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Alcohol detox is a situation in which the very process discourages many people from succeeding. It's no secret that alcohol withdrawal is painful and dreadfully unpleasant. Some people even say that they felt like they were dying during the most critical stages. As you can imagine, if you feel like you're dying and relief can be obtained easily with a few swallows of alcohol, relapse is common, even likely, for many people during alcohol withdrawal. It doesn't have to be, however. Relapse is most common during the detox stage of recovery, especially for those who try to go through it without professional help. The good thing is, there are methods, treatments, and medications to make the process more bearable if you only choose to seek them out.
This is how Robert Downey, Jr. describes his battle with alcoholism and addiction. A gun in his mouth, that he enjoys the taste of. Have you ever felt this way? Or perhaps you have noticed this sort of destructive attitude in someone close to you? Alcoholism is a dangerous, frightening, and often devastating condition; but even when it feels like there is no hope left, don't despair. It took Robert Downey Jr, decades, several stints in jail, and over four stays in alcohol rehab to overcome his battle with alcohol abuse. He is one of millions who has achieved a healthy, successful recovery after years of addiction. If he and millions like him can do it, so can you.
One of the first things you need to recognize in order to confront addiction is to understand it as a chronic brain disease. Alcohol use disorder is not a choice or a dangerous recreational activity; it is a chronic disease with no known cure. Like diabetes and cancer, alcohol use disorder can be treated and controlled, but it is not your fault, and it is not something you chose for yourself. It is important to understand this aspect of alcoholism in order to successfully receive treatment.
The first step is alcohol detox; this may also be the most difficult step. Before getting started, prepare yourself for the grueling journey ahead. Make sure you have a strong support system in place and do your homework. It can help to know what to expect during alcohol detox as well as the various treatments available to help you through the process.
Alcohol detox simply describes the process of managing the symptoms of alcohol withdrawal in order to successfully rid the body of its physical dependence to alcohol. This process is not to be confused with alcohol rehabilitation, which describes the entirely different process of treating psychological dependence factors, as well as learning how to cope with and overcome addiction.
Detox is a temporary phase that lasts only as long as alcohol withdrawal symptoms, while rehab is a long-term program that seeks to treat alcohol use disorder as a whole.
If you've read this far, it can be assumed that you or someone you know if suffering from alcohol use disorder or severe alcohol abuse. In this article you'll find out how alcohol detox works, which treatments are used during detox, and what to expect from alcohol withdrawal. The first phase may be the most difficult, but the result could be a lifetime of healthy, sober living.
Drinking alcohol (ethanol) heavily over a long period of time has a severe, pronounced effect on the brain. Since alcohol releases a flood of calming, happy chemicals like dopamine into the body, the brain will attempt to counteract this imbalance with excitatory neurotransmitters (stimulating chemical messengers) to keep its millions of processes in check.
When the flow of ethanol and happy chemicals is suddenly taken away, the brain's compensation techniques will backfire. Now, your brain's natural store of soothing and pain-relieving dopamine is completely depleted, but the excitatory chemicals are still being pumped out in abundance. These neurotransmitters - the same chemicals that cause anxiety, pain, and excitement - are now flowing unchecked with no counteracting dopamine to calm them. This results in a range of painful withdrawal symptoms that will continue until your body can balance its neural responses once again.
A successful alcohol detox will require competent and effective management of the withdrawal symptoms while your body physically sheds its dependence on alcohol.
There is a common misconception that alcohol is flushed from the body every hour. This does hold true - for one ounce of alcohol. If five or or more drinks are consumed within a short two-hour stretch however, it can take up to eight hours for such a high quantity of alcohol to be flushed from the bloodstream. Also keep in mind that ethanol can remain on the breath for 24 hours, in urine for 48 hours, and in hair for up to 90 days.
Because of the belief that alcohol leaves the system every hour, many disastrous mistakes have been made during long nights of drinking. Sometimes it happens that someone will consume five or six drinks in a short period and then wait for an hour before driving home or jumping in the pool. Even after an hour, this person would still be intoxicated due to the high quantity of alcohol consumed, and the results could be fatal. Six people die in the United States every day from alcohol poisoning, and that's not counting innocent bystanders who are killed by drunk drivers.
Since it takes about eight hours for the body flush out a bout of heavy drinking, this is usually the amount of time that passes before alcohol withdrawal symptoms kick in.
Alcohol has a markedly depressive effect on the Central Nervous System, causing major bodily functions like the heart rate and respiration to slow down. It is this fact that makes alcohol so dangerous to mix with other drugs. When alcohol is combined with other substances that slow the CNS, like heroin or benzodiazepines, overdose becomes much more likely. In fact, alcohol is a factor in most polysubstance overdose deaths.
