Alcohol Detox

Jump to:

1. The Need for Assessment
2. First Steps
3. Inpatient or Outpatient?
4. Managing Symptoms
5. Completion

In order to truly fight an addiction to alcohol, an addict must go through detoxification. Here, all traces of alcohol are removed from the body, and the addict’s brain and nervous system learn to function in the absence of alcohol. It’s a natural, normal and healthy process, but it can also be a bit terrifying for the addict to contemplate. The idea of surviving a day without alcohol might be frightening in and of itself, but the addict might also be concerned about death. News reports don’t help. For example, news articles reported, in late 2011, that Amy Winehouse’s father suggested that the singer died as a result of alcohol withdrawal. This turned out to be false, of course, but reports like this might fuel the fire that alcoholics keep burning in order to avoid detoxification and recovery. The addiction and the fear tend to feed off one another.

While alcohol detoxification might be frightening, it certainly doesn’t have to be life threatening. In fact, there are many therapies available that can make the process easier for the addict to complete. In short, there’s no reason that an alcoholic can’t go through detoxification and emerge ready to tackle the hard work of rehabilitation. With the proper care and attention, detoxification could be just the first step on a road to wellness.

The Need for Assessment

Everyone who drinks alcohol goes through a form of detoxification. When alcohol enters the bloodstream, the liver kicks on and works to remove the drug. This, at its purest form, is detoxification and the process is considered complete when no drugs remain in the system. For alcoholics, however, detoxification is a bit more intense. Alcohol abuse causes changes in the way the nervous system works. Some receptors become dulled and unresponsive, and other systems kick into overdrive to provide more chemicals and force this system to wake up. When the alcoholic stops using alcohol, the unresponsive receptors truly do wake up, but the augmented systems keep pumping out increased amounts of chemicals. The system goes into a sort of overdrive, flooding the nervous system with information. This can cause a wide variety of symptoms.

According to an article published in the journal Advances in Psychiatric Treatment, these are the 10 symptoms most alcoholics commonly report during detoxification:

These symptoms might not seem extremely serious, but other symptoms certainly are. Some people experience hallucinations, either visual or auditory, and they may rant and rave. They may even be diagnosed with a mental illness as a result of these symptoms. Other people face even more significant symptoms. According to an article published in the Journal of Family Practice, up to 25 percent of people experience grand mal seizures during alcohol detoxification, and five percent of people die as a result.

The risk of death from detoxification might seem low, but it still exists and it’s a real possibility for people who attempt to stop drinking without medical help. For this reason, most medical experts suggest that alcoholics visit their doctors or an addiction counselor before they try to stop drinking. This can, understandably, be difficult for family members to tolerate. After all, they simply want the person to stop drinking, and they may want that cessation to happen sooner rather than later. The delay can seem unacceptable. It’s important to remember, however, that the person can die due to detoxification so it’s essential to get the process just right, even if that means a delay of a day or two.

First Steps

Inpatient or Outpatient?

At the end of this assessment, medical staff members will have the information they need to help the addict choose from an inpatient or outpatient detoxification program. There are benefits and drawbacks to both approaches, and a setting that works for one addict might not work for another. For therapists treating alcoholics, this decision is often based on the addict’s medical history.

People who have been through detoxification processes before, or who have a history of seizures, should go through a detoxification program in a facility where they can be closely monitored at all times. People who have none of these risk factors might be able to participate on an outpatient basis, where they go back home at night. According to an article published in the New England Journal of Medicine, both methods can be effective. The researchers studied alcoholics with mild to moderate levels of abuse, and placed some in both programs. After six months, the difference between the groups was negligible, although the people who participated in the outpatient program spent less money on treatment. For people in good health with mild to moderate alcohol abuse, this could be a good option.

Managing Symptoms

During detoxification, doctors use a wide variety of medications to manage symptoms. They might provide benzodiazepines to assist with hallucinations and anxiety, for example, and they might provide beta-blockers to help with high blood pressure problems. In the past, doctors provided these medications to everyone at a specified dose. Now, more doctors are giving medications only when symptoms appear. This can help the alcoholic get through detoxification without feeling doped up, and it can help to control costs. According to a study published in the Journal of the American Medical Association, people who received medications when symptoms appeared experienced no more seizures than people who received a set dose of medications at regular intervals. In short, this dose-dependent version of medication therapy seems to be effective.

Medical staff might continue to take blood pressure and heart rate readings, and they might ask the alcoholic a series of logic questions, to ensure that the addict is thinking clearly and isn’t hallucinating. The alcoholic might also be asked to describe how he or she is feeling, and point out any symptoms that are cropping up. This can help the staff members know when to intervene with medications.

In addition, many alcoholics have nutritional deficiencies as a result of their substance abuse. Drinking alcohol puts a huge strain on the body, and the addict could have B-vitamin deficiencies and electrolyte imbalances. During detoxification, the alcoholic might be given vitamins and nutrient-rich foods. Staff might also begin to teach the alcoholic how to cook and eat well, which could turn into a valuable hobby the addict can continue when therapy is complete.

Completion

Most detoxification programs are complete within a few weeks. As the end draws near, the staff may begin to encourage the addict to participate in counseling sessions or 12-step meetings, to begin thinking about what addiction therapies will entail. It’s important for the addict to transition into these programs immediately once detoxification is complete, and detoxification staff members have a strong role to play here. They may have the addict’s trust and respect, and they can use those tools to help encourage the alcoholic to move forward with therapy.

At Alta Mira, we provide both alcohol detoxification and treatment programs. Our patients move right from one program to another, with no gap in the continuity of care. We believe this is the best method to use to help an addict truly recover in the most efficient and effective way possible. Call us today to find out more about how we can help.