Detox Local

Alcohol Detox: Finding the Right Center

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 09/25/2020

Number of References: 5 Sources

Alcohol detox is typically the first step in treating alcoholism. These programs are designed to help individuals endure the potentially fatal process of acute withdrawal in the safest possible manner. Alcohol detox centers also provide medications and therapy to make withdrawal more comfortable. Typically individuals will stay 3-7 days, depending on the type of program. Below, we will take a look at the details and specific services provided by these programs.

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When is an Alcohol Detox Center Recommended?

Professional support for alcohol detox is always recommended. Without medical supervision and support, abrupt cessation from alcohol can be deadly. This can be true for anyone once their body has developed dependence upon alcohol; not just decades-long drinkers or drinkers of “hard” alcohol. Severe withdrawal symptoms, while only sometimes fatal, can be extremely painful and unpleasant.

While past drinking habits can provide some indications regarding the likelihood of severe withdrawal symptoms, there is no way to know exactly how the body will respond when access to alcohol is removed. Alcohol detox centers have professional staff with the experience and resources to observe and facilitate the process of alcohol detoxification.

The Detoxification Process

In spite of the dangers, safe and effective treatment through detoxification is possible. Once admitted into alcohol detox, medical monitoring of symptoms will help to ensure safety, and medical and therapeutic techniques will work towards addressing the symptoms and behaviors that are associated with alcohol abuse disorder.

Below is an overview of what to expect during the detoxification process:

Intake

Entry into any alcohol detox program will begin with an assessment. This is typically getting a measure of someone’s vital signs, possibly bloodwork, and questions about drinking habits and duration of drinking. While many people struggling with alcoholism are prone to minimizing their drinking habits, it would only be harmful to them to be less than forthright in this setting. The questions about use habits are asked only to gauge the type and strength of medications that will be used to make them more comfortable during alcohol withdrawal.

Medical Monitoring

Medical monitoring is extremely important and is one of the most valuable aspects of receiving care from an alcohol detox center. Symptoms of alcohol withdrawal can range from mild to severe, and can vary in intensity and duration.

Some of the more common and less dangerous symptoms of withdrawal (such as fever, nausea, insomnia) can be addressed easily and with minimal complications. The more serious symptoms like delirium tremens, hallucinations, and withdrawal seizures will require a more intense medical intervention. No matter how the symptoms of withdrawal present themselves, the medical professionals in alcohol detox centers will have the training and experience to identify and address them.

Medication Management

There is a wide range of medications that can be used to lessen withdrawal symptoms and reduce the risk of dangerous complications. The most commonly used medications to treat alcohol detox symptoms are benzodiazepines. Benzodiazepines, also known as benzos, have a proven record of effectiveness in treating alcohol detox symptoms, with minimal complications.

  • Benzodiazepines: Benzodiazepines have the benefit of being able to safely treat multiple symptoms, and the underlying causes, simultaneously such as reducing anxiety, relieving agitation, and lowering the risk of seizures. The most common medications of this class used today include chlordiazepoxide, lorazepam, and diazepam.

For more information about specific benzos and their effectiveness, take a look at our article: Benzodiazepines for Alcohol Withdrawal

Other medications will be used to ease discomfort in a variety of ways such as reduce anxiety or depression, reduce shaking or tremors, help someone sleep, and lower blood pressure or heart rate. Some of the most commonly used medications include:

