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Alcohol Withdrawal and Detox

In regular and heavy drinkers, the body compensates for the depressive effects of alcohol by increasing production of hormones and brain chemicals such as serotonin, epinephrine and dopamine. When a person abruptly stops drinking alcohol, the body becomes flooded with abnormally high levels of these chemicals. This causes the brain to undergo rapid changes in order  to adapt to the increase in chemicals and maintain normal function. Severe complications include dehydration, vomiting, abnormal heart rhythms and a condition called delirium tremens (DTs), which results in death in 15 percent of cases.1

Alcohol withdrawal syndrome is a cluster of symptoms that occur when people detox from alcohol.2 About half of the people with alcohol dependence experience withdrawal symptoms. Severe alcohol withdrawal is often resistant to standard doses of medication that may ease symptoms and requires professional treatment. The severity and extent of withdrawal symptoms from alcohol vary depending on an individual’s history of abuse and overall health, including any exacerbating co-existing medical and/or psychological disorders.1,3

Detox Phases

Detoxification from alcohol is different for everyone and depends on the extent and duration of alcohol abuse and a person’s individual health, but usually occurs in three phases. The first phase takes place over a period of a few days and can be the most dangerous. It is within the first 72 hours of alcohol detox that people are most at risk of suffering major alcohol withdrawal symptoms. These may include anxiety, visual and auditory hallucinations, convulsions, whole body tremor, nausea, vomiting, insomnia, diaphoresis (profuse sweating), shakiness, convulsions, DTs, hypertension and heart failure.1,3

The second and longer phase of alcohol detox can take several months as the brain slowly begins to regulate and resume normal functioning. There may be lingering physical and psychological symptoms like depression or anxiety during this phase, but they are usually not life-threatening.1,3

During the final phase, elevated anxiety and dysphoria (profound state of unease or dissatisfaction) may not be obvious; however, normally insignificant challenges can provoke negativity, craving of alcohol and relapse.1,3

Medically-supervised detox typically includes the administration of benzodiazepines as clinically appropriate. Benzodiazepines are a class of drug that has proven efficacy for alcohol withdrawal.2 The absence of appropriate medical treatment or inadequate treatment during alcohol withdrawal can be fatal. While detox isn’t pleasant, it is important to seek treatment at a facility where medical professionals provide around-the-clock monitoring. At The Right Step, our compassionate, highly experienced addiction teams use evidence-based methods and research-backed medications to provide a safe and comfortable detox experience.

  1. Parker-Pope T. Amy Winehouse and the Perils of Alcohol Withdrawal. The New York Times. http://well.blogs.nytimes.com/2011/08/03/amy-winehouse-and-the-perils-of-alcohol-withdrawal/?_r=1 August 3, 2011. Accessed October 3, 2016.
  2. Sachdeva A, Choudhary M, Chandra M. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. J Clin Diagn Res. 2015 Sep;9(9): VE01–VE07. Published online 2015 Sep 1. doi: 10.7860/JCDR/2015/13407.6538.
  3. Schmidt KJ, Doshi MR, Holzhausen JM, Natavio A, Cadiz M, Winegardner JE. Treatment of Severe Alcohol Withdrawal. Ann Pharmacother. 2016 May;50(5):389-401. doi: 10.1177/1060028016629161. Epub 2016 Feb 9.
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