Along with nicotine and caffeine, alcohol is among the most common recreational substances in the United States. According to the National Institute on Alcohol Abuse and Alcoholism, 86 percent of Americans older than age 18 have drunk alcohol at some point during their lifetime. In 2018, 26 percent of people reported binge drinking in the past seven months.
With alcohol use and abuse so prevalent, millions of Americans meet the qualifications for alcohol use disorders and may have to go through detox before achieving sobriety.
Alcohol withdrawal is infamously uncomfortable and, unlike other drugs, it can be medically dangerous. Without medical treatment, severe alcohol withdrawal can even be deadly. So if you’re struggling with alcoholism, how can you safely and effectively get through detoxification?
Alcohol is a depressant drug that achieves its psychoactive effects by suppressing excitability in the central nervous system. It’s a GABAergic chemical, which means that it primarily works by effecting a chemical that occurs in the body naturally. GABA, or gamma-Aminobutyric acid, is responsible for regulating nervous system excitability, among other things. GABAergic substances can bind to receptors and increase GABA’s overall efficiency, leading to sedation, hypnosis, loss of motor control, loss of inhibitions, and lowered cognitive functioning.
The longer you drink frequently, and in large amounts, the more your brain will adapt to this foreign chemical. First, you will start to notice a growing tolerance to alcohol. You’ll be able to drink more before getting drunk, and you’ll need to drink more to achieve the same effects. If you continue to drink and increase the amount and frequency of your drinking to make up for your tolerance, you may start to become dependent. Your brain will adapt to alcohol to the point of integrating it into normal chemical functions. It will start to rely on it to maintain normalcy.
If you stop using, you may start to feel alcohol withdrawal like anxiety, insomnia, tremors, delirium, and seizures. Alcohol withdrawal can send your nervous system into a state of overactivity that can be extremely dangerous without medical attention. If you start to experience alcohol withdrawal, it’s important to speak to a medical professional right away.
There is a wide variety of alcohol detox methods, but some are more popular, safe, or effective than others. Here are some of the most common detox methods, along with their pros and cons.
This is the method of alcohol detox that’s most commonly seen in movies, but it’s also a really bad idea. Tom Cruise’s hosts in the small samurai village in The Last Samurai may think they are doing him good by ignoring his screams for sake as he goes through alcohol withdrawal, but they are actually putting him in danger. Though it turns out OK in the end — however unrealistic it is that he never seems to have cravings again — he could very well have died before some of the movies best action scenes.
Quitting alcohol cold turkey significantly increases your likelihood of experiencing uncomfortable and potentially life-threatening withdrawal symptoms like seizures and delirium. It’s especially dangerous to go from frequent high levels of alcohol use to an abrupt cessation. Your brain will open the excitability floodgates all at once, causing severe overstimulation in the nervous system. This can cause panic, irritability, tremors, seizures, sudden and extreme confusion, night terrors, insomnia, coma, and even death.
Because alcohol withdrawal can be so dangerous, some people recognize the need to wean off the chemical substance gradually. Weaning off alcohol at home may be safer than quitting cold turkey, but it has some serious drawbacks. Determining the right amount of alcohol to wean from can be difficult. If you use too little, you might risk dangerous withdrawal symptoms. If you use too much, you may not achieve sobriety. The most likely consequence of self-weaning is that you won’t be able to resist continuing to drink. Addiction is characterized by compulsive drug use that can be difficult to control. If you are trying to achieve sobriety and there is alcohol on hand, it will be difficult to overcome the compulsion to drink.
Some people who start to experience uncomfortable withdrawal may go to the hospital for safe treatment. Some hospitals even have units specifically set up for detoxification. People who receive detox at a hospital are often admitted after going through serious medical emergencies like seizures or alcohol poisoning. Hospital detox is much safer than going it alone, but there are some drawbacks. If your condition is stable before your peak withdrawal symptoms begin, you may not be admitted for the long haul. Alcohol withdrawal symptoms can last for up to a week, and it’s likely that you will be discharged when your condition is stable, not necessarily when your uncomfortable withdrawal symptoms have stopped.
Medical detox involves 24-hour medical care in a facility designed for drug detox. Treatment typically lasts for five to 10 days, depending on your specific needs. This is enough time for most people to get through the most uncomfortable and dangerous phases of withdrawal. When you first enter treatment, you will go through an intake process that’s designed to determine the care you need. Medical practitioners will evaluate your withdrawal potential, the possible severity of your withdrawal, and any other medical needs that are related or unrelated to addiction.
Medical detox programs are also in a larger continuum of care in addiction treatment, which is something that hospital detox won’t necessarily be able to offer. Detox centers will have clinical professionals on staff that can help you find the next level of care after detox. Alcoholism may not end after a week of detox.
Addiction is a chronic disease that affects the brain’s reward system and causes powerful compulsions to continue drinking. That’s why a detox service that’s part of a larger treatment network and equipped to treat addiction, as well as chemical dependency, is an advantage.
Medical detox is a process that’s designed to help keep people safe and as comfortable as possible. Your need for it will depend on medical evaluation and your risk of experiencing potentially dangerous withdrawal symptoms. If you’ve been drinking consistently for a long time, you may have developed a chemical dependency. If you stop drinking, you are at risk of experiencing dangerous withdrawal symptoms like seizures or delirium tremens.”
However, if you binged a few times, and you’re worried that you may be developing a substance use disorder, but you aren’t yet chemically dependent, you may not require medically managed detox. However, the safest way to make that determination is with the help of a qualified medical professional. When you enter an addiction treatment program, specialists will help determine you need for treatment and medical professionals will evaluate your physical health and medical needs.
National Institute on Alcohol Abuse and Alcoholism. (2018, August). Alcohol Facts and Statistics. from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
U.S. National Library of Medicine. MedlinePlus. Alcohol withdrawal. (January 10, 2019) from https://medlineplus.gov/ency/article/000764.htm
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
WebMD. (2017, March 20). What is GABA? from https://www.webmd.com/vitamins-and-supplements/qa/what-is-gaba
Foundation for a Drug-Free World. What is Alcoholism or Alcohol Dependence? (n.d.) from https://www.drugfreeworld.org/drugfacts/alcohol/what-is-alcohol-dependence.html