Detox programs are the first step in many alcohol and substance abuse treatment facilities. Sometimes, there is a fear associated with stopping use of a substance that is being misused. Withdrawal symptoms and cravings are a normal part of the withdrawal process, but often these prove to be too intense and relapse can occur in the early stages of recovery. Using a detox program can help make this process more tolerable and increase the likelihood of sobriety.
There are several medications available to assist through the detox process, and some can be continued as part of a Medication-Assisted Treatment (MAT) option. In addition, there are different rehab programs for alcohol use disorder (AUD) available depending on the needs of the person entering treatment.
Understanding Alcohol Abuse
Several social settings include alcohol. It is not uncommon for people to drink at weddings, parties, sporting events, or holiday celebrations. These situations are typically a celebration in which people are relaxing and socializing. This is not the same as feeling the need to drink alcohol in order to enjoy these social situations.
Some people can drink alcohol without any issue with abuse or addiction. When drinking occurs on a frequent basis, and the individual begins to drink to excess, abuse and addiction become a concern.
In general, if a person is drinking alcohol compulsively, unable to control how much they drink, or if the are feeling anxious, stressed, or irritable when they are not drinking, exploring the possibility of an alcohol use disorder may be warranted. Being aware of the signs and symptoms of alcohol use disorder, abuse, and addiction may help identify a need for an alcohol detox program.
What Is An Alcohol Use Disorder?
An alcohol use disorder (AUD) is a diagnosis that includes alcohol abuse and alcohol dependence, with a severity of mild, moderate, or severe, depending on how many criteria are met. When there is a cause for concern, a person may be asked specific questions regarding their drinking. If criteria for an AUD is met, a detox program in addition to an alcohol treatment program may be recommended.
What Are Alcohol Detox Programs?
Detox programs are one part of a medical treatment for alcohol use disorder. It is a general recommendation that a person who struggles with an alcohol use disorder should participate in an alcohol detox program prior to starting treatment. In these programs, a patient will typically be given medication that will help the person through the alcohol withdrawal process sometimes associated with AUD.
The standard medications given in an alcohol detox program are benzodiazepines. Specifically, long-acting benzodiazepines, such as chlordiazepoxide (Librium), lorazepam (Ativan) or diazepam (Valium).
In this setting, a physician will administer this medication to help ease withdrawal symptoms, and over a period of time the medication will be reduced and eventually stopped. This process, known as tapering, can control hallucinations, anxiety, and seizures.
Other medications have been found to help with alcohol withdrawal symptoms, and depending on patients need, some of the following may be prescribed in addition, or in place of, benzodiazepines:
- clonidine (Catapres) has been found to help with mood, blood pressure, sweating and tremors
- gabapentin (Neurontin) was effective with seizures, anxiety, tremors, nausea, and blood pressure
- baclofen (Lioresal) is a muscle relaxer that can help reduce cravings for alcohol
- antipsychotics may be prescribed for irritable or aggressive patients, or those suffering from hallucinations due to alcohol withdrawal
Depending on individual symptoms, a person may be prescribed specific medication to treat mild withdrawal symptoms. Some people may need a medication during the initial detox program, and may need to continue use of it throughout and after treatment.
Approved Medications For MAT Programs For Alcohol Use Disorder
Currently, there are three medications approved for medication-assisted treatment. Depending on the individual needs of the patient, a physician may decide to introduce one of these during the detox process:
- disulfiram (Antabuse) causes unpleasant symptoms when alcohol is consumed
- naltrexone (ReVia) blocks the feel-good receptors in the brain and reduces cravings
- acamprosate (Campral) reduces cravings by working on several areas of the brain
How Long Does An Alcohol Detox Program Last?
The length of a detox program depends on the individual, however, most symptoms start to appear within eight hours of the last drink and can last for several weeks. Managing symptoms is the purpose of the detox program, so the length of time varies from person to person.
