Alcoholism can completely upend a person’s life, as well as negatively impacting the people closest to them. The disease takes on a mind of its own after chemical dependency develops, wiping out any semblance of free will. No matter how desperately someone may desire sobriety, the deeply embedded addiction triggers and behaviors are usually impossible to overcome without professional help.
It is never too late to get needed help for an alcohol use disorder. Even later stage alcoholics can still reverse damage and change their lives, adding years of productivity and enjoyment to their life. However, one of the most strident deterrents to getting treatment for an advanced alcohol use disorder is the fear of going through detox and withdrawal.
True, alcohol detox can be especially daunting, with potentially life-threatening withdrawal symptoms, such as the delirium tremens (DTs) suddenly appearing halfway through the detox process. But in a medical detox there is specialized help with DTs from drinking excessively over a long period of time. These trained detox professionals are fully equipped to manage such serious symptoms, and to guide the individual through safely.
Overcoming Fear of the DTs from Alcoholism
What exactly is the delirium tremens, or the DTs, anyway? Some mistakenly confuse the term “DTs” with the hand tremors or body shakes that can occur in alcohol withdrawal. The DTs is actually considered a very serious health emergency that can emerge during alcohol detox rather unexpectant. The DTs are most common among those who have been heavy drinkers for a long time, impacting about 5% of individuals going through detox. Of those who experience the DTs, 5-15% will die from the condition.
The DTs may come on at or around the third day of detox. However, in some cases, detox may be winding down when, on day seven the sudden symptoms of the DTs begin. Symptoms of the DTs include:
- Uncontrollable tremors
- Severe mental confusion
- Extreme anxiety
- A sense that insects are crawling under the skin
- Heart failure
Sometimes the DTs will emerge when an unexpected hospital stay is required of a chronic alcoholic. In the hospital there will be no access to alcohol, meaning the emergence of withdrawal symptoms and possibly the DTs.
Getting Help With DTs From Drinking
While the DTs are a frightening possibility to consider, keeping perspective is key. Not only does it affect only a small percentage of alcoholics going through detox, when an individual undergoes detox in a medically supervised setting, their vital signs will be closely watched for the duration of the detox, and medical interventions are provided to reduce the possibility of seizures. Additionally, the medical detox providers can quickly identify the onset of symptoms and get immediate emergency medical help for the individual.
Getting help with DTs from drinking excessively for an extended period may mean a hospital stay to stabilize the individual and improve the outcome. Treatment will involve benzodiazepines and/or barbiturates or phenobarbital, often using IV infusion for quick relief and stabilization until symptoms subside. Dosing is congruent with the specific withdrawal signs observed, such as delirium, and will incrementally be reduced over a period of several days once the severe symptoms have stabilized.
The Importance of a Medical Detox
It is understandable why someone seeking treatment for alcohol dependence may be anxious about the detox and withdrawal phase of recovery. In fact, fear of alcohol detox can be a significant barrier to getting needed help for overcoming an alcohol use disorder. However, by seeking detox services through a medically supervised program, the individual can rest assured that they will be closely monitored throughout the process.
A medical detox is absolutely necessary for someone with a deeply ingrained alcohol use disorder. This is due to the possibility, no matter how remote, that the person could develop the DTs, which is a serious medical event. The medical detox team is trained to identify the early warning signs of the DTs, allowing them to be proactive in providing necessary emergency interventions.
Because the detox process can include psychological symptoms in addition to the physical symptoms, the trained medical detox specialists can also provide emotional support. This is essential during detox, as many may be tempted to give up and return to drinking just to avoid the emotional discomforts of withdrawal. Having this psychological support helps ensure that the individual safely segues into treatment.
What to Expect in Alcohol Detox
Alcohol detox and withdrawal will involve a wide range of severity, from mild to severe. The intensity of the withdrawal symptoms will be determined by such factors as the length of alcohol abuse history, the usual level of daily alcohol consumption, the individual’s state of health and their age, and whether there is a co-occurring mental health disorder.
Alcohol withdrawal symptoms will emerge within 6-12 hours of the last drink. In most cases, alcohol detox will be completed within one week. There are three phases to alcohol detox. These include:
Emerging symptoms: During the early phase of detox, the individual will experience nausea, abdominal pain, insomnia, sweating, and anxiety.
