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Alcohol detox – Manage with care

Large numbers of people are unaware of the risks involved in the withdrawal from alcohol for people who have developed dependency or addiction. Over time the central nervous system adjusts its neurochemistry to the repeated consumption of alcohol. The brain adapts to the presence of the toxin ethanol such that it comes to “expect” its delivery. 

For this reason, acute withdrawal represents a sudden interruption for which the brain simply isn’t ready as the reactions show.  These can prove catastrophic if not carefully managed. At the less severe, though nonetheless unpleasant end of the spectrum are symptoms like headaches, sweating, nausea, anxiety and shaking.  Much more serious symptoms don’t necessarily appear immediately. Between 24 and 72 hours (sometimes longer) after the last intake of alcohol a patient may experience hallucinations, delirium tremens and/or seizures. There is the very real risk of death due to such seizures and the people conducting medical management of detoxification will be alert to reducing this risk from the moment of admission.

Assisted detoxification from alcohol

By far the safest option for a person dependent on alcohol is to be admitted to an in-patient alcohol recovery programme where they can undergo what is known as assisted withdrawal under medical management.  Given expert care a person can withdraw safely and according to a prescribing regime that takes into account dependence to other substances and co-existing mental and physical conditions. Depending on the person’s recent levels of consumption and general health, the process of detoxification from alcohol can take up to a week or ten days. 

An appropriate benzodiazepine is generally prescribed to assist the alcohol withdrawal process but this is a short-term aid to detoxification rather than long-term treatment. These drugs are used because in the brain they act similarly to alcohol so while useful to achieve detoxification, their properties carry similar risks. A supplement of the vitamin thiamine is usually prescribed as alcohol dependence is strongly associated with malnourishment.

The advantages of an in-patient treatment for alcohol withdrawal

Given the inherent dangers, an in-patient treatment facility provides reassuring safety. The medical team is on site and immediately available 24 hours a day. This enables close monitoring of the patient and their symptoms. Adjustments to treatment can be made without delay as needed.

Withdrawal from alcohol and other drugs of dependence may be more quickly and easily achieved if the medical facility is fully integrated into an addiction treatment and recovery programme rather than, as is so often the case, detached from it.

It is important to remember that detoxification or withdrawal is a psychological as well physical process. It is essential for the patient to be supported psychologically and encouraged to focus as much as possible positively on holistic recovery rather than the physical process of withdrawal.  A luxury rehabilitation centre has an advantage here due to its comprehensive and detailed attention to the comfort and wellbeing of patients.

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Clinically Reviewed By

Dr. Victor Leroy

Dr. Victor Leroy, a psychiatrist with specialised training in addiction psychiatry from Lausanne University Hospital, combines medical expertise with a passion for systemic psychotherapy. He has worked at length in both the public and private sector, utilising a combination of patient-centered approaches to support them and their loved ones in recovery. A member of AVMCA and COROMA, he consults in French, English, German, and Italian, focusing on integrated care for addiction medicine.

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