Disclaimer: This article is not intended as a substitute for the counsel of a qualified physician or licensed therapist. This content should be used for purely informational purposes. Please consult your doctor if you have further inquiries on this subject. We intend to impart the most accurate and recent information but cannot make any guarantees.
The difficulty of the alcohol detox process is the number one reason for relapse. Alcohol withdrawal symptoms are severe and sometimes deadly; this is not a path you should attempt to travel alone. If you or a loved one is ready to end the pain, confusion, and disappointment of alcoholism, make sure you have the necessary information and resources on hand before you begin. Given the proper research, support, and preparation, you can learn to better understand the nature of addiction, which will lead to lasting sobriety.
Do these words ring all too true? If a person with fame, fortune, money, and friends in high places - could be pulled under by the so-called 'addiction monster', what hope could the average person have to overcome it?
If you feel this way, or see these sentiments reflected in the attitude and behavior of a close friend or relative, it may seem like a hopeless endeavor; however, there is always hope. The road to recovery is long and very, very difficult, but millions have accomplished it. When the only other path likely leads to an untimely death, you will lose nothing in the fight. The first step is alcohol detox (easier said than done).
First of all, you must put a stop to thoughts of self-loathing and blame. Would you blame someone for developing a deadly form of cancer? Of course not. Neither should you treat alcoholism as if it were a choice. Alcohol Use Disorder (AUD) is an illness - a disease. Until you and your loved ones can view it as such, you will not be prepared to treat the condition as the sickness that it is.
We want to help you to educate yourself and prepare for the first step of recovery - alcohol detox. Alcohol detox is perhaps the most important step; it will clear your system of deadly ethanol toxins and end your body's physical dependence on alcohol. After alcohol detox is completed successfully, it should be followed by a comprehensive rehab program that will address psychological dependence, preparing you for the lifelong treatment of alcoholism, also known as Alcohol Use Disorder. Both alcohol detox and alcohol rehabilitation are necessary components of long-term recovery and sobriety.
If you're reading this, it's safe to assume that you are seeking help, either for yourself or someone you care about. Keep reading; this article will cover everything you need to know in order to prepare your mind and body for the turbulent and harrowing experience of alcohol detox. The idea is not to sugarcoat the process. The experience may be dreadful, but what could be a better reward than the rest of your life?
Alcohol withdrawal occurs when your brain and body have become physically dependent on the presence of alcohol in order to function. Once your brain has become accustomed to the influx of sedative neurotransmitters released by alcohol and produces a steady stream of excitatory neurotransmitters to counterbalance the effects, it will no longer remember how to adjust the balance once ethanol has been removed from the equation.
In other words, your brain is bursting with stimulating agents to regulate the influx of alcohol. Take away the depressing influences of ethanol, and suddenly there are no happy, sedative chemicals left. Now, your brain is left with all of the chemicals that cause anxiety, excitement, stimulation, and pain; but none of the calming, soothing chemicals are left to counteract them. The result? Utter, painful chaos.
The key to successful alcohol detox is to manage the symptoms of alcohol withdrawal.
Depending on how much alcohol is consumed and during what period of time, alcohol can remain present in the bloodstream for anywhere between 2 to 8 hours. Ethanol does not just reside in the bloodstream however; it can be detected on the breath for 24 hours, in urine for up to 48 hours, and in a person's hair for up to 90 days.
Many presume that alcohol only stays in the bloodstream for up to an hour, but this is only if you consume one ounce of alcohol during that hour. If one consumes 5 or more drinks in less than two hours, it will take up to 6 hours or more for the body to flush it out. This common mistake can prove fatal for those who attempt to drive or consume other conflicting substances (such as pain relievers or sleep aids) before the alcohol has left their system.
Another dangerous result of this misconception is alcohol poisoning. If one assumes that everything they drink is being flushed out of the body every hour, they may easily consume dangerous amounts of alcohol in a two or three-hour period. Alcohol overdose, also known as alcohol poisoning, is a very real danger and kills six people or more every single day in the United States.