  • Anticonvulsants: Such as carbamazepine, these medications are used to reduce the possibility of seizure due to delirium tremens.
  • Barbiturates: Use of these medications is rare; typically reserved for cases of benzodiazepine-resistant alcohol withdrawal. Barbiturates will work very similarly to benzos, with similar benefits, however, studies have shown they carry stronger side effects, hence their status as a fallback option.
  • Acamprosate: Acamprosate has been used to treat alcohol cravings for 30 years with mild side effects and well-documented successes, this medication can be a valuable tool in treating alcohol abuse disorder. Acamprosate works by affecting the brain chemistry that can be responsible for the craving for alcohol. Additionally, studies have shown that acamprosate can also help improve sleep patterns related to alcohol abuse disorders. This is most commonly used after the acute phase of alcohol detox and is useful in helping to maintain sobriety.
  • Naltrexone: Naltrexone is most commonly prescribed to treat addiction to opioids, but studies have shown success in addressing alcohol abuse disorder. Naltrexone works by blocking the calming and euphoric effects of alcohol, which can lead to fewer cravings.
  • Disulfiram: Most often prescribed upon detox completion, this medication changes the way the body metabolizes alcohol. Disulfiram is mostly used as a deterrent to using alcohol. Disulfiram can remain in the body for up to 2 weeks, and if alcohol enters the body while disulfiram is still in the system, a list of painful reactions will immediately present themselves – many of which will mirror symptoms of an extreme “hangover”.

There are FDA-approved medications that can treat alcohol use disorder, however, these are less likely to be prescribed/administered during active alcohol detoxification, and more commonly used as a preventative medication.

Alcohol Withdrawal Medications

What To Expect During Alcohol Detox

The length of an alcohol detox program can vary from person to person. Most alcohol detox programs can last anywhere from 3 to 7 days depending on the severity of symptoms. In rare or severe cases detox may last 14 days. This will typically only matter if someone is a self-pay client, as insurance authorization is often for the full 7 days (or longer).

Day 1

The first 24 hours are often when the medical staff will get a good idea of the severity of withdrawal a person will experience. There will first be an assessment which includes questions, measuring vital signs, and bloodwork. The onset of symptoms, including the variety and intensity, will inform doctors of what can be expected during the full course of withdrawal. Due to this, the first day in detox is commonly when the highest level of monitoring will occur.

Day 2

During the first and second days, medications will be administered and their efficacy will be determined through consultations between the patient and medical staff. Adjustments may be made, such as the amounts or types of medications used as people often have unique tolerances or responses to medications. Additionally, IV fluids may be administered most often in the first few days, as many people who are admitted to detox are frequently dehydrated or malnourished. Thiamine supplements will also be given in the first few days especially, as heavy alcohol users very commonly exhibit thiamine and other B vitamin deficiencies. Delirium tremens may begin to manifest around this time, so medical monitoring and observation may increase during the second or third day.

Days 3 & 4

During days 3 and 4 the symptoms of withdrawal may begin to plateau, meaning that they will stop intensifying. This can be a very dangerous time for someone who was heavily addicted, as this is the time when delirium tremens may begin to show up. This is an extremely dangerous condition which results in wild changes in heart rate and blood pressure, hallucinations, seizures, and delirium or psychosis. This is often fatal if medical care is not provided, thus this can be the most sensitive time for extremely heavy and long term drinkers.

Days 5 & 6

For most patients in a medical alcohol detox, the 5th and 6th days are when relief begins. The withdrawal symptoms may begin to lessen somewhat during day 5, and this trend may continue through day 6. Medications and medical supervision are definitely still present, as are IV fluids and thiamine since excessive, nonstop sweating is a common symptom of acute alcohol withdrawal. A patient may even be capable of sleeping without a sedative by this point, but this may vary between people.

Day 7 & After

One week after the last drink is usually when the symptoms of acute alcohol withdrawal have lessened enough for someone to be safely discharged. They will typically be given a medication to take over the next few days or weeks to help dampen the lingering symptoms. This is a sensitive time, as those who do not continue treatment run the risk of relapse and ending up back in admissions in a few weeks.

Most medical alcohol detox programs will either offer further treatment on-site if available or refer patients to partner facilities in the local area. Post-acute withdrawal syndrome will cause psychological symptoms to persist for many days, weeks, months, and sometimes years so it is strongly recommended to continue treatment immediately after discharge from an acute alcohol detox program. The risk of relapse is very real, and next to relapse rates during acute withdrawal, the time immediately after is when many relapses happen.

