Overcoming an addiction to alcohol starts with admitting the problem exists in the first place. This should then be followed with a programme of detoxification to break the cycle of abuse. Withdrawing from alcohol can be a complicated process and can lead to unpleasant symptoms. However, treatment in a supervised medical facility can make the process easier and much more comfortable and can help to prevent the worst symptoms from occurring.
What Is Alcohol Withdrawal?
Since alcohol affects the entire body, withdrawal can be complicated. UKAT rehabilitation clinics generally recommend alcoholics complete an alcohol detox programme before entering rehabilitation. This is necessary for all traces of alcohol to be removed from the body so that a person can enter rehab completely clean.
That notwithstanding, we do not recommend that you attempt to treat yourself (if you are the one with a drinking problem) by detoxing alone, at home. As dangerous as excessive drinking can be, it can be even more dangerous to immediately stop drinking without medical supervision. We recommend you detox from alcohol in a supervised facility that can mitigate the potentially serious risks of withdrawal symptoms.
Alcohol affects almost every cell in the human body. It is a central nervous system depressant that enters the bloodstream very quickly. Once there, alcohol is carried to other parts of the body where it is broken down before being completely metabolised. How quickly alcohol is metabolised determines how it affects a person. This can be influenced by size, weight, sex, and overall physical health.
Alcohol withdrawal comes into play when people drink excessively. The nature of the human body is such that alcohol makes a person feel relaxed, happy, and even somewhat drowsy. The body attempts to compensate by producing certain brain chemicals. The more a person drinks, the more compensation is required to keep up. This creates what is known as tolerance. A person who is becoming tolerant to alcohol needs more of it to maintain the same pleasurable effects of drinking.
Increasing tolerance eventually leads to dependence and addiction. Alcohol withdrawal occurs when the level of alcohol in a person’s system begins to drop. This is why alcoholics don’t feel so well between drinks. As the effects of alcohol begin to wane, the body responds with symptoms that make the person feel unwell. The inevitable result is reaching for another drink to alleviate the symptoms.
Alcohol withdrawal occurs because the body is used to having a certain level of alcohol to deal with. But as alcohol is metabolised, there is less in the system. The body’s only response is to react with symptoms that signal something is wrong. So just as withdrawal can begin between drinks, it also sets in during the early stages of detox.
Alcohol Withdrawal Syndrome
The medical term used to describe the onset of symptoms caused by alcohol withdrawal is known as ‘alcohol withdrawal syndrome’. And while the term can be applied to symptoms experienced by alcoholics between drinks, it is normally reserved for describing the symptoms experienced during detox.
Alcohol withdrawal syndrome begins to manifest itself within 6 to 12 hours of the person taking a last drink. If you are concerned you might be dependent on alcohol, this would be a good test. Next time you drink, write down the time it occurs. Then note whatever time you begin exhibiting symptoms like anxiety, sweating, and the shakes. If you observe symptoms within six hours or so, it is possible you are suffering from alcohol withdrawal syndrome. This would indicate alcohol dependence as well.
Alcohol Withdrawal Symptoms and Effects
Experiencing withdrawal symptoms during alcohol detox is normal. The symptoms can range from mild to the severe, and there is no way of telling how severe yours would be until they actually occur. In most cases, it is possible to limit the severity of withdrawal symptoms through medical supervision at a detox facility.
Again, withdrawal symptoms usually begin within 6 to 12 hours following the last drink. This indicates that withdrawal can begin even if there is still a significant volume of alcohol in your blood. Mild to moderate symptoms include sweating, tremors, loss of appetite, vomiting, nausea, agitation, restlessness, and insomnia. You may also experience increased heart rate, increased blood pressure, feelings of anxiety, and mood swings.
Withdrawal symptoms are certainly unpleasant; they will make you feel unwell. UKAT rehabilitation clinics do everything possible to ensure patients are as comfortable as possible during detox. If you choose to detox in one of our medically supervised facilities, you may be given prescription medications to ease withdrawal symptoms.