Since it does take a while for large quantities of alcohol to leave the bloodstream, it usually takes 8 hours or more after the last drink for alcohol withdrawal symptoms to kick in.
Withdrawal occurs when a long-time alcoholic suddenly becomes sober. The body no longer knows how to function normally without ethanol running through the bloodstream, and so begins the long and painful process of cleansing massive quantities of toxins from the system and reestablishing chemical balances in the brain.
For most Alcohol Use Disorders, the withdrawal process has the same basic timeline, although it may vary slightly from person to person. It looks something like this, with the hours being counted from the time of the last drink:
Stage 1: 8 - 24 hours: The first stage of the withdrawal timeline begins, manifesting with the following symptoms:
Stage 2: 24 - 72 hours: The second stage of the timeline may be marked by the following symptoms, depending on the severity of the addiction:
Stage 3:4 - 7 days: Normally this is the point in the withdrawal timeline where symptoms begin to subside. Most people will continue to suffer from intense alcohol cravings and psychological side effects long after alcohol detox, but a rehab program can help you to overcome these lasting effects. 5% of alcoholics will experience a dangerous condition called delirium tremens during the third stage of withdrawal.
Delirium tremens is associated with the following symptoms:
Although it is a relatively rare condition, delirium tremens presents the most dangerous aspect of alcohol detox and is the main reason that medical personnel should be present during the process. Up to 15% of those who suffer from delirium tremens die as a result of its symptoms.
When the steady flow of alcohol is ceased, the body that was accustomed to regular, heavy drinking suddenly finds itself in a state of chaos. The brain is infused with the excitatory chemicals it had been using to balance the effects of ethanol and suddenly has no way to control the hyperactive effects of these chemicals. This drastic imbalance of neurotransmitters accounts for many of the initial symptoms of alcohol withdrawal, such as hand tremors, headaches, mood swings, anxiety, heart palpitations, and insomnia.
Beyond the reactions that are going on inside the brain, the rest of the body is working to rid itself of massive quantities of ethanol toxins. Without the sedative effects of alcohol to artificially soothe them, the esophagus and stomach make their discomfort known as they begin to heal from the caustic effects of the alcohol. The liver and kidneys go into overdrive during this process as they attempt to rid the body, blood, and tissues of the toxin. This is partly the cause of excessive sweating, nausea, and headaches.
Alcohol detox is the most important part of the journey to sobriety and alcoholism recovery because it allows the body and mind to rid themselves of physical alcohol dependence and prepare for a clean, healthy rehabilitation program.
Alcohol detox without professional or medical help is not recommended. Although it is certainly possible to complete this step at home, the process is so difficult and unpleasant that many fail to complete it without giving in to the need to have "just a sip" to relieve the painful alcohol withdrawal symptoms. This slippery slope is counterproductive and leads to ultimate failure.
Besides the question of pain and temptation, there is also a serious health risk involved. These are some reasons that home detox is not recommended:
Detox kits are a big business. Based on either chemical or herbal detoxification solutions, these over-the-counter products often promise a faster detox time and milder alcohol withdrawal symptoms. Unfortunately, there is no quick fix for alcohol detox.
According to the Primary Care Companion for CNS Disorders, detox kits - even of the "natural" herbal variety - are not usually effective or even safe.
According to investigations and case studies, most detox kits are not necessarily intended to relieve the alcohol detox process, but to mask or remove drugs and alcohol from visibility in sobriety tests. Most studies report detox kits as entirely ineffective in relieving the symptoms of withdrawal, with some products causing negative side effects such as stomach pain and even psychotic breakdowns.
Using a precise combination of prescription medications to aid the alcohol detox and rehabilitation process has been shown to boost the recovery success rate from 20% to 50%. Some of the medications used to aid this process are:
Of course, the use of any of the above medications would require close monitoring by trained medical professionals. Because of the high level of care and the cost of the prescriptions themselves, medicated alcohol detox can be very expensive. Some alcohol addicts do not choose the medicated route for this reason. Outpatient programs can be markedly more affordable, however.
