Alcohol detox: what to expect
In 2019, approximately 14.5 million people in the United States suffered from an Alcohol Use Disorder

Alcohol use disorder (AUD) can negatively affect your health, relationships, and employment, which is why getting sober is vital. One of the biggest challenges to recovery is the alcohol detox process.

What is alcohol withdrawal?
How does it effect your health?

Prolonged and excessive alcohol use can cause changes to your brain’s structure, impacting how it functions. Two of the neurochemicals it affects contribute to the short-term effects of drinking and the development of alcohol withdrawal syndrome. These two neurochemicals are gamma-aminobutyric acid (GABA) and glutamate.

Alcohol changes how GABA and glutamate receptors work, slowing down brain function. This is what provides the sedative effects of alcohol. Your brain increases the levels of glutamate and decreases GABA levels to compensate for what alcohol does to the brain.

If someone with AUD stops drinking, their brain becomes hyper-aroused, sometimes just hours after their last drink. This is because alcohol affects excitatory neurotransmitters and inhibitory transmitters, and if you stop drinking, you can upset the balance of these transmitters and suffer a variety of withdrawal symptoms. As a result, the majority of people with AUD experience alcohol withdrawal symptoms, although their severity can vary.

Alcohol affects the central nervous system and how the body builds tolerance and dependence, which means most people who have AUD require help from a professional alcohol detoxing center.

Alcohol withdrawal symptoms
Moderate and severe symptoms

The withdrawal symptoms can vary from person to person, as can their severity. According to the National Library of Medicine, the most common minor symptoms include:

  • Anxiety
  • Nervousness
  • Trouble sleeping
  • Rapid heartbeat
  • Sweating
  • Headache
  • Cravings
  • Nausea
  • Loss of appetite
  • High blood pressure
  • Vomiting
  • Mood swings
  • Irritability
  • Clammy skin

Those who have had an alcohol use disorder for longer or who have a severe addiction can experience the above symptoms as well as more serious ones. These can include:

  • Body tremors
  • Extremely high blood pressure
  • Fever
  • Auditory or visual hallucinations
  • Seizures
  • Confusion
  • Disorientation
  • Delirium
  • Very fast heart rate
  • Severe agitation
  • Dehydration

Delirium Tremens, or DTs, can be a serious concern for people going through alcohol detox. It can decrease blood flow to the brain, causing delirium, acute confusion, and in some cases can be fatal.

Although not everyone with AUD develops delirium tremens, there are some factors that can point to a higher risk of developing it. People who consumed higher levels of alcohol in the weeks prior to beginning detox, as well as those who have gone through previous attempts at alcohol withdrawal, have a higher risk of developing this condition.

Others who have a higher risk include people who are older, those who have experienced DTs in the past, those who have underlying medical or mental health conditions, those who take medications, and those who are in poor health.

In order to prevent the dangerous symptoms of delirium tremens, it is important to turn to medical detox services. Consistent medical monitoring can alert professionals to emerging symptoms, and medications can be administered to manage them.

Alcohol detox process

Although everyone has a slightly different experience when undergoing alcohol detox, as there are many factors that can affect its pace, there is a general timeline.

Symptoms tend to begin within six to 12 hours from your last drink. You may experience sweating, tremors, nausea, vomiting, faster heart rate, and higher blood pressure levels. These are the milder symptoms. For many people, they peak within 12 to 24 hours.

The next stage brings on moderate to severe symptoms, beginning about 24 hours after your last drink. If you experience hallucinations, this is when they usually start. This stage can last two days or longer.

You have the highest risk of developing DTs between 24 and 48 hours after your last drink. You can experience seizures that require urgent medical attention. DTs can begin even 72 hours after your last drink.

For those who have severe alcohol use disorder, symptoms can continue for days after the last drink if they do not receive treatment.

Factors that can impact the detox timeline — as well as whether you have protracted symptoms — include the amount of time you have had the addiction, what your usual alcohol consumption levels are, your physical health, your gender, and even your age.

Dangers of unsupervised alcohol detoxification
Why rehab is safe and effective

One factor that makes alcohol withdrawal dangerous if attempted without medical supervision is the unpredictability of the symptoms. When you have supervision from medical professionals, you know you will receive the care you need, no matter the severity of the symptoms or how quickly they begin.

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The potential severity of the symptoms of alcohol withdrawal means that not having supervision can also put you at a higher risk of relapsing. Symptoms can be so overwhelming that you return to substance use to make them stop. Having supervision during this difficult time can help you avoid relapsing.

People who relapse during the detox process are also at a higher risk of alcohol poisoning. This is because they tend to drink more than they usually do in an effort to make the symptoms fade as quickly as possible.

Mental health concerns

Going through the detox process does not only affect your body; it also affects your mental health. Going through it alone means you will not have the support you need to deal with the anxiety and depression you can experience during withdrawal.

Symptoms of alcohol withdrawal can also escalate quickly. You may not be able to ask for help once you need it. At a facility that offers medical detox, professionals will be able to adjust your medications to deal with changing symptoms.