We adopted the medically supervised model in the knowledge that the worst symptoms of alcohol withdrawal can be prevented most of the time. However, most of the time does not mean all of the time. It is possible that alcohol withdrawal can create a severe condition known as delirium tremens (DT).
DT is the result of sudden changes in the nervous system. The condition can cause hallucinations, delusions, severe shaking, paranoia, seizures, and convulsions. If left untreated, DT can even be fatal as it can lead to dehydration, shock, and cardiac arrest.
What Causes Alcohol Withdrawal
The causes of alcohol withdrawal are well understood from a medical standpoint. Withdrawal is the direct result of the body having to cope with less alcohol in the system than it is normally accustomed to. It is rooted primarily in how the brain reacts to the effects of alcohol.
When alcohol reaches the brain, it encourages the release of certain chemicals necessary to overcome the alcohol. Over several weeks or months of consistent drinking, the brain gets used to having to compensate for alcohol. It produces a certain level of chemicals in order to keep the body functioning normally.
If that level of alcohol should drop for any reason, it creates a situation in which the brain is producing more chemicals than it needs to to compensate. This is the mechanism that actually triggers withdrawal. There are only two ways to overcome withdrawal: either drink more alcohol or wait it out until the brain and body readjust. The second option is what occurs during detox.
Coping with Withdrawal
It is not unreasonable to be nervous about the idea of giving up alcohol, especially if you have been dependent on it for many years. It is normal to be worried that detox will be painful and uncomfortable; it is normal to worry about how you will cope with withdrawal.
Please know that we understand your concerns. Many of the staff who work for UKAT have been where you are now. They fully appreciate the internal battles you might be dealing with; they understand your anxiety over withdrawal. But they are living proof that alcohol detox and rehab work. They want you to know how much better their lives are free from alcohol.
We believe that anyone can cope with the unpleasantness of withdrawal with the right help and support. We believe anyone can overcome alcohol addiction with medically supervised detox and professional rehab. We sincerely hope you do not allow your fears to prevent you from getting help.
How Is Alcohol Withdrawal Syndrome Diagnosed?
Alcohol withdrawal syndrome can be diagnosed, at least initially, by observing the symptoms already explained earlier in this guide. A doctor observing anxiety, sweating, etc. in an alcohol abuser would likely recognise those symptoms as withdrawal-induced. Diagnosing the severity of the symptoms is another matter.
The medical community relies on something known as the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) to determine the scale and severity of alcohol withdrawal syndrome in individual patients. CIWA is a 10-item scale that scores each item independently. The scores are then aggregated to determine how severe a person’s symptoms are.
The highest possible score is 67. Anything higher than 20 is considered severe; a score between 16 and 20 indicates moderate alcohol withdrawal syndrome; a score of 15 or lower indicates mild withdrawal syndrome. The 10 items scored are nausea and vomiting, tremors, sweating, anxiety, agitation, tactile disturbances, auditory disturbances, visual disturbances, headaches, and orientation.
Delirium tremens is a concern when a person’s CIWA score is above 20. The closer that score gets to 67, the more likely a person is to experience DT. Again, this is yet another reason we recommend against attempting detox at home without medical supervision. You would have no way of knowing how severe your symptoms are. Thus, you would have no way of knowing whether you are approaching DT.
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What Causes Delirium Tremens?
Delirium tremens occurs when the body is subject to sudden and severe changes to a person’s nervous system and/or mental state. When it occurs as a result of alcohol withdrawal, the severe changes are caused by the body’s reaction to the loss of alcohol.
Earlier in this document you read about how the brain produces chemicals to compensate for alcohol in the system. If the difference between those compensating chemicals and the amount of alcohol available is drastic enough, you can create a condition in which the brain and central nervous system do not know how to respond. This is what triggers delirium tremens.
In a medically supervised setting, doctors and nurses work with patients to manage their symptoms. Symptom management reduces the likelihood of the drastic internal changes that lead to DT.
Symptoms of Delirium Tremens
The symptoms of delirium tremens are well defined. Experienced treatment providers should be able to recognise them at the earliest onset. For the purposes of this discussion, we have divided the symptoms into two categories: less serious and more serious.
