Alcohol Withdrawal and Detox

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Overview

Discussions related to the care of patients with alcohol dependence issues will ultimately include the terms “withdrawal” and “detoxification.” While they are often used interchangeably in day-to-day conversation, there are important differences. Understanding the differences can ultimately help patients, caregivers, policymakers, and other parties involved in substance rehabilitation programs make better decisions.

What Is the Difference Between Alcohol Detoxification and Withdrawal?

Detoxification, or detox, refers to the process by which the body expels toxins from itself. Strictly speaking, our livers perform detoxification every day to prevent the buildup of harmful substances in the body. In the context of alcoholism rehabilitation, however, toxins are understood to be the chemical agents responsible for a substance’s negative effects on the human body, which, in this particular case, is alcohol.

Withdrawal, on the other hand, can refer to either the process of stopping a drug (such as alcohol) or the symptoms associated with abruptly stopping the intake of said substance.

What Is Withdrawal Management? Is it the Same as a Detox?

Withdrawal management is the practice of safely taking a patient with substance dependency issues off of their drug or drugs of choice. The popular terms for withdrawal management just a generation ago were “detox” and “detoxification,” and those terms continue to be used in casual conversation today to refer to withdrawal management.

However, to be precise, detoxification is a process that is carried out by the human body, aided or unaided by a treatment. Withdrawal management, on the other hand, is the work done by clinicians and other rehab specialists. To simplify things, alcohol detox is done by your liver and kidneys, while alcohol withdrawal management is done by the patient and the rehab center staff.

Why Did the Word “Detox” Become Outdated?

It hasn’t really become outdated. Rather, the meaning in the context of rehab has become more specific. Public health bodies such as the World Health Organization (WHO) and the American Society of Addiction Medicine (ASAM) have noted that there are semantic problems with continuing to use “detox” and “detoxification” to refer to either withdrawal or withdrawal management, including in the context of alcohol dependence. This confusion of terms can lead to a lack of nuance in the understanding of the recovery process, which can be very sensitive for patients and other stakeholders.

While a growing number of public health bodies have already made the necessary changes to clearly define and differentiate detoxification from withdrawal and withdrawal management, older literature on the topic of alcohol dependency still uses these terms less precisely. Some laypersons and clinicians may continue to use the term “detox” in place of “withdrawal management” for brevity, to get a point across, or in the context of a casual discussion.

Why Should Alcohol-Dependent Patients Go to a Withdrawal Management Program?

Programs increase your chance of success. Alcohol dependence is a disease that, in essence, attacks the patient’s free will. This means that attempts at self-rehab tend to carry a much lower chance of success than attempts done in a proper facility or setting.

Proper alcohol withdrawal management by trained and experienced clinicians typically has greater odds of lasting success, especially when done in a group. The dynamic of going into a group rehab program also helps keep patients from feeling isolated, which can be critical to preventing early relapse. The presence of trained clinicians and counselors can also serve to keep patients accountable.

You get the chance of addressing the root causes of your alcohol dependency. While withdrawal management programs allow patients to safely wean themselves off their drug of choice, they are not solely about getting unwanted chemicals out of one’s system. Psychiatric care and counseling are also part of these programs. These can help the patient find the reasons for their dependency, which is necessary for the long-term success of any rehabilitation program.

You’ll save money. If you’re already at the point when you’re considering rehab, chances are you have already spent or lost thousands of dollars because of your drinking habit. Even so-called “cheap booze” exacts a toll on your productivity and your ability to use your time for better and happier things.

You will find others like you. Most people with alcohol dependence issues indulge in secret or with others that have similar problems. This often leads patients who attempt alcohol withdrawal management by themselves to feel isolated, as they will often lose contact with other substance dependents. By recovering with other people who truly understand what you’re going through, you will find rehab to be a less isolating experience. What’s more, these programs often open the door to new friendships, activities, and experiences that may create a positive lifelong impact.

