Safe, medically supervised alcohol detox

Alcohol withdrawal symptoms typically emerge within 6 to 24 hours of your last drink. Published research on alcohol withdrawal syndrome states that the most common early symptoms – tremor, agitation, raised heart rate, sweating – begin within one to three days of stopping.

Here is a rough guide to what the timeline looks like:

• 6–24 hours: early withdrawal begins – anxiety, nausea, sweating, tremor
• 24–48 hours: symptoms intensify – raised heart rate, blood pressure, risk of seizures
• 48–72 hours: peak risk window for serious complications, including delirium tremens (DTs), the most severe form of alcohol withdrawal
• Days 4–7: symptoms begin to settle for most people
• Days 7–10: for straightforward cases, detox is typically complete

Everyone’s timeline is different. Heavier or longer-term drinking produces a more intense withdrawal, as does concurrent dependence on benzodiazepines or Z-drugs. At Castle Health, your alcohol detox plan is built around your history and your medical needs.

Alcohol withdrawal is one of the few drug withdrawals that can be directly fatal. Research published in the journal Alcohol and Alcoholism notes that seizures may occur in more than 5% of people in untreated alcohol withdrawal. The mortality rate among those who develop delirium tremens without medical support is between 5% and 25%. But this figure falls sharply with proper clinical care.

Your central nervous system has been suppressed by alcohol for a prolonged period, and when that suppression is lifted, it can rebound sharply. 24-hour medical and nursing care means our team is watching for escalation before it becomes an emergency. 

At Castle Craig, you begin your detox in Kirkurd House, our dedicated admissions unit, where the medical team and nursing staff are with you throughout. A monitoring and care plan is created on the day you arrive to keep you as safe and comfortable as possible.

Some people consider managing detox from alcohol at home, especially if previous attempts haven’t required medical intervention. For anyone with a significant physical dependence on alcohol, this is really risky.

The University Hospitals Sussex NHS Trust guidance explains that attempting to reduce alcohol intake too quickly can trigger rapid-onset withdrawal symptoms. The appropriate rate of reduction is much slower than most people expect. Home detox is not recommended for anyone with a history of withdrawal seizures, DTs, or complex health needs.

If you’re considering this, please speak to your GP before making any changes to your drinking. Our team is also available for a confidential conversation.

Medical detox uses medication to manage withdrawal safely and reduce the risk of seizures. According to NICE Clinical Guideline CG100, the standard approach is a benzodiazepine tapering regimen. At Castle Craig, this is typically chlordiazepoxide, reduced each day gradually based on how you’re responding.

Other medications used during alcohol detox may include:

• Thiamine (vitamin B1): given to protect against Wernicke’s encephalopathy, a serious brain condition that can develop after prolonged heavy drinking. Guidelines suggest oral thiamine should begin before detox starts where possible.
• Diazepam: used in some tapering regimens to reduce the risk of seizures and ease withdrawal.
• Oxazepam may be used instead of diazepam for people with liver impairment. It is safer for this group, as research shows it is processed differently by the body.

All medications are prescribed and managed by our resident doctor, reviewed by our psychiatrist, and adjusted according to how you’re responding. Nothing is prescribed without proper clinical assessment.

Before you arrive, one of our admissions case managers will speak with you by phone. They’ll ask about your drinking history, physical health, any other substances you’re taking, and whether our programme is the right fit for you. This is how we make sure you arrive prepared, and how we build the right protocol before you’ve even walked through the door.

The pre-admission process usually takes two to three days, though we can move more quickly when needed. Your case manager tracks your admission right up to the point of arrival.

For more information on what the addiction assessment involves, our admissions team will be happy to talk you through it.

You arrive at Kirkurd House, our dedicated admissions unit. The nursing team will see you almost immediately for a comprehensive health check. A monitoring and care plan is created that day, tailored to your drinking history and physical health.

If you need medical detox – and most people admitted for alcohol use do – it begins in the admissions unit. Medication is prescribed by the resident doctor and typically reduced day by day based on how you’re responding.

Our psychiatrist reviews all patient files shortly after admission. For people with complex needs, including co-occurring mental health diagnoses, the psychiatrist contributes directly to ongoing care planning. From day one, each part of your care is building towards the next.

While you’re still completing detox, you can start joining group sessions and getting to know the people you’ll go through treatment with. Beginning while you’re still in detox means there’s no gap, and you don’t have to find your footing twice.

Some people arrive with concurrent dependence on substances like benzodiazepines or Z-drugs like zopiclone or zolpidem. When someone is dependent on both alcohol and benzodiazepines, the detox protocol has to account for both. According to NICE BNF guidance on alcohol dependence, inpatient withdrawal in these cases typically lasts two to three weeks or longer, depending on severity.

Our team at Castle Craig has handled the full range of alcohol detox cases for more than three decades, including those complicated by polydrug dependence. If you’re unsure whether your situation is more complex, that’s exactly the kind of thing the pre-admission call is there to clarify.

For more on our approach to treatment for concurrent benzodiazepine dependence, visit our dedicated page.

The cost of private alcohol detox varies depending on the length of stay, the complexity of your detox, and whether you’re funding privately or through insurance. We’re transparent about costs from the first conversation. Contact the admissions team for a clear picture of what to expect before making any decisions.

Yes, but it changes the clinical approach. Concurrent dependence on benzodiazepines or Z-drugs requires a carefully calculated combined protocol, typically over a longer period than a straightforward alcohol detox. Our team at Castle Craig has extensive experience managing complex detoxes of this kind. The pre-admission call is the right place to discuss your full history.

At Castle Health, a previous attempt helps us understand what support was missing last time. Understanding what happened before, and what support was or wasn’t in place, helps us build a better plan this time.

Your GP is not automatically notified, and we don’t share information about your care without your consent. There are specific circumstances where disclosure may be required by law, which the admissions team can explain in more detail. If you have concerns about confidentiality before you call, you can email us first.

No. You can contact our admissions team directly and self-refer. We’ll request a recent medical summary as part of the pre-admission process, but you don’t need a GP referral to get started. Most admissions to Castle Craig and Smarmore Castle are self-referred.