Additional factors may also affect the length of time a person will need to attend an alcohol detox program, including:
- length of time spent drinking alcohol
- amount consumed regularly
- other substance use disorders present
- other health problems
- other co-occurring mental health issues
- medications used during detox (some require tapering)
It is important to understand that each person and their needs in an alcohol detox program will likely vary from those of the next person. Obtaining services that are focused and individualized, while using approved medications to ease the discomfort associated with withdrawal symptoms, is an important first step towards abstaining from alcohol.
Symptoms Of Alcohol Abuse And Addiction
While there are specific criteria that need to be met to be diagnosed with an AUD, there are other signs that a person may be abusing alcohol, and might be struggling with addiction.
These symptoms appear in many ways, including physical, behavioral, and psychological signs, such as:
- stomach distress
- muscle cramps
- coordination issues
- balance problems
- sexual dysfunction
- slurred speech
- impaired thinking
- poor coordination
- memory issues
- drinking secretively
- wanting to stop but not being able to
- being upset about not being able to drink
- avoiding responsibilities to drink instead
- drunk driving, and other risk-taking behaviors
- continued use of alcohol after it is clear that drinking is causing problems
- drinking to stop withdrawal symptoms
Some individuals may experience severe side effects from drinking alcohol, including:
- birth defects
- shrinking brain
- Alcoholic Korsakoff’s Syndrome
- liver damage
- heart damage
- chronic pancreatitis
Signs Of Alcohol Overdose (Alcohol Poisoning)
Continuing to drink beyond the level of impairment can cause an alcohol overdose, often referred to as alcohol poisoning. When this occurs, there is so much alcohol in the bloodstream that parts of the brain start to shut down. Specifically, this includes areas that control autonomic functions, like heart rate, breathing, and gag reflex.
Some symptoms of alcohol poisoning include:
- slowed breathing
- irregular breathing
- difficulty remaining conscious
- hypothermia (low body temperature)
- pale or bluish skin
When it is suspected that a person is suffering with alcohol poisoning, it is important not to let them just go to sleep. The gag reflex plays an important role in choking, and if this reflex has been suppressed due to alcohol poisoning, vomiting could be fatal. If you suspect a person has alcohol poisoning, seek medical attention immediately.
11 Signs Of Alcohol Withdrawal
Many withdrawal symptoms can occur when a person stops drinking alcohol. These symptoms can be severe if additional medical problems are present. The more often a person drinks, the more likely withdrawal symptoms are to develop.
Some of the more common alcohol withdrawal symptoms may be:
- mood swings
- fogginess (can’t think clearly)
More intense symptoms can include:
- loss of appetite]
- rapid heart rate
- enlarged pupils
- nausea or vomiting
In some cases, severe withdrawal can occur and is known as delirium tremens. This is an intense, rapid onset of withdrawal characterized by hallucinations, severe confusion, seizures, fever, and agitation. These symptoms are intense, and delirium tremens can lead to death. Detoxing from alcohol in a treatment facility where these symptoms can be managed could likely affect outcomes for this dangerous type of withdrawal. Medications can be administered to help with most alcohol withdrawal.
Treatment For Alcohol Abuse And Addiction
Treating an alcohol use disorder often begins with a detox program in an attempt to safely remove alcohol from the body. Afterwards, the individual is encouraged to begin a treatment program.
These programs may include behavioral, motivational, individual and group therapies, interventions, goal-setting, long-term treatment plans and goals, building a support system, improving coping skills, and learning triggers for their drinking. A 12-step program may be included in these interventions, as well as a thorough, individualized aftercare plan.
If you have concern that you or a loved one may be struggling with an alcohol use disorder, or abuse or addiction to alcohol, there are services available to help. A detox program may be the first step toward a sober future, and we can help you or your loved one decide on the appropriate next step in treatment.Article resources
- Medline Plus — Alcohol Use Disorder (AUD) Treatment
- National Institute on Alcohol Abuse and Alcoholism — Alcohol Overdose: The Dangers of Drinking Too Much