiding in the recovery process and helping to prevent relapse.

Here are some alcohol withdrawal symptoms: 

  • Intense cravings for alcohol
  • Irritability and agitation
  • Anxiety
  • Mood swings
  • Tics and tremors (‘the shakes’)
  • Depression
  • Insomnia
  • High temperature and/or chills
  • Headaches
  • Abdominal pain
  • Shaking and shivering
  • Nausea and vomiting
  • Fatigue
  • Excessive sweating
  • Irregular or increased heart rate
  • Unpleasant, vivid dreams
  • Decreased appetite
  • Confusion
  • Difficulty concentrating

For further questions, such as how long do alcohol withdrawal symptoms last – see the FAQ section below. 

Alcohol Craving

Alcohol Craving - Man with shots of alcohol

Alcohol craving is a powerful and often uncontrollable urge that typically occurs in individuals with a history of alcohol abuse, particularly in those identified as alcoholics. This craving is deeply rooted in the physiological effects of alcohol on the brain and body. Interestingly, the craving for alcohol is most intense when the substance is present in the body. This can be explained by understanding how alcohol interacts with the brain’s reward system, releasing dopamine and creating a sense of pleasure or euphoria.

When an alcoholic consumes even a small amount of alcohol, it triggers neurochemical reactions that amplify the craving. This reaction is so strong that after the initial drink, the individual often finds it difficult, if not impossible, to control further consumption. The craving is not just a desire but a compelling need, driven by both physical and psychological dependencies. The body, having recognized the presence of alcohol, demands more, and this demand can become overwhelming.

The initial decision to consume a drink sets off a powerful cycle of craving that is hard to break. This is why many alcohol recovery programs and support groups emphasise complete abstinence. The presence of alcohol in the system doesn’t just trigger a physical reaction; it also reactivates learned behaviours and drinking patterns, making the cycle of addiction hard to interrupt.

Obsession with Alcohol

Obsession with alcohol, in contrast to craving, occurs predominantly when the substance is not present in the system, particularly following detoxification or during periods of sobriety. This obsession is largely psychological and is characterised by a persistent preoccupation with alcohol. Unlike craving, which is a physiological response to the presence of alcohol, obsession is a mental phenomenon that can persist even in its absence.

This obsession is often described as a mental battle, where thoughts of consuming alcohol are incessant and overwhelming. It’s not just a passing thought but a constant fixation, where the mind continually circles back to the idea of drinking. This obsession can be so intense that it dominates an individual’s thinking, leaving little room for other thoughts or activities.

Furthermore, this obsessive state can be deceitful. It often convinces the individual that they can control their drinking, leading to a false sense of confidence. Thoughts like “one drink won’t hurt” or “I can stop after one” are common. However, this is a dangerous misconception for an alcoholic, as the initial act of drinking triggers the intense craving cycle, making it nearly impossible to stop at one drink.

Personal coping strategies are vital here. These can include engaging in physical activity, practising relaxation techniques such as deep breathing or meditation, and seeking support from friends, family, or professional counsellors.

Delirium tremens

In instances where an individual has a prolonged history of alcohol abuse or underlying health issues, the detoxification process can escalate beyond standard withdrawal symptoms, triggering a severe condition known as delirium tremens (DTs). This condition is characterised by a range of acute symptoms such as vivid hallucinations, extreme tremors, seizures, and abnormally high blood pressure. The presence of these symptoms indicates a critical need for constant and comprehensive medical supervision.

Delirium tremens represents a critical stage in the detoxification process, signalling a heightened level of danger. These symptoms not only pose immediate physical risks but also indicate significant neurological changes due to alcohol dependency. The duration of these severe symptoms can extend up to a week or more, maintaining a state of medical emergency throughout this period.

The health implications of DTs are far-reaching. Individuals suffering from this condition are at a heightened risk of experiencing serious cardiovascular events like heart attacks, and cerebrovascular accidents such as strokes. Additionally, the physical strain and psychological stress associated with DTs can exacerbate other underlying health conditions, complicating the recovery process.


