Alcohol Withdrawal Medication UK: What Actually Happens?
By Rethink Drink. For UK adults. Reviewed November 2026.
In the UK, the main medicines used for alcohol detox are benzodiazepines, usually chlordiazepoxide (you may know it as Librium) or diazepam.
They're prescribed for a short, planned course, by a doctor or specialist alcohol service, with someone checking on you. Their job is to keep withdrawal safe. Usually alongside thiamine (vitamin B1), to protect your brain.
They are not the same as the tablets that help with cravings. And they are not something to sort out on your own.
If you, or someone you're with, has severe withdrawal symptoms after stopping drinking, such as visible shaking, being unusually restless, irritable or upset, confusion, seeing, hearing or feeling things that aren't there, or a seizure, call 999 or go to A&E. Don't drive yourself.
You might be reading this because you want to stop, and you're scared of what happens when you do.
Or you might have done this before. A home detox, a hospital stay, a few rough days on your own... and you're wondering what's different this time.
Whether you need medical help to stop, and which medicine, is a decision for a doctor who can assess you.
In short
Withdrawal can be dangerous. If your body depends on alcohol, stopping suddenly can lead to seizures and other serious complications. The NHS says that if you get withdrawal symptoms, get medical help before you try to stop.
Detox medicines are benzodiazepines. Usually chlordiazepoxide or diazepam. They're used for a short, supervised course, to keep withdrawal safe.
Thiamine (vitamin B1) is given alongside, to lower the risk of a serious brain condition linked to heavy drinking.
Most people can detox at home. NICE says an assisted withdrawal should usually be offered in the community. Some people need to be in hospital or a residential unit.
Craving medicines are different. Acamprosate and naltrexone help people stay stopped. Naltrexone is not a detox medicine and isn't used to treat withdrawal.
Never take benzodiazepines that weren't prescribed for you, and never with alcohol.
Check first: if your body depends on alcohol, stopping or cutting down too fast can be dangerous. Speak to your GP (General Practitioner) or local alcohol service before you change anything...
...Our free units calculator and AUDIT-C check give you a starting picture in a couple of minutes. They can't tell you whether your body depends on alcohol; a doctor can.
When should you call 999?
This comes first, because it matters most.
The NHS says to call 999 or go to A&E if you or someone else has severe withdrawal symptoms after stopping drinking, such as:
shaking that you can see
being unusually restless, irritable or upset
confusion (for example, not knowing what day it is)
seeing, hearing or feeling things that aren't there (hallucinations)
a seizure (fit)
Do not drive to A&E. Ask someone to drive you, or call 999 and ask for an ambulance. The NHS also says to bring any medicines you take with you.
For milder symptoms, like anxiety, trouble sleeping, sweating, or feeling or being sick when you try to stop, the NHS says to see a GP or an alcohol support service.
What is alcohol withdrawal?
When you drink heavily for a long time, your body adjusts to alcohol being there.
Take it away suddenly, and your system can be left over-excited. That's withdrawal.
The NHS lists the symptoms as:
anxiety
difficulty sleeping
feeling and being sick
a racing heartbeat
sweating
tremor (the shakes)
seeing, hearing or feeling things that aren't there (hallucinations)
confusion
seizures
The NHS says symptoms begin within 6 to 12 hours of your last drink, and usually last 3 to 7 days. Some can last a few months, especially if you've been drinking heavily.
The UK clinical guidelines list the serious complications: seizures, delirium tremens (severe shaking, agitation, fever, a fast heart rate, profound confusion, delusions and hallucinations), and Wernicke-Korsakoff syndrome (a brain condition that affects memory, eye movements and walking). They say withdrawal can be life-threatening in severe cases.
And it isn't only about stopping completely. The guidelines describe withdrawal happening when someone "abruptly" stops or substantially reduces their drinking.
What medication is used for alcohol detox in the UK?
Benzodiazepines.
The UK clinical guidelines call them the standard medicine for managing alcohol withdrawal. NICE (the National Institute for Health and Care Excellence) names chlordiazepoxide or diazepam as the preferred choices.
What they're for: helping someone stop drinking without the complications of withdrawal, such as seizures and delirium tremens.
How they're used, in outline:
A short course. The dose starts at a level set by the doctor, then comes down over a planned number of days.
Supervised. In the community, someone from the service is in regular contact, especially over the first few days, checking your symptoms and how you're doing.
Alcohol-free. You stop drinking while you take it. Services often use breath tests to check.
Tailored. If your liver is seriously affected, a doctor may choose a different benzodiazepine.
Your team sets all of it. Nothing about a detox should be guesswork.
In hospital, NICE also covers other options and specialist treatment for delirium tremens and seizures. That's for the medical team.
What is chlordiazepoxide (Librium)?
Chlordiazepoxide is a benzodiazepine, sold as Librium and as generic versions.
