Over 5.5 percent of the American adult population battled alcohol addiction in 2016, the National Survey on Drug Use and Health (NSDUH) reports. Some of the major physical side effects of alcoholism are cravings and withdrawal symptoms when alcohol processes out of the body. This means that when a person is not drinking, and the alcohol stops actively working in the bloodstream, they will suffer from negative symptoms once they have formed a dependence on alcohol.
Regular alcohol abuse can cause a person to become tolerant to its effects and therefore drink more. The more often a person drinks, and the more they drink, the more likely they are to develop a dependence on the mind-altering substance.
Alcohol works in the brain and body as a central nervous system depressant, slowing some life-sustaining functions, such as heart rate and blood pressure, and altering the levels of certain neurotransmitters, or chemical messengers, in the brain. Levels of dopamine, responsible for feelings of pleasure, are elevated by the interaction of alcohol in the brain. GABA (gamma-aminobutyric acid) levels are also impacted. GABA works on the stress response, lowering anxiety and tension, and inducing relaxation. When alcohol dependence is present and a person stops drinking, withdrawal symptoms are often in opposition to some of the effects of alcohol.
Sudden stopping alcohol consumption after dependence has formed can cause a kind of rebound effect wherein the brain struggles to regain natural balance with its neurotransmitters. Alcohol withdrawal can be significant and even life-threatening around 3-5 percent of the time, the New England Journal of Medicine (NEJM) warns. Severe alcohol withdrawal is called delirium tremens (DTs), and it is indicated by significant confusion, hallucinations, delirium, fever, and seizures. DTs can start within about 2-3 days after stopping drinking alcohol, later than the onset of traditional withdrawal, and it can be fatal without proper management.
Additional alcohol withdrawal symptoms include insomnia, agitation, irritability, anxiety, depression, tremors, trouble focusing and thinking clearly, memory disturbances, mood swings, rapid heart rate, fluctuating blood pressure, headaches, fever, gastrointestinal upset, and muscle tension. These withdrawal symptoms generally begin within about 6-8 hours after the last drink, peak in the first two days, and then most of them usually taper off within 5-7 days, The New York Times publishes.
Due to the potential severity of alcohol withdrawal, detox should be performed in a specialized facility where vital signs and emotional health can be monitored. There are different methods used within professional detox programs. Medical detox programs typically use pharmaceutical tools to manage withdrawal symptoms while holistic programs focus on the use of therapies and supplements to reach a stable physical state. Regardless of the methods used during alcohol detox programs, the main goal is to help a person become physically stable enough to enter a comprehensive alcohol addiction treatment program.
Understanding Medical Detox
Alcohol withdrawal can be significant and intense; therefore, someone who is dependent on the substance should never stop drinking suddenly, or "cold turkey," without medical supervision and intervention. The higher the level of dependence, the more potentially significant withdrawal symptoms will be.
Several things can influence how dependent on alcohol a person is, including how much and how regularly they consume alcohol. Obviously, the more frequently a person drinks, and the more they drink each time, results in more significant alcohol dependence.
Metabolism and biological factors also play a role. One person may process alcohol faster and more efficiently than another, which can play a role in the onset and severity of dependence. Genetics and family history of alcohol dependence can also be factors, as can co-occurring medical and/or mental health disorders, and high levels of stress and environmental aspects.
In the following cases, the NICE Clinical Guidelines recommend a medical detox protocol:
- When acute alcohol dependence is present
- In the case of co-occurring mental health or medical disorders
- If a person has undergone detox before and suffered a relapse
- When a person has a history of DTs
If a person also abuses other drugs simultaneously with alcohol, medical detox is the safest option.
A medical detox program provides around-the-clock supervision and monitoring of vital signs to maintain physical stability. Medications are often a component of a medical detox program. Central nervous system depressant medications, such as benzodiazepines, are often used during medical detox to minimize the more acute withdrawal symptoms. Benzodiazepines work in the brain similarly to the way that alcohol does, so their presence can help to keep the brain from rebounding as intensely. Typically, long-acting benzodiazepines like Librium (chlordiazepoxide), Serax (oxazepam), and Paxipam (halazepam) are preferred to shorter-acting drugs like Xanax (alprazolam) and Valium (diazepam). These drugs are also considered habit-forming, so they have the potential for abuse and dependency. They will need to be weaned off slowly over a period of time, often via a taper, in order to allow the body to slowly stabilize itself.
Other medications are often beneficial during medical detox, to control specific withdrawal symptoms. Mood stabilizers can help with anxiety and depression while anti-seizure medications may be needed for tremors and seizures. Gastrointestinal and anti-nausea medications, nonsteroidal pain relievers, and sleep aids may be helpful for certain alcohol withdrawal symptoms. Medications may also be used to control cravings for alcohol during detox. Individuals will often be dehydrated due to excessive alcohol consumption, and may need to have fluids replenished and electrolytes effectively balanced while in a medical detox program.
