Alcoholism is a disease characterised by continuous heavy drinking. Until people with alcohol use disorder admit to problems with alcohol and stop drinking, the risk of alcohol use disorder continues which affects both physical and mental health.
Alcohol starts to injure the brain once it reaches the bloodstream.
Excessive consumption can lead to Alcohol-Related Brain Damage, or ARBD, which is a type of brain disorder caused by alcohol consumption. Brain shrinkage caused by alcohol abuse is permanent, as alcohol kills brain cells and grey matter.
For more information and effects click ‘Learn More’.
Family Recovery Compass is a newsletter for friends and family members who feel trapped between supporting a loved one in addiction, and protecting their own wellbeing.
Every week, we tackle one specific situation in addiction family dynamics, and deliver practical decision-making frameworks and exact dialogue scripts – that help you respond with confidence instead of reaction.
Every month, we bring you an unfiltered recovery conversation with someone who’s either experienced addiction firsthand, or works closely with those in recovery.
No sanitised success stories – just practical insights on what actually works in recovery, that you can apply, in your life too.
Recovery capital is the internal and external resource used to begin the recovery process and maintain sobriety. This combines personal, social, and community support to provide a joined-up approach that supports the addict through recovery.
Do you or a loved one need addiction treatment for alcohol or drugs? Thousands blindly walk into addiction treatment in expensive rehab centres and find that the reality doesn’t meet expectations.
If you’re considering rehab treatment, first check our ultimate guide for complete instructions on how to find the right rehab centre for you.
Take-home Naloxone kits help families and loved ones respond quickly in an opioid overdose emergency, until emergency services arrive. Kits contain nasal or injectable forms of Naloxone.
Changes in legislation mean Naloxone kits are now more widely available from pharmacies and drug services, including Abbeycare.
For additional information, click ‘Learn More’ below.
Overcoming alcohol addiction means first ceasing alcohol intake, and taking care of physical and chemical withdrawal symptoms.
Detoxing from alcohol means undergoing withdrawal from alcohol, but with the assistance of prescribed medication and detox phase, to substitute in place of the alcohol itself.
Alcohol rehab focuses on tackling the problems underneath alcoholism, such as grief, trauma, depression, and emotional difficulties, in order to reduce continuing drinking after treatment.
Inpatient services at an alcohol rehab programme provides 24 hour access to specialist care.
Alcohol home detox provides a means of semi-supervised addiction treatment in the comfort of your home. It’s often suitable for those with inescapable practical commitments, or where a reduced budget for treatment is available.
An at-home detox is the most basic detox option available from Abbeycare, and assumes you have support available, post-detox, for the other important elements of long-term addiction recovery.
The term alcoholism refers to the consumption of alcohol to the extent that the person is unable to manage their own drinking habits or patterns, resulting in side-effects that are detrimental to the quality of life and health of the alcoholic, or those around them.
An alcoholic is someone who continues to compulsively abuse alcohol in this way, despite the negative consequences to their lives and health.
Immediately following treatment, the early stages of recovery and abstinence are most vulnerable to lapses.
At Abbeycare, a structured and peer-reviewed aftercare plan is usually prepared whilst still in treatment. This comprises social, peer, and therapeutic resources individuals draw upon, following a residential treatment programme for drug or alcohol misuse.
Clinically managed residential detoxification is:
– A structured detox that uses medication-assisted treatment and regular physical health observations
– Takes place in an inpatient rehabilitation unit or hospital
– Typically lasts from 7-10 days, but in Abbeycare, it is incorporated into a 28-day rehab programme
Cognitive Behavioural Therapy is a well-known therapy option used by doctors at drug and alcohol treatment facilities for the treatment of substance use disorders.
It is a form of talking therapy that helps one mange their problems by changing how they think and behave. This form of therapy is used to treat depression and anxiety and is useful for physical health problems as well as one’s mental health.
Family Therapy at Abbeycare Scotland or Gloucester is realistic, compassionate, and appropriate for families and loved ones of addicts.
Family therapeutic interventions in residential rehabilitation have been designed to support those living with or caring for participants entering the Abbeycare Programme.
Support for families in a group setting allows for a safe, constructive, and confidential place to listen and share common experiences.
Inpatient rehab is drug and/ or alcohol treatment in a rehab centre, where patients remain on-site for the duration of inpatient rehabilitation.
It includes detoxification from drugs, therapy (group work and 1-2-1 sessions), and aftercare planning. Inpatient rehabs typically last 28 days, but this varies on an individual basis.
Long-term treatment at Abbeycare has been developed for those suffering from alcohol or drug addiction. Completing a long-term drug and alcohol inpatient programme may be the solution to problematic substance use.