What is alcohol detoxification and what are the benefits?

During alcohol detox, the body undergoes a natural cleansing process to rid itself of alcohol and readjust to functioning without it. This process typically involves medical supervision to ensure safety and comfort, especially for individuals with severe alcohol dependence.

After the initial hurdles of detoxification, the benefits of abstaining from alcohol become increasingly evident, not just physically, but mentally and emotionally as well.

Over time, the body continues to repair itself from the damages wrought by alcohol. Beyond the first month, further improvements in liver function can be observed. The liver, remarkably resilient, continues to heal and function more effectively, enhancing overall health. Additionally, other physical benefits become more pronounced. These include a more robust immune system, improved digestion, and a reduction in the risk of alcohol-related diseases.

The psychological benefits of sustained sobriety are equally significant. Post-detox, many individuals report a clearer mental state, improved memory, and better emotional regulation. The brain’s ability to recover and rebuild neural pathways that were impaired by alcohol use is a slow but steady process, leading to improved cognitive functions over time.

However, recovery is not just a physical process; it’s also a journey of emotional healing. Long-term abstinence from alcohol often brings about a deeper understanding of oneself, leading to improved self-esteem and better relationships with others. The absence of alcohol can lead to clearer thought processes, allowing individuals to address underlying issues that may have contributed to their alcohol use.

Lifestyle changes also play a crucial role in this recovery journey. Engaging in regular exercise, adopting a balanced diet, and participating in stress-reduction activities like meditation or yoga can significantly support the body’s healing process. These healthy habits not only improve physical health but also contribute to mental and emotional well-being.

The support of a strong community, whether it’s through therapy groups, family, or friends, is invaluable in maintaining sobriety. This support network provides encouragement, understanding, and accountability, which are essential components for successful long-term recovery.

Alcohol rehab centre
  • Full medical detox
  • Full blood works
  • Psychiatric assessment
  • Customised treatment plans
  • Solution & Recovery focused
  • Holistic facility in idyllic setting
  • Connection with nature
  • Family engagement and counselling
  • Team members who have recovered from alcoholism
  • Maximum of 8 clients for more personalised care

How do I begin the detoxification process?

Embarking on alcohol detoxification involves understanding and preparing for a variety of withdrawal symptoms, which vary depending on the individual’s level of alcohol dependency and overall health. Seeking advice from a healthcare professional before starting detox is crucial, as it provides essential medical guidance and support, ensuring a safer and more effective detoxification process. This step is vital in the recovery journey.

For individuals with a milder alcohol dependency, such as those engaging in ‘Dry January’, home detoxification can be a suitable option, especially under medical supervision. In these cases, detoxing at home can effectively help reduce or cease alcohol consumption.

However, for those with severe alcohol addiction, the risks associated with home detoxification are significantly higher. These individuals may face intense and potentially life-threatening withdrawal symptoms. For them, detoxification in a specialised facility, such as InnerLife Recovery, is recommended. Located in the serene and exotic environment of Marbella in Spain, InnerLife Recovery offers a unique setting that contributes positively to the recovery process.

The tranquil and picturesque landscape of Marbella provides a calming backdrop, essential for mental and emotional healing. The natural beauty and warm climate of the region can have a therapeutic effect, promoting relaxation and reducing stress, which are key components in the recovery process. Being in a new and different environment can also help individuals break free from old routines and triggers associated with their alcohol use, facilitating a fresh start.

InnerLife Recovery combines this serene setting with professional medical supervision and attentive care. This ensures a safe detox process for individuals with long-term alcohol dependence, managing complex withdrawal symptoms and preparing them for further treatment. The centre offers a holistic approach, with medication management for physical symptoms, and therapy and counselling for psychological support.


