How to Overcome Alcohol Withdrawal Safely at a Detox Center
One of the most socially acceptable forms of substance use is also one of the most difficult to quit without help. According to the latest data available from the National Institute of Health (NIH), more than 18.8 million adults in the United States were diagnosed with some form of alcohol use disorder (AUD) in 2019.
This legal intoxicant is responsible for billions of dollars in healthcare and legal costs. Alcohol use disorder is linked to a number of metabolic syndrome (MetS) conditions that include hypertension, diabetes, and obesity. More than 140,000 U.S. deaths per year can be attributed to the effects of alcohol use.
These statistics are in addition to an incalculable amount of human suffering in terms of broken relationships, unemployment, homelessness, and crime.
At White Light Behavioral Health, our rehab facility in Columbus, Ohio, we offer support and medical intervention for people undergoing detox from alcohol and other drugs.
It’s especially important to have medical supervision while undergoing treatment for alcohol use disorder due to potentially serious effects during alcohol withdrawal.
What Is Alcohol Use Disorder?
AUD is a condition that develops with heavy or long-term alcohol use. It’s characterized by a history of heavy drinking and an inability to quit or curb drinking habits despite the negative consequences of alcohol use.
You’re more at risk for developing AUD if you:
- Began drinking at an early age
- Have a family history of AUD
- Have more than 12 drinks per week (women) or 15 drinks per week (men)
- Binge drink alcohol at least once a week: This is defined as more than five drinks within two hours.
- Have a mental health or mood disorder
Young people increase their risk of struggling with AUD if they come from a family with at least one close member who has a drinking problem. Other risk factors for youth include peer pressure, self-esteem issues, mood disorders, and stress.
A study conducted by the Epidemiological Survey on Alcohol and Related Conditions identified these five subtypes of problem drinkers.
- Young Adult Subtype
This is the most common designation and affects up to 32% of problem drinkers and 22% of those classified as having a familial connection. The study found that this group was also the least likely to seek treatment for AUD.
- Young Antisocial Type
This was discovered to be the second most common AUD subtype, affecting about 21% of those with AUD. People in this group tend to be younger and have a family history of AUD. About half of the people in this group are also diagnosed with borderline personality disorder and tend to use alcohol in combination with cigarettes and other drugs. Approximately one-third of those who fall within the subtype seek treatment at some point.
- Intermediate Family Subtype
This group makes up 19% of people with AUD. The people in this category are in codependent relationships with at least one family member also experiencing AUD. They tend to be middle-aged, and about 20% combine alcohol with other substances. There is also a 50% incidence of a co-occurring condition like bipolar disorder. One-quarter of this group will seek treatment.
- Functional Subtype
This subtype also comprises about 19% of those who meet the clinical criteria for AUD. They tend to be older than those in other subtypes, are more educated, and experience more personal/career stability.
This group also contains the highest rate of people in or nearing retirement. Although they are able to maintain jobs and relationships, they are still at risk for health and mental health consequences of alcohol use. About 17% of people in this subtype will seek treatment at some point.
- Chronic Severe Subtype
Although this is the smallest subtype at 9% of study participants, it is the largest group among those who seek treatment for AUD (66.6% +/-). These individuals also have higher rates of codependency, mood disorders, and physical or mental health issues.
No matter where you fall on the spectrum of people struggling with AUD, there is always hope and help available at White Light Behavioral Health.
Signs That You May Have AUD
Not every person who takes a drink or grows up in an environment of heavy alcohol use will develop a drinking problem. However, the younger you are when you take your first drink, the more often you drink to excess, and the higher your rate of concurrent conditions like anxiety or depression, the greater your chances of developing AUD.
It can be more difficult to determine if you have a drinking problem when you’re experiencing it, though many people suspect an issue within themselves that they deny when asked.
You may have AUD if:
- You can’t control the amount or frequency of your drinking.
- Your attempts to quit drinking fail.
- You spend a lot of time looking for, drinking, or recovering from alcohol.
- You constantly crave alcohol or have a compelling urge to drink.
- Your alcohol use is negatively impacting other areas of your life, like work, school, and relationships. You may even stop social and other activities in favor of drinking.
- You continue drinking despite negative consequences.
- You’ve become physically dependent on alcohol.
- You experience withdrawal symptoms when you’re not drinking.
It’s also an indication that there’s a problem if your frequently drink alone or become angry or defensive when asked about your drinking habits.
Are you concerned about someone close to you? They could be struggling with alcohol use disorder if you notice signs like:
- Frequently drinking to excess
- Sudden changes in appearance and/or behavior
- Losing control of their emotions or behavior while drinking
- Engaging in risky behavior while drinking
- Frequent absence or lateness with no explanation
- Lack of personal hygiene or home upkeep
- Sudden or unexplained financial or legal issues
- Frequent complaints of headaches, nausea, or general tiredness with no apparent medical explanation
None of these signs on their own necessarily indicates a problem. However, the continuing appearance of several symptoms might indicate AUD. The World Health Organization has created a screening tool to determine the possibility of AUD. This Alcohol Use Disorders Identification Test (AUDIT) assesses risk factors and behaviors that characterize AUD. There are both clinician-administered and self-report versions.