The less serious symptoms include:
- heavy sweating.
Since these symptoms may also present as a natural result of withdrawal apart from DT, exhibiting them doesn’t always mean DT is either present or imminent. Doctors and nurses will look for some of the more serious symptoms of DT when they notice the less severe symptoms appearing. Those more serious symptoms include:
- visual hallucinations
- auditory hallucinations (hearing things)
- tactile hallucinations (feeling things that are not there)
- extremely vivid nightmares or daydreams
- increased heart rate and blood pressure
- severe tremors
- an impending sense of doom.
In terms of visual hallucinations, they can be part of the surrounding environment or separate from it. An example of a hallucination that is part of the surrounding environment would be seeing a flower pattern on the wallpaper morph into an insect or snake. Hallucinations separate from the surrounding environment do not involve anything the patient is directly looking at.
Tactile hallucinations involve sensations felt in the skin. For example, a person might feel as though an insect is crawling up an arm. Another one might feel pressure as though a snake was wrapped around an arm or leg.
In some cases, people experiencing DT also experience extreme anxiety and/or panic attacks. These additional symptoms may be severe enough to prevent an individual from speaking in complete sentences or forming logical thoughts. The person may seem completely incoherent to others in the room.
The Onset of Delirium Tremens Symptoms
Whereas the normal symptoms of alcohol withdrawal syndrome begin appearing between 6 and 12 hours after a person last drinks, symptoms of DT will not appear until much later. The average DT patient does not begin showing symptoms of the condition for at least three days; symptoms do not appear for up to 10 days in some cases.
It is interesting to note that the symptoms of DT tend to be more severe overnight. The worst symptoms are experienced somewhere around the fourth or fifth day, at which point they begin to subside along with the rest of the symptoms of alcohol withdrawal.
Signs of Alcohol Withdrawal
You might find yourself in a position of not quite understanding whether you are dependent on alcohol. Thus, you may not fully realise whether you need detox and rehab. We would encourage you to pay attention to your own well-being in between periods of drinking. If you recognise any of the signs of alcohol withdrawal within 6 to 12 hours of drinking, there is a strong chance you have a serious drinking problem.
The signs of alcohol withdrawal can be divided into two categories: physical and psychological. This is because alcohol affects both the mind and body. Note that you do not have to exhibit all the signs to be going through withdrawal. Some people do; others only exhibit some of the signs.
The signs of alcohol withdrawal are as follows:
- Hand tremors
- Nausea and/or vomiting
- Visual hallucinations
- Minor to moderate seizures.
The number and severity of the symptoms you might experience during withdrawal depend on the seriousness of your dependence. As a general rule, the most severe symptoms are experienced by those most severely dependent on alcohol.
Again, pay attention and try to notice if you exhibit any of the above symptoms between periods of drinking. If you do notice any of them, also take note of what you do to relieve them. Relieving the symptoms by drinking again is a key indicator that you have a dependence problem.
How to Treat Alcohol Withdrawal
Attempting to detox alone leaves you very few options for treating alcohol withdrawal symptoms. Therefore, we strongly advise that you to seek medically supervised detox if you’re planning to stop drinking. In a medically supervised setting, you are likely to receive a rather high dosage of prescription medication to begin the process.
As detox progresses, your medication will gradually be reduced to compensate for withdrawal symptoms gradually easing. Note that the medication you are given will not prevent you from drinking. It is only intended to take the edge off withdrawal symptoms.
Your treatment provider is likely to prescribe vitamins during detox as well. The thinking behind this is more practical than anything else and has to do with the tendency for alcohol abusers to not eat properly.
A poor diet may mean you are not getting enough of the vitamins, minerals, and other nutrients your body is going to need during recovery process. Supplemental vitamins make up for that deficiency. Prescribing vitamins basically gives your body what it needs to begin the healing process.
The other thing caregivers will do during withdrawal period is try to make you as comfortable as possible. The goal here is to remove as many discomforts as practical so that you can focus maximum effort on getting through detox. Caregivers do not want you worrying about something they can easily take care of through simple adjustments.
