Alcohol Detox: Breaking Free from Addiction
Table of Contents
Facing alcohol withdrawal can be intimidating and overwhelming. It can be hard to imagine what life could look like beyond addiction. Having guidance when taking this essential step is vital so that you know what to expect and can keep yourself safe. Addiction medical experts and therapists can help you navigate each stage of withdrawal and prepare you for the next phase of recovery. Everyone can find hope in the shadows with the proper knowledge and determination. When there is a will, there is a way – and we will help you find it.
In this article, we will explain the following:
- The physical and psychological symptoms associated with alcohol withdrawal
- What acute alcohol withdrawal looks like, and how to manage it efficiently
- How long does the alcohol withdrawal process last and what to expect
- Everything you need to know about alcohol detox
- The risks associated with at-home alcohol detox and whether it’s a viable option
- The advantages of medically supervised alcohol detox and how it works
- Medications that can help with alcohol detox and make it more comfortable
- How and where to seek help during and after withdrawal to overcome addiction and prevent relapse
- Assistive programmes such as therapy, counselling, and support groups for those dealing with alcohol withdrawal and detox
- Outpatient rehab versus residential rehab.
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Alcohol Withdrawal Symptoms
Coming off alcohol is a challenging and exhausting process that brings many psychological and physical symptoms that vary in severity depending on your drinking patterns.
The thought of alcohol withdrawal symptoms often scares people struggling with alcohol issues the most. It is easy to understand why: experiencing it unaware and unassisted is dangerous, extremely uncomfortable and even life-threatening. That’s why it’s vital to seek professional medical support. Being well-informed and prepared and having access to proper clinical care will make the process much smoother and safer.
The physical signs of alcohol withdrawal may vary depending on your past drinking habits but generally include the following:
- Malaise or a general feeling of being unwell
- Stomach pain and nausea
- Dry mouth
- Heavy sweating
- Muscle cramps
- Heart palpitations
- Tachycardia (heart rate over 100 beats per minute)
- High blood pressure.
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The severity and intensity of psychological symptoms associated with alcohol withdrawal also vary greatly depending on the individual’s level of addiction. Typically, these may include the following:
- Sadness and melancholia
- Hypersensitivity to sensory stimuli
The signs and symptoms listed above are usually considered mild and typical of the usual withdrawal process that does not threaten one’s life.
However, in some cases, such as if an individual has long-term heavy drinking habits or certain pre-existing conditions, they may experience severe symptoms requiring immediate medical attention. You should be particularly aware of the following:
- Extreme paranoia
- Bouts of rage
- Hallucinations or alcoholic hallucinosis
- Delirium tremens (extreme disorientation and agitation that can lead to heart failure).
Acute Withdrawal from Alcohol
Alcohol withdrawal syndrome is a tricky and complex disorder that affects individuals who have become dependent on alcohol and suddenly stopped consuming it. It is known to cause mild to severe physical, psychological, and autonomic dysfunctions that can occur shortly after the last alcohol intake. Most symptoms of alcohol withdrawal syndrome are similar to a typical hangover, but one marked difference is an irresistible craving for alcohol. This syndrome only occurs in people who suffer from alcohol addiction. While hangovers usually disappear within a few hours, the withdrawal syndrome lasts several days and causes grave distress.
Alcohol Withdrawal Timeline
The length and intensity of the withdrawal process caused by alcohol misuse are unique for everyone and vary based on several factors. These can range from how long one has been heavily drinking alcohol to having pre-existing physical or mental disorders that can exacerbate symptoms. Generally, however, most people experience three phases of withdrawal (although your symptoms may not progress this way – not everyone goes through all three stages).
Phase 1: Mild Symptoms
The first symptoms appear within 24 hours after your last drink. The symptoms of mild alcohol withdrawal syndrome resemble those of a hangover but are much more intense.
The predominant symptom is tremors or shaking, with the intensity ranging from mild to severe. Alcohol tremors mainly occur in the hands but can also affect the head and tongue.
Other symptoms may include the following:
- Profuse sweating
- An accelerated heartbeat
- High blood pressure
- Hyperventilation accompanied by chills and a low-grade fever
- Feelings of frustration, anxiety, and anger
- Insomnia and disturbing dreams
- Generalised feelings of profound sadness
- Compulsive cravings.
It is also not uncommon for people to experience short periods of delusion. For example, they might see or hear things that are not there. Delusion symptoms are typically short-lived, and the patient often understands that what they perceive is not real.
While generally not life-threatening, Phase 1 withdrawal symptoms can last up to a week or longer. They peak after 24 hours and begin to subside after three days. However, feelings of unease, such as fear or sadness, and difficulty sleeping can remain for a few more weeks.