Motivational Enhancement Therapy can be used by trained addiction recovery therapists to elicit internal changes within and promote long-term recovery from substance use disorder.
All the answers to addiction can be found within with this comprehensive and successful therapy concept leads to behavioural changes, reflective listening, self-motivational statements, and a comprehensive recovery process.
Outpatient drug or alcohol rehab is daytime treatment as opposed to living in a treatment facility.
Outpatient treatment is similar to inpatient in terms of the methods used to treat substance abuse. Where they differ is in their approach to recovery.
Abbeycare’s prison to rehab is a 12-week structured rehab programme which involves direct transfer from prison. The suitability of the candidate is decided by prison staff.
Short-term residential treatment programmes are the chance to press the reset button and access a therapeutic programme designed to create recovery from the use of alcohol and drugs.
Feeling stuck in a rut. Want to stop but can’t seem to achieve sobriety?
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The 12-step programme was created by alcoholics anonymous (AA), and is specifically designed to aid addicts in achieving and maintaining abstinence.
The central ethos behind the programme is that participants must admit and surrender to a divine power to live happy lives. Ideas and experiences are shared in meetings, and help is sought in an attempt to achieve abstinence.
Abbeycare’s policy to respect your privacy and comply with any applicable law and regulation regarding any personal information we may collect about you, including across our website and other sites we own and operate.
There is no specific medication for marijuana detox, but withdrawal symptoms are managed medically using SSRIs, NASSAs and melatonin until the body eliminates Tetrahydrocannabinol (THC).
Short-term anxiety medications are prescribed, such as Buspirone, taken 5mg 2-3/day; however, doses can be increased to a total of 45mg/day for those with pre-existing anxiety.
The process typically lasts between 7-10 days, with mild cannabis cravings and depression persisting for up to 3 weeks into rehab - about five months shorter than protracted depression in opioid withdrawal.
Physical withdrawal symptoms may appear during treatment. However, these are appropriately managed with medications to ensure a comfortable detox.
Physical withdrawal symptoms are:
Night sweats, occurring in 3.9%, caused by the slow release of THC from fat cells over ~3 weeks that binds to CB1 receptors in the hypothalamus [2]
Struggling to stay asleep, as patients spend on average 75% of sleeping sessions asleep compared to a 90% healthy average; however, this increases to 85% when lofexidine is used in detox [3] [4]
Vivid dreaming or nightmares, occurring in 17.3%, caused by a rebound of REM sleep as cannabis is no longer available to suppress the hypothalamus responsible for REM sleep and dreaming [2]
Sensitivity to lights and sounds, as cannabis no longer suppresses CB1 receptors in the thalamus responsible for sensory relay of input (e.g., bright lights and noise)
Decreased appetite due to a rebound effect of THC as it is no longer available due to CB1 receptor desensitisation - cannabis is no longer available to stimulate these receptors, resulting in eating less
Psychological Symptoms Of Cannabis Detox
Psychological withdrawal symptoms are monitored in detox so that any medications can be offered as needed. These symptoms are not guaranteed and will vary on a case-by-case basis.
Psychological withdrawal symptoms are:
Onset of paranoia in 24-72 hours caused by overactivation of CB1 receptors; however, this is treated with Buspirone [5]
Overestimating or underestimating time, caused by a rebound effect , or overreaction, of CB1 receptors in the basal ganglia, a brain area responsible for time perception
Emotional blunting occurs due to the absence of cannabinoid stimulation from THC; however, this typically resolves in 3-4 weeks as the endocannabinoid system readjusts
Low mood, depression and anxiety are caused by a 15% reduction in CB1 receptors; however, CB1 functionality returns after 2 days of detox [6]
Anhedonia occurs in detox due to unresponsiveness to naturally occurring endocannabinoids, such as anandamide, that regulate mood
Recovery Markers Following Cannabis Detox
Detoxing from cannabis:
Reduces FEV1/ FVC by 1.9%, decreasing chronic bronchitis symptoms to those of those who have never smoked cannabis [7]
Improves memory function by 0.2% every week in the first 4 weeks of abstinence [8]
Decreases anxiety and improves sleep quality by 5% after 12 weeks [9]
Inpatient Cannabis Detox Vs Natural Remedies
Inpatient Cannabis Detox
THC Detox Drinks
How This Works
Residential care that uses symptom-managed detox
Claims to increase urination to flush out THC
Medical Support
Yes
No
Removal From Triggers, Associations, etc Of Addictions
Yes
No
Dangers
Low risk - Under strict supervision
Dehydration due to being a diuretic
Efficacy
High efficacy - Targets both physical and psychological dependence
Green tea and cranberry juice claim to increase urination
Medical Support
No
Removal From Triggers, Associations, etc Of Addictions
No
Dangers
Green tea has a high caffeine content
Efficacy
Low efficacy - Limited research to suggest natural remedies work
Cannabis Detox Timeline
Cannabis Detox Time Period
How The Patient Presents At This Stage
Medical Interventions At This Stage
24 - 48 Hours
Nervousness and anxiety
Insomnia
Irritability
Sertraline, Buspirone (5mg 2-3 times/day)
Melatonin or Trazodone
2 - 6 Days
Strong cannabis cravings
Cannabis withdrawal depression
Cannabinoid Hyperemesis Syndrome
Loss of appetite
Diazepam, SSRIs
Ibuprofen
Metoclopramide
7 - 10 Days
Mild cannabis cravings
Depression
Anger and aggression
Fluoxetine, Venlafaxine, and Mirtazapine
What Changes Cannabis Detox
Genetics
There is a 3-fold increase in circulating Tetrahydrocannabinol during treatment for those with the CYP2C9*3/*3 variant, as the enzyme that breaks down THC only works at 7% capacity [10].
