How to stop drinking safely
Clinical review pending. This guide was written from the sources it cites but has not yet been reviewed by a licensed clinician.
If you drink heavily every day, don’t stop suddenly without talking to a clinician first. Withdrawal usually starts 24 to 48 hours after your blood alcohol level drops, can last 5 to 7 days, and in severe cases causes seizures or withdrawal delirium (delirium tremens), which can be life-threatening.
That isn’t a reason to keep drinking. It’s a reason to plan the first week with medical help.
Why stopping cold can be risky
People who drink heavily every day can go into withdrawal when they stop. NIAAA’s warning is that the body can “go into a painful or even potentially life-threatening process of withdrawal.”
The VA and Department of Defense guideline (2021) says “severe alcohol withdrawal can be a life-threatening condition.” It names withdrawal delirium and withdrawal seizures, which can progress to status epilepticus.
Not every case is severe. The withdrawal signs NIAAA lists include trouble sleeping, shakiness, restlessness, nausea, sweating and a racing heart. Some people also sense things that aren’t there.
If you want a fuller picture of what alcohol withdrawal looks like, hour by hour, our sibling site covers it in detail.
Who needs supervised withdrawal
Medically supervised withdrawal, in a hospital or inpatient unit if needed, is the standard for people at high risk. The VA/DoD guideline strongly supports inpatient supervised withdrawal for people with:
- severe withdrawal, measured by a clinician on a scale called CIWA-Ar at a score of 20 or more
- a history of delirium tremens or withdrawal seizures
- serious co-occurring medical conditions
You won’t be able to score yourself on CIWA-Ar; that’s done by a clinician. But you can answer the other two questions honestly. If you’ve ever had a seizure or severe confusion while coming off alcohol, or you have a serious medical condition, say so up front.
If none of those apply, a clinician should still help you decide where and how to stop.
Where supervised withdrawal happens
NIAAA’s Alcohol Treatment Navigator describes intensive inpatient care as “medically-directed 24-hour services” that “may manage withdrawal.” When you contact programs in our treatment directory, ask whether they offer it. A primary care clinician can also assess your risk and point you to the right setting.
If you aren’t sure where to start, SAMHSA’s National Helpline, 1-800-662-4357 (free, 24/7), refers callers to local treatment.
What AUD medications do and don’t do
The four FDA-approved medications for alcohol use disorder are for preventing relapse. None of them is a treatment for withdrawal.
| Medication | When it fits around withdrawal |
|---|---|
| Acamprosate | For staying off alcohol after you’ve stopped. Its label says it “does not eliminate or diminish withdrawal symptoms.” |
| Naltrexone tablets | Works best in people who can stop drinking on their own for several days before starting |
| Naltrexone injection (Vivitrol) | Approved for people able to stay off alcohol in an outpatient setting |
| Disulfiram | Never started until you’ve gone at least 12 hours without alcohol, and never while intoxicated |
So the usual order is: get through withdrawal safely, then start a medication to help you stay stopped.
The APA guideline reserves benzodiazepines for acute withdrawal or a co-occurring disorder, not for treating alcohol use disorder itself. That’s a prescriber’s call.
For more on the relapse-prevention drugs, see medications for alcohol use disorder.
Emergency signs: call 911
Call 911 right away if someone coming off alcohol has:
- a seizure
- confusion, or doesn’t seem to know where they are
- hallucinations: seeing, hearing or feeling things that aren’t there
These can be signs of severe withdrawal or withdrawal delirium. Don’t wait to see if it passes.
For suicidal thoughts or an alcohol or drug crisis that isn’t a medical emergency, call or text 988, the Suicide & Crisis Lifeline. It’s free, confidential and available 24/7.
Your next step
If you drink every day and want to stop, book an appointment with a primary care clinician this week, or find a program through the ZIP code finder. Tell them how much you drink and if you’ve had withdrawal before. Not sure your drinking counts as heavy? The drink counter converts what you drink into standard drinks.
If you’re helping someone else through this, see how to help someone who drinks.
Sources
- SAMHSA/NIAAA, Medication for the Treatment of Alcohol Use Disorder: Pocket Guide (2015)
- VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders, Version 4.0 (August 2021)
- NIAAA, Treatment for Alcohol Problems: Finding and Getting Help (updated February 2025)
- NIAAA, Alcohol Use Disorder: A Comparison Between DSM-IV and DSM-5 (updated April 2021)
- NIAAA Alcohol Treatment Navigator, Types of Alcohol Treatment (no date shown)
- Acamprosate Calcium Delayed-Release Tablets label, DailyMed (published Aug 11, 2026)
- VIVITROL prescribing information, DailyMed (revised May 2026)
- Disulfiram Tablets label, DailyMed (published Oct 16, 2026)
- American Psychiatric Association, Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder (January 2018)
- SAMHSA, SAMHSA’s National Helpline (last updated June 9, 2023)
- 988 Suicide & Crisis Lifeline (accessed Oct 24, 2026)