Its UK product information lists "symptomatic relief of acute alcohol withdrawal" as one of its uses. It's also used, short-term, for severe anxiety.
What's worth knowing:
It's for a short course only. It can cause dependence, even when used short-term. The product information says it should be used for the shortest possible time, and always tapered off gradually.
It shouldn't be mixed with alcohol. The product information says drinking alongside it should be avoided. Alcohol adds to its sedating effect.
It's dangerous with opioids. Taken together with opioid medicines, it can cause severe drowsiness, breathing problems, coma and death.
It can make you drowsy. Drowsiness, dizziness and unsteadiness are common. Don't drive until you know how it affects you, and ask your team.
An NHS Scotland patient leaflet describes how it works in practice: the dose is based on your own assessment, it's reduced step by step, a nurse checks your symptoms, and it's a short course.
A word on supply. In spring 2026, the Department of Health and Social Care and NHS Scotland warned of a shortage of chlordiazepoxide, and NHS Scotland asked services to check whether their plans should include diazepam instead. If your team uses a different benzodiazepine, that may be why. They'll explain.
Why is thiamine (vitamin B1) given?
Heavy drinking raises the risk of Wernicke's encephalopathy, a serious brain condition. Thiamine is given to help lower that risk.
The UK guidelines say thiamine should be prescribed for people having a medically assisted withdrawal, as tablets or sometimes as an injection. They also say it should be considered for people who drink harmfully or dependently even if they're not planning a detox.
If you're not sure whether you should be taking it, ask your GP.
Do I need a medical detox, or can I stop on my own?
This is the question to take to a doctor. But here's what UK guidance looks at.
NICE says to consider an assessment for an assisted withdrawal for people who typically drink over 15 units a day, and/or score 20 or more on the AUDIT (a questionnaire about drinking).
And Drinkaware puts it plainly: if you're dependent, stopping suddenly can be dangerous and even life-threatening. If you get withdrawal symptoms like shaking, sweating or feeling sick, speak to your GP or local alcohol service before you cut down or stop.
Our free units calculator and AUDIT-C can help you see roughly where you are before that conversation. The AUDIT-C is the short version of the AUDIT; your GP can go through the full one with you.
We've also written about this here: Do I need a detox first?
Home detox or hospital?
Many people can detox at home. NICE says people who need an assisted withdrawal should usually be offered one in the community.
Some people need to be in hospital or a residential unit. The UK guidelines and NICE point to reasons such as:
a history of withdrawal seizures or delirium tremens
also using other drugs in a harmful or dependent way, or needing to come off benzodiazepines at the same time
serious physical or mental health problems
pregnancy
not having a safe place to stay, or anyone to support you at home
The threshold is lower for some groups, including older people, people experiencing homelessness, and people with liver disease.
Are detox medicines the same as tablets to stop cravings?
No. And this is where a lot of confusion starts.
Detox (withdrawal) medicines | Relapse-prevention (craving) medicines | |
|---|---|---|
Examples | Chlordiazepoxide, diazepam | Acamprosate, naltrexone, disulfiram |
What they're for | Keeping you safe while alcohol leaves your system | Helping you stay stopped afterwards |
When | A short course while you stop | Usually once you've stopped |
Treats withdrawal? | Yes | No |
The NHS says acamprosate and naltrexone help reduce cravings, and are usually offered once you've stopped drinking and need help to stay sober. That's the usual UK way. Naltrexone can also be used another way: on The Sinclair Method, it's taken only on days you plan to drink, before drinking, while you're still drinking (more below). Disulfiram works differently; it causes unpleasant effects if you drink.
Naltrexone is not a detox medicine. In the UK it's licensed to help prevent relapse and reduce craving, as part of a full treatment programme, not to treat withdrawal. It isn't used to manage withdrawal symptoms, and it isn't a safe way to come off alcohol on its own. UK guidelines use benzodiazepines for that.
The UK guidelines do say acamprosate can be started before or during a medically assisted withdrawal, and that relapse-prevention medicine should usually be offered afterwards. That's a decision for your team.
More on these medicines: Acamprosate vs naltrexone and Naltrexone for alcohol in the UK.
Can I buy detox medication online?
Please don't.
Benzodiazepines can cause dependence. They're dangerous with alcohol, and with opioids. And the course needs someone watching how you respond.
A detox without that monitoring can go wrong quickly. If you're thinking about it, call your GP, your local alcohol service, or Drinkline (0300 123 1110) first.
What happens after a detox?
A detox gets alcohol out of your system safely. It doesn't change why you drank.
The UK guidelines say services should offer relapse-prevention medicine afterwards, unless there's a reason not to, alongside psychological support.
And if you've been through a detox before, then gone back to drinking... you're not alone, and it isn't a willpower problem. It's covered here: Understanding alcohol relapse.
What if I want to drink less, not stop?
That's a different goal, and it can be the right one for some people.