Types of Alcohol Detox Programs

There are a variety of different types of alcohol detox programs that are geared towards varying needs and circumstances. Some types, including hospitals or crisis centers, are strictly to stabilize someone and to keep them from dying due to complications. Dedicated detox centers will address the entire length of acute withdrawal and act as a liaison to continued care providers. Some details on the different types include:

  • Hospital ER/Crisis Center Stabilization: Typically used only in emergency situations, this can be the first stop for many people trying to recover from alcoholism. They typically will administer drugs to stabilize a person, give them a prescription to taper down over the next few days and discharge them. The most common length of stay is between 8 and 24 hours depending on the circumstances. Both hospitals and crisis centers have contacts with specialty detox programs in the local area and will refer patients according to their needs or financial abilities.
  • Inpatient Alcohol Detox: These are facilities that offer 24-hour medical supervision and care during detox. These programs are usually 4 to 10 days, depending on the severity of symptoms. Aside from on-site nursing and medical staff, they frequently provide psychiatric care, therapists or counselors, and outside 12 step meetings being brought into the facility. This is the most comprehensive level of care in the current detox landscape, but is often quite costly.
  • Outpatient Alcohol Detox: Aimed at people who will not experience severe withdrawal symptoms, these programs are day long and allow you to return home at night. The length of the program can vary, but most are at least 1 week long and can often be 30+ days. Usually, between 4 and 8 hours per day, they offer medications to manage symptoms, counseling and exercises, and group and individual therapy.
  • Rapid Alcohol Detox: This is a fairly new technique and its efficacy is still up for debate. They are the most expensive option by far and are also much more dangerous than other options. The goal is to put someone under anesthesia and administer medications to precipitate intense and rapid withdrawal from alcohol. The idea is that acute withdrawal will be completed while the patient is unconscious, reducing the discomfort they experience. These programs last 24 to 48 hours and are done in a medically monitored setting.

Therapy During Detox

First and foremost it’s important to know that recovery is possible! Alcohol use disorder can be a pervasive and problematic experience, but with a comprehensive plan including medical and talk therapies, chances of sustained recovery improve dramatically. Alcohol detox centers will provide a solid foundation for recovery, upon which a person can build a lifetime of happiness.

Some of the options for therapy would include:

12 Step Programs

The most well known – and the original – 12-step program is Alcoholics Anonymous (AA). AA has been an effective tool in treatment of alcohol use disorder for decades. Isolation and loneliness are common feelings among those who struggle with alcoholism, and AA helps by connecting people who share similar experiences and struggles. That connection creates fellowship, and this fellowship thrives in AA. With groups meeting in dozens of countries around the world, someone won’t need to go far to find experience, strength, and hope.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is one of the most widely used forms of talk therapy, and for good reason: it works. The use of CBT has expanded over the years and can be very effective in treating numerous issues including depression, anxiety and substance use disorders. CBT works by addressing the patterns of thoughts, beliefs and behaviors that may lead to or are intertwined with negative or unhealthy behaviors. Some of the outcomes of CBT include improved communication, reasoning skills, empathy, problem-solving skills, coping skills and self-confidence.

Group Therapy

Group therapy can be formal or informal in structure but should always be facilitated by a licensed therapist. Group therapy works because it can address problems in a setting that can improve social skills through communication, listening, teamwork and empathy. A common issue that plagues many who suffer from alcohol abuse disorder is isolation and loneliness. By creating a safe space for all, group therapy can play an important role in overcoming isolation and building a sense of community.

Finding An Alcohol Detox Center

Recovery from addiction or dependence on alcohol is possible! Finding the right alcohol detox center will be an important step in the journey. Some things to consider when deciding on a detox center:

  • Does the alcohol detox center have an affiliation or connection to treatment facilities (either inpatient or outpatient)? Entering a treatment center immediately following detoxification can greatly improve recovery chances and reduce the possibility of relapse.
  • Does the alcohol detox center accept your insurance? Different facilities may have different payment and insurance options available.
  • How does the alcohol detox center fare in the community? Do they have a proven track record of success? Do they rate well on review sites? Their success in treatment should be a major factor in your decision.

The journey of recovery is most successful when someone has help along the way. There are people available to provide this help, the only requirement being that someone ask for it. What better time to reach out? Find a detox center nearby below:

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