Medical detox addresses the potentially life-threatening withdrawal symptoms associated with alcohol detox. Various medications may be used to prevent seizures and delirium tremors, ensuring patients stay safe throughout the process.
Key Takeaways
- Alcohol detox is complex, as individuals often experience severe withdrawal symptoms that can be life-threatening. Medications are used to keep clients safe.
- A comprehensive assessment is used to determine the severity of withdrawal and guide the approach. Patients are carefully monitored throughout the detox process.
- After detox is complete, clients move on to rehab. They undergo therapy to address the root causes of alcohol addiction.
Table of Contents
- What Happens During Alcohol Withdrawal?
- What Is the CIWA-Ar Protocol?
- Who Is At Risk of Severe Alcohol Withdrawal?
- What Medications Are Used in Medical Detox?
- What Is the Medical Detox Setting Like?
- What Happens After Alcohol Detox?
- Contact BlueCrest for the Recovery Support You Require
- FAQs
Introduction
The detox process is never easy, but overcoming alcohol can be especially complex. Alcohol enhances GABA activity, producing a calming effect, and suppresses glutamate activity, the brain’s primary excitatory transmitter. With chronic, heavy use, the body compensates by downregulating GABA and upregulating glutamate.
When alcohol is abruptly removed, the brain is running with too little inhibition and too much excitation, pushing it into a hyperactive state, increasing the risk of seizures and delirium tremens, both of which are potentially fatal. According to a National Institute of Health research, mortality rates can be as high as 20%. However, they can be reduced to as low as 1% with a medically supervised approach.
This article explains how the alcohol detox process works to keep patients safe.
What Happens During Alcohol Withdrawal?
While the timeline for alcohol withdrawal can vary, it is typically as follows:
- 6-12 hours: Early symptoms: Tremors, anxiety, nausea, elevated heart rate
- 12-24 hours: Potential for hallucinations
- 24-48 hours: Peak seizure risk window
- 48-72 hours: DT onset risk- the most dangerous phase
- 72+ hours: Gradual symptom resolution
In most people, symptoms will completely resolve within a week or two. However, for some, they can last for months or years, developing into post-acute withdrawal syndrome (PAWS).
What Is the CIWA-Ar Protocol?
The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is used to assess the severity of alcohol withdrawal symptoms so teams can develop a framework for evaluating detox. It assesses ten symptom domains, including:
- Nausea and vomiting
- Tremor
- Paroxysmal sweats
- Anxeity
- Agitatio
- Tactile disturbances
- Auditory disturbances
- Visual disturbances
- Headache
- Orientation and clouding of sensorium
Nine ot the ten items are scored on a scale of 0-7. The orientation is scored on a scale of 0-4 for a maximum possible score of 67.
These scores guide the administration of medication. For example:
| Score range | Severity | Typical Clinical Response |
| <8 | Mild symptoms | Monitoring, supportive care, oral hydration, and medications may not be needed |
| 8-15 | Moderate symptoms | Medications are typically initiated or escalated |
| >15 | Severe withdrawal symptoms | Aggressive medication management, close monitoring for risk of seizures and DTs |
Who Is At Risk of Severe Alcohol Withdrawal?
Several factors contribute to a higher risk of severe alcohol withdrawal. They include:
- A History of Seizures and DTs: People with a history of these conditions are more likely to experience them during detox.
- Prior Detox Events: After going through detox several times, your body becomes accustomed to operating with higher levels of GABA and lower levels of glutamate, increasing the risk of withdrawal severity.
- Physical Health Issues: Co-occurring conditions like liver disease, cardiovascular disease, malnutrition, and acute illness can contribute to severe withdrawal symptoms.
- Quantity and Duration of Alcohol Use: Individuals who consumed large quantities of alcohol over long durations of time may need medical supervision to safely detox.
- Polysubstance Use: People who combine drugs with alcohol will face a more complex detox process.
What Medications Are Used in Medical Detox?
Various medications may be used to prevent serious complications. They include:
- Benzodiazepines: The gold standard for severe alcohol withdrawal, benzos bind to GABA receptors in the brain, making up for the deficiency that occurs when alcohol is suddenly removed. They also offer sedative properties to reduce anxiety, agitation, and tremors.
