Alcohol Detoxification

Assessment, supportive care, and pharmacotherapy are the main steps of alcohol detox. Details about each step and medical protocol detox here.

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ARTICLE SUMMARY: The process of removing drugs and/or alcohol from the body is know as “detoxification”. Below, we review the main steps of medical detox programs for alcohol dependence. Then, we invite your question(s) in the comments section at the end.



The Process of Detoxification

Detox, or detoxification, is the process of removing drugs and/or alcohol from the body. According to SAMHSA’s Treatment Improvement Protocols (TIPs) detoxification is defined as:

A set of interventions aimed at managing acute intoxication and withdrawal. The purpose of any detoxification process is to minimize the physical harm caused by the use of substances.

The detox process for alcohol withdrawal is usually managed in inpatient settings under constant medical care. This is because medical intervention may be needed…and alcohol detox is unpredictable. Seizures can occur and some people experience psychosis. Cardiovascular issues also require monitoring…and medical detox ensures that you can quit drinking safely.

The stages of detox are connected with each other, and each stage builds upon the previous one. The main protocols used during medical detox include:

1. Assessment for alcohol dependence

Before the detox, you will need to compl3ete paper work outlining:

  • Insurance or payment information.
  • Your medical history.
  • Your family history.

Moreover, you can plan to complete physical and psychological evaluations, as well as a full assessment of possible addiction. Drug testing is often required.. This stage is important for clinicians to plan the course of your treatment.

2. Supportive care

According to latest clinical guides to management of alcohol withdrawal non-pharmacological interventions are the first approach, and in some cases, the only approach needed. It is recommended that the patient is taken care of in a quiet room without dark shadows, noises, bright lights, and other stimuli. Main supportive care include:

  • Frequent routine examination.
  • Nursing care.
  • Reality orientation.

Care is also medical. Detox clinics provide routine tests for alcohol concentration in your system, blood count, renal function, liver enzymes, urinalysis, and toxicology screening. General supportive care addresses fluid depletion, hypoglycemia, and electrolytes disturbances. Common treatments include hydration and vitamin supplementation.

3. Pharmacotherapy

Withdrawal from alcohol can be very uncomfortable, possible dangerous, and hard to handle. In order to manage the acute withdrawal, you may need the help of medication(s). The most commonly used medications are benzodiazepines, which are the standard treatment for detox. Other medications used in alcohol withdrawal treatment include:

  • Acamprosate
  • Alpha2-agonists, beta-blockers and neuroleptics
  • Baclofen
  • Barbiturates and propofol
  • Benzodiazepines
  • Carbamazepine
  • Disulfiram
  • Gabapentin
  • Naltrexone
  • Sodium oxybate
  • Topirimate
  • Valproate

Drugs Used in Alcohol Detox

Medications help a great deal in treating alcohol withdrawal. Some of the most commonly used medications include:

Acamprosate. This medicine addresses post acute withdrawal symptoms such as anxiety, dysphoria, insomnia, and restlessness.
Baclofen. Rapidly reduces symptoms of severe alcohol withdrawal.
Barbiturates. These medications were widely used in managing withdrawal symptoms, but recently, this therapy has been nearly replaced with benzodiazepines. Barbiturates are considered to be very addictive, and they were prescribed in highly supervised settings only for a short period of time.
Beta blockers. Used for managing some symptoms such as high blood pressure and rapid heart rate.
Benzodiazepines. Known as ‘gold standard’, this therapy is one of the most common therapy for dealing with alcohol withdrawal. The treatment includes use of long-acting benzo on a fixed schedule for 3 days period. The widely used group of benzos include:

  • Ativan (lorazepam)
  • Librium (chlordiazepoxide)
  • Valium (diazepam)

Carbamazepine. This anti-convulsant drug is used to treat alcohol withdrawal, and prevent seizures.
Disulfiram. It is prescribed for daily use for abstinence of alcohol since it produces unpleasant reaction such as sickness if a person drinks.
Gabapentin. This medication addresses some withdrawal symptoms such as seizures, and hot flashes.
Naltrexone. This medication decreases the rewarding effects of alcohol by blocking the rewarding receptors in the brain.
Sodium oxybate. This medication is used to treat alcohol withdrawal symptoms, and in the maintenance of abstinence from alcohol.
Topiramate. An anticonvulsant drug that has an effect on the neurotransmitters involved in alcohol dependence.
Valproate. It is used in management of withdrawal symptoms.

Dangers of Detoxing Alone

Detoxing at home (or on your own) from alcohol dependence can be very dangerous. Medical supervision is strongly recommended because some of the withdrawal symptoms may cause fatal outcomes. Delirium tremens, seizures, dysregulation of body temperature, and high blood pressure can lead to fatal consequences.

Delirium tremens is the most severe form of alcohol withdrawal that can trigger harsh symptoms such as:

  • Autonomic hyperactivity
  • Agitation
  • Confusion
  • Instability
  • Hallucinations

Other medical complications of alcohol withdrawal include:

  • Cardiomyopathy
  • Gastrointestinal bleeding
  • Encephalopathy
  • Hypoglycemia
  • Hepatic failure
  • Infections
  • Pancreatitis
  • Undetected trauma

These medical complications require hospitalization, and intensive care.

