Alcohol withdrawal symptoms: how long they last and when to call 999

What are the symptoms of alcohol withdrawal?

Alcohol withdrawal is what happens in the body when someone who has been drinking heavily for a long time stops or cuts down suddenly. The NHS describes getting withdrawal symptoms as a sign that your body has become dependent on alcohol ^[1]. NICE defines acute alcohol withdrawal as the physical and psychological symptoms people can experience when they suddenly reduce their drinking after drinking excessively for prolonged periods of time ^[3].

The NHS separates milder and more serious symptoms. It describes anxiety after waking, sweating and mild tremors, nausea or retching in the morning, and vomiting as the sort of mild or moderate withdrawal symptoms that suggest you may need medicine to stop safely, and it lists hallucinations, severe tremors and seizures as severe symptoms that need 999 ^[2]. Put together with the NHS 999 list ^[1], that gives a clear line. A slight tremor of the hands, sweating or morning nausea means ringing your GP, alcohol service or NHS 111 today. Severe tremors, shaking visibly, or shaking that comes with confusion, agitation, hallucinations or a fit means 999, and if you cannot tell which side of the line you are on, treat it as the severe side and call. If you recognise yourself in the first group, please treat it as a medical matter that deserves proper help. There is nothing to be ashamed of in that.

Drinkaware explains why it happens. Alcohol is a depressant and damps down the brain's fight or flight response. Over time the nervous system gets used to that, so when the alcohol level suddenly drops, the body can go into fight or flight mode even though there is no danger present. Drinkaware says this reaction is behind all withdrawal symptoms, the anxiety as much as the shakes ^[6].

The full list of withdrawal symptoms the NHS gives is below ^[1].

• anxiety
• difficulty sleeping
• feeling sick or being sick (nausea and vomiting)
• a racing heartbeat, sweating and shaking (tremor)
• seeing, hearing or feeling things that are not there (hallucinations)
• confusion
• seizures, also called fits

How long does alcohol withdrawal last? The NHS timeline

According to the NHS, withdrawal symptoms begin within 6 to 12 hours of your last drink and usually last from 3 to 7 days ^[1]. The NHS adds that some symptoms may last for a few months, especially if you drink heavily ^[1].

Several of the milder symptoms the NHS describes are tied to the morning: anxiety after waking, and nausea or retching in the morning ^[2]. The NHS also gives needing a drink when you wake up in the morning as an example of craving, one of the signs of alcohol-use disorder ^[1]. If your mornings look like that, it is worth telling a GP exactly that, in those words.

You will find other timelines online, some with hour by hour charts and figures that differ from one site to the next. I have kept to the NHS figures here on purpose. Withdrawal varies from person to person, and a chart can lull someone into thinking the dangerous part has passed, or frighten them about a symptom that happens not to be on it. If anything about how you feel worries you, ring your GP, your local alcohol service or NHS 111 for advice, and call 999 for any of the danger signs below.

The NHS does not say which symptoms are the ones that can linger for months ^[1], so if sleep, mood or nerves are still troubling you weeks later, mention it to your GP. It is one reason support carries on well after the first week.

Alcohol withdrawal seizures and other signs to call 999

The NHS says to call 999 or go to accident and emergency if you or someone else has severe withdrawal symptoms after stopping drinking ^[1]. Do not drive yourself to hospital. The NHS advice is to ask someone to drive you or to call 999 for an ambulance, and to bring any medicines you take ^[1]. If you are with someone who is having a fit, call 999 straight away and follow what the call handler tells you.

Alcohol withdrawal seizures are one of the main reasons some people need hospital care to stop drinking. NICE guidance says people in acute withdrawal who have, or are judged to be at high risk of, withdrawal seizures or delirium tremens should be offered admission to hospital for medically assisted withdrawal ^[3]. Delirium tremens is often shortened to the 'DTs' ^[6]. NICE also lists a history of epilepsy, or of withdrawal-related seizures or delirium tremens during a previous assisted withdrawal programme, among its reasons for considering inpatient care ^[4].

These are the severe symptoms the NHS lists as needing 999 or accident and emergency ^[1]. Shaking visibly here means more than the slight morning hand tremor described above: the NHS alcohol support page calls it severe tremors ^[2].

• shaking visibly
• feeling much more restless, irritable or upset than is normal for you
• confusion, for example not knowing what day it is
• seeing, hearing or feeling things that are not there
• having a seizure

Why stopping suddenly can be dangerous

This is the part I most want people to hear. If your body has come to depend on alcohol, the NHS warns that stopping all at once can be very dangerous, and that anyone who gets withdrawal symptoms needs medical help before attempting to quit ^[1]. Alcohol Change UK puts it more starkly: people who are clinically alcohol dependent can die if they suddenly, completely stop drinking ^[5].

NICE makes the same point to doctors. For people who are dependent but not in hospital, it recommends advice to avoid a sudden reduction in drinking, together with information on how to contact local alcohol support services, and it notes that a sudden reduction can result in severe withdrawal in dependent drinkers ^[3].

I understand the impulse to pour everything away and stop tonight. It often comes after a frightening morning or a hard conversation, and it can feel like the only honest response. If you have been drinking heavily every day, the safer step is to ring your GP or local drug and alcohol service first. If you cannot get through to your GP, NHS 111 can advise you, and any danger sign means 999.

Please do not work out your own plan for cutting down either. How a person comes off alcohol safely depends on an assessment of their drinking and their health. Drinkaware gives the same advice: if you get symptoms like shaking, sweating or nausea, speak to your GP or a local alcohol service before reducing or stopping, and they can help you do it safely ^[6].