Alcohol Withdrawal
Withdrawal is experienced when a heavy user of alcohol suddenly stops consuming it completely. Symptoms can appear as soon as a few hours after your last drink or up to five days later.
Withdrawal is usually a consequence of heavy, prolonged drinking. Its symptoms include:
- Hand and/or head tremors
- Nausea and vomiting
- Agitation and irritability
- Anxiety
- Depression
- Sudden bouts of sweating
These symptoms are more than just a routine hangover. The severity and duration depend on how long you’ve been drinking to excess as well as the degree of consumption. Although withdrawal symptoms usually improve within five days, they can last for weeks.
The Importance of Getting Help During Alcohol Withdrawal
Suddenly stopping any substance use can lead to emotional anguish and physical discomfort. However, alcohol withdrawal is one of the few cases where the process is potentially fatal without medical supervision.
Withdrawal can occur on a spectrum that depends on a range of factors that influence the severity. On the severe end of the spectrum is a condition called Alcohol Withdrawal Syndrome (AWS).
AWS is a more severe form of alcohol withdrawal that’s likely to affect heavy, long-term drinkers nearly three times more often than people with mild to moderate AUD.
In addition to typical, milder alcohol withdrawal symptoms, signs of AWS include:
- Itching, burning sensations, or numbness
- Auditory disturbances, such as sensitivity to sounds
- Visual and auditory hallucinations
- Feelings of fullness in the head
- Disorientation
- Hyperactivity
- Insomnia
- Seizures
- Delirium tremens (DTs)
Delirium tremens, also known as DTs, is the most severe form of alcohol withdrawal syndrome. Onset usually occurs during the final withdrawal phase, about 48 to 72 hours into detox. It begins with severe withdrawal symptoms and progresses to include high blood pressure, increased respiration, fever, chills, and extreme confusion. Cardiac events and seizures occur, and DTs can be fatal without medical intervention.
All these symptoms result from changes in the brain caused by prolonged, excessive intoxication. Doctors and clinicians can evaluate the presence and degree of AWS by using screening tools including the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar).
This assessment grades symptoms on a numeric scale to determine the presence and severity of withdrawal syndrome symptoms. It is used in emergency rooms, intensive care units, and alcohol detox centers to help guide medical personal when a client arrives for treatment. Other commonly used assessment tools include the modified Minnesota Detoxification Scale (mMINDS) and the Severity of Ethanol Withdrawal Scale (SEWS).
Risk Factors for Alcohol Withdrawal
Not everyone who is a heavy or frequent drinker will develop AWS if they try to quit. For example, DTs affect only about 5% of those who are going through withdrawal.
However, there are some factors that put you at higher risk for AWS. These include:
- Drinking from an early age
- Poor health/mental health or a history of trauma
- Family history of AUD
- Previous history of AWS
What to Expect From Alcohol Detox and Treatment
Medically supervised detox is designed to provide a comfortable, calming environment where you can safely undergo the withdrawal process with medical supervision. It’s especially critical due to both the potentially dangerous nature of alcohol withdrawal and the high risk of relapse within the first 24 to 48 hours after the last use.
The timeline for alcohol withdrawal occurs over three phases, which can vary in duration and severity in accordance with other issues like your general health, co-occurring conditions, previous history of detox, and severity/degree of alcohol use.
Phase 1
About four to six hours after you quit using alcohol, the first withdrawal symptoms appear. In mild cases, it might feel like a hangover, complete with a headache and nausea. Other symptoms include hand tremors, insomnia, and sweating.
Phase 2
The second phase begins around 12 to 24 hours after your last drink. Other symptoms may worsen, and they can be joined by visual and auditory hallucinations, rapid heartbeat, anxiety, and agitation.
Phase 3
Within 48 to 72 hours, the worst withdrawal symptoms appear. You may experience a racing heart, high blood pressure, fever, and profuse sweating. You might feel confused and disoriented as well. Those who are prone to DTs experience severe physical and emotional instability.
For most people, physical symptoms will begin to ease after the first 72 hours or so, but the emotional impact might continue much longer. It’s important to withdraw from alcohol under medical supervision.
Once the alcohol has completely left your bloodstream, and your brain chemistry has stabilized, healthcare professionals can work with you to devise a course of treatment.
While there is no one standardized treatment for AUD or withdrawal, there is a long history of treatment methods and components that have shown great results.
A combined, comprehensive approach of therapies and coping skills seems to work best for long-term recovery. Medications used to treat alcohol withdrawal include:
- Vitamins and supplements
- Anticonvulsants
- Antipsychotics
- Antihypertensives medications
- Gaba-receptor agonists (withdrawal-suppression meds)
- Anti-relapse medications
Individual counseling sessions that may help with recovery after withdrawal include:
- Cognitive Behavior Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Motivational Interviewing (MI)
Group support, such as a 12-step program like Alcoholics Anonymous (AA), often helps with relapse prevention after leaving a detox program. Ongoing medical care may be necessary due to organ damage from prolonged alcohol use.
Help With Alcohol Withdrawal in Columbus, Ohio
Recovering from alcohol use disorder is an ongoing process that many people have struggled with for years. At White Light Behavioral Health, we strive to provide clients with a comfortable, supportive setting where they can safely detox and take their first steps toward a life of sobriety. If you or someone you care about is struggling with drug or alcohol use, contact us to discuss your options.
