The first step in treating alcoholism is to remove alcohol from the system, and this is much more involved than merely “sleeping it off.”
Detox is necessary because a person cannot participate in the treatment program and gain full benefit from the educational opportunity if he/she is in any way under the influence. Recovery starts when the alcohol is out of the system, Alcohol Withdrawal is generally the first step..
This can be a tricky process and people should not try to Withdrawal without medical assistance. Alcohol Detox is potentially very dangerous. The body can react violently towards the removal of alcohol, as it craves more. Withdrawal is designed to remove the symptoms of withdrawal and help the patient through the procedure.
While Alcohol Detox is a relatively short-term process, it has long-term value for helping alcoholics in recovery. The withdrawal symptoms usual begin between six and 48 hours after heavy drinking. The symptoms will both lessen and increase between 24 and 48 hours.
Part of the medical aspect of Withdrawal is the patient receiving a physical examination. This is a good idea because there may be some preexisting medical condition that could be exacerbated during Withdrawal. Conditions such as an irregular heartbeat, inadequate heart function, liver disease, alcoholic pancreatitis and digestive bleeding, can all be problematic in Withdrawal. It is important for the patient to receive adequate medical care prior to the Withdrawal taking place.
Where is Alcohol Withdrawal done?
Withdrawal can be done in an inpatient or outpatient, but should always be under medical supervision. In their article “Treatment of Alcohol Detox”, Hugh Myrick MD and Raymond F. Anton MD, state that before 1980, most alcohol Withdrawal was done in a clinical setting, but since then, most treatments are done outpatient. They went on to say that at present, fewer than 20 percent require admission into inpatient status. However, when needed, inpatient is the safest approach to Alcohol Withdrawal.
The important factor is the medical oversight of the Withdrawal. This is necessary because Withdrawal can be very difficult, if not traumatic. Some people might only experience mild side effects of alcohol withdrawal, such as the “shakes.” They may also have a loss of appetite, headaches, sweating and insomnia. They may feel sick to their stomach and feel generally uneasy. But it could be worse and often is.
You’re probably heard of people seeing pink elephants, which is a description of Delirium Tremors, the “DT’s.” About 5% of patients experience these, and they occur usually between two to four days after the patient has stopped drinking. People can have convulsions, or experience autonomic hyperactivity, common to patients with epilepsy. Their eyes roll back and they shake. The withdrawal might also produce a seizure. The risk of seizures is high, as approximately 25% people will experience one during Withdrawal if not medically treated. You can see it’s serious business.
May only take a couple of days
Withdrawal may only take a couple of days, but it can take up to two weeks for some patients. Some possible drugs that are used by doctors during Withdrawal include selected benzodiazepines, buprenophex and anticonvulsant medications. In outpatient settings, where people have mild symptoms of withdrawal, carbamazepine is an alternative drug to benzodiazepine.
Treatment for alcohol withdrawal is not without its controversy. For mild to moderate symptoms, should any medications be administered? Most agree that when severe withdrawal is the case, medication is absolutely necessary. The debate over medications in the mild to moderate cases continues. In the severe cases, the benzodiazepines (BZs) that are used to treat anxiety, insomnia and seizures, are used. Research is being done on non-BZ treatments.
It is important to consider the whole person in Alcohol Withdrawal. That is why it is important for medical intervention before and during Withdrawal. It is the first and certainly one of the most critical steps taken towards recovery.
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