Detoxification, or detox, is the first phase of substance abuse recovery for those who are in rehab. It involves a period of time after your last drink or drug use that you dedicate to ridding all of the alcohol or toxins in your body so that you can begin treatment with a clean slate.
The primary goal of alcohol detoxification is to safely and comfortably embark upon a period of abstinence at the start of the recovery process. Once you are clean, recovery can begin.
Why Is It Necessary to Detox From Alcohol Properly?
Alcohol can be one of the most dangerous substances to detox from. As detoxification progresses, withdrawal symptoms may become life-threatening, so professional medical monitoring is often necessary in many cases of abuse and dependency. While the importance of physically ridding yourself of alcohol is stressed in detoxification, it is also important to evaluate for any of the psychological factors that often accompany severe alcohol dependence, since they are likely to complicate treatment and evaluation plans.
Some detoxification facilities — especially high-end luxury programs, that are designed to offer one-on-one care — may make assessments about individual psychopathology during detoxification so that any psychological issues may be managed properly.
It is important that you understand that the struggle doesn’t end with this decision; the treatment can be uncomfortable. Detoxification can be the most difficult part of the treatment process because the body struggles without the presence of alcohol that it has grown accustomed to, and this can lead to painful withdrawal symptoms.
Alcohol Detox & Withdrawal Symptoms
Everyone will experience alcohol detoxification differently. However, most people will experience at least some of the following withdrawal symptoms:
- Racing heart beat
- Increased blood pressure
- Mood swings
Seizures are the most dangerous of the acute alcohol withdrawal symptoms. They occur because your brain and the cells within it actually begin to change as they grow accustomed to the persistent presence of alcohol and its sedating effects throughout your system.
When alcohol is abruptly removed from your system, your brain struggles to adjust to the rebounding level of stimulation. Sometimes the brain can’t keep up with all this new excitatory neuronal activity, and this can result in a seizure.
The risk of seizure remains high, in some cases, for several days after the last drink. Therefore, it is vital to your treatment course that you begin with alcohol detoxification to have all toxins removed from your body. Beginning treatment for alcohol abuse after safely completing detoxification is the best way to set yourself up to maintain sobriety — that way, the most physically uncomfortable part is over, and you can focus your efforts on recovery.
What to Expect From Alcohol Detoxification
The severity of a person’s withdrawal during detox is closely related to how severe and long-standing his or her addiction has been to that point. It is important to keep in mind that your experience of detoxification— its severity and duration — can differ from what you read here or what you may have observed in other people. Exactly how your detoxification progresses can be influenced by many factors, so it’s difficult to determine with accuracy what course your detoxification may take.
However, it is possible to get a general time frame for the detox process, complete with the progression of symptoms.
The First Hours
Cravings are some of the first symptoms of alcohol withdrawal, and a definitive sign that the body is beginning the detoxification process. Cravings can occur within hours of taking a final drink and continue far into the detoxification process. The first hours of detox may also involve symptoms such as:
- Nightmares and/or insomnia.
- Tremors (physical tremors are quite common for all levels of alcohol addiction).
- Anxiety, depression and/or irritability.
- Physical sickness.
- Spikes in heart rate and blood pressure.
- For more extensive addictions, symptoms may persist and get progressively worse throughout the detox process.
The First Two Days
After the initial hours of detox come more severe symptoms of alcohol withdrawal, which can range from hallucinations to deadly seizures. The symptoms that develop within the first two days of detox can become life-threatening, as the brain reacts to alcohol leaving the system.
- Hallucinations are possible during this stage of detoxification.
- Seizures are possible as well, most commonly in the first 12 to 48 hours after the last drink, but can continue for days after the process begins.
- Rapid heart rate will continue and chest pain may arise, which may indicate heart or blood pressure issues.
- Delirium tremens (a severe, dangerous effect of acute alcohol withdrawal).
- For many, the alcohol detoxification process does not end at 48 hours.
- Severe or long-standing cases of alcohol addiction may require particularly close monitoring for days after the decision to detox is made.
The Rest of the Alcohol Detox Process
Detox can continue for many days after the initial withdrawal symptoms develop. It is likely that your cravings will grow and physical discomfort will increase somewhat as detox gets underway. If present, and not managed closely, seizure activity may continue and also increase in severity.
After the first 48 hours of detoxification, seizure risk will begin to lessen in many cases. However, continued medical observation may be required, as the risk of extreme confusion and cardiovascular events such as heart attack, and even stroke remains elevated.
These symptoms usually occur within 48 to 96 hours after the last drink, but occasionally they have a delayed onset, starting between 7 and 10 days after the last drink.
Delirium Tremens Symptoms
- Fever and sweating.
- Rapid mood changes.
- Body tremors.
- Agitation or irritability.
- Extreme confusion or disorientation.
As mortality rates in unmanaged cases of delirium tremens are quite high, sedating medications, diligent supervision, and supportive care will be important until the health risks subside over the course of a few days.
Risk Factors for Delirium Tremens
Delirium tremens won’t develop in every recovering drinker, but because it is so dangerous you should have a physician or other addiction treatment professional assess your risk in order to best prepare for potential complications. The rapidity of onset and severity of symptoms can depend on how much and how often a person drank. Risk factors for developing delirium tremens during alcohol withdrawal include:
- Not eating enough food during a period of chronic or heavy drinking.
- History of alcohol withdrawal experiences.
- Head injury, infection, or illness in a person with a history of heavy drinking.
- The cessation of drinking after a time of drinking heavily.
- Drinking a lot or often for more than 10 years.
Alcohol detoxification and withdrawal can be physically and psychologically taxing — health complications, cravings, and mood swings are not uncommon. This sounds like scary information, but it’s important to know the detox process inside and out, especially when you have a severe dependency.