Holistic alcohol detox treatment confronts the process from a whole-body wellness approach. The recovery of the entire person - body, mind, and spirit - is addressed during this type of program. Besides treating the symptoms of physical alcohol dependence, a holistic detox program seeks to address other aspects of well-being that may have caused or been affected by alcoholism. These aspects include issues like emotional and spiritual health, environment and finances, intellectual abilities, professional and social aspects, and of course, overall physical health.
Addressing so many details of a person's life and well-being is by no means simple. This is achieved through a wide range of treatment and therapy plans, such as:
Although holistic detox may take longer, it is usually treated as a natural transition from alcohol detox into alcohol rehabilitation therapy. Like medicated detox, inpatient holistic alcohol detox does not come cheap. Many argue that its effects last longer and feel more comprehensive than the standard medicated detox, however.
Most alcohol treatment programs offer several different strategies and levels of intensity based on budget and the severity of the alcohol addiction. These are the most basic standard options:
Ideal for the functional alcoholic, the outpatient program allows the patient to maintain work and family obligations while undergoing treatment. In this type of detox program, the alcohol addict will attend several meetings, therapy sessions, and doctor appointments each week, but then return to their normal environment. This is usually the most affordable option, but the downside is the ready availability of alcohol. Relapse is more likely in an outpatient program.
A step-up from standard outpatient programs, an intensive outpatient detox facility provides more support for the recovering alcoholic with 2 - 3 times more weekly meetings and therapy sessions. As opposed to the 3 - 5 hours per week provided by outpatient facilities, this type of program offers 9 hours or more per week of therapeutic treatment while still allowing the patient to live in their own home.
This much more rigorous approach is often the most successful option for severe alcoholics who wish to achieve sobriety. An inpatient facility offers round-the-clock support for the detoxing patient and takes them out of an environment that may facilitate an alcoholic lifestyle. Perhaps the most important aspect of an inpatient program is the absolute unavailability of alcohol. Without access to alcohol, the patient is much less likely to relapse, at least until they leave the facility.
Alcohol rehab and long-term addiction therapy make an enormous difference for an alcohol addict that is serious about becoming sober. According to the Substance Abuse and Rehabilitation Journal, recovering alcoholics who complete rehab and attend regular therapy sessions afterward have a 67% success rate of remaining sober for 5 years or more, as opposed to a 17% success rate for those who completed a detox program alone.
The reason why is because alcohol detox only addresses the physical dependence of the alcohol addiction, but the causes of addiction run much deeper than physical dependence. Psychological dependence may not feel as extreme to the recovering addict who is going through withdrawal, but psychological dependence is responsible for many more relapses, sometimes after years of remaining sober.
During the alcohol rehab process, the recovering individual will work with addiction counselors and therapists to complete the following:
Through a combination of individual, group, and family therapy, as well as a range of classes and workshops, alcohol rehab prepares an individual to begin a new life of sober living and to avoid relapse for the long-term.
Most alcohol rehabilitation programs offer a variety of aftercare solutions to assist the recovering alcohol addict as they return to normal life. Sober living facilities, aftercare therapy sessions, and even weekend stays in the rehab program are all common aftercare solutions.
Since alcohol addiction is usually considered a lifelong condition, rehab is not the end-all solution. Sobriety rates are much higher for individuals who continue to attend group therapy meetings for months or years after recovery. Some recovering alcoholics choose to continue attending meetings for the remainder of their lives in order to reduce their risk of relapse. The most popular alcoholic support groups are offered by the following organizations:
Alcohol Use Disorder, like most addictions, affects the delicate neurological balance of the brain.
It is a sedative, meaning that alcohol depresses the Central Nervous System. This is why it can alter speech, coordination, reaction times, vision, and memory. Here is how the process works:
This is the scientific process of alcohol affecting the brain. There are several more factors that contribute to addiction, however.
