If only there was a way to magically bypass the detox and withdrawal phase of recovery. But until some brilliant inventor creates a magic pill that can allow a person to leapfrog over the suffering of detox, there is the medically supervised detox, an absolute necessity when alcohol is the substance involved.
It is widely understood that people with an alcohol dependency who want to enter recovery should undergo a medically supervised detox. There is good reason for this guidance, as the effects of coming off alcohol can produce highly unpredictable, even dangerous, symptoms. Trained detox specialists are prepared to intervene should such symptoms arise and result in a medical emergency.
Alcoholism continues to lead the rehab admissions in America. While the opioid crisis has captured the national headlines, in reality alcohol addiction represents 80% of the individuals suffering from a substance use disorder, according to the Substance Abuse and Mental Health Services Alliance.
There is a strong genetic component to the disease, with over 50% of Americans having a family history of alcoholism. In addition to genetics, neuroscience research is beginning to identify the chemical effects of alcohol on the brain structures. Using MRI and PET imaging, scientists are able to literally see the impact of alcoholism on the human brain. According to the National Institute on Alcohol Abuse and Alcoholism, a method called event-related potentials (ERP) has allowed researchers to identify markers that appear in the brains of alcoholics and their children, becoming a useful tool for identifying individuals at risk for alcoholism.
Other potential risk factors for developing an alcohol use disorder include alcohol being introduced at an early age, psychological factors, such as a co-occurring mental health disorder, poorly formed coping skills or a lack of resilience, or stressful life events.
Importance of a Medical Detox
All too often, someone wrestling with an alcohol dependency may hit a low point and impulsively decide to stop drinking on his or her own. Attempting to undergo alcohol detox alone is a serious mistake, as sudden, unpredictable acute withdrawal symptoms can emerge, requiring immediate medical attention. Medical detox specialists possess the training to quickly intervene should severe withdrawal symptoms suddenly occur.
During a medical detox, a specially trained detox team will have the client’s intake data available that can prepare them for any potential problem. This information helps to alert the detox team if there is a health condition or a history of acute withdrawal syndrome. Throughout the detox process the team will monitor the client’s vital signs so they can identify any serious symptoms.
The delirium tremens (DTs) is a very serious development that constitutes a medical emergency. While the DTs only affect a small percentage of individuals going through alcohol detox, the mortality rate for those who do is about 5%-15%, the need for medical attention should it emerge is essential. Symptoms of the DTs include severe mental confusion, tremors, fever, high blood pressure, hallucinations, and seizures.
During medical detox, specialists will administer medications as needed to dramatically reduce many of the common alcohol withdrawal symptoms, as well as provide emotional support. The goal of a medical detox is to use medical interventions to guide the client safely through the withdrawals with the least amount of discomfort, while preparing the individual to transition into the treatment phase of recovery.
Factors that Influence Withdrawal Severity
Certain factors can determine the level of severity of the withdrawal symptoms, which can range from mild alcohol withdrawal symptoms to severe. These factors include:
- Length of history of the alcohol use disorder
- The level of alcohol consumed daily
- Having a history of alcohol withdrawal syndrome (AWS)
- Age of individual
- A coexisting mental health disorder
- General health status of individual
Withdrawal Symptoms and Detox Timeline
Alcohol detox needs to be viewed as a necessary step in achieving freedom from alcohol addiction. It is the gatekeeper to recovery, so it must be endured before one can proceed into addiction treatment. Detox is the most unpleasant part of recovery, where the body attempts to adjust to the sudden absence of alcohol, something that results in unpleasant physical withdrawal symptoms that begin within 6-12 hours. Again, alcohol detox should only be attempted under the care and supervision of a trained medical detox team.
In most cases, withdrawal symptoms will be unpleasant, but not life threatening. However, for someone with a long history of excessive alcohol consumption or other risk factors, serious complications can arise. Withdrawal symptoms generally fall into one of two categories based on the severity of the alcohol addiction or dependency.
Common Alcohol Withdrawal Symptoms
- Tremors of the hands
- Rapid heartbeat
- Agitation or irritability
Severe Alcohol Withdrawal Symptoms
- Body shakes
- Mood swings
- Severe mental confusion
Alcohol detox occurs in three stages—the emergent stage, the peak stage, and the subsiding stage—and is typically completed within 7 days.