13% of all emergency room visits can be attributed to polydrug abuse. Mixing substances is a dangerous habit and can also make the withdrawal and recovery process more punishing. If your body has to detox from more than one substance, you could suffer from a wider variety of withdrawal symptoms, and it may take longer for the symptoms to subside.
Alcohol withdrawal will be slightly different for each person. The severity of alcohol abuse and the length of the addiction may both have an effect on the process. The following timeline is a rough estimation of what the average person might expect during alcohol withdrawal.
Stage one - 8-24 hours: During the first eight to twenty-four hours since the final drink, the following symptoms will likely set in.
Stage two - 24-72 hours: Although this stage will vary from person to person, the second stage of withdrawal will likely result in the following symptoms.
Stage three -4-7 days: For most people, alcohol withdrawal symptoms will slowly recede during the third stage; however, this is also the point at which delirium tremens may set in. This is an unpredictable and dangerous condition that may cause psychosis, or even death. 5% of all patients develop delirium tremens during alcohol withdrawal. Those who do develop delirium tremens may experience the following symptoms:
Delirium tremens presents a real risk for those trying to recover from alcohol addiction. 15% of everyone who develops delirium tremens will die as a result. This is why professional medical supervision during alcohol detox is a must, especially for long-term or severe alcoholics.
Once alcohol use disorder has taken hold of your life, you will be unable to stop drinking without developing the many unpleasant symptoms described above. In fact, you may continue to drink just to stave off those side effects.
What's really happening is a wide range of chemical and physical reactions. First, your brain will be inundated with stimulant neurotransmitters that will throw the brain into an even more pronounced imbalance. As those chemicals rush through the body, they will cause tremors, anxiety, insomnia, and emotional side effects like mood swings.
Meanwhile, you will start to feel the physical effects that long-term alcohol abuse has had on your body. Without the pain-relieving benefits of alcohol-induced dopamine to soothe them, the digestive system will begin to heal from the acidic and caustic damage caused by ethanol. This is where stomach aches, cramps, and vomiting come in. Then, the kidneys and liver will try to cleanse ethanol toxins from the body, resulting in heavy sweating, heart palpitations, and headaches.
In short, your body will not be a pleasant place to be during alcohol withdrawal, but this step is vital to cleansing your body and mind of physical dependence. You won't be able to properly rehabilitate from alcohol addiction until you have completed the detox stage.
Detoxing from alcohol from the comfort of your own home may seem preferable, but it can be dangerous. It is highly recommended to go through withdrawal under the supervision of a medical and counseling team in order to mitigate the risks involved. That is not to say that you can't detox at home; of course you can do so safely through an outpatient or intensive outpatient detox program. Just remember that the approval and assistance of experienced addiction specialists will result in a much safer and comfortable experience as well as higher chances of success.
Especially for those attempting their first alcohol detox, many assume that they can quit cold turkey with no professional assistance at all. While some have achieved recovery on their own, it is much more difficult and dangerous. Here's why:
The so-called detox drinks that you find in your local drug stores or on the internet may sound too good to be true. That's because they are. Detox kits are actually intended for one purpose - to mask drugs or alcohol from showing up in urine drug test results. There is absolutely no qualified evidence that detox kits can treat withdrawal symptoms or decrease the time it takes to complete alcohol detox. In fact, some of these concoctions may actually be harmful to your health.
The Primary Care Companion for CNS Disorders condemns the use of over-the-counter or homemade detox drinks, suggesting instead the use of FDA-approved treatments or herbal remedies provided by professional alcohol detox programs.
There are a variety of medications that can be prescribed to soothe the symptoms of alcohol withdrawal and facilitate the recovery process. Medications like the following have been shown to increase recovery rates by as much as 30%.
It is important to note that the above medications should only be administered under strict supervision by a licensed physician. Results and side effects must be monitored carefully to achieve a successful and safe detox. Some recovering alcoholics are put off by the potential fees of these medications as well as the necessary supervision by medical personnel. However, many of these prescriptions, as well as detox and rehab programs, are covered by health insurance plans.
While medical detox addresses the physical symptoms of alcohol withdrawal, holistic detox programs focus on whole-body healing. Holistic treatment offers therapy for the body, mind, and soul, treating the self as one integral unit. This can be effective for treating a number of factors that contribute to addiction, as well as the physical dependence itself.
Holistic detox includes a wide range of therapeutic treatments, such as:
Although a holistic detox program often requires more time, the process can address a wide range of emotional and physical issues that are detrimental to recovery. Holistic detox is often personalized to each individual case and requires professional guidance.
