One out of every 12 adults in the United States suffers from alcohol dependence, making alcohol the most regularly used addictive substance in America, the National Council on Alcoholism and Drug Dependence (NCADD) reports. Drinking large amounts of alcohol regularly can cause the brain to get used to the way that alcohol interferes with neurotransmitter transmission, movement, and absorption. If you’re a heavy drinker, abruptly quitting alcohol without the help of medical professionals — known as going “cold turkey” — can be painful and dangerous. Carrie Carlton, LCSW, Clinical Director of Beachway Therapy Center in Boynton Beach, Florida says those considering detoxing from alcohol on their own might want to consider an in-patient medical detox.

According to Carlton, “When someone who has become alcohol dependent decides to stop drinking, he/she will experience some level of physical discomfort. For this reason, it is extremely difficult for a person to merely stop drinking on their own without assistance and support.”

What are the dangers and symptoms when someone stops cold turkey?

Common symptoms include:

• Depression
• Anxiety
• Headache
• Fatigue
• Nausea and vomiting
• Nightmares
• Shakiness
• Fever
• Irritability
• Delirium tremens (DTs)
• Getting the Shakes

For those who are less chemically dependent, withdrawal symptoms might be as "mild" as merely getting the shakes, or the sweats—or perhaps nausea, headache, anxiety, a rapid heartbeat, and increased blood pressure. Although these symptoms are uncomfortable and irritating, they are not necessarily dangerous. But they are often accompanied by "craving" more alcohol, making the decision to continue abstinence much more difficult to make. Even the "morning after" hangover of someone who only occasionally drinks to excess is actually a mild form of alcohol withdrawal from the excesses of the night before, as the alcohol content of their blood begins to drop. The symptoms can appear within a few hours after not drinking.

The full-blown DTs

Within six to 48 hours after not drinking, hallucinations may develop. These usually are visual hallucinations but they can also involve sounds and smells. They can last for a few hours up to weeks at a time. Also, within this time frame after quitting, convulsions or seizures can occur, which is the point at which alcohol withdrawal can become dangerous if not medically treated. The symptoms may progress to delirium tremens (DTs) after three to five days without alcohol. The symptoms of DTs include profound confusion, disorientation, hallucinations, hyperactivity, and extreme cardiovascular disturbances. Once DTs begin, they can cause cardiac disturbances, seizures and other medical complications that can be fatal.

Alcohol withdrawal timeline

First 12 hours: Heavy drinkers experience tremors a few hours after their last drink. Symptoms during the first 12 hours include sweating, irritability, rapid heartbeat, high blood pressure, nausea, vomiting and insomnia.

Days 1-2: Symptoms peak 24 to 48 hours after the last drink. Symptoms are most severe and may include seizures, night terrors, hallucinations and panic attacks.

Days 3-5: Ongoing feelings of nervousness, shakiness and mood swings can last up to a week after the last drink. Delirium tremens may occur during this time as well.

Days 6+: After detox, some former heavy drinkers experience longer-lasting effects of withdrawal. Symptoms are mostly psychological. They may include mood swings, anxiety, irritability, changing levels of energy and trouble sleeping. These symptoms come in waves and can last for months after the last drink.

What can a medical detox do that going it alone cannot achieve?

Medications used during alcohol detox

When alcohol detox is treated in an inpatient rehab facility, different medications may be used to help reduce uncomfortable withdrawal symptoms. Medications can also help keep a person’s body chemicals in balance, lowering the risk for serious complications. In rehab, a medical professional will administer the medication and monitor its effects. If the medication begins to cause unwanted side effects or interferes with the detox process, another remedy can be used. Typically, vital signs are checked every few hours as well as body temperature. Patients are often given anti-seizure medication and benzodiazepines such as valium to make the withdrawal more physically tolerable. An in-house detox also makes things psychologically easier for the patient, as they are around other clients who are going through the same experience.

Several medications commonly administered during the detox phase are:

Benzodiazepines

Benzodiazepines (benzos) are most frequently used to treat withdrawal symptoms during the alcohol detox phase. They are used to help calm your central nervous system and may also be prescribed to treat insomnia, anxiety and muscle spasms.

Naltrexone

Naltrexone helps reduce alcohol cravings during the detox stage. In the event of a relapse, naltrexone works by inhibiting the high feeling that alcohol may cause. Since the medication can stimulate withdrawal symptoms, it is recommended that you wait seven to 10 days before taking naltrexone.

Acamprosate

Years of heavy drinking can significantly alter how the brain looks and works. Acamprosate, sold under the name Campral, is prescribed to help your brain begin to function normally again after you quit drinking. Research studies have also started to look into whether or not acamprosate helps reduce the symptoms of PAWS including insomnia, anxiety and restlessness. It also works to reduce alcohol cravings; however, it will not produce an unwanted effect if alcohol is consumed.

Disulfiram

Another medication used in the treatment of alcoholism is disulfiram. Unlike other medications, disulfiram works by producing severe reactions if alcohol is consumed. For instance, if you drink while on disulfiram, you will experience unwanted effects like facial flushing, nausea, headache, weakness and low blood pressure. The negative effects are meant to deter you from continuing your drinking pattern. Disulfiram is not meant to reduce your alcohol cravings or restore brain functions like some other medications.

What should patients do after treatment at a detox facility?

Once the physical detox is over, patients must learn the long term tools to stay sober. A continuing outpatient plan may be helpful.

About Beachway Therapy Center

Beachway Therapy Center provides both a PHP (Partial Hospitalization Program) and Outpatient services, along with therapies ranging from cognitive behavioral therapy (CBT), motivational interviewing, addiction counseling, 12-Step orientation, dialectical behavioral therapy (DBT), trauma informed practices and a wide variety of supportive group therapies.