Detoxification, or detox for short, is the process of removing toxins such as alcohol or drugs from the body. This can be accomplished either at home or in a specialty detox facility in either an outpatient or inpatient setting. Regular alcohol abuse can lead to a physical and emotional dependence on the substance, and withdrawal side effects may occur during detox.
Signs of Withdrawal
Symptoms of alcohol withdrawal can range in intensity and duration depending on how dependent the body is to alcohol, how much the individual drank and how fast, any underlying medical conditions or genetic predispositions, and how often the person drinks excessive quantities of alcohol. Alcohol withdrawal may be mild, moderate, or severe.
Mild alcohol withdrawal usually starts between 8 and 24 hours of one’s last drink and includes side effects such as:
- Clammy skin
- Dilated pupils
- Elevated blood pressure and heart rate
- Loss of appetite
- Difficulty concentrating or “mental fog”
Moderate alcohol withdrawal may begin between 24 and 26 hours after the last drink. All mild symptoms may be intensified, and additional side effects may include:
- Mood swings
A more severe form of alcohol withdrawal is called delirium tremens (DTs) and can be fatal if not treated properly. The American Medical Association reports that DTs occurs in about 5 percent of alcohol-dependent patients suffering from alcohol withdrawal syndrome. It starts within 2-3 days of the last drink, and warning signs include:
- Severe mental confusion
Over 16 million American adults over the age of 17, and close to 700,000 adolescents between the ages of 12 and 17 battled an alcohol use disorder in 2013, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Recovery often begins with detox. The severity of withdrawal symptoms and level of alcohol dependence may determine the level of care that will be the most successful.
Tapering and Outpatient Detox
Mild to moderate alcohol withdrawal may be managed in an outpatient setting or at home under certain circumstances, although cravings and side effects are generally best managed in a residential care setting with 24-hour medical monitoring and assistance available. The individual attempting alcohol detox at home must have a comprehensive support network that is committed to monitoring the detox process. Cravings can be very intense, and withdrawal symptoms may take a few days to peak and reach full intensity.
Since alcohol withdrawal can be life-threatening, understanding the warning signs of DTs and severe alcohol withdrawal are important during at-home detox. The NIAAA reports that alcohol-related issues make up the third leading cause of preventable death in America, killing 88,000 men and women annually in the United States.
It is not recommended for an individual to stop drinking alcohol suddenly if they are dependent on it. In order to safely remove alcohol from the body, a slow and controlled tapering schedule may be implemented, wherein the amount of alcohol is lowered over time until drinking is stopped completely. Someone trustworthy and reliable is needed to help with this weaning process, since individuals going through withdrawal may be unable to fight the desire to drink alcohol to stop the uncomfortable side effects that may feel overwhelming. Tapering can help reduce cravings and may minimize withdrawal symptoms, and often medications may be more effective for this purpose.
There are numerous “at-home detox kits” at drugstores and found online boasting holistic and natural detox methods. Generally speaking, these do-it-yourself kits are untested and likely to be ineffective. There are some natural, or holistic methods, that may be effective during detox, especially when combined with pharmaceutical or other proven methods however.
Alcohol depletes the body of essential vitamins and minerals. Eating a healthy and balanced diet, and drinking plenty of water can help the healing process, as can a regular exercise plan. Physical fitness and recreational activities can occupy the mind and release natural endorphins that can help repair the brain’s natural reward system that was damaged by alcohol addiction. Getting the right amount of regular sleep is important during detox as well, since a well-rested individual is able to function more effectively and efficiently. Supplements may be recommended by a medical professional to be taken during detox to aid in achieving physical stabilization.
Typically, the safest way to detox from alcohol is at a specialty alcohol detox facility that provides around-the-clock medical supervision and care. This level of care is often referred to as “medical detox” and may include the use of pharmaceuticals, such as benzodiazepine tranquilizers, to manage difficult withdrawal symptoms and drug cravings. Seizures as well as elevated heart rate, blood pressure, and body temperature are often the result of an overactive central nervous system. This can occur as the body and brain attempt to rebound from the suppressing effects of alcohol during withdrawal.
Benzodiazepines are central nervous system depressants, like alcohol, and they can minimize this reaction. Valium, Ativan, and Librium are benzodiazepines with long half-lives, meaning they can stay in the system for longer periods of time to help manage the physical withdrawal side effects. Benzodiazepines are also effective at managing the anxiety that can occur during detox. Acamprosate, disulfiram, and naltrexone are the three medications specifically approved by the U.S. Food and Drug Administration (FDA) to treat alcohol dependency, as published by the National Institute on Drug Abuse (NIDA). These medications serve to reduce alcohol cravings and withdrawal symptoms, and they may also act to deter future drinking by making patients sick if alcohol is consumed when the medicine is active in the bloodstream.
During a medical detox program, vital signs can be taken regularly in an effort to prevent DTs and other severe alcohol withdrawal symptoms. Alcohol can dehydrate the body and produce an dangerous electrolyte imbalance that may need to be rectified with fluids that are intravenously introduced in a hospital or inpatient facility. Alcohol can also damage internal organs such as the liver and kidneys as well as negatively affect blood pressure and heart rate, potentially requiring additional medical interventions to prevent cardiac complications or stroke.
Often an underlying mental health or medical complication may not be apparent and can have negative consequences during alcohol detox that may require specialty treatment or additional medications. The National Alliance on Mental Illness (NAMI) estimates that as many as a third of those who abuse alcohol also battle mental illness and vice versa.
Depression and anxiety are common during alcohol withdrawal, and mental health symptoms can be intensified if a mental health disorder co-occurs with an alcohol use disorder. Antidepressants or anti-anxiety medications may be needed to manage these symptoms during detox.
The Need for an Alcohol Detox Facility
Relapse, or a return to drinking after being sober for any length of time, can increase the risk for a potentially life-threatening overdose, which is a toxic buildup of alcohol in the body. The CDC reports that six American adults, on average, die every day in the United States as the result of alcohol poisoning. Also, the more severe the dependency to alcohol, the more likely the chance for an adverse reaction during detox or the more intense the withdrawal symptoms may be. Those who have remained drunk for several days in a row, who have a previous history of alcohol withdrawal symptoms, drink in the morning to get through the day, have gotten drunk every night for a month, or who drink throughout the day are more likely to have a high dependency on alcohol and therefore should detox in a specialized facility.
Alcohol is commonly combined with other drugs, which may cause negative and unintended interactions. The Drug Abuse Warning Network (DAWN) reported that in 2011 a quarter of all patients seeking emergency department (ED) treatment for an adverse reaction related to misuse of drugs also involved alcohol. Similarly, the 2011 DAWN also published that 58 percent of ED visits related to negative reactions to alcohol also involved illicit drugs while 56 percent involved pharmaceuticals.
When more than one substance is involved, such as drugs and alcohol together, detox in a specialty facility is recommended to avoid potentially dangerous or life-threatening consequences. Medical professionals can develop a plan to remove all substances safely from the body.
It is also important to note that detox is not a final solution to a problem with alcohol abuse or dependency, but rather the important first step toward becoming sober. In order to maintain sobriety long-term, mental health and patterns of self-destructive behaviors need to be understood and managed through behavioral therapy and counseling sessions that may need to evolve throughout the treatment plan. In order to increase the odds for a successful recovery from alcohol abuse or dependency, individuals are encouraged to enter into a treatment program following detox.
Axis can provide you or your loved one with an individualized treatment plan in a safe, secure, and supportive environment that caters to all facets of recovery from detox to aftercare. Contact us today for more details.