The result of alcohol addiction is that once alcohol is removed from the system, as happens during the process of alcohol detox, the overabundance of excitatory neurotransmitters and sudden lack of sedative neurotransmitters generates a wide range of severely unpleasant side effects, such as anxiety, "the shakes", nausea, aches and pains, insomnia, and heart palpitations, among others. This phenomenon is known as alcohol withdrawal and the side effects are called alcohol withdrawal symptoms.
The body's natural inclination in the face of these unpleasant after effects is to crave the one thing that will give immediate relief - more alcohol. Thus, the never ending cycle of alcohol addiction begins, ends, and begins again.
There is a fine line between drinking alcohol on a regular basis and forming a dependence to alcohol. The line is often so blurry that one does not realize that a dependence is forming until it is already well established.
It often starts innocently enough, and the process of forming dependence may take years. Actress Claudia Christian describes her slow spiral into alcohol addiction like this:
"I was a very light drinker in my 20s. In my 30s, I was a social drinker, and somewhere in my early 40s, I developed Alcohol Use Disorder."
A common misconception is that someone is either an alcoholic or they are not, but the reality is that alcoholism can develop slowly over decades, and it can happen to anyone.
In the previous section, we described the internal process in the brain that is caused by prolonged alcohol abuse. Because of the imbalance that ethanol created in the brain, a new chemical structure is created in response to the prolonged presence of ethanol and alcohol tolerance develops. More alcohol must be consumed more often to create the same pleasurable effect.
Sometimes without realizing it, the alcohol addict will drink slightly larger quantities at each sitting, subconsciously seeking out the release of dopamine that triggers pleasure and euphoria. Over time, drinking ceases feeling pleasurable at all, and the now alcoholic will continue drinking heavily just to feel normal and avoid unpleasant alcohol withdrawal symptoms.
Drunkenness has become the new normal and the brain is under the impression that it cannot function normally without a steady stream of ethanol.
Amy Winehouse. Whitney Houston. Hank Williams. Jimi Hendrix. Brian Jones.
These celebs all passed away due to mixing alcohol with other substances. The music industry might have a different landscape if these individuals had been more aware of the dangers of mixing intoxicating substances.
Referred to as polysubstance (polydrug) abuse, this risky behavior is responsible for almost 15% of emergency room visits. Although mixing any types of drugs or intoxicants is dangerous, one of the most lethal combinations is alcohol when mixed with other sedatives. For example, the lethal combination of alcohol with heroin or other opioid drugs is responsible for the most polysubstance overdoses.
The reason why is simple. Opioids also trigger the release of sedative chemicals in the brain, depressing the Central Nervous System. Combining either of these with alcohol exacerbates the effect to the point that the CNS can no longer keep the heart beating and lungs expanding. As the depressed nervous system continues to slow, its processes slow to the point of stopping, and death is quick to follow.
Besides the risk of untimely death, mixing other substances with alcohol makes the recovery process that much harder and the withdrawal process that much more devastating. Also, keep in mind that most drugs remain in the system longer than alcohol, drawing out the detox process even longer.
Physical dependence - This type of dependence is based on the body's physical need for alcohol after long-term alcohol abuse has formed a physical habit. This is based on the process described above in which a person cannot feel normal without the influence of ethanol in their system (some may be functioning alcoholics). A physical dependence is indicated when unpleasant alcohol withdrawal symptoms are experienced after one becomes sober. If someone experiences alcohol withdrawal symptoms, then they are definitely physically dependent on alcohol.
Psychological dependence - This type of dependence is slightly more involved and varies from person to person. It occurs when the alcohol fulfills emotional needs as well as physical feelings of pleasure. For example, if someone feels anxious and uncomfortable in social situations and drinks in order to function successfully around other people, the alcohol is fulfilling a psychological need. Often referred to as 'self-medicating', psychological dependence is often related to an emotional or mental condition (a co-occuring disorder) that the alcohol addict seeks to mend with heavy drinking.
