Alcohol Detox: What You Need to Know

Written By Detoxes - January 25th, 2019
Alcohol Detox: What You Need to Know

What is Alcohol Detox?

There are many terms and concepts related to breaking a dependency on alcohol. It can sometimes be hard to know what people mean when they refer to rehab, sobriety, being “on the wagon,” or detox.

Detox, or detoxification, should be taken somewhat literally. It refers to two main projects: getting the alcohol out of one’s system and getting ready to either go through a full rehabilitation program (such as a twelve-step program) or to remain sober by other means.  First, alcohol detox refers to removing alcohol from one’s system by stopping use altogether; but it also means detoxifying the system, as necessary, when it experiences withdrawal symptoms.  Detox is essentially the frightening early efforts in a road to amazing and life-changing recovery.

The Experience of Alcohol Detox

A person needs detox–and may be hit by withdrawals–if he or she has gone beyond just partying hard, and just being psychologically dependent on alcohol. The Mayo Clinic describes a warning sign that would indicate a need for detox upon quitting: having to drink more and more to feel the effects, and getting less of the pleasant or uninhibited sensations from a particular amount of alcohol.

When a person has reached the point at which s/he knows it is time to quit, s/he is susceptible to withdrawals.

              Withdrawals Make Detox Necessary

One of the main components of a detox program is helping a person through withdrawals.  Here’s an overview of how withdrawals work.  An article in the Journal of Neurology, Neurosurgery and Psychiatry tells us that the blissful and excited feelings one gets from alcohol are caused by the increase in NMDA receptors which receive glutamate, a neurotransmitter (brain chemical that sends messages) associated with excitement or pleasure. In short, when a person stops drinking for an extended period of time, brain chemistry is thrown into chaos.  Cells die, and the inhibitory function of alcohol is erased.  Without this inhibitory function (which is helped by NMDA, now reduced due to the absence of alcohol), the brain goes into a sort of panic, triggering work of the sympathetic nervous system.

The result is a list of symptoms one associates with withdrawals, including sweating, an increase in blood pressure, and an increase in heart rate. Essentially, the “fight or flight” mechanism has been triggered.

Withdrawals often include headaches and nausea.  More extreme effects are seizures and delirium tremens (the infamous DTs), which, due to extreme hyperactivity of the sympathetic nervous system, listed above, results in terrifying confusion and a mental breakdown.  DTs can lead to a collapse of the cardiovascular system.

One reaction that many people dependent on alcohol have when suffering withdrawals is to start drinking to make the pain go away.  This is reason enough, by itself, to justify checking into a rehabilitation program to detox from alcohol as opposed to going alone.  However, because cardiovascular trauma or seizures are of obvious danger, and can sometimes be life-threatening, it’s important to have professional help at this crucial period of time, which lasts for two or three days after alcohol is cut out.

Detoxing in a Facility

One doesn’t necessarily have to check into an inpatient program to detox.  It depends on how severe symptoms are, and how healthy one’s emotional life is overall.  Naturally, decisions on type of care are made in consultation with the professionals at the center.

Whether you are at a center dedicated to helping patients rehabilitate from substance dependency or a hospital with staff qualified to serve in this way, the first thing the healthcare professionals will do is determine the extent of your withdrawals and the severity of yout addiction.  This will include a blood test, sometimes a toxicology screen, and an interview with you to discuss how much alcohol you generally consumed, the time of your last drink, etc.  The experts on substance abuse treatment will then proceed with the particular type of detox that is appropriate for you. 

Medication During Detox

One of the decisions that your healthcare professional will make immediately upon diagnosing you is whether or not to use medication.  One of the most common drugs for withdrawal symptoms is the class of drugs called benzodiazepine.  The doctor will almost certainly use these if you are experiencing delirium tremens, yet these medications are used even when symptoms aren’t so severe.  You may have heard of the popular forms of benzodiazepine, such as diazepam, lorazepam, and chlordiazepoxide.  In plain English, the point of these medications is to correct an imbalance of GABA-A neurotransmitters that is caused by alcohol abuse.

Because they don’t clash with alcohol and are considered safe, these drugs are popularly-used and trusted by doctors.  Keep in mind that these drugs are used to deal with serious conditions and to create the detoxification.  Once the detox has been achieved, the patient then goes into full rehabilitation, and ideally medication won’t be used at that point.  The use of medication helps explain how and why a person can detox on an outpatient basis.  A person in that situation would be best served by completing a full rehab program immediately following detoxification.

Why Can’t One Detox at Home?

Denial is a big part of alcohol abuse.  Once people admit to themselves they have a problem, they must clear the larger hurdle of seeking professional help for it.  To some people, that means admitting the problem was bigger than they’d thought.  Now, it’s probably clear that a person undergoing DTs or having serious cardiac episodes has little choice but to check into a facility for detoxing.  However, it’s important to take this step as soon as you are ready to stop drinking.  The withdrawal symptoms described above begin in just a few hours after a person goes cold turkey.

Leaving aside the dangers of seizures and the other most intense issues, above, being in the care of professionals is crucial when transitioning out of alcohol dependency.  As described above, one’s “fight or flight” system is distorted and overactive during this time.  This can manifest itself in high anxiety, paranoia, and even suicidal feelings.  It’s self-evident that being alone, or even in the company of friends, who will in turn be dismayed by what they see in you, is dangerous in this situation.

A recovery center puts you in a calm and quiet environment, away from everyday cares.   

Further, you’ll be in the care of professionals who can intervene when problems come up.

Perhaps this is why a WebMD article suggests, “You’re more likely to stick with a detox program when you have lots of hope.”