Detoxing from alcohol alone IS NOT RECOMMENDED.

Before making the decision for home detox, it is highly recommended that alcohol users make all examinations with a physician.

Let’s verify your coverage for treatment at an American Addiction Centers location. Your information is kept 100% confidential.


Benefits of Medical Detox Clinics

So, why would you want to go to a detox clinic?

Medically speaking, when treating alcohol dependence, you should be monitored under medical supervision 24/7. Severe symptoms can be triggered all of a sudden… and some of these occur only after few days after your last drink. Seizures manifest in about 25% of all alcohol withdrawal cases, and if these symptoms are left untreated, you put yourself in serious health complications.

Moreover, while only 3%to 5% of people experience delirium tremens, the condition has an anticipated mortality of up to 37% without appropriate treatment.

In sum, medical admission provides the safest setting for treating alcohol withdrawal. Appropriate alcohol detox protocol can help:

  • Ease withdrawal symptoms.
  • Manage any serious medical condition that may occur.
  • Prevent the development of more serious symptoms.
  • Provide the smoothest path for their patients to deal with their difficult period of discomfort.

If you are alcohol dependent, you should always seek medical assistance when you are ready to stop drinking.

Life After Alcohol Detox

Once you completed alcohol detox program, you face the challenges of everyday life. You’ll need to consider the fact that it takes time to adjust back into normal life. Personal and professional responsibilities can quickly build up.

One of the main reasons you’ll want to consider rehab is to re-learn how to cope with life. It’s a skill to learn how to manage emotional issues. It takes time.

After all, recovery is a lifelong process, and detox is only the first step of getting sober. Next on your list is creating a recovery plan that will make the lessons learned in rehab a reality. Consider establishing recovery plan with an addiction specialist since they can keep you focused on remaining sober. A detailed plan increases the chances of staying alcohol-free.

Some of the check-points on your list may include:

  • Establishing a healthy daily routine.
  • Finding local support groups.
  • Finding alcohol-free activities and hobbies.
  • Keeping distance from triggers, and learning how to cope with them.
  • Living in a sober house.
  • Learning when to ask for help.
  • Planing meet-ups with sober friends.
  • Rebuilding broken relationships with family and friends (consider counseling session and/or family therapy)

Moreover, consider enrolling into an aftercare program whose goal is to transfer you safely into normal life. Some aftercare programs include:

  • Individual counseling.
  • Family therapy.
  • Sober living homes.
  • Support groups.

Find an aftercare program that fits to your needs, choose the one that is best for you.

Life after detox can seem like an endless struggle. But you are not alone! No matter your situation, always keep in mind that help is available, you only need to make the call.

Call us to learn about your detox and recovery options.

Detox Success Stories and Statistics

The National Survey on Drug Abuse and Health reported that 15.1 million people aged 12+ had an alcohol use disorder in 2016. But not everyone gets help. According to the National Institute on Alcohol Abuse and Alcoholism, only about 1.5 million Americans enroll into treatment for alcohol abuse, or are admitted to a general hospital because of medical complications due to alcohol dependence annually.

So are alcohol detox programs successful, or not?

Programs that use evidence-based approach for alcoholism are effective. NIAAA’s research shows that about one-third of people who completed alcohol detox program have no further symptoms 1 year later, while others substantially reduce their drinking, and report fewer alcohol-related problems.

Moreover, the National Institute on Drug Abuse claims that relapse rates are similar to those of chronic diseases such as asthma, diabetes, and hypertension. This means that 40% to 60% of people who enrolled into treatment may relapse. But relapse is not a failure, it is a chance to start over, and alert that you need some adjustment in your treatment plan.

Research that keeps track of people in treatment shows that most individuals who remain into the program reduced their substance use, improve their life functioning, and decreased their criminal activity.

Also, a study published in the journal Addiction compared relapse rates of people who received alcohol treatment, and those who didn’t. The findings showed that people who received alcohol treatment almost doubled the rate of success in alcohol abstinence from the people who did not receive treatment.

Furthermore, the American Society of Addiction Medicine (ASAM) reports that about 10% of people who enroll into 12-step program recover, while a 2014 AA survey on more than 6,000 participants showed:

  • 27% were sober less than a year.
  • 24% were sober 1 to 5 years.
  • 13% were sober 5 to 10 years.

However, the person who is ready and eager to change will succeed in reaching recovery. There are numerous successful recovery stories, and it’s about time you write yours. Don’t wait until it’s too late, reach out for help.

For inspiration check out this video on few celebrities that achieve alcohol recovery:

Reference sources: NIDA: Evidence-Based Approaches to Alcohol Addiction
SAMHSA: A Treatment Improvement Protocol TIP 45
NIAAA: Alcohol Facts and Statistics 
MedlinePlus: Alcohol Use Disorder (AUD) Treatment
NIAAA: Treatment of Alcohol Withdrawal
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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