An important part of treating alcohol withdrawal is being prepared for any complications that arise. This is what they do in a professional setting. Trained professionals are always on the ready to step in when necessary. If you attempted to detox alone, you would not have this help immediately available.
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Medication-Assisted Therapy for Alcohol Dependence
Treating alcohol dependence is a lot different today than it was just 20 years ago. Thanks to advances in medical science, we now have a number of different medications available to assist with alcohol recovery. A medication-assisted therapy for alcohol dependence utilises medications in two different ways.
To get drinking under control, doctors can prescribe one of four different medications. Two of these medications help control alcohol cravings by blocking opioid receptors in the brain. Addressing opioid receptors reduces the pleasurable effects of alcohol, thus putting less stress on the brain’s reward system.
A third drug that blocks a specific chemical the brain produces may be prescribed following detox in order to prevent relapse. This drug reduces cravings for alcohol. As for the fourth drug, it acts as a deterrent to continued drinking by producing very unpleasant side effects. Within minutes of taking a drink, a person on this drug will experience a severe hangover.
The other use of medications for alcohol dependence involve medications given during detox and withdrawal. Benzodiazepines spring to mind. Benzodiazepines are administered in short courses to help alleviate withdrawal symptoms, including seizures.
Beta blockers are used during withdrawal to keep blood pressure and heart rate under control. They are combined with a vitamin B complex and other vitamins to facilitate an easier and more comfortable withdrawal. The vitamins can also stave off something known as Wernicke-Korsakoff syndrome.
Medication-assisted therapy does not guarantee that withdrawal will be painless. It also does not guarantee ultimate success in terms of recovery. Medications are tools that are combined with other therapies to create an overall positive outcome; they are not a cure for alcoholism in and of themselves.
We are pleased to be able to tell you that medically supervised alcohol detox in the UK utilises medication-assisted therapy as a general rule. In other words, it is getting harder and harder to find alcohol detox administered via the cold turkey method.
Medication-assisted detox is now the norm, and medical science has proven
that it works and that it is safer for patients. You can expect to receive prescription medications at least during detox, possibly after detox as well. Ultimately your doctor will decide what is best for you.
Note that you will not have access to these medications should you attempt detox alone. The medications can only be prescribed by doctors and administered by doctors and nurses.
Alcohol Abuse Detox Process
Detoxing from alcohol is not a particularly complicated process to understand. It begins with a medical exam designed to determine your overall health. The results of this exam will help decide how detox is actually administered. We will describe the process as though you were preparing to go through it yourself.
As detox begins, you will be given your first dose of prescription medication and vitamins. Then you will be made as comfortable as possible. Once withdrawal symptoms start appearing, caregivers will monitor you for any potential complications. You will be given additional doses of medication as determined by the treatment plan’s schedule.
Your withdrawal symptoms will probably get worse through the first and second days. They typically peak somewhere around day three or four. From there, provided you do not develop any complications, most of your withdrawal symptoms should completely subside within 7 to 10 days. At that point, detox is considered complete.
You may be prescribed another medication following detox to help you control your cravings. This is because alcohol cravings can last considerably longer.
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Alcohol Detoxification Timeline
Every person reacts to alcohol withdrawal differently, so there is no definitive timeline that applies to every situation. There is a general timeline, though. This timeline is based on how the average person responds to detox over a seven-day period and is divided into three stages.
Stage I begins with the onset of detox and lasts between eight and 24 hours. During this period, the patient begins to experience symptoms such as anxiety, insomnia, and nausea. These are the first signs that the brain and body are trying to deal with less alcohol in the system.
Stage II begins somewhere on the first day and usually lasts through until the third day. It is typified by more intense withdrawal symptoms including high blood pressure, increased body temperature, fever, and tremors. These symptoms tend to peak on the third or fourth day for most people.
