Reviewed byBaurzhan Kassymov, MDAddiction physician · updated 11.11.2026
Key facts
- ICD-10 code
- F10.3
- Who provides it
- an addiction physician; a psychiatrist joins if psychotic symptoms appear
- Where
- at home for mild to moderate withdrawal; in an inpatient unit when the risk is high
- Duration
- the acute phase lasts 3–5 days; residual symptoms can persist for up to 2–3 weeks
- Confidentiality
- treatment without registration with the state addiction (dispensary) registry; medical confidentiality
- When it is an emergency
- seizures, hallucinations, disorientation, high fever — call 103 or 112
- Outcome
- getting safely through withdrawal, restored sleep and reduced anxiety
What to know
Withdrawal syndrome is what people usually call “the shakes” or “coming down.” It is important to understand that this is not just a rough morning but a medical condition that occurs in a person who already has an established alcohol dependence. Without alcohol, a nervous system used to being constantly suppressed starts working in overdrive. The longer and the more a person has been drinking, the stronger and more dangerous this reaction can be.
Withdrawal does not occur only after binges. It can also affect people who have been drinking “just a little” every evening for many months and then try to stop abruptly — for example, before surgery or because of an illness. On this page I will explain how we determine the severity of the syndrome, why treatment is chosen according to symptoms rather than a fixed regimen, and how long each phase lasts. This will help the family understand what is normal and what is a reason to call a doctor immediately.
Signs of Alcohol Withdrawal Syndrome
- trembling in the hands or the whole body a few hours after the last drink
- heavy sweating, a racing heart and raised blood pressure
- anxiety, irritability and a feeling of inner restlessness
- insomnia, or shallow sleep with vivid, disturbing dreams
- nausea, vomiting, loss of appetite and an upset stomach
- a strong urge to drink “to feel better,” and relief after alcohol
- brief visual or auditory misperceptions — a reason to call urgently
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
How Withdrawal Develops and Why It Is Dangerous
Alcohol enhances inhibitory processes in the brain and suppresses excitatory ones. With long-term drinking, the brain compensates by “turning up” excitation. When alcohol suddenly disappears, the balance is upset: the nervous system becomes overexcited and the activity of the sympathetic nervous system rises. Hence the tremor, sweating, rapid heartbeat, anxiety and insomnia — the classic picture of withdrawal syndrome according to ICD-10 and ICD-11.
Symptoms usually peak at 24–72 hours. In some people, the syndrome is complicated by seizures (more often in the first two days) or alcohol withdrawal delirium (usually on days 2–4). Risk factors include long-term drinking, previous episodes of seizures or delirium, older age, liver disease, and low potassium and magnesium. That is exactly why withdrawal needs to be assessed by a doctor rather than “toughed out” on your feet.
How Alcohol Withdrawal Is Treated
The initial assessment can start by video: the doctor will ask how many days have passed without alcohol and whether there is tremor, hallucinations or a history of seizures. This is followed by an in-person examination: blood pressure, pulse, temperature, and the degree of tremor and anxiety — the doctor rates severity on a standardized scale (for example, CIWA-Ar). Treatment is matched to the score and repeated as needed. Follow-up assessments take place every few hours in the inpatient unit or daily with home treatment.
Only mild and moderate withdrawal is treated at home. Inpatient care is necessary with a history of seizures or delirium, serious illnesses, or if the person lives alone or daily monitoring is not possible. If seizures, hallucinations, disorientation or a temperature above 38 °C (100.4 °F) appear, do not wait for a scheduled consultation — call 103 or 112. Neither the person nor the family should use sleeping pills “by guesswork.”
How we help
Assessing severity on a clinical scale
We do not judge severity “by eye.” The doctor rates nausea, tremor, sweating, anxiety, agitation, perceptual disturbances, headache and orientation, and adds up the scores. The total determines whether observation is enough, whether medications are needed, and in which setting — at home or in the inpatient unit. The assessment is repeated to track how things are changing.
Symptom-triggered treatment
Medications that calm the overexcited nervous system — most often from the benzodiazepine group — are prescribed according to how severe the symptoms are, rather than on a fixed schedule. This approach is recommended by NICE and the WHO: it makes it possible to give enough medication to a severely ill patient without overloading a mildly ill one. Doses and duration are determined only by the doctor.
Correcting vitamins and electrolytes
Thiamine is an essential part of treatment, to protect the brain from Wernicke's encephalopathy. Potassium, magnesium and fluids are also corrected, with IV drips given when needed. Without replacing these deficiencies, the risk of seizures and heart rhythm disturbances is higher, and recovery is noticeably slower and harder.
Support during the protracted phase
After the acute period, many people continue to have poor sleep, irritability, low mood and cravings — this can last for weeks. At this stage, consultations with an addiction physician are added, and with a psychiatrist and psychotherapist if needed. This is a time when the risk of relapse is high, and regular support is especially important for the patient and their family.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythWithdrawal can be relieved with alcohol, “a little at a time”
FactSmall amounts briefly ease the symptoms but delay withdrawal and make it worse. Gradually “cutting down” without a doctor almost never works and often ends in a new binge.
MythIf there has never been delirium before, there won't be now
FactPrevious episodes increase the risk, but their absence is no guarantee. Delirium can develop for the first time, especially after long-term drinking, with illness and exhaustion. That is why monitoring matters during the first 3–4 days.
MythWithdrawal only happens after a binge
FactWithdrawal syndrome can also develop in people who drink amounts they consider moderate every day, but over a long period. Stopping abruptly in such people also requires a doctor's examination and monitoring.
Prices: Alcohol withdrawal treatment
| Alcohol withdrawal treatment | 30 000 ₸ |
| Addiction doctor home visit: examination and advice | 20 000 ₸ |
| Repeat IV drip the next day | 20 000 ₸ |
| 24 hours in the inpatient unit | 45 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
How long does alcohol withdrawal last?
The acute phase usually takes 3–5 days, with a peak on days 2–3. After that the symptoms ease, but poor sleep, irritability and cravings may persist for another 2–3 weeks. This is a normal part of recovery, and it is easier to get through with the support of a doctor and loved ones.
Can withdrawal be treated at home?
For mild to moderate withdrawal — yes, as long as an adult is nearby to keep an eye on the person and a doctor is available. With a history of seizures or delirium, serious illnesses or older age, inpatient care is safer. The doctor makes the decision after an examination.
How is this different from binge detox?
Binge detox is about organizing help at the moment of stopping: a home visit, an IV drip and interrupting the drinking. Withdrawal treatment is a broader concept: treating withdrawal syndrome at all its stages, including monitoring over the following days, severity assessment and prevention of complications.
What should we do if hallucinations start?
Do not leave the person alone, speak calmly, remove dangerous objects and do not argue with them about what they are seeing. Call 103 or 112 immediately — this may be the start of alcohol withdrawal delirium (delirium tremens), which requires inpatient treatment and cannot be treated at home.
Does an online consultation help?
Online, a doctor can assess the situation from a description and video, advise whether it is safe to stay at home, and counsel the relatives. However, withdrawal treatment cannot be prescribed and monitored without an in-person examination. Online is a first step, not a replacement for a doctor's visit.
What should be done once withdrawal is over?
This is a good time to discuss treatment for the addiction itself. At Akalam, we offer a consultation with an addiction physician, psychotherapy and, if the patient wishes, alcohol “coding” (a treatment widely used in Kazakhstan and CIS countries) after the required period of sobriety, or a rehab program. The choice always remains with the patient.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy