07 Oct Medically Assisted Alcohol Detox
Some believe addiction to alcohol is a lonely battle: an isolated and complex emotional altercation between the individual urge to recover, and the urge to abuse.
But alcoholism is anything but an individual confrontation, as loved ones, friends and family endure much of the pain—and sadly—much of the tragedy that comes along with alcohol dependence.
Looking into the eyes of a loved one struggling to survive certainly can take its toll, both physically and emotionally.
The continual uncertainty of what tomorrow entails of will or will not a loved one survive, is a frightening and inevitably destructive pattern to consistently live day in and day out.
The ripple effect of alcohol abuse spans a wide and extensive scope, and as it slowly trickles into every aspect of life—from the mundane to the extraordinary—the damage that is caused is anything but individually faced.
But like all demons and illnesses, healing, or at least containing the problem, begins at its source; and fortunately, identifying the underlining issue of abuse can be an extensive and introspective journey into one’s soul—and the light at the end of tunnel, no matter how far away that light may be, shines even brighter when its discovered with the help of loved ones.
But ultimately, what is the end goal of alcohol separation? Is it to merely just survive? Is it so other won’t judge or ridicule? Is to have and maintain a relationship with your spouse, parents, kids, or siblings? Is to find happiness, and a deeper understanding or appreciation of life?
The beautiful (and scary) thing is, no one knows until that day comes; but, no one will ever know if those issues are never addressed in the first place.
The first step towards tangible, long-term healing is quite simply stated on the surface, but nonetheless, the most self-examining and challenging realization to first acknowledge: acceptance that a problem exist.
It takes not only bravery, but also intelligence and cognitive sophistication to realize you have a problem, internally.
That is because there is no greater critique than the one that lives within the walls of your own heart, and as much as a cliché or romantic as that sounds, this statement couldn’t hold truer than now.
Currently, there are over 18 million Americans suffering from alcohol dependence or alcohol use disorder (AUD), and sadly, only a fraction of those individuals suffering will seek professional help.
In today’s hyper-active culture of instantaneous gratification, immediate outcomes and jam-packed visual and physical dopamine overload (e.g., IPhones, gaming, porn, money, food, gambling, sex, etc.), detoxification and alcohol recovery can seem like a highly unappealing, time-consuming and demanding ordeal.
Which is, of course, true. Alcohol dependence is not something that comes off as easy.
But what keeps so many Americans away from detoxification and long-term separation of alcohol is the pain and discomfort that would seem to be associated with the process of cleansing and eventually achieving sobriety.
For these two reasons, alcoholism, and the persistent nature of alcohol abuse, is why detoxification is so commonly avoided.
For example, let’s consider exercising. Getting a “good sweat in” everyday would seem to be a consensus among Americans for living a healthy and productive life. But the truth is, only 18% of Americans report exercising at least an hour a day. This goes to show, exercising, to most of us, isn’t something that comes as easy.
Our busy, monetarily competitive and family-oriented lives keep us away from lacing up our sneakers and prioritizing time out of our day to exercise; additionally, besides its time-consuming nature, exercising is also hard to do physically and mentally. Running, lifting weights, swimming, stretching, etc., takes a committed and focused mind to accomplish consistently.
People that are able to accept the grueling, daunting task that is exercise use that pain as fuel to the end product: a person that feels healthy and stronger, whose body releases natural endorphins in the brain, and overall, feels a sense of accomplish and confidence.
Sounds pretty good, right?
Metaphorically speaking, exercising and detoxification (and thus recovery), share many of the similarities regarding why so many people often overlook their value and decide to react in the opposite direction.
With exercise, the alternative is often linked to eating unhealthy, sitting on the couch, which slows down their metabolism and leads to feeling of insecurity and sadness.
With detoxification, the alternative is often linked to abuse and dependence, resulting in the brain’s increased tolerance level of alcohol to mandate a higher concentration the longer the abuse insinuates. Over time, this leads to many of the same negative effects of not exercising: sadness, increase risk of heart attack, hopelessness and embracement.
Ultimately, if, and when, the individual suffering from alcohol abuse does decide to make the brave decision to participate in detoxification treatment, here is what the process looks like:
Detoxification is a term used to describe the initial course of action that an individual endures (suffering from AUD) to prohibit the use of substance, in an effort to cleanse the body from toxins and effectively overcome the side effects associated with alcohol withdrawal (AW).
The basic detoxification process is usually conducted in a safe, alcohol-free environment (either outpatient or inpatient) where staff members and physician-care may or may not be present to consult, support, and aid in the process of eradicating the body of alcohol.
Depending on the patient’s drinking behavior and severity of usage, pharmaceutical medications, such as benzodiazepine (“benzos”) may be prescribed as means to mitigate agitation, hallucinations and discomfort that is commonly associated with AW. “Benzo” medications also help to monitor hand trembling, sleeplessness, confusion, seizures, convulsions, and thoughts of suicide or doing harm to others.
Detoxification—in non-clinical terms—relates to “breaking up the old pattern” of binge drinking and/or long-term alcohol usage to create a new routine of separation from substance or, at least, to realize their limits and better understand why they overdrink.
In clinical terms, successful detoxification implies the patient has no longer any physiological trace of alcohol in the body; however, AW can continue long after detoxification has been concluded.
Side Effect of Alcohol Withdrawal
Detoxification from alcohol usually follows a 3-step phase, which is based on the severity of symptoms and length of time endure:
1.) Acute Alcohol Withdrawal – The most severe and incapacitating of the three stages, acute alcohol withdrawal usually occurs after the first few hours after a person’s last drink, and can last up to a week.