Many alcoholics find it difficult to admit that they are addicted to alcohol because of common misconceptions of what alcoholism looks like. The stereotype of alcoholism usually involves the following:
In reality, Alcohol Use Disorder affects people from all walks of life; every religion, gender, social class, and ethnicity may be affected. Just as cancer can strike any person at any time, the disease of alcoholism can creep into anyone's life, even if they are smart, successful, and respectable in all other areas. The sooner you can redefine your perception of alcoholism, the sooner you can learn to treat the disease.
If you've noticed unhealthy alcohol abuse habits in yourself or a loved one, but are unsure if the problem has reached the addiction stage, here are some signs to identify an alcohol addiction, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM):
Chances are, if you're reading this article, you've noticed some of these symptoms in yourself or someone close to you. If someone is experiencing more than two of these signs, alcohol addiction has either already set in or is very likely in the near future. It is time to get help and begin your alcohol detox plan.
While alcohol abuse is a dangerous behavior for many reasons, it is not necessarily the same as alcohol addiction. Technically, the DSM defines an alcohol abuser as anyone who continues drinking even after it has persistently caused problems with work, family, health, or the law.
Alcohol abuse involves damage - whether it be emotional or physical - that can be directly attributed to drinking habits paired with a refusal or inability to stop drinking.
This may sound a lot like alcohol dependence but there are a few major differences. The major differences are:
After reading this list, perhaps you identify yourself as an alcohol abuser rather than an alcohol addict, but don't be too quick to discount your use of alcohol as safe or acceptable. Excessive drinking is often the cause of a wide range of social, health, and work-related problems for tens of millions of people around the world. Here are some alarming statistics regarding alcohol consumption in the United States, according to the Centers for Disease Control and Prevention (CDC):
Almost 14 million adults, or one in 13 people, in the United States have an alcohol abuse or alcohol dependence problem. As many as 53% of Americans report that they have a close relative with an alcohol abuse problem.
79,000 deaths each year are attributed to alcohol problems, making it the third leading cause of preventable death in the United States.
41% of fatal traffic accidents are related to alcohol.
According to a survey by the National Institute on Alcohol Abuse and Alcoholism, 92% of Americans have reported binge drinking within the past month.
Even though risky behaviors like binge drinking are not necessarily indicators of alcohol addiction, this type of alcohol abuse is a problem in and of itself. Binge drinking is generally defined as having 4 drinks in a two-hour period for women or 5 drinks in a two-hour period for men. The CDC reports that binge drinking is the most harmful, dangerous, and expensive form of excessive alcohol use. One in every 6 Americans binge drinks around four times a month, greatly increasing their risk of injury, risk-taking behaviors, alcohol poisoning, unsafe sexual practices, work and relationship problems, and of course, developing alcohol addiction in the future.
Since alcohol abuse is a direct indicator of potentially forming alcohol dependence in the future, it is highly recommended to end alcohol abuse before it can develop into a more dangerous alcohol addiction. Since most alcohol abusers have not yet formed a physical dependence to ethanol, it is often a much easier process to decrease or put a stop to drinking altogether. If you or someone you know abuses alcohol, start your alcohol detox program now before the behavior progresses further.
As discussed previously, ethanol crosses the blood brain barrier directly into brain cells and disrupts the delicate neurological balance theirein. This results in both short and long-term effects on the brain's structure and function.
Short-Term Effects: Alcohol passes quickly into brain cells; the effects are immediate and apparent. Its depressive effect on the Central Nervous System produces feelings of euphoria while simultaneously slowing the brain's ability to process information and reaction to stimuli. This results in slurred speech, lack of coordination, slowed reaction times, impaired memory, and altered decision-making patterns on the part of the drinker.
Long-Term Effects: You already know that long-term heavy drinking causes the brain to increase its tolerance to alcohol and counteract the effects of alcohol by changing its neurologic reponses and neurotransmitter patterns. The changes go far deeper, however. Long-term alcohol abuse can result in the following, sometimes permanent, effects on the brain:
Granted, some of the changes described above could take years of heavy drinking to progress to any noticeable level, but some of these long-term changes begin taking place after only a few weeks of heavy drinking.
