Detox from alcohol

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Alcohol detox is the first phase of treatment from alcohol. This phase entails flushing the alcohol out of the body.  During alcohol use, the body builds a tolerance for alcohol by altering the functioning of its neurotransmitters.

When you or your loved one stop drinking, the body goes into shock, and the brain gets over-excited. During the detox process, your body tries to regain its equilibrium before alcohol use. This process leads to alcohol withdrawal symptoms.

The symptoms start a few hours after your last drink and can range from mild to severe. 

The alcohol detox withdrawal symptoms include: 

  • Headaches 
  • Vomiting and/or nausea 
  • Loss of appetite 
  • Insomnia 
  • Mood changes 
  • Sweating 

The more severe symptoms are: 

  • Racing heartbeat 
  • High blood pressure 
  • Tremors or "the shakes." 
  • Disorientation 
  • Hallucinations 
  • Seizures 
  • Delirium tremens (DTs).  

People struggling with alcohol dependency are likely to get severe alcohol withdrawal symptoms.

Delirium tremens (DT) is a severe symptom but uncommon. This symptom occurs two to five days after you stop drinking and can be fatal. 

There are two approaches to alcohol detoxification. Detox at home is only recommended for those struggling with mild to moderate alcohol dependence. Home detox has its benefits and challenges.  

Although you get to detox within the comfort of your home, you'll need the willpower to overcome the alcohol cravings and the risk of relapse. 

The alcohol detox process is not easy or comfortable. The physical and psychological reactions when you quit drinking can prove to be unbearable.

That's why it is advisable to go for medical assistance during the detox process.  

Medical detox refers to getting rid of alcohol toxins or other addictive substances under the supervision of medical professionals.

In a rehab centre, this detox process is managed by professionals such as physicians, nurses, nutritionists, clinical staff, and therapists.

Some facilities have a nurse practitioner, or a physician assistant administer the medical detox. 

Alcohol addiction is an important step that initiates the beginning of treatment.

Some people are hesitant to go through this step because of the withdrawal symptoms.

However, talking to a medical professional and getting assistance will make the detox process more manageable. 

How bad is alcohol detox? 

Alcohol detox is not bad as there are ways to detox safely. What is bad is when you go 'cold turkey.'

The cold turkey method involves quitting alcohol abruptly. This process can be dangerous if not managed properly.

Furthermore, the cold turkey method is likely to fail as the physical and psychological reaction of the body can prove unbearable for many alcohol addicts. 

Alcohol abuse triggers the body to adapt to the presence of this substance in the body. Since alcohol is a depressant, the body adapts by limiting the functioning of its neurotransmitters in the brain.  

Alcohol alters brain chemistry. When the body builds a tolerance to alcohol, the individual starts taking more alcohol than initially to feel the same intoxicating effects. 

When you quit drinking, your body begins altering the effects of alcohol. The central nervous system gets overexcited as the function of glutamate and GAMA neurotransmitters is no longer inhibited. 

The changes in the neurotransmitters contribute to the onset of alcohol withdrawal syndrome (AWS). Long-term alcohol use also affects the cardiovascular system, immune, gastrointestinal, and other systems [1].  

Most of the physical symptoms from alcohol withdrawal are because the body is trying to restore its normal functioning before the alcohol intake. 

The severity of symptoms depends on the duration of use and severity of use.

Other factors that affect the severity of the withdrawal symptoms include: 

  • Genetics 
  • Age 
  • Presence of other medical conditions 
  • Whether the person is using other substances combined with alcohol. 
  • Previous history of withdrawal. 
  • Presence of a head injury or brain trauma. 
  • Weight.  
  • Diet (whether you are healthy or have poor nutrition).  

If you are a heavy drinker, it will be harder for you to detox because of the severity of the withdrawal symptoms.

The symptoms of alcohol withdrawal can start with mild symptoms such as insomnia, loss of appetite, anxiety, headaches. 

 But they can progress to more severe symptoms such as: 

  • Seizures 
  • Hallucinations 
  • Physical pain 
  • Confusion or difficulty thinking clearly 
  • Intense fear or anxiety. 
  • High blood pressure 
  • Fever 
  • Fast breathing. 

Generally, in the next two to three days after you quit drinking, you may experience unbearable symptoms. That's why it is recommended that you seek medical assistance for alcohol detox. 

How to detox from alcohol? 

There are two approaches to detox from alcohol. The first approach is home detox and there are treatment providers who can assist you with home detox. 

You GP for instance can provide you with medical detox from home. Alternatively, you can get home detox services from a local addiction treatment facility.  

It is risky for you to detox from home if you are alcohol dependant. Also, if you're a daily drinker or if you engage in binge drinking (taking 6 to 8 units of alcohol in a single session) you are at risk of experiencing dangerous withdrawal symptoms.  

One of the ways to detox from home is to slowly taper off the amount you take in a week. The second one is to obtain medical detox from your medical provider or GP. They will provide medications such as: 

  • Benzodiazepines 

This medication is the first line of medication in addiction treatment. Benzodiazepines are a class of sedatives used to treat common symptoms in withdrawal process. These symptoms include panic, anxiety, and certain type of seizures.  

Frequently prescribed benzodiazepines include chlordiazepoxide (e.g. Librium) and Diazepam (e.g. Valium).  

  • Neuroleptic medications  

Commonly used to treat delirium tremens. DTs are likely to affect 5% of alcohol dependent patients [2]. The severe symptoms of delirium tremens appear 2 to 3 days after cessation.

These symptoms can last 48 to 72 hours and require neuroleptic medications to minimize the severity.  

