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The alcohol detox stage is the first step in treating alcoholism. During this time, alcohol is completely flushed from your body. Withdrawal symptoms typically subside within approximately one to two weeks after starting detox; however, this could take longer depending on the severity of your AUD. From there, you will be able to focus on other aspects of the recovery process such as different activities, therapies, counseling sessions and support options.
Alcohol is a depressant that your body begins to rely on over the course of months and years of drinking. Your brain eventually stops producing certain chemicals that it receives from alcohol, becoming dependent on the drug. That’s why when you quit drinking, it takes time for your body to adjust. This is what causes withdrawal symptoms such as headache, fever, nausea, irregular heartbeat and hallucinations.
Some people are apprehensive to quit drinking because they’re nervous about the withdrawal symptoms experienced during alcohol detox. While some people may only be affected by minor effects of alcoholism, others may face extreme pain. Withdrawal symptoms can change quickly and aggressively, which is why it’s important to detox under the care of medical professionals. Treatment specialists at a rehab facility will be able to help you manage your pain with different medications. This allows you to focus on your recovery and get better.
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Symptoms of Alcohol Detox
The alcohol detox phase can involve withdrawal symptoms ranging from mild intensity to life-threatening. Oftentimes, the longevity and severity of your alcohol use disorder (AUD) will play a role in the withdrawal symptoms you experience. For example, individuals who have struggled with years of heavy drinking are more likely to develop serious withdrawal symptoms like seizures or delirium tremens.
Minor symptoms of alcohol detox include:
More serious alcohol detox withdrawal symptoms are:
- Extreme hallucinations
- Delirium tremens (in rare cases)
Although uncommon, the most serious effect from alcohol withdrawal is delirium tremens. It can start within two to five days after your last drink and can be life-threatening. However, less than five percent of people will develop delirium tremens when quitting drinking.
Due to the severity of some withdrawal symptoms, alcohol detox should be monitored by a medical professional. This is especially true for those who have a history of lung or heart diseases, or other medical conditions, as withdrawal symptoms can quickly worsen. Your treatment specialist will be able to track your blood pressure and heart rate to make sure your condition doesn’t worsen. You can also talk with them about the symptoms you are experiencing, as well as if you are in any pain. This information helps your medical team determine which medicine will help alleviate your discomfort.
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Alcohol Detox Timeline
Withdrawal symptoms can begin to surface in as early as two hours after your last drink. While the most painful symptoms typically subside within the first week, some mild symptoms can last for several weeks to a year. There is no exact timeline as to when or what withdrawal symptoms you will experience; however, there’s a general outline of what to expect.
Here’s a breakdown of the alcohol detox process:
First six to 12 hours
The initial symptoms of alcohol detox are mild, but can quickly begin to worsen as time goes on. Some of the early withdrawal symptoms include headaches, anxiety, shaking, nausea and irritability.
As you approach the end of the first 24 hours of detox, symptoms may become increasingly severe. Alongside the effects felt from the first 12 hours, additional symptoms may involve disorientation, hand tremors and seizures.
Similar to the first full day of detox, the most painful symptoms will continue into the second day. Hallucinations and panic attacks are common during this time as your body rids alcohol from its system.
Days three to seven
For the remainder of your first week in detox, different withdrawal symptoms may come and go. This is also the timeframe where you’re most at risk for life-threatening symptoms such as delirium tremens.
After one week
By the time you’ve completed your first week of detox, many of the withdrawal symptoms will begin to taper off. While some symptoms may persist for a few weeks, most of them are minor and can be treated with medication.
Even after the most serious withdrawal symptoms have lessened, some people may experience post-acute withdrawal syndrome (PAWS) – the prolonged symptoms of detox. Generally, these symptoms include anxiety, low energy, trouble sleeping and delayed reflexes, and can last from several months to a year.
The most uncomfortable detox withdrawal symptoms usually peak around 10 to 30 hours after the last drink and start to lessen by 40 to 50 hours.
Although delirium tremens is unlikely, roughly 30 percent of those who get it will also develop Aspiration Pneumonia.
A medically-assisted withdrawal helps prevent serious complications, keeps track of a patient’s health condition, and relieves any painful effects.
Medications Used During Alcohol Detox
When alcohol detox is treated in an inpatient rehab facility, different medications may be used to help reduce uncomfortable withdrawal symptoms. Medications can also help keep a person’s body chemicals in balance, lowering the risk for serious complications. In rehab, a medical professional will administer the medication and monitor its effects. If the medication begins to cause unwanted side effects or interferes with the detox process, another remedy can be used.
Several medications commonly administered during the detox phase are:
Benzodiazepines (benzos) are most frequently used to treat withdrawal symptoms during the alcohol detox phase. They are used to help calm your central nervous system and may also be prescribed to treat insomnia, anxiety and muscle spasms. The medication comes in two forms: short-acting and long-acting. Usually, long-acting benzos are administered for three days or taken as needed. Chlordiazepoxide (Librium) and diazepam (Valium) are two types of benzos prescribed most often in an inpatient rehab setting.
Naltrexone helps reduce alcohol cravings during the detox stage. In the event of a relapse, naltrexone works by inhibiting the high feeling that alcohol may cause. Since the medication can stimulate withdrawal symptoms, it is recommended that you wait seven to 10 days before taking naltrexone. It comes in two forms: a tablet and injectable. The pill form of naltrexone is sold under the brand names ReVia and Depade, while the injectable form is known as Vivitrol.
Years of heavy drinking can significantly alter how the brain looks and works. Acamprosate, sold under the name Campral, is prescribed to help your brain begin to function normally again after you quit drinking. Research studies have also started to look into whether or not acamprosate helps reduce the symptoms of PAWS including insomnia, anxiety and restlessness. It also works to reduce alcohol cravings; however, it will not produce an unwanted effect if alcohol is consumed.
Another medication used in the treatment of alcoholism is disulfiram. Unlike other medications, disulfiram works by producing severe reactions if alcohol is consumed. For instance, if you drink while on disulfiram, you will experience unwanted effects like facial flushing, nausea, headache, weakness and low blood pressure. The negative effects are meant to deter you from continuing your drinking pattern. Disulfiram is not meant to reduce your alcohol cravings or restore brain functions like some other medications.
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- Author — Last Edited: August 7, 2018
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