Physical symptoms

Vitamin and mineral depletion and dehydration can be a concern for those who undertake an alcohol detox process on their own. Dehydration can make symptoms worse and can even put your life at risk. For some with alcohol addiction, their nutrition is so poor that they can develop alcohol dementia, which in some circumstances is irreversible.

Detoxing from alcohol can be fatal if you do not have assistance. Seizures, high fevers, high blood pressure, and hallucinations can all be life-threatening.

Importance of medical detox
Having medical supervision can save lives

Medical detox is vital for those undergoing recovery from alcohol use disorder. It is the best way to ensure you remain safe and as comfortable as possible throughout the process.

Medical detox can help you remain stable so that you can focus on your recovery. With the right medications, you do not have to deal with the worst of the withdrawal symptoms, and you do not have to put your body through the potential danger of delirium tremens.

Continuous supervision ensures new symptoms do not get worse, allowing for quick medication adjustments. It also helps prevent relapses.

If you develop severe symptoms of alcohol withdrawal, having medical supervision can save your life.

Alcohol detox medications
To minimize moderate to severe withdrawal symptoms

To stabilize you as you go through the alcohol detox process, you may need to take some crucial medications. Your treatment team will determine which ones will work best for your symptoms, with SAMHSA outlining these most effective options:

Benzodiazepines can help with both mild and more severe withdrawal symptoms. These drugs depress the central nervous system, counteracting the symptoms alcohol withdrawal can cause. The most common benzodiazepines for alcohol detoxing are diazepam (Valium), lorazepam (Ativan), and chlordiazepoxide (Librium).
For benzodiazepine-resistant cases of alcohol withdrawal symptoms, barbiturates can be helpful because they also depress the central nervous system. They can also help prevent seizures. Phenobarbital is the most commonly used option.
SAMHSA states that anticonvulsants like Keppra, Depakote, and gabapentin can help keep you safe if you have a higher risk of experiencing seizures.
Relapse prevention medication

Many patients need additional help to prevent them from relapsing during detox. Some medications assist with relapse prevention and are commonly recommended. The American Journal of Psychiatryrecommends three options: Disulfiram, Naltrexone, and Acamprosate.

Disulfiram inhibits one of the enzymes that can metabolize alcohol, resulting in unpleasant effects if you drink alcohol while on it. It can help discourage drinking and can help prevent relapses, according to the National Institute on Drug Abuse.
Versions of Naltrexone, like Vivitrol or Revia, can help decrease alcohol cravings, allowing you to focus on your recovery.
Acamprosate is another important medication that can help restore the balance between GABA and glutamate in the central nervous system. It can also be an alternative medication for people with liver damage who cannot take naltrexone.
Treatment options for alcohol detoxing

Inpatient alcohol detoxing is the right option for most people with alcohol use disorder. Medical supervision in inpatient detox can keep you safe and comfortable by offering the continuous support you need to navigate withdrawal symptoms.

Getting help from professionals is especially important for people who have tried detoxing or experienced severe withdrawal symptoms before.

Once you have stabilized, you can continue to stay on track with your recovery by turning to medication-assisted treatment. These medications can help curb cravings, therefore preventing relapses and allowing you to focus on your therapy.

Entering treatment

Before entering treatment, you will need to complete a few different exams so that you can receive the right treatment.

A professional at the center will ask about your history of drinking and other substance use disorders. Assessing how much you drink per day can help the medical team decide on the right treatment course. This is when you can also discuss insurance information.

The treatment team may also ask you to undergo a few different types of physical exams, including:

  • Blood tests
  • Liver function tests
  • Urine tests

The Substance Abuse and Mental Health Services Administration (SAMHSA) states that blood and urine tests can best tell medical professionals about the levels of alcohol in your body. They also serve to see how your liver functions. Your liver is what metabolizes alcohol in the body, and it is common for people with alcohol use disorders to have liver damage.

Using the ultrasounds and other imaging tests that SAMHSA recommends, professionals can detect and evaluate early damage so that they can develop a treatment plan.

An HIV Risk Screening is another exam you may have to undergo as you enter treatment.

There will also be mental health screenings so medical professionals can diagnose co-occurring conditions that require treatment. A dual diagnosis can require complex treatment. Treating both conditions at once is the best way to address the feedback between them.

A psychosocial evaluation will allow you to meet a mental health expert and speak about your treatment goals, motivation levels, and more.

Get help for an alcohol use disorder

Starting your recovery from an alcohol use disorder means going through the detox process. Worries about withdrawal symptoms can prevent many people from attempting to get sober. Fortunately, you do not have to go through painful and dangerous withdrawal symptoms when you reach out for help.

By turning to a center that can treat substance use disorders, you can receive the medical detox you need. Get started with your recovery today.

Once you have gone through detox, you are ready to enter one of our addiction treatment programs. You work with our team of difference makers to determine which programs would be the best fit for you.

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