But if your body depends on alcohol, cutting down quickly can bring on withdrawal too. So the same rule applies: speak to your GP or local alcohol service before you change anything.
We've written about cutting down safely here: Gradual alcohol reduction.
The Sinclair Method is another route some people look at to drink less over time. It isn't a detox, and it isn't a substitute for one. It uses naltrexone before drinking, at a time your prescriber sets, which is off-label in the UK. It's explained here: What is The Sinclair Method?
Common questions
How long does alcohol withdrawal last?
The NHS says symptoms usually start within 6 to 12 hours of your last drink and last 3 to 7 days. Some can last a few months, especially after heavy drinking.
Is Librium the same as chlordiazepoxide?
Yes. Librium is a brand name for chlordiazepoxide.
Can I drink while taking chlordiazepoxide?
No. Its product information says alcohol should be avoided while you take it.
Can my GP give me detox medication?
Your GP is a good place to start. They can assess you and, where it's needed, refer you to your local specialist alcohol service. You can also contact your local alcohol service directly.
What are the tablets to stop craving alcohol?
In the UK, acamprosate and naltrexone are the main ones. They're for staying stopped, not for withdrawal. Nalmefene is licensed to help some people cut down.
Can you die from alcohol withdrawal?
In severe cases, yes. The UK guidelines say withdrawal can be life-threatening. That's why the NHS says to get medical help before you try to stop if you get withdrawal symptoms, and to call 999 for severe symptoms.
If you'd like support from us
Rethink Drink is a UK coaching service built around The Sinclair Method. Our programmes include a consultation with an independent prescriber, who decides whether treatment is suitable. Clinical oversight is provided by consultant psychiatrist Professor Jonathan Chick. Any prescription is dispensed by an independent partner pharmacy. Our coaches work with you, week by week, on everything around it.
And whatever happens, you can talk to someone today. Drinkline, the national alcohol helpline, is free and confidential: 0300 123 1110.
Please look after yourself
This page is here to help you understand your options. It isn't medical advice, and it can't replace a conversation with a doctor who can ask qualifying questions.
Before you change how much you drink or start any medication, speak to your GP or a prescriber.
We really hope this post helps. If you have any questions, you can contact us here.
The Rethink Drink team
Sources
NHS. Alcohol use disorder (page last reviewed 24 April 2026). https://www.nhs.uk/conditions/alcohol-use-disorder/
National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence (CG115). https://www.nice.org.uk/guidance/cg115/resources/alcoholuse-disorders-diagnosis-assessment-and-management-of-harmful-drinking-and-alcohol-dependence-35109391116229
National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis and management of physical complications (CG100), recommendations. https://www.nice.org.uk/guidance/cg100/chapter/1-Guidance
Department of Health and Social Care. UK clinical guidelines for alcohol treatment, chapter 10: pharmacological interventions. https://www.gov.uk/guidance/clinical-guidelines-for-alcohol-treatment/10-pharmacological-interventions
Department of Health and Social Care. UK clinical guidelines for alcohol treatment, chapter 11: community based medically assisted withdrawal. https://www.gov.uk/guidance/clinical-guidelines-for-alcohol-treatment/11-community-based-medically-assisted-withdrawal
Department of Health and Social Care. UK clinical guidelines for alcohol treatment, annex 3: alcohol withdrawal symptoms. https://www.gov.uk/guidance/clinical-guidelines-for-alcohol-treatment/annex-3-alcohol-withdrawal-symptoms
MHRA Products. Chlordiazepoxide hydrochloride, including Librium capsules: Summary of Product Characteristics. products.mhra.gov.uk
NHS Scotland, Right Decisions. Chlordiazepoxide: patient information leaflet. https://rightdecisions.scot.nhs.uk/patient-information-leaflets/mental-health/chlordiazepoxide
NHS Scotland. Medicine Supply Alert Notice MSAN (2026) 12: chlordiazepoxide capsules (2 April 2026; valid until mid-July 2026). https://www.publications.scot.nhs.uk/files/msan-2026-12.pdf
Drinkaware. Alcohol withdrawal (last reviewed 3 April 2025). https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/general-health-effects/alcohol-withdrawal-symptoms
MHRA Products. Adepend 50 mg film-coated tablets (naltrexone hydrochloride): Summary of Product Characteristics, listed with the other UK naltrexone products. products.mhra.gov.uk
National Institute for Health and Care Excellence. Nalmefene for reducing alcohol consumption in people with alcohol dependence (TA325). https://www.nice.org.uk/guidance/ta325/chapter/1-Guidance
Department of Health and Social Care. Medicine Supply Notification MSN/2026/021: chlordiazepoxide capsules (30 March 2026), via Community Pharmacy England. https://cpe.org.uk/our-news/medicine-supply-notification-chlordiazepoxide-5mg-and-10mg-capsules/
