Alcohol appreciates a unique status in the United States.
While alcohol is a drug, it is legal to manufacture, distribute, and consume it. Alcohol use is incredibly prevalent, and it is associated with nearly every social event, from weddings to ball games to dinners with friends. Even further, the demand for alcohol has been so acute throughout its history that Prohibition (1920-1933) failed disastrously.
But, as the National Institute on Alcohol Abuse and Alcoholism notes, not all Americans can simply enjoy an alcoholic beverage from time to time. Rather, an estimated 16.8 million Americans in the 12+ age group have an alcohol use disorder. Per the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a person can be diagnosed with an alcohol use disorder if two or more listed symptoms are present within the same 12-month period. There are 11 possible criteria, and they include psychological, physical, and behavioral symptoms.
How Withdrawal Symptoms Factor In
Individuals with an alcohol use disorder will typically find it difficult to achieve and maintain sobriety. This is due in part to the withdrawal symptoms individuals with an alcohol use disorder experience when they stop drinking or significantly reduce the familiar amount of intake. Speaking broadly, there are different levels of withdrawal intensity, depending on whether the person was a chronic drinker or had a less severe problem with alcohol. As WebMD discusses, the following withdrawal symptoms may emerge when a person has a history of chronic alcohol abuse:
- Cravings for alcohol
A person may also experience a severe cluster of symptoms known as delirium tremors, or DTs. These symptoms include a rapid heart rate, fever, and confusion. Approximately 1-5 percent of individuals in withdrawal from alcohol abuse will experience DTs. Severe symptoms may emerge as soon as two hours after the person’s last drink. If a person has been experiencing a less severe alcohol use disorder, the following more minor (but no less significant) withdrawal symptoms may emerge:
- Shaky hands
- Mild anxiety
- Cravings for alcohol
These symptoms may emerge as soon as 6-12 hours after the last drink, even if there is still alcohol in the person’s blood. For some, there may be psychiatric symptoms, such as hallucinations (audio, visual, or tactile), 12-24 hours after the last drink. Although these symptoms may not be life-threatening, they should be taken seriously. It is important to understand that a symptom can subside, but there is also the possibility that it will worsen. However, help is available to lessen the severity of these symptoms and make relapse less likely.
Necessary Treatment Elements to Avoid Relapse
Within the addiction treatment community, there is a universal advisement that individuals who are experiencing an alcohol use disorder, especially one with a severe grade, start the recovery process with medical detox. Medical detox can occur at a rehab center with an onsite detoxification facility, at a hospital, or at a standalone detox center, among other qualified places. During this medically supervised phase, an attending doctor may recommend that the recovering person take an FDA-approved medication.
The reason to take an approved medication is twofold. First, using a medication can often help a recovering person to avoid relapse. Again, when a person is in withdrawal, the uncomfortable symptoms can cause them to drink again, just to feel better (i.e., use may not even be about the alcohol high anymore). If the withdrawal symptoms are managed, the person will be less likely to return to alcohol abuse simply to make the symptoms go away. In addition, medications that control withdrawal symptoms can ensure that they do not progress to a worse state, such as a seizure.
It is critical to note, per the National Institute on Drug Abuse, that detox alone is never enough to help a person avoid relapse after treatment.
In fact, there is a 40-60 percent relapse rate for alcohol and other drug abuse.
After medical detox, the next step is primary treatment for the alcohol abuse, which mainly includes therapy, group recovery meetings, and additional supportive services, such as family therapy. Medical detox plus primary addiction treatment, which includes many layers of services, is considered the gold standard to help a person maintain abstinence.
After completion of a rehab program for alcohol abuse, it is universally recommended that the recovering person engage in different aftercare services, such as continuing to go to therapy, attending group recovery meetings, and possibly living in a sober living home, among other options. Aftercare is critical to avoiding relapse as it provides ongoing support of sobriety. Recovery can be a lifelong process, but it’s just about the most worthwhile process a person can participate in.