Approximately 88,000 people die from an AUD annually, and AUDs make up the third-leading preventable cause of death in America according to the National Institute on Alcohol Abuse and Alcoholism. Although treatment for an AUD is available, those with a severe AUD need to understand why alcohol detox must take place under medical supervision at the start of treatment.
Understanding detox
Detoxification is the beginning of alcoholism treatment, and many withdrawal symptoms may occur during detox. According to the MedlinePlus, these withdrawal symptoms may include:
- Anxiety
- Depression
- Hallucinations
- Changes in heart rate (arrhythmias)
- Excessive sweating
- Increased rate of respirations or hyperventilation
- Delirium Tremens, which result severe hallucinations, fevers, seizures, severe disorientation, and constant tremors
- Stroke
- Heart attack
- Panic attacks and extreme anxiety
- Irritability, hostility or aggression
- Severe mood swings
- Nightmares
- Confusion
- Enlarged pupils (making it difficult to see during daylight hours)
- Loss of appetite
- Other uncontrollable emotions
The withdrawal symptoms of detox usually begin within 8 hours of the last drink and usually peak from 24 to 72 hours. However, withdrawal symptoms may continue for weeks after detox. In most cases, these continuing symptoms are minor, but depending on severity of the AUD, some symptoms may require continued medical supervision and medical treatment.
Managing detox withdrawal symptoms
Because the withdrawal symptoms range in scope and severity, the most effective management plans take place in an alcohol rehab facility. Medications to treat dramatic changes in blood pressure, heart rate, and delirium tremens often require medical testing prior to administration.
For example, medical staff may need to obtain blood pressure readings, draw labs to test for signs of metabolic shock, or administer IV medications. Furthermore, sedative medications may be needed to reduce the severity of these withdrawal symptoms.
Medication treatment for withdrawal symptoms
Alcohol is a barbiturate, which means it lowers cardiac function, cognitive awareness and metabolism. However, suddenly stopping alcohol consumption during detox places the body in a state of shock. Some of the most common medications to treat withdrawal symptoms at an alcohol detox center include the following:
- Benzodiazepines mimic the effects of alcohol without inducing the euphoric state of feeling “drunk.” They also help to slowly bring cardiac and pulmonary function back to normal ranges.
- Antidepressants may be used to ease the emotional turmoil during detox. These medications often require several days to weeks to become fully effective, but some antidepressants are available in IV form, which provide relief for up to six weeks from depression symptoms.
- Anti-anxiety medications may be used to relieve nervousness and agitation during detox.
- Antipsychotic medications may be needed to relieve hallucinations or other psychotic symptoms.
Medical supervision and safety from oneself
In cases of severe alcoholism, a person may experience extreme bouts of guilt, worthlessness, and depression during detox. As a result, the incidence of experiencing suicidal thoughts or ideation increases. This requires immediate intervention, and medical supervision can help ensure a person’s safety when he or she is incapable of doing so. Similarly, medical supervision can help ensure a person does not act on homicidal thoughts or ideation.
Attempting to detox outside of medical supervision is not only painful, but potentially life-threatening. If a person suffers from a moderate to severe form of alcoholism, detox should only be attempted in a licensed medical or psychiatric facility.