- Anticonvulsants: Typically used to address mild to moderate withdrawal symptoms, these are preferred to benzos because they aren’t addictive and don’t require as much monitoring.
- Adjunct Medications: Beta blockers block the effects of adrenaline to keep heart rate and blood pressure under control. Clonidine reduces norepinephrine release from the central nervous system to manage hyperactivity.
- Thiamine and B Vitamins: Alcohol addiction is typically linked to a thiamine deficiency, which is associated with Wernicke’s encephalopathy, which can progress to the more severe Korsakoff syndrome, an irreversible neurological disorder. Therefore, thiamine is almost always administered in alcohol detoxification treatment.
It should be noted that alcohol is not typically used in alcohol addiction treatment. Some people may try home detox, utilizing a tapered approach.
However, this is not advisable, and it’s rarely used in professional treatment centers. Moreover, it should never be implemented without medical supervision.
What Is the Medical Detox Setting Like?
Medical detox can take place in inpatient or outpatient settings. With residential treatment, clients are monitored 24/7 throughout the detox process. Outpatient care involves clients coming to the facility for medical adjustments and check-ins while managing symptoms at home.
Regardless of the setting, the process may look something like this:
- Intake and Assessment: The medical intervention process begins with a thorough assessment of the client’s mental and physical health, including labs, CIWA-Ar scoring, a full exam, and a review of medical history. Treatment programs will use this information to develop a recovery framework.
- Monitoring: Clients are carefully monitored throughout the withdrawal process. Specialists at the treatment facility check vital signs and provide medical monitoring, adjusting doses as needed.
- Duration: This part of the treatment plan typically lasts 3-7 days.
What Happens After Alcohol Detox?
Medical detox addresses physical dependence issues. After that stage of detox is complete, clients typically move on with ongoing treatment that addresses mental disorders that may have contributed to addiction. Evidence-based practices are integrated, and clients are taught coping strategies, so they can deal with their emotions without relying on drugs and alcohol.
A PubMed study of 136 recovery patients reveals that those who went on to behavior therapy and self-help programs after detox were more likely to remain abstinent from drugs and alcohol as compared to those who went through detox alone, with a comparison rate of 81% to 39%.
This is the stage where BlueCrest Recovery comes in. We start by diagnosing the underlying condition, using the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Then we determine the best treatment approach.
We further tailor programs to clients’ needs, ensuring they fit their goals and lifestyles. Our team combines traditional methods with holistic therapies, addressing the mental, spiritual, and physical aspects of substance use.
Contact BlueCrest for the Recovery Support You Require
At BlueCrest, we understand the recovery process isn’t easy. We are here for you every step of the way. Our team will connect you with the best detox programs. Then we follow up with evidence-based care to ensure you achieve long-term sobriety.
Contact us to learn more about our comprehensive program. We’re here when you’re ready to take the first step.
FAQs
Can you cold turkey from alcohol addiction?
A cold turkey approach is never recommended, especially for people with a long history of severe addiction. It is best to get professional help to avoid serious complications.
Can I detox from alcohol at home?
You can detox from alcohol at home as part of an outpatient program. However, attempting to detox without the oversight of healthcare professionals is dangerous and should not be attempted.
What is the difference between alcohol detox and alcohol rehab?
Alcohol detox addresses the physical aspects of alcohol addiction, including cravings and withdrawal symptoms. Rehab focuses on mental health conditions that may contribute to drinking problems, preventing relapse, and ensuring clients maintain sobriety.
What are the physical signs of alcohol addiction?
Physical alcoholism signs include frequent hangovers, withdrawal symptoms, unexplained injuries and accidents, neglect of self-care and hygiene, insomnia or changes in sleep patterns, digestive issues, redness of the face and palms, and abdominal swelling. If you notice these symptoms, it may be time to get professional help.
What are the signs of alcohol poisoning?
Alcohol poisoning signs include mental confusion, vomiting, seizures, unconsciousness, with an inability to wake up, slow or irregular breathing, low body temperature, or hypothermia.
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