Alcohol detoxification, mostly commonly referred to as alcohol detox, is the process by which the body clears all alcohol from its system. This typically involves symptoms of withdrawal, which in the case of alcohol, can be severe. Because the symptoms of alcohol withdrawal syndrome can be life-threatening, detox should take place in a medically supervised environment. While many people undergo detox on an outpatient basis, the majority of people who suffer from alcoholism will be admitted as inpatients in case of medical complications.
Most people who drink alcohol have drank too much at one time or another and experienced a hangover. A hangover is the result of alcohol overindulgence; symptoms often include headache, nausea, vomiting, and overall malaise. In most cases, these symptoms pass in a few hours to a day. Alcohol withdrawal occurs after a person has become dependent on alcohol. It involves the body’s reaction to losing a chemical – alcohol – which it has become accustomed to having in its system.
For those who are addicted to alcohol, withdrawal can be incredibly dangerous and may bring life-threatening withdrawal symptoms. As a result, medical detox is always required for alcohol withdrawal. Individuals who are addicted to alcohol should never attempt to detox on their own. Medical supervision is always needed. In addition to the health complications that may occur as a result of detox, relapse is highly likely since returning to alcohol can often put an end to the uncomfortable and sometimes painful symptoms of withdrawal.
The process of alcohol detox involves not only withdrawal from the substance, but the beginning of treatment for alcoholism, or alcohol dependence. The interventions used during detox – including medical, psychological, and pharmacological means – are meant to minimize the severity of withdrawal symptoms and support individuals as they begin their journeys in recovery.
Alcohol Withdrawal Syndrome
The following are the most common symptoms of alcohol withdrawal:
- Cravings for alcohol
Alcohol withdrawal syndrome can last several days. Physical symptoms like tremors and nausea typically occur 6-24 hours after the last drink. Seizures can occur up to 26 hours later, and delirium may set in after as long as 72 hours.
The most severe form of alcohol withdrawal is delirium tremens, commonly known as DTs. About 5 percent of people who undergo alcohol detox experience delirium tremens.
Symptoms of DTs include:
- Severe agitation
- Tremors or seizures
- Persistent hallucinations
- Largely increased heart rate, breath rate, and blood pressure
DTs can be life-threatening and is a serious medical condition. Medical intervention is required for those experiencing DTs.
Alcohol withdrawal commonly leads to dehydration, electrolyte imbalance, and vitamin deficiencies. Medical supervision throughout the detox process is needed to monitor for these complications, and prompt medical intervention is necessary in some cases.
Clients are also screened for irregular heartbeat, congestive heart failure, liver disease, pancreatic disease, infectious diseases, bleeding in the stomach or digestive tract, and damage to the nervous system. Pre-existing medical conditions can complicate the alcohol withdrawal process and need to be closely monitored to ensure the person’s safety and comfort.
While many people can safely complete the detox process on an outpatient basis while being regularly monitored by a medical professional, certain criteria mandate that inpatient detox is the safest route. The journal Alcohol Health and Research World lists the following criteria as being indicative of a need for inpatient treatment:
- A history of severe withdrawal symptoms or complications
- High levels of recent alcohol intake
- A history of seizures or delirium tremens
- Co-occurring disorders that could complicate the detox process
Various medications can be used to ease symptoms of alcohol withdrawal. Benzodiazepines can treat anxiety, insomnia, and seizures, and they are frequently used in cases of alcohol withdrawal syndrome. Doses of benzodiazepines are typically administered multiple times a day for several days until withdrawal symptoms have subsided. The dosages administered are determined by the severity of withdrawal symptoms, as well as the individual’s personal factors. Adrenergic medications, which lower pulse and blood pressure, and anti-seizure medications may also be administered to help control symptoms. In cases of severe delirium tremens, antipsychotic medications can be given to counteract hallucinations. As always, the use of medications during alcohol withdrawal should be determined on an individual basis.
Following the detox process, further treatment is needed in order to sufficiently address the underlying alcohol addiction. Detox is never considered a complete form of addiction treatment. Medical professionals and facilities offering alcohol detox can typically assist the individual in finding appropriate treatment resources and transitioning into the addiction recovery process.
Oftentimes, detox may be included as part of an overall treatment plan, allowing clients to receive comprehensive care at one facility – starting with detox and progressing to addiction treatment. Treatment for alcohol addiction involves individual and group therapy as well as pharmacological interventions. It generally also incorporates support groups and other alternative treatment modalities into a comprehensive treatment approach.