Overall, medical detox generally uses medications to allow alcohol to safely process out of the body while withdrawal side effects are minimized as much as possible.
Holistic Detox Methods
Holistic typically refers to methods that do not use medications, and there are several non-medication-based measures for helping a person detox from alcohol. Natural supplements that help a person regain natural physical balance may be still be used during a holistic detox program; however, other medications are avoided.
Instead of using medications to wean the person off alcohol, in a holistic program, alcohol itself may be used. This means that a person will not stop drinking alcohol suddenly, but instead will slowly taper down their level of consumption over a safe period of time until they are not drinking at all. If a person is not significantly dependent on alcohol, this may not even be necessary. Trained medical providers can help clients determine whether or not it is safe to stop drinking and when.
A holistic detox program focuses on the wellbeing of the entire person: mind, body, and soul. In this vein, therapies are designed to improve a person's overall health and wellness. Most of the time, more than one holistic method is used to provide a comprehensive and integrated detox program that focuses on the entire person.
Holistic detox methods may include:
- Acupuncture: The National Acupuncture Detoxification Association (NADA) protocol is the most widely accepted form of acupuncture for detox and substance abuse issues, the journal Substance Abuse and Rehabilitation This method uses 3-5 points in the ear where small needles are placed to eliminate toxins from the body. Acupuncture is designed to enhance blood flow and promote the healthy flow of energy, or chi, throughout the body. It can also be a method of removing harmful toxins, like alcohol, from the body.
- Chiropractic care: Chiropractic medicine helps to realign the body properly, which can alleviate aches and pains, and also balance a person through physical manipulation of the body. Generally, when someone feels good physically, they are more inclined to have a strong mental state as well. During alcohol detox, chiropractic care can help a person become more physically comfortable and therefore more mentally open to healing.
- Massage therapy: In the same vein as chiropractic care, the act of touch can relieve physical pain. Massage therapy can help to reduce some of the physical tension and strain associated with alcohol withdrawal. This can help a person to sleep better as well. A good night's sleep can go a long way toward helping a person to think more clearly and be more emotionally balanced.
- Yoga and meditation: Yoga is a physical practice that focuses on breathing and body poses to promote self-reflection and self-realization. It is often combined with mindfulness meditation, which also teaches people how to be more aware of themselves physically to then be more in tune with themselves emotionally. Practitioners are taught to focus on the present moment and to accept that some level of discomfort is acceptable. Physical self-awareness can enhance mental clarity and strength. Mindfulness meditation can be highly beneficial to relieve anxiety and lower stress levels, Psychology Today publishes, which makes it a great holistic tool for alcohol detox as well.
- Behavioral therapies: Used during most addiction treatment programs, behavioral therapies, such as Cognitive Behavioral Therapy (CBT), can also be beneficial during alcohol detox. CBT teaches individuals to identify negative emotions and potential stressors, and then teaches healthy coping mechanisms for handling them. CBT also enhances self-awareness through group and individual therapy sessions. Self-destructive behaviors are addressed and positively modified, and relapse prevention tools are learned and practiced in a safe environment.
- Nutritional and fitness programs: Alcohol addiction can lead to a depletion of some of the body's nutrients. Individuals struggling with addiction often do not take care of themselves physically and may be at an unhealthy weight as a result of the disorder. Nutrition plans that focus on reestablishing healthy physical balance and restoring some of the body's essential vitamins and minerals can be very helpful during alcohol detox. Regular, balanced meals and the introduction of natural supplements or vitamins can enhance physical health.Fitness programs can also improve a person's physical wellbeing during alcohol detox, as exercise can be a tool to naturally reduce stress and anxiety. Exercise can provide mental clarity and may also help to flush toxins, such as alcohol, from the body in a natural way. Exercise can improve a person's ability to sleep and raise self-esteem levels while providing a natural and healthy outlet for stress and anxiety.
- Expressive therapies: Creative expression via art, music, dance, movement, drama, or play therapies can provide individuals with a natural outlet for their emotions, which may be heightened during alcohol withdrawal. Creative therapies are nonjudgmental, and often, this nonverbal form of communication can serve as a tool for expressing difficult emotions that may not have fully surfaced. Painting, sculpting, drawing, writing, singing, playing a musical instrument, acting, role-playing, dancing, poetry, journaling, and song-writing are all forms of creative expression that may be used during expressive therapy sessions to enhance self-reflection for emotional and spiritual healing and growth.
Detox programs may combine both holistic and medical methods in order to form an integrated care plan that can help a person to become more physically and emotionally balanced before continuing on into a complete alcohol addiction treatment program. Trained providers and therapists can help individuals and families decide on the optimal alcohol detox program that will serve their unique needs and circumstances.
Generally, medical detox programs are provided in a residential, or inpatient setting, while holistic programs may be either inpatient or outpatient, depending on the person and level of dependency. Detox programs can build the foundation for a healthy lifestyle and an improved quality of life into recovery.