In 2012, 17 million adults age 18 and older were diagnosed with alcohol use disorder.
For individuals wishing to seek treatment for alcohol dependence, the thought of an extensive medical detox process can be daunting.
However, with the right medical care, individuals can withdraw from alcohol in a safe, comfortable manner and maintain sobriety. Participating in an alcohol medical detox program is the first step.
Alcohol withdrawal and detox should never be undertaken alone, as withdrawal symptoms can be severe and even life-threatening. The American Academy of Family Physicians estimates that possibly 2 million Americans experience these withdrawal symptoms a year. Some of the symptoms of withdrawal, such as delirium tremens, can be fatal if individuals are not receiving proper medical care. Symptoms generally correlate with an individual’s alcohol use, and they can begin as soon as 6-12 hours after the individual’s last drink. Such symptoms include:
- Mood swings
- Nausea and vomiting
- Rapid heartbeat
- Delirium tremens
Delirium tremens is the most dangerous of the withdrawal symptoms. It can cause hallucinations, fever, confusion, and seizures; extreme dehydration, head injuries, stroke, and heart attack may also occur. This is considered a medical emergency that can occur as soon as 24-48 hours following the last drink, and it has a fatality rate between 1 and 5 percent. The risk for developing delirium tremens is greater if individuals have a comorbid medical illness, a history of seizures or delirium tremens, heavy daily drinking, abnormal liver function, older age, and the presence of severe withdrawal symptoms.
Medical detox in an inpatient treatment facility is recommended for anyone who is addicted to alcohol and seeking to withdraw from it.
This ensures that the individual is safe and comfortable throughout the detox process. Some may suggest that individuals with mild alcohol dependence may be able to complete the detox process at home, with a loved one supervising. This is ill advised, not only because of the risk of such severe symptoms, but also because family members and/or friends are not trained to handle medical emergencies that may arise. In addition, those who attempt to detox at home are more likely to relapse and return to drinking to counteract the discomfort of withdrawal symptoms.
While in an inpatient treatment center, individuals will be supervised around the clock. Medical staff will monitor the individual’s blood pressure, heart rate, and body temperature; individuals may have certain electrolyte levels in the blood tested to monitor hydration status. In certain cases, individuals may be prescribed medications to ease some of the withdrawal symptoms, including benzodiazepines such as lorazepam (Ativan), often in a tapered dose.
There have also been developments with certain medications that may assist in the treatment of alcohol dependence. One of these medications, naltrexone, is also used for opioid dependence, and it may help reduce cravings for alcohol as well as reduce the risk of relapse in some individuals. A second medication, acamprosate, is thought to reduce long-term withdrawal symptoms, such as insomnia and anxiety, and may be most effective in individuals with severe dependence. Disulfiram is another medication that works differently than the previous medications; it interferes with how alcohol is broken down in the body and causes unpleasant symptoms, such as flushing, palpitations, and nausea, if individuals consume alcohol while taking it. It has shown to be quite effective in highly motivated individuals.
Once individuals successfully complete the medical detox process, they will begin the addiction treatment process.
One of the most important components of treatment is behavioral therapy. In Cognitive Behavioral Therapy, individuals identify and seek to change behaviors that have become associated with alcohol use and dependence. When the behaviors are identified, individuals will work closely with a therapist to examine these behaviors and create more positive behaviors. Individuals may be given homework to complete that will help them replace their negative thoughts and behaviors with new positive ones.
Individuals can also participate in family therapy. In this type of therapy, therapists will help individuals and their loved ones to learn and apply behavioral strategies and skills to improve their home environment.
Twelve-Step programs have shown effectiveness by encouraging individuals to become involved in a self-help or peer support group, which can help them maintain sobriety.
There are often three stages involved in 12-Step programs: acceptance, surrender, and active involvement.
In acceptance, individuals accept that addiction is a disease that is chronic and progressive, and over which they have no control. They admit that their lives have become unmanageable due to their alcohol use, that willpower alone is unable to repair that damage, and that abstinence is the only alternative. Surrender involves individuals handing themselves over to a higher power, accepting the fellowship and support of their fellow recovering group members, and following the recovery path that the 12-Step program suggests. Lastly, individuals commit to staying active in meetings and activities related to the program.
With all of these tools, individuals who have a desire to become and stay sober will be able to safely begin their recovery journey.