Genetic variations at CYP2C9, notably the CYP2C9.2 and CYP2C9.3, are 30% less effective at metabolising Tetrahydrocannabinol in the liver, resulting in the later onset of cannabis withdrawal symptoms and prolonged withdrawal period lasting over 4 weeks [11].
Body-Fat Composition
The tetrahydrocannabinol content stored in fat molecules is 10 times greater than that in surrounding tissue, resulting in those with a high body fat percentage (>32%) experiencing an extended treatment period lasting over 14 days, compared to 7-10 days [12].
A high body fat percentage (>32%) leads to prolonged withdrawal symptoms, such as cannabis cravings and night sweats, for up to 50% longer.
A high body fat percentage (>32%) and food deprivation results in a 50% increase in circulating Tetrahydrocannabinol levels, so treatment focuses on nutritional support and sufficient caloric intake during detoxification [13].
Females have, on average, 7% more body fat than males, typically resulting in a longer period for cannabis withdrawal; however, this depends on a patient's exact body fat percentage.
Psychotic Disorder Predisposition
A predisposition to psychosis may lead to auditory and visual hallucinations that require short-term treatment using Quetiapine or Olanzapine; however, symptoms may not present until Day 7, so continued monitoring is needed [14].
A predisposition to psychosis, such as a family history of psychosis, requires 15-minute observations as necessary to assess the need for antipsychotic medication.
If psychotic symptoms persist throughout treatment, psychotherapy is delayed until the later stages of rehab to ensure active engagement and prevention of cannabis relapse.
Self-Medication
ADHD patients self-medicating also require an in-depth assessment of current diagnoses and medication regimes - if ADHD medications are not being used, these are offered as part of an individual care plan.
Whilst concurrent ADHD and chronic pain are treated during the programme, addiction rehabilitation units are not responsible for the diagnosis and ongoing support for these disorders.
26.7% of chronic pain patients experience pain and irritability, necessitating the use of ibuprofen and gabapentin in withdrawal [15].
Cannabis Detox Misconceptions
Common misconceptions of marijuana detox are:
Drinking water speeds up treatment: there is no research suggesting that increasing urination through drinking water affects the breakdown of Tetrahydrocannabinol in the body
Tetrahydrocannabinol is fully excreted within 24 hours: cannabis is a lipophilic substance stored in fat tissue and takes 7-10 days to break down
Exercise alone reduces Tetrahydrocannabinol levels: detectable Tetrahydrocannabinol levels in urine do not differ from baseline after 45 minutes of exercise [15]
Fasting speeds up Tetrahydrocannabinol release: the concentration of detectable Tetrahydrocannabinol in urine does not differ from baseline after a 24-hour fast [15]
Cannabis Detox At Abbeycare
Cannabis detox at Abbeycare takes place within the first 7-10 days of a full 28-day rehab programme.
Withdrawal symptoms are managed during a symptom managed detox at Abbeycare, ranging from medical intervention (e.g., melatonin to aid restful sleep) and pastoral care to ease worries about the detox process.
This process is completed in our inpatient centres so that symptoms are monitored and a healthy, balanced diet is implemented, especially when patients lose appetite during this phase.
About the author
Philippa Scammell
Philippa Scammell MSci holds an integrated Master's degree in Psychology
from the University of York and has completed undergraduate statistical studies at Harvard University. Philippa has substantial experience in inpatient psychiatric care (Foss Park Hospital York), Research in Psychology at University of York, and group therapy facilitation (Kyra Women's Project). Philippa writes on clinical psychology and addiction recovery. Content reviewed by Laura Morris (Clinical Lead).