Peak symptoms: The symptoms will peak on days 2-3, and include tremors, high blood pressure, increased body temperature, irregular heart rate, agitation, and mental confusion.
The DTs may emerge on days 3-4 and would involved severe mental confusion, hallucinations, delusions, seizures, shallow breathing, shaking, rapid heart rate, and disorientation.
Subsiding symptoms: Days 5-7 feature declining intensity of symptoms, although some psychological symptoms, such as depression, anxiety, and sleep disturbance may linger.
Medical Interventions for Alcohol Detox and Withdrawal
Someone with a history of chronic heavy alcohol consumption will benefit from medications that are useful during the detox process, and in early recovery. During alcohol detox there is a risk of seizures, so benzodiazepines (Valium, Ativan, or Librium) are routinely prescribed. In addition to helping control the risk for seizures, the benzodiazepine can also help reduce anxiety and insomnia.
In some individuals, gabapentin is useful as an anticonvulsant. This drug can help treat seizures, as well as improve symptoms such as tremors, anxiety, high blood pressure, and nausea. For individuals experiencing psychotic symptoms such as hallucinations, an antipsychotic medication can help stabilize them.
Medication Assisted Treatment for Alcoholism Recovery
Medication-assisted treatment (MAT) may be helpful for individuals who have a history of relapsing. For someone with a moderate to severe alcohol use disorder, MAT may help individuals sustain recovery. Once detox has been underway for at least five days the drug naltrexone can be introduced. Naltrexone (Vivitrol, ReVia) is an opioid antagonist, which attaches to the brain’s opioid receptors and can function as an anti-craving medication in early recovery. Over time, the drug may help individuals lost all desire to drink alcohol. Naltrexone is non-narcotic and comes in a time-release injectable or pill form. Side effects include nausea, vomiting, headache, and fatigue.
Transitioning From Detox to Treatment
It is essential to complete detox before beginning to participate in an addiction recovery program. Once stabilized, the individual will embark on an intensive treatment program at a residential rehab center where they will stay for the duration commensurate with the severity of their alcohol addiction. Programs may be one month to one year in length.
Alcoholism is treated using an array of interventions that work together to usher in a new sober lifestyle. To arrive at that goal, one must first overhaul the learned addiction behaviors and develop new health thought and behavior patterns. This is a process that takes time and patience for the new habits to take root. These are taught through such evidence-based approaches as cognitive behavioral therapy, dialectical behavior therapy, motivation enhancement therapy, and contingency management. Therapy is provided in both individual sessions and in group formats, and may include family members and spouses.
How to Stay Sober in Recovery
Remaining sober will be a lifelong endeavor, requiring sobriety to be one’s number one priority. Without sobriety everything else will fall apart. Achieving a sustained recovery is the result of adopting new coping skills to access in times of distress. These recovery skills may include anger management techniques, stress reduction exercises, conflict resolution skills, and relaxation techniques.
Another helpful source of support are recovery groups, such as A.A. or non-12 step groups like SMART Recovery. These recovery communities offer much needed social support where challenges can be discussed among others with the same types of challenges who also value sobriety. These groups are a good source for making new sober friends and promote accountability to someone other than oneself.
Sober living housing is an excellent way to transition from rehab toward one’s home community, allowing a period of time to reside in a substance-free environment. Sober living offers peer support, accountability to the other roommates and the house rules, and provides a deterrent to relapse by requiring regular drug and alcohol testing.
Embracing a new healthy lifestyle is another predictor of recovery success. Individuals who adopt healthy routines, such as getting regular exercise and eating a nutritious diet, find they begin to care more about their overall wellness, which deters relapse. As health is restored, individuals become more confident and content with their new lives in recovery.
Ken Seeley Communities Offers Comprehensive Treatment for Alcoholism in California
Ken Seeley Communities provides a full spectrum of addiction services, including intervention services, medical detox that includes help from DTs from drinking, addiction treatment and rehabilitation, outpatient therapy, and sober living housing. Specializing in creating fully individualized treatment plans for each and every client, Ken Seeley Communities blends a variety of interventions to align with the client’s unique recovery goals. For more information about our continuum of addiction services, please connect with Ken Seeley Communities today at (877) 744-0502.