How the NHS helps people through withdrawal

When you see a GP or alcohol service, they will ask about your drinking and how it is affecting your life. You may be asked to fill in a questionnaire, and you may be offered blood tests to check whether drinking is affecting your health ^[1]. The NHS asks you to try to be accurate and honest about how much you drink ^[2]. That honesty matters, because the amount you drink shapes what kind of help is safe for you.

NICE calls supervised withdrawal medically assisted alcohol withdrawal. It means coming off alcohol under the supervision of medical staff, sometimes with prescribed medication to relieve symptoms, and it can be carried out at home, in the community or in a hospital or other inpatient unit ^[3]. The NHS says most people receive support to stop drinking in the community, and that if you need medicine it can often be taken at home or when attending a local service daily ^[2]. Some people need a short stay in a medically supported unit ^[2].

NICE suggests considering an assessment for community-based assisted withdrawal for people who typically drink over 15 units of alcohol per day ^[4]. It suggests considering inpatient or residential withdrawal for anyone who drinks over 30 units of alcohol per day, has a history of epilepsy or of withdrawal-related seizures or delirium tremens in a previous assisted withdrawal, or needs to come off alcohol and benzodiazepines at the same time ^[4]. The same applies to people who regularly drink between 15 and 30 units per day and also have significant physical or mental health problems, or a significant learning disability or cognitive impairment, and NICE asks for a lower threshold for groups such as homeless and older people ^[4]. I mention these figures so you know what a clinician will be weighing up. Deciding where you fit is their job.

NICE also recommends that dependent drinkers who are in acute withdrawal are offered thiamine, as part of its guidance on preventing a serious brain condition called Wernicke's encephalopathy ^[3]. After withdrawal, NHS treatment can include talking therapies such as cognitive behavioural therapy and help to prevent relapse, which may include acamprosate or naltrexone to reduce cravings ^[1]. These are NHS treatments, arranged through your GP or alcohol service.

Where to get help today

Your GP is the usual first port of call, and Alcohol Change UK describes them in just those terms ^[5]. You can also contact your local drug and alcohol service directly. The NHS says local authorities are responsible for alcohol treatment services ^[2], and the NHS website has a search for alcohol addiction support services in your area ^[1]. Alcohol Change UK also points people to their local authority website and to the NHS service directories in each nation ^[5].

Here are the main routes ^[2][5]:

• your GP, for an assessment, advice and a referral
• your local council drug and alcohol service, which you can find through the NHS service search or your council's website
• Drinkline, the national alcohol helpline, on 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm) ^[2]
• AA and SMART Recovery groups, which the NHS says are accessible in most areas, and SMART also holds meetings online ^[2][5]
• Al-Anon, for the families and friends of people who drink, with a confidential helpline on 0800 0086 811 ^[5]
• NHS 111 for advice today if you cannot reach your GP, and 999 for any danger sign

If you are worried about someone else

Watching someone you love shake and sweat through a morning is frightening. If they have severe tremors or are shaking visibly, unusually restless, irritable or upset, confused, seeing things that are not there, or having a fit, call 999 ^[1][2]. Otherwise, the most useful thing you can usually do is help them get to a GP or the local alcohol service, and go with them if they would like you to.

Families sometimes try to force the issue by hiding or pouring away alcohol. I understand why. If the person is dependent, a sudden stop can be dangerous for the reasons above, so please make sure they get medical advice first ^[1].

Your own wellbeing matters as well. Al-Anon Family Groups support the families and friends of problem drinkers, whether the person is still drinking or not ^[2]. NICE recommends that alcohol services involve families and carers and talk with them about the impact the drinking is having on them ^[4]. If the strain is showing in your relationship, relationship counselling can give you both somewhere to talk.

Where counselling fits after withdrawal

I am a counsellor, and I am not a doctor. Withdrawal is a medical process and belongs with your GP and the specialist service. My part comes alongside and afterwards, once the shaking has stopped and the harder questions arrive: what the drinking was doing for you, and how to live well without it.

NICE says community assisted withdrawal should come with psychosocial support, and that intensive programmes after withdrawal should include psychological help such as support to attend self-help groups and to involve families and carers ^[4]. In counselling, we often start by looking at what an ordinary day without a drink actually feels like, hour by hour, and where it gets difficult. I have written about tempering a craving and three strategies for cravings and urges, and my page on counselling for drinking problems explains how I work.

I know from my own recovery how raw the early days can feel, and how much it helps to have someone steady to talk to. I see people in person in Hove, which is close by for anyone looking for addiction counselling in Brighton, and online across the UK. You can see the areas I cover if you would like to meet face to face.

Common questions

Sources

1. Alcohol-use disorder, NHS (accessed 12 Nov 2026)
2. Alcohol support, NHS (accessed 12 Nov 2026)
3. Alcohol-use disorders: diagnosis and management of physical complications (CG100), Recommendations, NICE (accessed 12 Nov 2026)
4. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (CG115), Recommendations, NICE (accessed 12 Nov 2026)
5. Get help now, Alcohol Change UK (accessed 12 Nov 2026)
6. Alcohol withdrawal, Drinkaware (accessed 12 Nov 2026)

Written by Bradley Riddell, a BACP-registered counsellor (registered member 109340) with over 25 years' experience and lived experience of recovery. He is not a doctor: this article is general information, not medical advice. Check his registration. Sources checked 12 November 2026.