Table of Contents
What is alcohol detox and alcohol rehabs ?
Alcoholism is a chronic disease. Like other chronic diseases, if left untreated, alcoholism can have serious, life-threatening consequences. Fortunately, there are effective treatment programs for alcoholism. While details vary from program to program, alcohol detox and alcohol rehab programs share certain essential components.
Alcohol detoxification, or detox, for individuals with alcohol dependence, is the abrupt cessation of alcohol intake, a process often coupled with substitution of cross-tolerant drugs that have effects similar to the effects of alcohol in order to prevent alcohol withdrawal.
What are the withdrawal symptoms of alcoholism ?
Medical management of alcohol withdrawal for people who are alcohol dependent is often necessary, because the symptoms of withdrawal can be dangerous. They can include:
- Changes to vital signs such as increased heart rate or elevated blood pressure.
- Upset stomach
- Inability to concentrate.
- Mood swings.
- Shaking or trembling
- They feel shaky and easily startled.
Not everyone has all these symptoms, and symptom can range from mild to severe. Typically, alcohol detoxification takes place in a regular medical ward of a hospital, a specialized detoxification unit, or in an outpatient clinic. Detox, which may last a few days to more than a week, is an important and necessary preparation for treatment.
How long does it take to overcome the withdrawal symptoms of alcohol ?
The withdrawal symptoms will be more acute in the first 2-4 days and it will completely disappear within one week. However the craving for alcohol may continue. Alcoholism affects the communication network of the brain and it will take some time for the brain to adjust to the new condition. The extent of withdrawal symptoms and the duration to get over the problem will vary from person to person. It depends on the intensity of your addiction and how long you have been in the habit, the efficiency of your metabolism etc.
Dealing with the fear of alcohol withdrawal symptoms
One justification that alcoholics will use for not giving up the abuse is their fear of alcohol withdrawals. The process of entering sober living can involve an uncomfortable few days, but the rewards that come afterwards make it well worth it. The reality is that alcohol detox symptoms are rarely that uncomfortable and some people experience very little in the way of unpleasantness. The experience that the individual has with withdrawals can depend as much on their expectations as anything else.
How to reduce alcohol withdrawall ? :
Benzodiazepines such as chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan) or oxazepam (Serax) are the most commonly used drugs used to reduce alcohol withdrawal symptoms. There are several treatment patterns in which it is used.
The first option takes into consideration the varying degrees of tolerance. In it, a standard dose of the benzodiazepine is given every half hour until light sedation is reached. Once a baseline dose is determined, the medication is tapered over the ensuing 3–10 days.
Another option is to give a standard dose of benzodiazepine based on history and adjust based on withdrawal phenomenon.
A third option is to defer treatment until symptoms occur. This method should not be used in patients with prior, alcohol-related seizures. This has been effective in randomized controlled trials. A non-randomized, before and after, observational study found that symptom triggered therapy was advantageous.
Dosing of the benzodiazepines can be guided by the CIWA scale. The scale is available online.
Chlordiazepoxide (Librium) is the benzodiazepine of choice in uncomplicated alcohol withdrawal due to its long half-life.
Lorazepam or diazepam is available as an injection for patients who cannot safely take medications by mouth.
Lorazepam and oxazepam are indicated in patients with impaired liver function because they are metabolised outside of the liver.
- Vitamins, particularly vitamin B1 (thiamine), are often prescribed if you are alcohol-dependent – especially during ‘detox’. This is because many people who are dependent on alcohol do not eat properly and can lack certain vitamins. A lack of vitamin B1 is the most common. A lack of this vitamin can cause serious brain conditions called Wernicke’s encephalopathy and Korsakoff’s syndrome.
- Nalmefene is a newer treatment available as an option for reducing alcohol consumption in people with alcohol dependence. It is considered for those who have an alcohol consumption of more than 60 g per day for men and more than 40 g per day for women (8 g of alcohol is equal to one standard unit of alcohol), without physical withdrawal symptoms and who do not require immediate detoxification. Nalmefene is another treatment often started by a specialist rather than a GP. Patients who are prescribed it should be regularly reviewed by a healthcare professional whilst taking it.
- Baclofen is a medicine that is reported in some medical studies to help some people to stay off alcohol or to reduce drinking quantity. It may also reduce craving and reduce anxiety in alcohol-dependent people. However, the evidence for the effect of baclofen is conflicting and other studies do not support these reports. More research is needed to clarify whether baclofen is helpful. Note: it is currently not licensed for the treatment of alcohol-related problems.