You’ll get a shot at preserving your relationships. Alcohol dependency affects more than just your mind and body. Quite often, they put a strain on your relationships, some of which you may truly value. Rehab programs, in many cases, will provide an opportunity for therapy sessions with family members and other loved ones. By joining a rehab program, you can very well save or, at least, prevent the further deterioration of valued relationships.

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You can withdraw in relative safety. Withdrawal can be difficult at best. At worst, it can be fatal. Unsupervised withdrawal from alcohol can be an excruciating experience and can even result in death. For alcohol dependence, a physician will typically prescribe medication to prevent serious harm to the patient as they get the drug out of their system. This can be a very complex undertaking that can be more dangerous when done outside of a competently-run program.

Rehab programs are linked with longer lifespans. Alcohol abuse and dependency have been proven in multiple studies to reduce average life spans due to the long-term health risks and the short-term dangers that come with being inebriated.

Why Shouldn’t You Do Alcohol Withdrawal Management Alone?

We already touched on some of the reasons why it might be a bad idea to try to quit a serious substance dependence disorder alone. Solo attempts at “alcohol detox” or self withdrawal management tend to result in higher relapse rates and harm to the patient. The guidance of qualified clinicians is crucial not just for helping the patient kick the habit, but also for preventing harm to the patient and others around them.

Common Alcohol Withdrawal Complications

Patients undergoing withdrawal will often experience the symptoms and complications below. A withdrawal management program under the guidance of qualified professionals will typically be in a better position to provide relief and prevent unnecessary harm to a patient experiencing the following:

  • Diarrhea and vomiting, leading to dehydration
  • Erratic or increased heart rate
  • Aggression and irritability
  • Itching
  • Cramping or tremors
  • Labored breathing
  • Confusion

Symptoms may vary depending on the patient’s unique reaction to withdrawal. The duration of the patient’s dependence and the amount of toxins that their system needs to expel can also change the type and relative intensity of the symptoms.

Most patients undergoing rehab will also require psychiatric care and counseling for managing mental health issues. The proper management of mental health issues should also help increase the long-term prospects of a patient. Patients undergoing rehab often experience one or more of the following conditions:

  • Anxiety
  • Major depressive disorder
  • Impulsive behavior
  • Personality disorders
  • Neuroticism
  • Multiple addictions

Typically, physicians will tailor a patient’s withdrawal management program depending on the psychological factors they find. This is necessary as withdrawal without proper intervention can lead to self-harm or injury. Patients assessed to be a serious risk to themselves or others may also be monitored closely to ensure that the withdrawal management process causes the least amount of harm.

How Long Should Alcohol Withdrawal Management Take?

Unfortunately, there is no quick answer to this question. It all depends on the substance, the duration, and intensity of the patient’s dependence, as well as the type of treatment attending clinicians decide is appropriate for the patient. Other factors include the presence of multiple substance dependencies, underlying psychiatric conditions, medical history, and the patient’s present physical condition.

Knowing these factors, safe withdrawal often takes a two-pronged approach, where the patient’s body is allowed to detoxify and expel toxins in a controlled manner and they are given psychiatric treatment to help them avoid recurrent cravings. Alcohol detoxification can take anywhere from a few days to several months. Psychiatric treatment for addiction, however, typically takes much longer, sometimes for the rest of their lives.

Conclusion

Alcohol withdrawal and detoxification are two related but different terms often used in the context of the rehabilitation of alcohol-dependent patients. Detox and detoxification have shifted from more general terms describing both bodily processes and rehabilitation programs. Today, leading public health organizations are moving towards the usage of detox to refer solely to the bodily process of expelling toxins.

The outdated usage of “detox” can present an inaccurate picture of rehabilitation and withdrawal, as one might assume detoxification alone is enough to help an alcohol-dependent patient recover. In reality, helping patients recover from their physical cravings for their drug of choice is the easy part. The more complex and arduous part tends to be the psychiatric treatment of the underlying conditions that have led to dependency.

For this reason, what used to be simply called “detox” a generation ago is now more accurately referred to as withdrawal management. By understanding what detoxification, withdrawal, and withdrawal management truly are, patients and the people who care for them can get an updated and more nuanced idea of the rehabilitation process.

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