Phase 2: Moderate Symptoms
The signs and symptoms of Phase 2 of alcohol withdrawal syndrome are similar to Phase 1 but more severe. They usually start between 48 and 72 hours after the last drink.
Phase 2 withdrawal symptoms typically include the following:
- Tremors and shakes intensify, and the patient experiences difficulty talking and standing;
- An episode of true hallucination may occur, during which the patient cannot tell what is real. Hallucinations can indicate upcoming delirium tremens;
- Symptoms often fluctuate in intensity throughout the day. They usually amplify at night, accompanied by profound fear and unease. Very vivid and persistent hallucinations can appear, such as frightening visions of insects. Patients feel like they are being watched, followed, or endangered;
- Patients are at an increased risk of epileptic seizures if they have pre-existing epilepsy, have had a head injury, or display multiple substance dependencies such as benzodiazepines or barbiturates;
- Epileptic seizures generally occur within the first 10 to 36 hours following the last alcoholic beverage.
Phase 3: Severe Symptoms or Delirium Tremens (DTs)
Delirium tremens is the most extreme form of alcohol withdrawal syndrome, persisting for up to a few days. Fatalities from DTs are rare when professional medical care is in place. Still, the condition is life-threatening, particularly if the patient is physically frail and exhausted. Therefore, it requires immediate medical attention.
- Delirium tremens cause extreme disorientation and an altered state of consciousness with brief bouts of hyperactivity. During these activity peaks, the patient may compulsively attempt to complete imaginary tasks;
- The patient experiences vivid visual and auditory hallucinations;
- Violent body shaking, heavy sweating, sleeplessness, and severe emotional distress are common;
- The patient may also suffer from a severe fever and dehydration.
Alcohol detox is the first step in overcoming alcohol dependence. It is the most crucial part of this process, as it requires you to consciously decide to quit drinking and begin purging alcohol from your system.
The severity of your alcohol withdrawal experience will depend on how much you drank and for how long. Some people barely feel it, experiencing only minor physical discomfort. In contrast, others go through a more intense form of alcohol withdrawal syndrome.
Typically, symptoms peak three days after your last drink and subside during the first week of detox. In some cases, some symptoms may linger for a few weeks or longer.
When someone drinks heavily, their body begins to rely on alcohol to operate. So, taking good care of yourself during detox is crucial to having a successful transition period. Doing so can help make this process significantly more comfortable.
Certain withdrawal medications may also be necessary for a short period during detoxification to assist the patient in managing their withdrawal symptoms and maintaining or regaining health.
Alcohol addiction is powerful, and resisting cravings can be challenging. Having a reliable support system is essential for those undergoing rehab. Some patients only stop drinking for the sake of loved ones, not necessarily themselves. If you are that loved one, showing support may be enough to push the person you care about through the tough times without relapsing. Do not underestimate the power of supportive relationships.
Home Detox for Alcohol
Detoxing from alcohol without medical guidance is dangerous and could lead to unexpected symptoms that are unmanageable without medical assistance. As for withdrawal medications, it is up to a licensed narcologist to prescribe them. They know the best treatment plan for each patient and the appropriate dosage for each drug.
Still, some people favour detoxing at home because it might be more affordable or convenient for them, or perhaps they feel daunted by the prospect of residential rehab.
For the safest possible home detox, the following criteria must be met:
- The individual has no other physical issues or pre-existing conditions, nor are they dependent on any substances other than alcohol;
- The patient initiated detox after a period of heavy drinking that did not last longer than three days;
- The patient is highly motivated to quit drinking and not return to old habits.
If you are attempting to detox from alcohol in the comfort of your own home, try to:
- Get as much rest as possible. If struggling to fall asleep, try to avoid sleeping pills and look into non-medicinal methods like meditation or herbal teas. Daytime naps can also be beneficial;
- Drink lots of water and stay hydrated. Freshly squeezed juices and smoothies are also good options to maintain optimal fluid balance and quickly help your body eliminate toxins. Make sure you consume at least two litres of liquids throughout the day;
- Maintain a tidy and airy living space. Taking walks is also important during detox to help you relax and clear your mind from negative thinking;
- Follow a ketogenic diet, which could be beneficial in reducing alcohol withdrawal symptoms.
Medically Supervised Detox for Alcohol
Medical detox is the safest choice for those struggling with severe alcohol abuse, as withdrawal could be fatal. Moreover, it is more likely that the patient will fall back into drinking due to strong cravings, so they must receive medical assistance to control them.
Upon admission to a medically supervised detox programme, a team of healthcare professionals assess the patient’s overall health and take steps to stabilise them before beginning treatment.