Managing the Effects of Coming Off Alcohol
While the unavoidable effects of coming off alcohol is an unpleasant one, here are some methods that can help to minimize the discomfort:
- Hydrate. While the body is detoxing electrolyte levels can benefit from drinking fluids, which helps combat nausea and dehydration.
- Distract. Depending on the severity of the withdrawal symptoms, it may help if you can take a walk, take a brisk shower, listen to music or a podcast, or watch TV.
- Eat healthy. Increase the intake of fresh fruits and vegetables to help balance blood sugar levels.
- Holistic. Try deep breathing techniques, aromatherapy using oils that reduce cravings and help with detoxification, a YouTube yoga class, or a meditation app.
Riding out the detox process is just that, so brace yourself for waves of cravings that will soon dissipate, remind yourself of the reasons you seek sobriety, and know that the detox process is a very short-lived inconvenience.
Medically Assisted Treatment for Alcoholism
The medication naltrexone, under the brand names Vivitrol or ReVia, can be very helpful to individuals with a more severe alcohol use disorder. Naltrexone works as an opiate antagonist in the brain, which has been found to help recovering alcoholics remain sober when prescribed along with therapy and other protective measures. After the individual has completed alcohol detox, they are prescribed a 3-12 month regimen of naltrexone to help the individual stabilize in early recovery. Over time alcohol cravings will diminish and relapse risk can be significantly mitigated. Naltrexone is not intended as a permanent medication, and should be closely monitored through continued engagement in recovery efforts.
Treatment for Alcoholism
After detox is completed, a structured addiction treatment program will guide individuals through the process of changing disordered addiction-related behaviors and habits. Recovering from alcoholism requires an extended period of treatment to replace those self-destructive patterns and acquire new behaviors and recovery skills that help support sobriety. Rehab is available in an outpatient format, which is appropriate for mild to moderate alcohol use disorder, or a residential format, which is appropriate for moderate to severe alcoholism.
While in treatment the individual will participate in a variety of treatment activities and therapies that approach all angles of recovery, including:
- Psychotherapy. Individual therapy, using various evidence-based psychotherapies, helps the individual work through any underlying emotional issues or past traumas that may be a factor in the alcoholism.
- Cognitive behavioral therapy. CBT guides individuals toward adopting new thought and behavior patterns that replace the disordered patterns that have culminated in alcohol abuse through addict behaviors.
- Group therapy. Group sessions offer peers in recovery opportunities to share about their personal experiences and challenges, fostering an essential source of mutual peer support.
- Family-based therapy. Family-focused therapy helps family members process their frustrations, mend hurt feelings, and discuss the fears around the disease of alcoholism and how it has impacted the family.
- MAT. Medication-assisted treatment (MAT) using naltrexone can support recovery and help sustain sobriety by managing cravings.
- Relapse prevention planning. Each individual will examine his or her unique triggers or stressors that could potentially disrupt recovery and lead to a relapse.
- Meetings. 12-step meetings, or some form of alternative programming, can provide additional social support, as well as opportunities for establishing new sober friendships.
- Holistic therapies. There are complementary therapies, such as yoga classes, massage therapy, acupuncture, mindfulness training, and art therapy that can help the individual in recovery regulate stress.
- Nutritional counseling and exercise. Establishing new lifestyle habits that are focused on wellness are incorporated into the program to help promote physical and psychological healing.
Life in Recovery
Taking that first step is momentous, putting you on the path to reclaiming your life and fulfilling the dreams that had been lost in the fog of addiction. Life will begin to improve in a multitude of ways, especially following that first year of recovery. But even in that first year of adjusting to a sober lifestyle, improvements in sleep quality, your physical appearance, energy, cognitive and memory functions, and overall mood will spur you to stick tight to the plan. Stay in outpatient therapy, participate in a recovery community, and try sober living if the home environment is not supportive to your recovery goals. Do whatever it takes because life is so worth the effort.
Ken Seeley Communities Alcohol Recovery Program in Palm Springs
Ken Seeley Communities is a leader in the field of addiction recovery. Founder Ken Seeley is a renowned professional interventionist who was a staple on the A&E series, Intervention. His recovery complex includes all facets of the recovery continuum, including intervention services, medical detox, outpatient rehab programming, residential rehab programming, and sober living housing. If you are ready to tackle the effects of coming off alcohol in a safe, supportive environment, please reach out to our team at (877) 744-0502.