The brain is not the only part of the body that suffers under the burden of alcohol abuse. Over time, every cell begins to feel the weight of the poisonous ethanol that seeps into the blood and throughout the body.
Short-Term Effects: Alcohol has a swift effect on the body and its organs. Initially, drinking can relax the blood vessels and allow for more blood flow to the outer extremities, lowering the heart rate. As drinking continues, however, the heart must work harder to maintain sufficient blood flow through the organs, creating a highly fluctuating heart rate. Other short-term effects of alcohol consumption include:
Long-Term Effects: The most common alcohol-related deaths are caused by organ failure, particularly of the liver. This is because of the disastrous effect that long-term alcohol abuse has on organ health and function. Here are a few of the ways that alcohol affects the body and its organs over time:
Robin Williams described the uncertainty and fear of addiction when he said, "It's [addiction] - not caused by anything, it's just there. It waits. It lays in wait for the time when you think, 'It's fine now, I'm OK.' Then, the next thing you know, it's not OK. Then you realize, 'Where am I? I didn't realize I was in Cleveland."
Brevity aside, this is perhaps the most difficult aspect of alcoholism for non-alcoholics to understand. "Just quit," they say. "Is it really so hard?" Those who do not undergo the daily battle that is addiction cannot even imagine the power that it holds over you or the seeming impossibility of defeating it.
First and foremost of the barriers barring the way to recovery is the sheer difficulty of quitting itself. To say alcohol detox is difficult would be an extreme understatement. Once alcoholic dependence is established, it is one of the most painful and unpleasant withdrawal processes to go through. First, anxiety sets in; then, the nausea, vomiting, and debilitating stomach pain. This stage will soon be followed by tremors, fever, heart palpitations, and wild mood swings. In the worst cases, the final stage can include hallucinations, seizures, and severe confusion or agitation.
In light of such extreme circumstances, it's not hard to see why so many make the attempt but fail to finish the alcohol detox process without relapsing. After all, if you feel like you're dying, and instant relief is only one drink away, even those with the strongest of willpower are susceptible to break down. Because it is so very grueling, most experts recommend a strong support system and medical staff closeby before beginning the alcohol detox process.
"I'm a fun, polite person and it turned me into a rude bore. For a long time people were saying to me, 'We think you have a problem,' but in the end I had to come to the realization myself... I had to stop myself. And stopping has shown me a world of happiness that I didn't think was possible."
"If pushing a peanut up a hill with your nose keeps you sober, well, then, just push a peanut up a hill with your nose."
"I really was in the position to say, 'Well, if I can go through this and stay sober, then anyone can.' There was no better way to honor the memory of my son."
"My recovery from addiction is the single greatest accomplishment of my life ... but it takes work - hard, painful work - but the help is there, in every town and career, drug/drink freed members of society, from every single walk and talk of life to help and guide."
-Jamie Lee Curtis
"You want to get sober for your parents, you want to get sober for your job, you want to get sober for the cops, you want to get sober to protect your image. A lot of good reasons, by the way, but unfortunately, the only thing that works is that you have to want to get sober for you."
Each of the celebrities above overcame drug or alcohol addiction. These are only a few of the millions of people who continue to fight the battle of addiction recovery every single day. It is not easy, or simple, or quick; but recovery is very possible for anyone who is willing to take that first step.
The first step to recovery is alcohol detox, but recovery is a long and involved process that will likely require the support of trained professionals, therapy, and the loved ones who are waiting for you on the other side. Take that first step, and find the way to the rest of your life.
Our facilities currently open for services:
Outpatient drug and alcohol rehab and addiction counseling located in Boise, Idaho.
Our National Medical Detox and Inpatient Addiction Facility.
Outpatient drug and alcohol rehab and addiction counseling located in Washington State.