Detoxification starts as soon as the patient’s condition is stable and they are strong enough. A doctor will decide on the optimal medication combination depending on how long the person has been drinking, their age, and general health.
During a detox programme, health professionals assist the patient in managing their symptoms and provide answers to any questions they may have. They constantly monitor the patient and never leave them dealing with their anguish alone.
Medicines That Can Support Alcohol Detox
When dealing with severe alcohol syndrome, patients require several different medications to assist them in recovering from the withdrawal, such as anti-depressants and anti-convulsants such as benzodiazepines, antiemetic medicines, and acamprosate. The intensity and type of symptoms the patient experiences will determine the type of medication administered.
Benzodiazepines like Xanax, Valium, and Ativan are highly successful in helping patients with alcohol withdrawal. These drugs act on the same areas of the brain that alcohol does. They help flush out the remaining traces of alcohol while providing a certain degree of familiar comfort to the patient. They also provide relief from the hallucinations, delusions, and seizures that occur with severe alcohol withdrawal syndrome. However, benzodiazepines are one of the most abused prescriptions. It is essential to respect the prescribed timeline and discontinue use once severe alcohol withdrawal symptoms have subsided. Otherwise, a benzodiazepine addiction may ensue.
For successful and long-lasting sobriety, quitting alcohol and detoxing is only the first step. Proper psychological support and treatment are necessary if the patient is to have the best chance of a durable recovery. It requires the patient to reflect on why they started drinking heavily in the first place, analyse their personal history and family dynamics, and develop a strategy that prevents them from going back to substance abuse.
Here’s an overview of the types of support available to patients during and after alcohol detox.
Joining support groups can be helpful for anyone dealing with addiction. By talking about their worries and struggles, aspirations and recovery plans, people struggling with alcohol dependence can feel supported or even just heard and understood.
Individually tailored sessions with a therapist do wonders for analysing the root cause of addiction. Discovering what is lacking in the patient’s life that made them turn to alcohol is key. Delving deep into personal and familial issues and dynamics is essential to address them and stop relapse from happening.
Outpatient rehab is a potential avenue for those looking to recover from alcohol addiction without staying in a medical institution. It is often suggested for individuals dealing with manageable addiction that has not been ongoing for too long and who can control environmental factors and their withdrawal symptoms. Outpatient rehab gives one the necessary medical support while living their regular life.
Inpatient rehab is the ideal choice for individuals who have experienced long-term alcohol abuse that has caused serious damage to their health, career, and relationships. This type of treatment enables the patient to receive continuous support from an expert in case of severe withdrawal symptoms. It also provides a safe environment, free from triggers that could lead to relapse, and demonstrates that abstinence from alcohol is possible.
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What To Expect From Your Body When You Stop Drinking?
Once you stop drinking, your body begins to heal itself almost immediately. Generally speaking, the most intense withdrawal symptoms last no more than one week. After that, your condition starts to improve noticeably. Sleeping becomes much easier, eating habits return to normal, and people usually regain lost weight as they become more physically alert and active.
How Long Does Alcohol Stay In Your Brain?
It takes different amounts of time for varying parts of the brain to bounce back from alcohol abuse. However, much of the damage should be repaired within fourteen days of detoxification. The thinking area of the brain takes the longest time to recuperate. Ongoing sobriety and abstinence make at least partial recovery of all diminished cognitive functions possible.
How Long Does It Take For Your Liver To Process Alcohol?
The liver can process about one alcoholic drink per hour, so it depends on the amount consumed. Generally, alcohol does not stay in your system for very long. It remains detectable in the bloodstream for about 6 hours, and its half-life is around 4-5 hours. Some tests can detect the presence of alcohol up to 24 hours after consumption, although these are generally urine tests.
- Wiers, C.E. et al. (2021) “Ketogenic diet reduces alcohol withdrawal symptoms in humans and alcohol intake in rodents,” Science Advances, 7(15). Available at: https://doi.org/10.1126/sciadv.abf6780.
- How Long Does Alcohol Stay in Your System? (2022). Available at: https://americanaddictioncenters.org/alcoholism-treatment/how-long-in-system.
- Sachdeva, A., Choudhary, M. and Chandra, M. (2015) Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond, Journal of Clinical and Diagnostic Research. Available at: https://doi.org/10.7860/jcdr/2015/13407.6538.
- How to safely detox from alcohol at home. Available at: https://www.wearewithyou.org.uk/help-and-advice/advice-you/how-safely-detox-alcohol-home/.
- Alcohol and the Brain: An Overview | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Available at: https://www.niaaa.nih.gov/publications/alcohol-and-brain-overview.