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Alcohol Withdrawal and Detox

Alcohol withdrawal can be an unpleasant experience that happens when a person becomes dependent on alcohol. In some cases, it can be dangerous or even fatal.1 Since it can be uncomfortable and unsafe to try and go through alcohol withdrawal or quit alcohol cold turkey, supervision during withdrawal is encouraged.Detox treatment is typically the first step in the recovery process and helps stabilize a person before continuing other forms of treatment.2

This article will cover alcohol withdrawal and detox including what alcohol dependence is, the dangers of withdrawal, and the importance of detox from alcohol as the first step in the recovery process.

What Is Alcohol Withdrawal?

Alcohol withdrawal occurs when a person who has developed a physiological dependence on alcohol suddenly stops drinking and experiences uncomfortable withdrawal symptoms. This occurs after prolonged and excessive alcohol use.2, 3 With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.4

Potentially serious complications such as seizures and other adverse physical and emotional effects can occur during alcohol withdrawal.1, 4 Detoxification with medical supervision is important to minimize the risks of severe withdrawal symptoms and withdrawal complications.1, 2 This also plays an important role in preparing someone for additional rehabilitation and treatment after alcohol withdrawal.

Alcohol Withdrawal Symptoms

The nature and severity of alcohol withdrawal can depend on how long a person has been alcohol dependent, how much alcohol they consume, and other physical health conditions.8

Withdrawal symptoms from alcohol can include:

  • Elevated pulse.1, 9
  • Elevated blood pressure.1
  • Elevated body temperature and sweating.5
  • Dysphoria.4
  • Anxiety.4
  • Irritability.4
  • Sleep disturbances.4
  • Nausea.1
  • Hand tremors.5

More severe or complicated alcohol withdrawal can include:

  • Delusions.5
  • Hallucinations.1, 9
  • Delirium.1, 9
  • Psychomotor agitation.5
  • Seizures.1, 9

Since some of these symptoms can be challenging, risky, and sometimes fatal, it is important not to try and quit alcohol cold turkey, or suddenly, especially if you or a loved one has a history of heavy, prolonged alcohol use.1, 2

Alcohol Withdrawal Timeline

Withdrawal symptoms will typically begin within 4 to 12 hours after a person’s last drink and largely resolve after 4 to 5 days.5, 9 Alcohol withdrawal symptoms often peak in severity on the second day after a person’s last drink.9

Seizures are one of the more severe and potentially dangerous complications of acute alcohol withdrawal. Though they may arise within several hours after the last drink in some individuals, the risk for alcohol withdrawal seizures remains high through roughly 24 to 48 hours after stopping alcohol use.1, 8, 9

Delirium tremens, an agitated, confused state that may develop as a severe progression of alcohol withdrawal, can begin 48 to 72 hours after a person’s last alcohol use and may last up to
5 days.9, 10 Delirium tremens can develop if severe withdrawal symptoms remain untreated or under-managed during the detoxification period.10

What Factors Impact Alcohol Withdrawal?

Based on current understanding and research about alcohol withdrawal syndrome, professionals have identified certain risk factors for experiencing more severe withdrawal symptoms. This may include symptoms that are prolonged or have specific complications such as tremors or seizures. These risk factors include:1

  • Older age.
  • The person’s overall health and nutrition.
  • Co-occurring medical and psychiatric conditions.
  • Use of other drugs combined with alcohol (polysubstance use).
  • Severe alcohol dependence.
  • Higher levels of alcohol intake.
  • Previous detoxification/withdrawal.
  • Past occurrences of seizures.
  • More severe withdrawal symptoms when attempting treatment.

Alcohol Withdrawal Treatment and Detox

Detox is the process of getting alcohol and drugs out of a person’s system.2 It is an important step in the treatment and recovery process to help stabilize a person and prepare for further rehabilitation.2

Withdrawal treatment medications often play an important role in managing potentially life-threatening symptoms of alcohol withdrawal. Benzodiazepines can be used to help reduce the likelihood and severity of withdrawal seizures and the development of delirium tremens.9

Other medications like anticonvulsants, antipsychotics, beta-blockers, and alpha-adrenergic agonists are occasionally used off-label to treat specific symptoms as needed.9

There are several therapeutic approaches and treatment settings available for alcohol addiction rehabilitation. After evaluation, intake, and detox, the following treatment options are available:6

  • Behavioral therapy: This is designed to change patients’ behavior and relationship with alcohol and can include cognitive behavioral therapy (CBT), motivational enhancement therapy, or family therapy.
  • Treatment medications can help decrease and discontinue the use of alcohol and prevent relapse. These may include naltrexone, acamprosate, or disulfiram.6
  • Inpatient or outpatient
  • Mutual support groups like Alcoholics Anonymous (AA)
  • Aftercare or continuing care to support a person as they step down their level of care and continue the recovery process.

Finding an Alcohol Detox Center

Detox can occur in different settings and at varying levels of intensity depending on your needs. It’s important to find a facility that will help create a detox and treatment plan that’s individualized to you.

Choosing the type of treatment that is best for your needs may feel overwhelming; however, support is available. If you are concerned about your drinking, talk with your doctor who can help evaluate your medical needs and suggest an appropriate level of care. They may be able to refer you to a treatment program that meets your needs.

You can also reach out to the caring team at American Addiction Centers (AAC). There are admissions navigators available 24/7 to take your call and listen to your story to help you find the right treatment program. They can also help check your insurance coverage at AAC facilities. To learn more, call today and start on a path to a healthier life.

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