Somewhere toward the end of day 3 or the beginning of day 4, Stage III kicks in. This stage begins with the peaking of withdrawal symptoms that may include seizures, agitation, and hallucinations. Once at peak, withdrawal symptoms gradually subside over the course of the next 3 to 6 days. Stage III is usually complete somewhere between day 7 and day 10.
You may find your experience is similar to this outline. Alternatively, your experience may be quite different. There is no way to know for sure until you actually go through it.
Treatment Methods and Options
While it can be frightening to think of the serious withdrawal symptoms related alcohol detox, we want to remind you that the most serious symptoms (including those of DT) are rare. This is especially true for those who undergo detox under medical supervision.
Detox does not need to be painful or excessively uncomfortable. UKAT centres offer a high level of care for patients under the supervision of fully qualified medical professionals and support staff. We assure you that your well-being is our highest priority at all times. The broad spectrum of treatments we offer ensures that you have the greatest chance of long-term success.
To that end, treatment centres offer a variety of methods and treatment options. We will discuss those methods and options with you as we help you find the right treatment centre. Our goal is to give you the best possible chances for recovery by getting you into a detox facility that offers medical supervision and the level of comfort you are looking for.
Finding the Right Treatment
If you feel you have an alcohol problem, the only way to know for sure is to examine your drinking habits. It is not possible to diagnose alcoholism simply by conducting an external examination or submitting to a blood test. An accurate diagnosis requires taking a close look at the amount alcohol you drink, the frequency of your drinking, and the behaviour you exhibit both while drinking and not drinking.
In general, you likely have a problem requiring treatment if you feel as though you have lost control of your drinking to the point that it is impacting other areas of your life. If that is your current experience, finding the right treatment is critical to your long-term health.
Please note that there is no cure for alcoholism. Rather, there is only treatment. Letting your problem go untreated could result in devastating consequences for your health, your family, and your finances. On the other hand, professional treatment can help restore you to a more healthy and happier life.
Finding the right treatment is a matter of assessing your situation and determining your needs. The first step in doing so is contacting UKAT and speaking with one of our counsellors. We are experts in helping alcohol dependent people and their families find appropriate treatment.
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Is It Safe to Detox from Alcohol at Home?
The question of safety and alcohol detox at home is a tricky one. It is a hard question to answer because modern definitions of alcohol abuse and misuse are based on a spectrum rather than clearly defined standards. As such, the safety of any detox programme is in direct proportion to the severity of the alcohol problem.
We recommend not trying self-detox at home. If nothing else, the risk of delirium tremens is always there. You just never know. If you do want to detox at home, the safest way to do it is with the help of a medical professional.
You could enrol in an outpatient programme that administers detox at home by way of a registered nurse making regular visits. This kind of home detox still affords you the benefit of some medical supervision along with prescription medications.
If you want to try detoxing at home without medical supervision, you could be taking unnecessary risks. There are ways to do it, though; these are discussed in the next section.
Self-Detoxification from Alcohol
Alcohol problems on the lower end of the alcohol misuse spectrum – these are typically problem drinking and early-stage alcohol abuse – can be addressed at home by way of a self-detox strategy. Even without medical supervision, we advise you to enlist the help of family members and friends should you decide to try it.
There are four components to self-detoxification:
Alcohol consumption tends to lead to poor nutrition, which can make detox more difficult. So along with detoxing, you should make a point of eating well. That means foods like fruits and vegetables that supply your body with the nutrients it needs.
Trying to self-detox is going to be a lot harder if you do not completely remove alcohol from the picture. Before you begin, clear all the alcohol from your house. Do not let any friends or family members coming to help bring alcohol back in.
During your detox you may need physical and emotional support. This is why enlisting the help of friends and family is encouraged. You also want someone there just in case an emergency arises.
Detox is made easier by occupying your mind with other things. Getting your mind off detox and onto something else means you are focusing less on how you feel. Experts recommend listening to music, pursuing your favourite hobby, engaging in conversations, etc.
If at any time you feel your self-detox is not going well, the best thing to do is seek medical help. Do not start drinking again in order to deal with uncomfortable withdrawal symptoms. This only serves to make the problem worse.
