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In England there are an estimated 602,391 dependent alcohol users. Only 18% of these are receiving any treatment. In 2018/2019, 76,000 people were treated for problematic drinking in the UK, and there were 358,000 alcohol related admissions to hospital.
The over-65 age group were reported to have the highest rate of hospital admissions for alcohol related conditions. Alcohol misuse is the biggest risk factor for death, ill health and disability among 15- to 49-year-olds in the UK. There are 200 diseases and injury conditions where alcohol is a factor.
What is a detox from alcohol?
Alcohol detox is the first stage in treating alcoholism. An alcohol detox is where alcohol is completely flushed from your body. It is the process that occurs in the body when it clears the waste products and toxins after excessive and long-term alcohol consumption.
If your body is dependent on alcohol, you may experience withdrawal symptoms which can range from mild to severe. Your withdrawal symptoms will depend on how much you have been drinking and whether you have reduced your alcohol intake gradually or not.
The idea of withdrawal symptoms can make people reluctant to detox from alcohol. Any withdrawal symptoms should pass within 1-2 weeks. The symptoms can become aggressive and change quickly, which means it is important to detox under the supervision of a medical professional.
Severe withdrawal symptoms can be treated with medication. Withdrawal symptoms can begin within as little as two hours after your last alcoholic drink. The most severe symptoms should begin to subside within a week; however, you may still be experiencing some symptoms several weeks later, or in some cases even a year later.
The most severe symptoms will usually peak around 10-30 hours after your last drink and should start to reduce 40-50 hours after your last drink, although this can vary from person to person. A medically assisted detox can help with any painful withdrawal symptoms and prevent any serious complications.
The purpose of an alcohol detox is to treat the physical dependency on alcohol first so that other aspects of the addiction can be addressed. This may include counselling, therapy or accessing medication for any other conditions.
Why would someone have an alcohol detox?
Alcohol is a drug. It is classed as a central nervous system depressant. Consuming alcohol slows down brain functioning and neural activity and reduces the functioning of various other functions within the body. After you drink alcohol, it is absorbed into the blood where it then travels to the brain. When someone drinks small quantities of alcohol, it can typically make you feel relaxed, animated and disinhibited. It can also impair coordination which is why it is considered unsafe to drink and drive or operate machinery.
When someone consumes large quantities of alcohol, it results in depressant effects in the body. This is because the body is not equipped to process large amounts of alcohol.
The depressant effects can include:
- Delayed reaction time.
- Slurred speech.
- Cognitive impairments.
- Poor coordination or lack of motor skills.
- Unsteady/unable to walk properly.
- Distorted judgement.
- Distorted perceptions.
- Poor coordination.
- Lack of motor skills.
- Decreased inhibitions.
At higher concentrations, the effects of alcohol become more severe. People may become more prone to losing control of their emotions and potentially becoming aggressive. Alcohol can often be a factor in violent crimes or anti-social behaviour for this reason.
Although alcohol is classed as a depressant, it also has stimulatory effects. This depends upon the amount and rate at which the alcohol is consumed. If consumed in smaller quantities, alcohol is more likely to have a stimulatory effect.
This can include:
- Improvements in mood.
- Increased confidence.
- Increased heart rate.
- Increased blood pressure.
Alcohol can have harmful effects on the body. The most severe form of alcohol abuse is alcoholism. An alcohol detox would be suggested if you are suffering from alcoholism.
Alcoholism is an addiction to alcohol. Alcoholism is the most serious type of problem drinking. It describes an often uncontrollable and strong desire to consume alcohol. Alcoholism is known by a variety of terms such as alcohol addiction, alcohol dependence or alcohol abuse and it has been more recently referred to as alcohol use disorder. It occurs when a person drinks so much that their body becomes physically dependent on, or addicted to, alcohol.
People who suffer from alcoholism will often be unable to prioritise anything else above their need to drink; this can include their work commitments and their family and friends. Even when their drinking is having a negative and often devastating impact on their life and relationships, this is still not enough to make them stop as the pull to use alcohol is so strong.