  • Anticonvulsant medication 

Physicians may prescribe seizure medications such as Carbamazepine, Gabapentin, or Valproic acid. Such medications may be administered alongside benzodiazepines or as a replacement.  

  • Acamprosate  

This medication is prescribed to help ease withdrawal symptoms after the detox phase. These symptoms include alcohol cravings, insomnia, loss of appetite, itching, dizziness, stomach problems.  

The common brand name for Acamprosate is Campral. This medication is taken after the detox period mainly to help reduce alcohol cravings.  

Aside from home detox, you can go for detox in an outpatient treatment or inpatient facility. Outpatient care allows people to seek treatment during the day and go home once the sessions are over.  

The best way to choose between inpatient and outpatient treatment is to consult your GP or a treatment provider. Your GP will provide medical advice on the best treatment plan based on your needs.  

SAMHSA states that there are several levels of medical detox [3]. They are:  

  • Ambulatory medical detox without onsite monitoring 
  • Ambulatory medical detox with onsite monitoring 
  • Medically monitored inpatient medical detox  
  • Medically managed intensive inpatient detox.  

A licensed addiction counsellor or your medical provider will help you determine the safest way to detox.  

The detox phase generally lasts for about a week. But the alcohol withdrawal symptoms can persist for weeks, or months. 

The alcohol detox timeline is as follows: 

  • First 6 to 12 hours: The mild symptoms begin to set in such as headaches, insomnia, anxiety, shaking, irritability.  
  • Day one: As you approach the end of day one of detox, the symptoms become severe. You are likely to experience the mild symptoms along with more severe symptoms such as hallucinations (auditory, visual or tactile), disorientation, tremors.  
  • Day two to three: The severe symptoms persist similar to day 2. If you are a chronic alcohol user, this is the time when you experience life threatening withdrawal symptoms.  
  • After a week: Most of the symptoms begin to subside once you complete the first week of detox. You may experience acute withdrawal symptoms that go on for more than a week. These symptoms are manageable and can be treated with medication.  
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Is alcohol detox hard? 

Alcohol detox can be different depending on the individual. Those suffering from moderate alcohol addiction may experience mild symptoms that they can easily manage at home or with the assistance of a medical professional. 

Many people may not realize that they are struggling with alcoholism. However, alcohol detox is hard and dangerous for those struggling with alcohol use disorder, alcohol dependency, or chronic alcohol addiction.

In that case, you can check the DSM-V criteria for diagnosis of alcohol use disorder to see if you or your loved one have this condition [4]. 

Alcohol detox sets the beginning of alcohol treatment. As such, it is hard because the body has to adapt to living without alcohol.

When you frequently use alcohol, the body becomes dependent on this substance and makes changes to accommodate it.  

During detox, the issue is the withdrawal symptoms are the body reacts to the absence of alcohol. The severity of this reaction depends on the frequency and duration of use, among other factors. 

The most uncomfortable phase of alcohol withdrawal is around 10 to 30 hours after you stop drinking.

It is at that time that most severe withdrawal symptoms set in. In most cases, these symptoms lessen by about 40 to 50 hours. 

Although delirium tremens is uncommon, those who get it, are at risk of getting complications such as aspiration pneumonia. 

Post-acute withdrawal syndrome (PAWS) is also common after the detox process.

PAWS is a cluster of persisting withdrawal symptoms that can last for a month or sometimes up to a year.  

The symptoms are largely psychological and mood-related (e.g., long-term cravings, exhaustion, feeling ill). There are few cases where PAWS may include physical symptoms. 

Is alcohol detox safe? 

Alcohol detox is safe if you seek medical assistance. Once you consult a certified addiction professional and understand what to expect from withdrawal, you can decide whether you want to detox from home or at a rehab facility. 

During medical detox, your treatment provider will administer drugs that substitute the effect of alcohol in the body. Therefore, when you experience withdrawal symptoms, the drugs will make the process less painful or life threatening. 

Professional treatment is recommended for people with alcohol use disorders.

This is because alcohol detox can lead to serious complications such as delirium tremens, seizures, cardiovascular complications, amongst others. The symptoms range from mild to severe.

A major concern with withdrawal is the risk of relapse. A person who tries cold turkey may end up relapsing to avoid the discomfort of withdrawal. 

You can safely detox from alcohol from home. But you should be extra careful, especially if you will be detoxing on your own.

As mentioned earlier, the issue with detoxing on your own is whether you have the willpower to avoid a relapse.

Also, depending on the severity of your alcohol use, the withdrawal process could lead to symptoms that require medical attention. 

Detoxing at a treatment facility is recommended because detox is only the beginning of treatment. Once you complete the detox process, you stand a higher chance of maintaining sobriety by attending therapy.

The various counselling sessions help you get knowledge and coping skills to help you on your path to sobriety. 

To sum it up 

Alcohol detox is the most difficult phase of recovery. This process triggers alcohol withdrawal symptoms that range from mild to severe.  

Each person has their own experience with withdrawal. However, people who are heavy drinkers are likely to experience severe symptoms of alcohol withdrawal. 

Professional treatment advice is recommended if you or your loved one are thinking of quitting alcohol. Consulting a professional will impart you with knowledge on how best to approach detox safely. 

If you want a rehab centre but don't know where to start, you can look at the treatment providers listed near you at the NHS search site [5]. You can also do a quick search online to find a treatment centre near you.

Most centres have a free call back option and will reach out to you when you leave your contact details on their site. 

Alcohol consumption can quickly turn into an addiction that significantly affects your personal and professional life.  

Alcohol detox can also affect your mental health if you are a heavy drinker. Yet treatment is a call away. Reach out to a treatment provider today to begin your journey towards an alcohol-free life. 

Abbeycare Pricing Bot

Last Updated: November 8, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.