Reviewed byBaurzhan Kassymov, MDAddiction physician · updated 11.11.2026
Key facts
- ICD-10 code
- F10.3
- Who provides care
- a psychiatrist–addiction physician; in the inpatient unit, a doctor on duty and nurses around the clock
- Where
- mild cases at home in Almaty and the suburbs; moderate and severe cases in the clinic’s inpatient unit
- Duration
- the acute phase lasts 3–7 days; sleep, mood and anxiety may take several more weeks to recover
- Anonymity
- anonymous treatment, medical confidentiality, no entry on the state dispensary registry
- When it is urgent
- seizures, hallucinations, delusions, disorientation, a temperature above 38 °C (100.4 °F) — call 103 or 112 immediately
- Outcome
- withdrawal completed without complications, sleep restored, and a relapse prevention plan in place
What to know
Withdrawal syndrome is not “just feeling bad”; it is a diagnosis with clear stages and risks. In ICD-10 it is coded as F10.3, and if delirium develops, as F10.4. It appears in a person with alcohol dependence 6–24 hours after the last drink, peaks on the second or third day and, if uncomplicated, subsides within 5–7 days. The doctor’s job is to get the person through this period without seizures or delirium tremens.
In Almaty we often see the same scenario: a person decides to quit abruptly on Sunday evening so they can go to work on Monday, and by Tuesday morning they cannot hold a cup and have not slept for two nights. The pace of a big city pushes people to “tough it out on their feet,” drive to the office through traffic and get behind the wheel. This is dangerous: the risk of seizures is highest on the second or third day of withdrawal. Here we explain how severity is assessed and why monitoring matters precisely on these days.
Signs of alcohol withdrawal syndrome
- trembling in the hands and throughout the body, especially noticeable in the morning
- heavy sweating, chills and a pounding heart without physical exertion
- anxiety, irritability and a sense of impending doom
- insomnia, or shallow sleep with nightmares and frequent waking
- nausea, vomiting, loss of appetite and upset bowels
- blood pressure and pulse noticeably above the person’s usual readings
- brief “shadows,” sounds or sensations that are not really there — a warning sign
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 boosts inhibitory processes in the brain. With long-term drinking, the nervous system compensates by increasing excitatory activity. When alcohol suddenly stops coming in, the inhibition disappears but the excitation remains — hence the tremor, anxiety, insomnia and swings in blood pressure and pulse. The longer and heavier the drinking, the greater this imbalance and the higher the risk that it will progress to seizures or delirium.
Each new episode of withdrawal in the same person is usually more severe than the last — clinical guidelines describe this effect as “kindling.” That is why it is important to know whether there have been seizures or delirium tremens before. The risks are higher in people over 50, in those with liver and heart disease, with concurrent use of sleeping pills, and with electrolyte deficiencies. These are exactly the factors the doctor weighs when deciding where to treat.
How withdrawal treatment works
First, the doctor takes a history: how long the drinking has lasted, when the last drink was, previous episodes of seizures and delirium, illnesses and medications. Severity is rated on a standard withdrawal scale based on tremor, sweating, anxiety, nausea and perceptual disturbances. Mild cases are treated at home with repeat check-ups; moderate and severe cases in an inpatient unit. Then come IV drips, B vitamins, monitoring of blood pressure, sleep and eating, and repeated scoring on the scale.
Withdrawal is not treated at home if there have been seizures or delirium before, if hallucinations, confusion or a high temperature have appeared, if there is serious heart or liver disease or epilepsy, if the person lives alone, or if they have also been taking sedatives. At the first signs of delirium — disorientation, fear, visions — or with seizures, call 103 or 112. Delirium is never treated at home; it always requires inpatient care.
How we help
Severity scoring
The doctor uses a standardized clinical alcohol withdrawal scale recommended by international guidelines. It turns a subjective “I feel awful” into a score and makes it possible to compare the condition over time — a few hours later, the next day. If the score rises despite treatment, that is a reason for hospital admission or a change in prescriptions.
Preventing seizures and delirium
For moderate and severe withdrawal, the doctor may prescribe a short course of benzodiazepines with gradual tapering — this is standard under the protocols of the Ministry of Health of the Republic of Kazakhstan and international guidelines. Only the doctor determines the dose and duration. Taking sleeping pills or “sedatives” from the medicine cabinet on your own is dangerous because of suppressed breathing and the risk of a new dependence.
IV fluid and vitamin support
Drips with saline solutions replace fluids and electrolytes, while B vitamins — especially thiamine — protect the brain from encephalopathy. Potassium and magnesium are corrected based on lab results, since their deficiency raises the risk of seizures and heart rhythm problems. In the Akalam inpatient unit, these values are checked daily and prescriptions are adjusted accordingly.
Managing the post-acute withdrawal period
After the acute phase, many people complain of poor sleep, anxiety, mood swings and cravings for several weeks. This is the time of highest relapse risk. The doctor selects non-drug and drug-based ways to restore sleep, recommends psychotherapy and discusses relapse prevention treatment, so that alcohol is not used again as a “sleeping aid.”
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 is just a bad hangover
FactAnyone can get a hangover after a single episode. Withdrawal syndrome occurs only when dependence has already developed, and it carries a risk of seizures and delirium. These are different conditions with different treatments.
MythIt is safer to keep drinking a little than to quit all at once
FactA self-managed “step-down” almost always turns into a continued binge. The safe way out is under the supervision of a doctor, who uses medications when needed rather than alcohol.
MythIf the first day goes fine, there will be no complications
FactWithdrawal often peaks on the second or third day, and delirium can begin on days 3–5. That is why monitoring is important on exactly those days, not just the first one, even if the person insists they already feel better.
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 lasts 3–7 days, peaking on the second or third day. Sleep problems, anxiety and irritability can persist for several weeks — this is known as the post-acute withdrawal period. It is not life-threatening, but it needs attention because it increases the risk of relapse.
Can withdrawal be treated at home?
In mild cases — if there have been no seizures or delirium before, there are no serious illnesses and relatives are nearby — yes, with repeat visits from the doctor. In moderate and severe cases, an inpatient unit is safer. The decision is made based on the examination and the scale score.
How can you tell delirium tremens is starting?
Warning signs: the person does not understand where they are, mixes up the days, sees or hears things that are not there, feels intense fear, and has a high temperature and sweating. In this situation you must not wait until morning or for the addiction physician to arrive — call 103 or 112.
Can I work during withdrawal?
During the acute phase, it is better to take a few days off. Tremor, insomnia and anxiety reduce concentration, and driving in Almaty with these symptoms is dangerous. If you need documents for your employer, discuss this with the doctor in advance, at the first consultation.
Do folk remedies and pickle brine help?
They may ease thirst a little, but they do not affect the mechanisms of withdrawal and do not prevent seizures or delirium. Sleep and water are important, but with marked symptoms you need a doctor. Herbal blends with a sedative effect are also unsafe when combined with alcohol still in the body.
How is alcohol withdrawal treatment different from drug withdrawal treatment?
This page is about stopping alcohol. Withdrawal from narcotic substances has different mechanisms and is treated under different protocols — it is covered on a separate page. If you are not sure what exactly the person has been using, tell the doctor honestly.
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