People who are struggling with alcoholism often feel like they cannot function properly without alcohol. This can impact on health, relationships, work and day-to-day functioning.
Common signs of alcoholism include:
- Being unable to control alcohol use.
- Regularly craving alcohol.
- Being unable to stop drinking.
- Putting alcohol above personal responsibilities.
- Spending a substantial amount of money on alcohol.
- Alcohol use impacting upon your relationships, work or any other aspect of your life.
- Other people are concerned about your alcohol use.
Recognising that you have a problem with alcohol is the first major step on the road to accessing support and recovering from alcohol addiction. If you feel like your alcohol consumption is impacting negatively on your life, you should seek support for this.
You can make an appointment to speak to your GP. Try to be as accurate and honest as you can about your drinking habits and any problems they may be causing you. Your GP may suggest different types of support options available in your local area. If you are physically dependent on alcohol, stopping completely without professional support could be dangerous. You should get some advice about this and any medication you may need to do this safely.
Symptoms of being physically alcohol dependent may include:
- Nausea or retching in the morning.
- Having hallucinations.
- Anxiety after waking up.
- Having seizures or fits.
The detox process is the first step to recovery from alcohol addiction and would be suggested before any other form of treatment is attempted.
How long does an alcohol detox take?
Withdrawal symptoms typically subside within approximately 1-2 weeks after starting a detox; however, this could take longer depending on your level of alcohol dependency. The initial symptoms of alcohol detox within the first 6-12 hours are usually mild but can quickly begin to worsen. As the end of the first 24 hours approaches, symptoms may be severe.
The most painful symptoms may continue into the second day of the detox process. Between days 3-7, symptoms may come and go. This is also the timeframe where you are most at risk of experiencing life-threatening symptoms. After one week, many of the withdrawal symptoms may be beginning to lessen although some more mild withdrawal symptoms can be ongoing.
The detox stage is usually the first step before being able to focus on the other aspects of recovering from alcohol addiction. These could include therapy, counselling and group support options.
What happens during an alcohol detox?
When someone is addicted to alcohol, they will often need to go through a detox process. This is an important first step in alcohol recovery. A detox is the process where all traces of alcohol and drugs are removed from the body.
Alcohol is a depressant, and after months or years of drinking your body begins to rely on it. Your brain produces chemicals during alcohol use; however, with excessive alcohol use, your brain gradually stops producing these chemicals. Over time your central nervous system adjusts to having alcohol all around your body and your body has to work hard to keep your brain in a more alert state and to keep your nervous system working.
This is when you have become dependent on alcohol. When you begin an alcohol detox, it takes time for your body to adjust. This is why you have withdrawal symptoms. If you drink alcohol heavily for weeks, months or even years, you may have mental and physical withdrawal symptoms.
Withdrawal symptoms can include:
- Shaky hands/body.
- Irregular heartbeat.
Some people also experience delirium tremens (DTs); these are severe symptoms which include vivid hallucinations and delusions. These happen when people have an extreme reaction to alcohol withdrawal.
The condition is more likely to occur when a person is severely addicted to alcohol and has experienced withdrawals previously. Only about 5% of people with alcohol withdrawal symptoms have the symptoms of delirium tremens. The symptoms of delirium tremens usually begin within 2-3 days after a person stops drinking.
The symptoms of delirium tremens include:
- Emotional distress.
- Intense confusion.
- Intense agitation.
- Intense irritability.
- Seizures (usually within 24 hours of the last drink).
The purpose of a detox is to address the physical side of an addiction before the psychological side of an addiction is addressed. The detox process aims to minimise the negative impact of withdrawal symptoms, making the experience as safe and as comfortable as possible.
The most effective form of detox is one that is medically assisted where trained professionals can support you. This can sometimes happen in a rehabilitation centre, also known as rehab. People go into rehab in order to receive rehabilitation and health treatment for an addiction. This could be an alcohol addiction or another drug. In order to help someone overcome addiction, rehab uses a range of therapies and treatments. A rehab centre can treat you as an inpatient or an outpatient. When alcohol detox is treated in an inpatient rehab facility, medication may be used in order to lessen any severe withdrawal symptoms.