There are many factors that will influence which type of alcohol detox is right for you. Budget, work schedule, family obligations, and the severity of your addiction may all play a part in your decision. In general, these are the three types of detox treatment available:
Outpatient alcohol detox: Offering several hours per week of treatment, outpatient rehab is often appropriate for functional alcoholics with a heavy work schedule or family obligations. It may not prove as successful for severe alcohol use disorder, however.
Intensive outpatient alcohol detox: A step up from traditional outpatient therapy, intensive outpatient provides a more rigorous schedule of 12 hours per week of therapy or more. In this program, the patient can continue to live at home and maintain daily obligations while receiving detox treatment almost every day.
Inpatient alcohol detox: Residential detox programs are provided at live-in facilities where patients sleep, eat, and receive treatment under constant supervision. While this is often the most expensive option, it may prove more successful for the severest alcohol addictions.
The alcohol detox phase generally lasts about a week, but it only solves a small part of the problem. Once alcohol withdrawal symptoms have subsided, your body's physical addiction to ethanol will be mostly resolved, but the journey is far from finished. Addiction is caused by psychological factors as well as physical, and addressing the psychological aspects of addiction requires more time and assistance.
The psychological side of addiction will need to be addressed in a good alcohol rehabilitation program, where you will also be counseled on effective ways to confront and combat addiction during everyday life. In fact, the Substance Abuse and Rehabilitation Journal states that long-term sobriety rates increase by as much as 50% for those who complete alcohol rehab after detox. Some of the issues that rehab will focus on include:
Over time, all of these things will be addressed during drug rehab through a combination of group therapy, counseling, educational classes, psychiatric care, and workshops. Ideally, these treatments can and will result in a sober mindset that will equip you with the tools you need to maintain recovery and avoid relapse.
Unfortunately, it would be remiss to assume that rehab will 'cure' alcoholism. Alcohol use disorder is a chronic disease and technically, there is no cure. However, by attending the right aftercare programs and building a long-lasting support system, you can greatly increase the chances of a lifelong remission. Some aftercare programs that may be available immediately after rehab are:
Aftercare programs often last for a few weeks or months after alcohol rehab is complete, but many recovering alcoholics continue to attend support groups for years, or even for the remainder of their lives. This kind of vigilance may be key to maintaining sobriety for the long-term. These are some of the support groups that are available in most states:
Like all drugs, alcohol has a strong effect on the chemical makeup of the brain. This is how it works:
Of course, the process above is only the direct and immediate response of drinking alcohol. Addiction is not so simple; it happens over time. Alcohol addiction goes something like this:
Once the process described above is complete, the body and brain will be physically dependent on alcohol. If you try to stop drinking at this point, your body will go through alcohol withdrawal. You will also experience intense cravings when you don't drink, since your body will want to avoid the symptoms of alcohol withdrawal. This is how alcohol use disorder begins, ends, and begins again in a vicious and brutal cycle.
Throughout this article we have discussed both physical and psychological addiction, but what do these terms really mean? Here are some detailed definitions:
Physical addiction: As described above, a physical dependence takes place when the body and brain have become accustomed to the presence of alcohol in the system to the point that they no longer function normally without ethanol. When alcohol is removed from the equation, withdrawal symptoms will set in. A physical addiction is marked by the presence of withdrawal symptoms when you try to quit drinking.
Psychological addiction: This type of dependence is more subtle, but no less powerful. Psychological dependence occurs when alcohol serves some deeper emotional need. In cases of co-occurring disorders, people often self-medicate with alcohol to treat their own symptoms of social anxiety, depression, bipolar disorder, or other mental conditions. Others may turn to alcohol to relieve stress or sleep better, but using alcohol to serve emotional needs can lead to much more complicated and long-lasting addictions.
If someone were to ask you, "What does an alcoholic look like?" What would you say? Society and pop culture would have us believe that a 'common drunk' has a certain look or lives a certain type of lifestyle. In popular culture, an alcoholic is often portrayed by the following characteristics:
In truth, this stereotype very rarely holds true. There are millions of people with alcohol use disorder from all walks of life. Successful executives, schoolteachers, high school kids, and political leaders have all suffered from alcoholism. Alcohol use disorder can cause any number of problems, but it is not always obvious or easy to recognize. Like most diseases, alcoholism can affect anyone, sometimes without warning.
Perhaps you are wondering about your own drinking habits or those of someone close to you. Either way, there are some warning signs to look for if you're worried that someone you know may be suffering from alcohol use disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM):
If you or someone you know shows two or more of the above behaviors, alcohol use disorder has either already set in or is imminent. It's time to confront the alcohol abuse head on and seek out the necessary help before further damage can be done.
