What Does Diazepam do During Alcohol Withdrawal?

If you’ve been thinking about cutting back on alcohol - or stopping altogether - the idea of taking medication might come as a surprise. You’re not alone in that. We speak to so many people who say: “I thought I’d just push through it”, or “I didn’t realise withdrawal could be dangerous”.

And here’s the truth: for some people, stopping alcohol after a period of regular or heavy use can come with risks. It’s not about willpower. It’s about biology. And this is where medication, like diazepam, can play a really important role - not just in keeping you safe, but in making those early days feel a little less overwhelming.

Let’s walk through it together.

What’s actually happening in your brain when you stop drinking?

Alcohol might feel like it slows you down - helps you switch off, sleep, take the edge off. That’s because it increases the activity of a calming brain chemical called GABA (short for gamma-aminobutyric acid). Think of GABA as your brain’s natural brake pedal. It slows things down, takes the tension out of your system.

But when you drink regularly, your brain starts to adjust. It pushes back by turning the volume down on GABA and turning the volume up on excitatory chemicals like adrenaline, cortisol and glutamate. It’s trying to stay balanced. This is how you build a tolerance to alcohol - meaning you need more alcohol to have the same effect.

Now here’s the kicker: when you suddenly remove the alcohol, that calming effect disappears - but your brain’s still stuck in high gear. This is what causes withdrawal symptoms. Your body becomes overstimulated. You might feel shaky, sweaty, anxious, restless. You might struggle to sleep, or feel like your heart’s racing. In more severe cases, there’s a risk of seizures or hallucinations.

It’s not just unpleasant - it can be dangerous. And that’s why, for some people, we use diazepam.

So, what exactly does diazepam do?

Diazepam is a medication in the benzodiazepine family. It essentially steps in and acts like a temporary GABA booster. It calms the nervous system, reduces overactivity, and helps the body settle.

If alcohol has been pressing your brain’s brake pedal for months or years - diazepam gently applies the brakes for you while your brain relearns how to do it on its own. It doesn’t replace alcohol, and it doesn’t “numb you out.” It simply helps your system stabilise as it adjusts to functioning without alcohol.

Depending on your needs, diazepam might be used for a few days to a week. It’s always prescribed with a tapering plan - meaning the dose gets gradually reduced as your body settles. We don’t want you to be on it for long. We just want to help you cross the bridge safely - and we’ll walk you across it.

What withdrawal actually feels like - and where diazepam helps

Here’s how it often goes: the first 6 to 24 hours after your last drink, your body starts to notice the change. You might feel a little restless, your sleep might be patchy, and you might feel like your thoughts are racing, or like you’ve got a low-level buzz of anxiety running under everything.

By the 48-hour mark, these symptoms can peak - especially if you’ve been drinking heavily. Tremors, nausea, sweating, mood swings, even hallucinations in some cases. This is the window where things can tip from uncomfortable to unsafe.

Diazepam helps take the edge off those symptoms - not in a numbing way, but in a supportive way. It allows your body to rest, your heart rate to slow, your sleep to return in short bursts. It gives your brain a softer landing. And in doing so, it gives you more clarity and control to focus on the bigger picture: why you’re doing this, and what life could look like on the other side.

“Do I have to take it? What if I don’t want to?”

Great question. The short answer? No, not everyone needs medication. And if you don’t want it, we’ll talk through the alternatives.

But if you’re drinking heavily or regularly - especially daily - there’s a good chance your body has developed some physical dependence. In those cases, going it alone isn’t just hard. It can be risky.

At Clean Slate, we assess every person individually. We take into account your drinking patterns, your medical history, and your goals. If diazepam is appropriate, we’ll explain exactly why, how it works, and what to expect. No jargon. No pressure. Just options, clearly laid out. And you’ll never be left to figure it out on your own.

You don’t have to white-knuckle it

There’s a common myth - especially among high-achievers, carers, perfectionists - that we have to do everything the hard way to prove we’re “really” ready to change.

But recovery doesn’t have to be brutal. It can be supported, informed, and kind. Taking a break from alcohol is a big deal. Giving your body time to recalibrate safely is a big deal. And asking for help - including medication support when needed - is not a weakness. It’s wisdom.

If you’re not sure whether you’ll need medication, or you just want to talk things through, we’re here. We offer a safe, evidence-based, fully remote medical detox from home - and a team of people who’ll treat you like a whole human, not a “case.”

We’re here to help you take that next step whenever you’re ready. Check your suitability today.

Sources

Amato, L., Minozzi, S., Vecchi, S. and Davoli, M., 2022. Benzodiazepines for alcohol withdrawal. Cochrane Database of Systematic Reviews, 2022(3), Art. No.: CD005063. [online] Available at: https://www.cochrane.org/evidence/CD005063_benzodiazepines-alcohol-withdrawal.

Haber, P.S. and Riordan, B.C., 2021. Guidelines for the treatment of alcohol problems. 4th ed. Sydney: Specialty of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney. [online] Available at: https://alcoholtreatmentguidelines.com.au/medications-for-managing-alcohol-withdrawal/benzodiazepines].

Weintraub, S.J., 2017. Diazepam in the treatment of moderate to severe alcohol withdrawal. CNS Drugs, 31, pp.87–95. [online] Available at: https://link.springer.com/article/10.1007/s40263-016-0403-y.

Al-Maqbali, J.S., Al Alawi, A.M., Al-Mamari, Q., Al-Huraizi, A. and Al-Maqrashi, N., 2023. Symptoms-triggered approach versus fixed-scheduled approach of benzodiazepines for management of alcohol withdrawal syndrome: Non-randomized controlled trial. Alcohol, 106, pp.10–14. [online] Available at: https://www.sciencedirect.com/science/article/pii/S0741832922000982/.