Medication can keep body chemicals in balance during the detox phase and can also work to prevent severe withdrawal symptoms such as seizures, which are the most common form of fatality from alcohol detoxification. The medication will be given by a medical professional and its effects will be monitored for any unwanted side effects or if it is interfering with the detox process.
Medications that can be and are commonly given during the detox process are:
- Benzodiazepines – These are the most commonly used medication to treat withdrawal symptoms during the detox process. They work by calming the central nervous system and can be used to treat insomnia. They can also treat muscle spasms and anxiety.
- Acamprosate – Long-term, excessive alcohol use can change the way the brain looks and functions. Acamprosate, otherwise known as Campral, can help your brain begin to function normally again. It can also help to reduce the craving for alcohol.
- Disulfiram – If alcohol is used while being medicated with disulfiram, there will be a severe reaction. Symptoms can include nausea, sickness, headaches, facial flushing, low blood pressure and muscle weakness.
- Naltrexone – This medication helps to reduce the craving for alcohol during the detox process. Naltrexone also inhibits the high feeling that alcohol use gives, therefore if there is a relapse, the alcohol use will not have the desired effect. Naltrexone will not usually be given until 7-10 days have passed as the medication can stimulate withdrawal symptoms.
A detox in a rehab centre will usually include a three-step process, which includes:
- A comprehensive review of alcohol use and medical history, including psychiatric history.
- Medication if this is appropriate to the individual treatment programme.
- Stabilisation which consists of medical and mental health support.
If you’re dependent on alcohol, it can be dangerous to stop drinking suddenly and in some cases even fatal. It would usually be recommended to seek medical support before beginning the detox process.
Some of the risks of detoxing alone without medical support include:
- Aspiration pneumonia.
- Heart arrhythmias.
- Kidney dysfunction.
- Liver dysfunction.
- Intense cravings.
If you are attempting an alcohol detox at home, it is recommended to reduce your alcohol intake gradually over the space of a few weeks before stopping completely.
Before you decide to start your detox, it may be useful to follow these steps:
- Keep a diary of how much you are drinking – Without changing your drinking habits, write down how many drinks you have each day, what time you have these and how many units of alcohol each drink contained. You should keep this diary for one week.
- Start to reduce your alcohol intake. Once you know how much you are drinking, you can now take steps to reduce your alcohol intake. This should be done slowly at first; as a guide you could reduce the amount you drink by 10% each day. If you are having withdrawal symptoms, this could indicate that you are cutting down too quickly and you should reduce your alcohol intake more slowly. When you are drinking less than 10 units per day, you could then stop drinking completely.
You can find a helpful guide for working out how many units are in an alcoholic drink on alcohol change.
If you are struggling to reduce your alcohol intake, you could:
- Ask a friend or family member for support.
- Add water or other soft drink to your alcoholic drink.
- Try a lower strength alcoholic drink.
- Stay hydrated with non-alcoholic drinks.
- Try to eat healthily and exercise.
You will need to seek medical help immediately if you experience any of the following:
- Developing double vision.
- Becoming confused.
- Experiencing hallucinations.
- Having a seizure.
Some useful contacts if you are concerned about alcohol use are:
- Alcoholics anonymous is a free self-help programme with support groups.
- Smart Recovery groups help people decide if they have a problem and offer tools and techniques in order to support recovery.
- Adfam is a national charity working with families affected by drugs and alcohol.
- We Are With You is a treatment agency that helps individuals, families and community groups manage the effects of drug and alcohol misuse.
Benefits of an alcohol detox
As alcohol can be detrimental to your health, there are many benefits to detoxing from alcohol completely.
These benefits include:
- Improved mental health.
- Healthier weight.
- Improved sleep.
- Improved brain function.
- Improved memory and mental focus.
- A healthier immune system.
- A healthier heart.
- A healthier liver.
- A healthier digestive system.
- Decreased risk of cancer.