Common Alcohol Detox and Withdrawal Symptoms
As a reminder, there are some common alcohol detox and withdrawal symptoms you may experience even when detoxing at home. Do not be alarmed by them; they are normal.
Within the first 6 to 12 hours you can expect to start feeling anxious.
You will probably begin sweating, and you will more than likely feel nauseous. Some slight hand tremors may also be involved. If the severity of your alcohol problem is on the low end of the spectrum, these may be the only symptoms you experience. As you move up the spectrum, other symptoms may appear.
Additional symptoms could include fever, insomnia, and hallucinations. Increased heart rate and blood pressure are also a possibility. If you do start experiencing some of the more advanced symptoms of alcohol withdrawal, you might want to consider getting medical help. Your alcohol problem is likely more serious than you originally thought.
Process from Detox to Rehab – What Happens?
Whether you detox through an outpatient programme or in residential treatment, your doctors and therapists will have a plan to get you from detox to rehab and then on to full recovery. The process starts with some basic principles that are adjusted by caregivers according to your individual treatment plan.
Detox is normally a 7-to-10-day process that is medically supervised at all times. The goal of detox is to remove alcohol from your system and then give your body the necessary time to make adjustments. It prepares you for rehab. Beginning rehab without first detoxing is not wise, nor is it fruitful for most people. Your body has to be free of alcohol before it can begin rehabbing.
The rehab portion of alcohol recovery begins immediately after detox. It consists of a number of different therapies that may include one-on-one counselling, group counselling, group participation activities, and life skills exercises.
Rehab programmes generally last between 4 and 12 weeks. While no one is forced to complete a rehab programme, it is in your best interests to do so. Finishing rehab and then transitioning into aftercare gives you the greatest chances of long-term success.
Staying Sober and Preventing Relapses
Once you have completed both detox and rehab, it is time to reintegrate back into the life you left behind. Please understand that the risk of relapse is high during this reintegration period. Staying sober and preventing relapse is going to take a combination of your commitment and aftercare services designed to provide you critical support during this time.
We want you to know that giving your full effort to aftercare will improve your chances of avoiding relapse during the first year. So make all your counselling appointments, see your doctor as scheduled, and participate in every support group meeting on the schedule.
Frequently Asked Questions
Can you prevent alcohol withdrawal?
No, your body will go through alcohol withdrawal if you are dependent on alcohol and stop drinking.
Can you die from alcohol withdrawal?
Yes, it is possible to die during alcohol withdrawal. Death is extremely rare, though.
What should you eat during alcohol detox?
Eat healthy foods like fruits and vegetable that give your body the nutrients it needs to get through this taxing process.
What can you expect during detox?
During detox you can expect to feel at least somewhat uncomfortable. Your symptoms will vary depending on the severity of your condition.
How does it take to detox from alcohol?
The average time for detox is between 7 and 10 days.
How long does a person stay off alcohol after a detox?
A combination of aftercare services, group support, and the support of friends and family is what makes it possible to stay off alcohol after detox.
Why should I enter an alcohol detox programme?
Professionally administered detox gives you the best chances of recovery by offering you a medically supervised procedure based on the latest treatment models.
What is a binge drinker vs an alcoholic?
A binge drinker is someone who drinks excessively at specific times but is not dependent on alcohol. An alcoholic is a person whose body and mind are dependent.
Is there a distinction between moderation and abstinence?
Experts recommend moderation to people who misuse alcohol but who are not dependent on it. Moderation is not an option for alcoholics. The only real ‘cure’ for alcoholism is abstinence.
Why is it necessary to detox properly from alcohol?
A person dependent on alcohol is suffering from a condition in which both the body and mind rely on alcohol. Detoxification is necessary in order to restore the body’s proper functioning.
Are withdrawal symptoms different for different people?
People respond differently to the withdrawal process. Some exhibit all the classic signs of withdrawal while others exhibit only a few of them. Symptom severity also varies from one person to the next.
How important is medically supervised detox?
It is very important. Due to the potentially serious consequences of alcohol withdrawal, we always recommend medically supervised detox.