From seizures, vomiting, increased heart rate, tremors and hearing voices to extreme agitation, insomnia, profuse sweating and delirium—acute alcohol withdrawal may require hospitalization and inpatient treatment.
2.) Post-Acute Alcohol Withdrawal – During the second phase of AW, volatile thoughts of violence and harm to oneself/others have subdued, however, they typically will transition into feelings of shame, depression, guilt and low self-esteem. The threat of convulsions, hallucinations and seizures may have passed, but anxiety, low mood, nightmares and insomnia may still be present, which can anywhere from two to seven weeks.
3.) Extended Abstinence – In the final phase of AW, elevated mood and energy levels increase near their normal state. Confusion and dysphoria (unease or consistent feelings of unhappiness) have subdued dramatically, but cravings of alcohol may still exist. Visual and physical associations (e.g., others drinking, a familiar sounds/smells/images, etc.), can initiate a subconscious craving during this phase.
Medically Assisted Alcohol Detox
It is imperative to note that medically assisted alcohol detox is a distinct category of substance-relief treatment options.
Medically assisted detox is a process by which doctors and trained professionals work closely with a patient to cleanse the body from alcohol using a reduction-based, personalized format.
Instead of abruptly ending from the usage of alcohol “cold-turkey,” medically assisted alcohol detox is conducted in a controlled environment where the patient is weaned off of the drug via a similar of different substance. The objective of medically assisted alcohol detox is to give the most comfortable and seamless transition into recovery. For patients with long-term abuse of alcohol, detoxification can send the body and brain into shock. Depending on the customized treatment plan designed by physicians, which are based on the severity of usage and a variety of other factor—medically assisted alcohol detox implies that the patient continues the usage of (some) substance, but in amounts that are calculated and lowered methodically with each additional dose.
It is also important to note that successful detoxification is a treatment plan that is not designed to encourage or eliminate the urge or behavior to use alcohol; the main goal of detoxification is to simply stop the pattern of physical substance usage, and to successfully purge the entire body of the abused drug. In other words, successful detoxification is intended to create a pathway for long-term treatment options such as cognitive behavioral treatment (CBT), Alcoholics Anonymous (AA), sober living, etc., in so that it provides the best possible opportunity for longstanding substance separation.
For example, let’s say there is an aggressive brushfire that is burning rapidly and threatening to destroy a small local town. Firemen and city officials decide to work closely with each other to develop a strategic plan that will contain the blaze.
During this process, many variables come into consideration in an effort to implement the safest and most effect tactic for settling the flames. From wind direction to the shape of the land and topography, from humidity to wind speed—each additional subtly nuance of Mother Nature can turn a possible solution into a tragic disaster.
After further analysis and consultation, the firemen decide to implement a blackburn strategy, which is, essentially setting “controlled blaze” intentionally with the hope that it will alter the direction of the fire and burn up the fuel that lies between the fire and the small town that is being threatened.
At first glance, the blackburn strategy can seem counterintuitive—but the end result—might be the deciding factor in whether or not the town was burned to the ground or not.
Medically assisted alcohol detox works in a similar fashion: control the problem, or mitigate risk, by creating well-calculated and measured plan that intentionally utilizes the effects of other substances to “put out” the initial problem.
Advantages of Medically Assisted Alcohol Detox
Chemical dependence of alcohol, unlike other addictions, is not only one of the most uncomfortable drugs to detox from, it is also one of the most dangerous as well. Medically assisted alcohol detox is a popular method of treatment (of both physicians and patients) due to its easing of immediate effects and lowered risk of seizures, convulsion and several other potentially life-threatening AW symptoms.
Alcohol detoxification may come in conjunction with extremely stressful/emotional/psychologically debilitating personal and/or workplace issues. Medically assisted alcohol detox may work proactivity with the patient so the negative side effects of AW don’t result in rash and/or destructive decision-making (e.g., continual alcohol abuse, urge to do other drugs, suicide, doing harm to others, stealing, gambling, quitting work, paying for sex, etc.).
Although the patient is not clean from substance use immediately, medically assisted alcohol detox gives the patient the opportunity to be in a different state of mind, which may provide a different level of clarity, rationale, perspective and peace of mind. This process is reported to help strengthen/support the next phase that is hopefully corresponded with detoxification: alcoholic recovery, CBT, AA and other forms of social and behavioral support.
Disadvantages of Medically Assisted Alcohol Detox
Many that are against medically assisted alcohol detox argue that the it only masks the underline problem: addiction.
In some cases, the substitute of one drug over another can create an increased state of dependence. Even though medically assisted alcohol detox is strategically designed to lower the dose over a specific period of time, the patient will/may still experience some form of AW when substance (of any form) is no longer available. “Swapping” of one drug over another may encourage the patient to seek out that drug more aggressively than alcohol due to the emotionally and physically draining effects of AW.
“Alcohol Detox and Rehab Programs: What to Know.” WebMD. 14 Mar. 2019. https://www.webmd.com/mental-health/addiction/alcohol-detox-programs#1
“Medically Assisted Alcohol Detox.” Alcohol.org. 15 Mar. 2019. https://www.alcohol.org/detoxification/inpatient/
“What to Expect from Medical Drug and Alcohol Detox.” Intervention Helpline. 15 Mar. 2019. https://interventionhelpline.com/blog/what-to-expect-from-medical-drug-and-alcohol-detox/