By Michael Rass
Like food and other substances humans ingest, drugs and alcohol must be processed by the body before they can be eliminated from the system. “The presence of drugs and alcohol in your body may last for hours, days, or even weeks, depending on a multitude of factors,” says Kacie Sasser, the senior director of medical services at Lakeview Health. “Various substances are metabolized in different ways by different people.”
Many factors play a role, including the age of a person, their body weight, genetic heritage, kidney and liver function, their individual metabolic rate, and the substance, of course. When patients come to Lakeview Health for addiction treatment, they are carefully monitored to make sure their stay and the beginning of their recovery are as comfortable as possible. This includes regular urine and blood screens to determine what substances remain in the body.
For patients with alcohol use disorder, the clinical team at Lakeview Health uses a test that utilizes phosphatidyl ethanol (PEth) in the blood as a direct marker of chronic alcohol misuse. While the more familiar blood alcohol concentration (BAC) can only indicate alcohol consumption during the previous few hours, PEth can be detectable in human blood three to four weeks after the beginning of sobriety.
While any acute intoxication normally lasts a few hours, traces of alcohol stay in the system much longer. Most other drugs will typically show a positive result in a urine test up to five days after using them.
The exceptions are cannabis and benzodiazepine. “Both are lipophilic drugs,” says Sasser. “They are metabolized and then sit in people’s fat cells for quite a while. The more fat cells a person has, the longer their body can hold on to the substance.” They are usually no longer psychoactive but are stored in the body for many days. Marijuana use can be detected in a urine test up to a month after using.
If prolonged use of drugs and alcohol has led to addiction, withdrawal symptoms will emerge once the substance has been partially purged from the system beyond a certain threshold. For opioids and alcohol, severe withdrawal symptoms can appear within 24 hours after the last usage if the substance use disorder is severe.
“The physical symptoms of withdrawal can be very unpleasant and sometimes even dangerous,” says Sasser. At Lakeview Health, patients can safely detox in the in-house facility with around-the-clock supervision by the medical team.
Even when the substance is no longer present, withdrawal symptoms can cause problems. The initial acute withdrawal symptoms are often followed by what’s known as post-acute withdrawal syndrome (PAWS). During this second stage of withdrawal, patients typically have fewer physical but more emotional and psychological withdrawal symptoms.
Acute withdrawal symptoms include sweating, nausea, vomiting, diarrhea, chills, anxiety, and tremors,” explains Sasser. The most common PAWS symptoms are mood swings, anxiety, irritability, fatigue, low energy, difficulty concentrating, and disturbed sleep. In some cases, the more severe symptoms of acute withdrawal recur.
Post-acute withdrawal occurs because the patient’s brain chemistry is gradually returning to normal in an early recovery. As the brain seeks a new equilibrium, the levels of brain chemicals can fluctuate, causing PAWS.
This second wave of withdrawal symptoms is often unexpected by patients and can make the recovery from addiction even more challenging than it already is. “There are reported cases of PAWS symptoms up to a year into sobriety,” says Sasser.
Withdrawal symptoms occurring months after going into recovery can pose a dangerous relapse risk. Addiction is a complex disease requiring treatment on multiple levels over a considerable time span. The treatment program at Lakeview Health employs five levels of care to provide patients with the best possible toolset for a sustained recovery.
The Lakeview Health treatment model is an integrative health approach addressing the individual needs of patients comprehensively. Following treatment, each patient will leave Lakeview with the aftercare support and coping skills needed for a successful recovery and a fresh start into a healthy life of sobriety.
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