Alcohol withdrawal duration varies depending on several factors, including the severity of alcohol dependence, the duration of alcohol use, general health, and individual physiological factors. Generally, the timeline can be outlined as follows:

1. Early withdrawal: This phase begins 6-12 hours after the last drink. Symptoms can include anxiety, insomnia, nausea, and abdominal pain. These symptoms tend to peak within 24-48 hours.

2. Peak withdrawal: Typically occurring 48-72 hours after the last drink, this is when symptoms can be most intense. Some individuals may experience severe symptoms such as hallucinations, seizures, or delirium tremens (DTs), especially if they have been heavy, long-term drinkers.

3. Extended withdrawal: After the initial 72 hours, many symptoms start to decrease in intensity. However, some individuals may experience prolonged withdrawal symptoms, known as Post-Acute Withdrawal Syndrome (PAWS). These symptoms, like mood swings, sleep disturbances, and reduced energy levels, can last for weeks or months.

Inner Life Recovery can play a pivotal role in navigating the challenges of alcohol withdrawal. Here’s how:

– Medical supervision: Inner Life Recovery provides medical supervision during detox, ensuring that withdrawal is managed safely and effectively. This is crucial, especially for those at risk of severe withdrawal symptoms.

– Tailored treatment plans: Recognizing that each individual’s journey is unique, Inner Life Recovery offers personalised treatment plans that cater to the specific needs and circumstances of each client.

– Therapeutic support: In addition to medical care, Inner Life Recovery offers various forms of therapy, including individual counselling and group therapy, to address the psychological aspects of addiction and recovery.

To navigate through alcohol addiction and recovery, various therapies can be incredibly effective. Two notable approaches are Cognitive Behavioural Therapy (CBT) and Dialectical Behavior Therapy (DBT). Each of these therapies offers unique methods to address the challenges of addiction and recovery, and facilities like InnerLife Recovery often provide these therapies as part of their treatment programs.

Cognitive behavioural therapy:

CBT is a form of therapy that combines elements from cognitive and analytic therapies. It focuses on understanding the patterns of behaviour that have led to alcohol addiction and works to develop new, healthier strategies and coping mechanisms.

CBT assists individuals in recognizing the triggers and patterns that contribute to their addictive behaviour. By understanding these patterns, individuals can learn to alter their responses to triggers and develop healthier coping strategies.

InnerLife Recovery incorporates CBT into its treatment programs, providing individualised sessions where clients can explore their personal behavioural patterns and work on effective change strategies in a supportive environment.

Dialectical Behaviour therapy:

DBT is a type of cognitive-behavioural therapy. It focuses on teaching skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

DBT is particularly effective in helping individuals manage intense emotions and impulses, which are often significant challenges in alcohol addiction and recovery. It teaches practical skills to handle stress, control emotions, and improve relationships with others.

At InnerLife Recovery, DBT is offered as part of a comprehensive therapy program. Clients engage in both individual and group therapy sessions, where they learn and practise DBT skills. This approach is especially beneficial in helping clients deal with the emotional and relational aspects of recovery.

Both CBT and DBT are integral parts of the therapeutic process in alcohol addiction and recovery. They provide valuable tools and insights that help individuals understand their addiction, manage their emotions and behaviours, and build healthier relationships. InnerLife Recovery’s incorporation of these therapies, within the serene environment of Spain, enhances the recovery experience, offering clients the best chance at long-term sobriety and improved mental health.

Practising personal therapies outside of the clinical setting can be a valuable complement to formal addiction treatment. Two such therapies that can be highly beneficial are meditation and cold therapy. Let’s delve into how they work and their benefits:

1. Meditation:

Meditation is a mindfulness practice that involves focusing your attention and eliminating the stream of thoughts that may be crowding your mind. It can be done in various forms, including mindfulness meditation, guided meditation, and transcendental meditation.

Meditation is renowned for its stress-reducing effects. It helps lower the production of stress hormones and induces a state of relaxation.

Meditation cultivates emotional awareness and the ability to respond to emotions in a more controlled manner, which is particularly helpful in managing triggers for alcohol addiction.