We mentioned earlier that anyone can suffer from alcoholism. Actress Claudia Christian once said that,
That is to say, alcoholism can strike anyone, any time. And for each and every person, alcohol use disorder may present differently. Here are the most common presentations:
Usually identified in the mid to late 20s, young antisocial alcoholics drink to suppress feelings of social anxiety. Of these, many show symptoms of antisocial personality disorder.
Most young adult alcoholics do not admit that they have a problem, yet 32% of alcoholics are under 25. Young adult alcoholics often go on "benders", binge drinking intermittently.
This type of alcoholic usually lives with or is descended from other alcoholics. Since they tend to live with other people who abuse alcohol, recovery may prove more difficult. Intermediate familial alcoholics often include the children, spouses, siblings, or grandchildren of alcoholics.
Alcoholics in this subset may go years without seeking treatment because they feel safe in a 'successful' lifestyle. A functional alcoholic will often keep up with work and family obligations in spite of having five or more drinks per day.
Although chronic severe alcohol use disorder is the least common, it is the most commonly represented in alcohol treatment facilities. Chronic severe alcoholics are more often required by law to receive treatment due to mental illness or illegal activities.
Alcohol abuse and alcohol use disorder may seem similar upon first glance, but they represent very different behaviors. Alcohol abuse is defined by the DSM as "the continued use of alcohol even after it has persistently created problems for work, family, or social relationships." Alcohol abuse can certainly cause problems, but it is not necessarily indicative of addiction. These are the differences:
Tolerance: Alcohol abuse rarely results in a high tolerance, while alcohol use disorder is always marked by tolerance.
Withdrawal: A person with alcohol use disorder will notice withdrawal symptoms when they quit drinking, while alcohol abuse does not result in alcohol withdrawal.
Lack of control: Someone with alcohol use disorder has little control over how much and how often they drink, while a person who abuses alcohol can still exert restraint when it's necessary.
If you've determined that your own behavior is defined as abuse rather than alcoholism, don't celebrate just yet. Heavy drinking and binge drinking behaviors are both dangerous and potentially harmful to your life and relationships. Case in point, the Centers for Disease Control and Prevention (CDC) gives us the following statistics:
Young people often make excuses for alcohol abuse, insisting that they only drink with friends or on the weekend. However, anyone who has more than four of five drinks in a two-hour period is engaging in binge drinking, a dangerous and detrimental behavior by itself. This kind of alcohol abuse can lead to problems at work or at home, as well as risky behaviors like drunk driving or unprotected sex.
Whether your habit is defined as alcohol addiction or alcohol abuse, heavy drinking can and will result in changes to your health and relationships. It can also lead to a more serious and pronounced addiction later on. Don't wait until alcohol abuse presents real damage to your personal and professional life. If your drinking habit borders on addiction or abuse, put an end to it now and start your alcohol detox program.
We've been over the way that alcohol crosses the blood-brain barrier and enters brain cells directly. This creates a near instant sensation of euphoria as well as a relaxation of the CNS. The chemical reactions that cause these feelings also have effects on the brain as a whole. Over time, long-term drinking will have an even more pronounced effect.
Short-term effects: Due to its impact on the Central Nervous System, alcohol creates sensations of drowsiness and relaxation. This sedative effect also decelerates the brain's functions and reactions to stimuli, alters decision-making patterns, and weakens short-term memory.
Long-term effects: Drinking heavily over time has much more disturbing repercussions on the brain. Because of the disproportion of neurotransmitters that ethanol releases in the brain, its physical makeup and functionality can be altered if the influx of alcohol does not stop. Here are the ways that long-term alcohol abuse changes the brain:
Alcohol can have alarming effects on brain chemistry, but it is the damage that ethanol abuse causes to organ systems that results in the most alcohol-related deaths.
Short-Term Effects: Although it is not as easy to see from the outside looking in, alcohol begins affecting the body's systems almost immediately:
Long-term effects: The consequences of long-term alcohol abuse are most evident throughout the organ systems of the body. Organ damage due to heavy drinking is responsible for the most alcohol-related deaths. Over time, heavy drinking will:
If you've tried to cut down on your drinking habits or quit entirely only to realize that you are unable to, you are not alone. If quitting were easy, there would be no need for detox and rehab programs at all. Some of the most successful people in the world have asked for help to achieve recovery and for many, like Robert Downey, Jr., that help has resulted in many long years of sobriety and prosperity.
Going through alcohol detox and withdrawal will not be easy, but it will be worth it. Reach out for the help you need to start working towards your own recovery. The rest of your life is waiting.
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