Regular meditation enhances concentration and cognitive function, which can aid in maintaining focus on recovery goals.

Some studies suggest that meditation can reduce cravings for addictive substances by modifying the brain’s reward system.

2. Cold therapy (Cold exposure):

Cold therapy involves exposing your body to cold temperatures, typically through cold showers, ice baths, or cold water swimming. This practice activates the body’s natural response to cold, including increased blood circulation and the release of endorphins.

Cold therapy triggers the release of endorphins, which are natural stress relievers. It can help reduce anxiety and depression, common co-occurring conditions with addiction.

Cold exposure can elevate mood and increase feelings of alertness and well-being, which can be particularly helpful during recovery.

Some individuals find that cold therapy improves their sleep patterns, leading to better overall sleep quality.

Regular exposure to cold can increase your tolerance to stress and discomfort, helping you build mental resilience, which is essential in overcoming addiction.

The experienced professionals at InnerLife Recovery can provide guidance on incorporating these therapies into your daily routine and ensuring they align with your overall recovery plan.

InnerLife Recovery often includes mindfulness training as part of its therapy program, helping you learn meditation techniques that can be practised independently.

If you choose to undergo cold therapy, the serene location of InnerLife Recovery in Spain provides opportunities for cold water swimming or cold exposure in natural surroundings, making it an ideal setting for this therapy.

Your recovery plan at InnerLife Recovery is tailored to your unique needs and preferences. This includes considering and incorporating personal therapies that resonate with you.

Practising personal therapies outside the clinical setting can be a powerful addition to your recovery journey. It’s important to discuss your interest in these therapies with your treatment team at InnerLife Recovery to ensure we align with your overall recovery goals and are integrated effectively into your treatment plan.

Engaging in physical activities like martial arts, boxing, and other sports can be highly effective strategies to stay away from alcohol during the recovery process. These activities offer both physical and psychological benefits that serve as healthy replacements for alcohol use. Here are some examples of how they can help:

1. Martial arts (e.g., Karate, Judo, Taekwondo):

Alcohol recovery process martial arts

Martial arts require discipline and focus, which can help individuals redirect their energy away from alcohol and toward achieving personal goals in their practice.

Regular training in martial arts can reduce stress and anxiety, providing a healthier outlet for managing emotions.

Progress in martial arts, achieving new belt levels or mastering techniques, can boost self-esteem and provide a sense of accomplishment.

2. Boxing:

Alcohol recovery process boxing

Boxing is an intense physical workout that promotes overall health and fitness. It can help individuals regain physical well-being after the toll of alcohol abuse.

Boxing provides a cathartic release for built-up tension and frustration, which can be common triggers for alcohol use.

Learning boxing skills and sparring with others can boost self-confidence and provide a sense of empowerment.

3. Physical sports (e.g., basketball, football, tennis):

Alcohol recovery process physical sports

Engaging in team sports creates a sense of belonging and social support, reducing feelings of isolation that can contribute to alcohol use.

Regular participation in physical sports promotes physical health and well-being, making individuals less inclined to resort to alcohol for self-medication.

Sports involve setting and achieving goals, which can provide a sense of purpose and direction during recovery.

Incorporating these physical activities into your life can serve as positive replacements for alcohol use during the recovery process. They offer an opportunity to channel your energy into constructive endeavours and provide a healthier way to cope with stress, anxiety, and emotional challenges.

While InnerLife Recovery may not provide these specific activities, the centre’s holistic approach to recovery acknowledges the importance of physical well-being. We can support your efforts to include these activities in your life by offering guidance on finding local classes, facilities, or sports groups that align with your interests.

Remember that maintaining a balanced and healthy lifestyle is essential for long-term sobriety. Combining physical activities with therapeutic interventions, counselling, and support from InnerLife Recovery creates a holistic approach to recovery that addresses both the physical and psychological aspects of addiction.