Alcohol detoxification is the first step in treating alcoholism and is an important part of the recovery process. It is a process of gradually reducing alcohol consumption and managing withdrawal symptoms. In this article, we will discuss the alcohol detox protocol, the medications used to treat alcohol withdrawal syndrome, and the importance of screening for alcohol abuse. The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline is a free referral service that provides information about substance abuse treatment programs and other resources.
The helpline is available in English and Spanish, and text messaging service 435748 (HELP4U) is available in English. If you are uninsured or underinsured, SAMHSA can refer you to state-funded treatment programs or facilities that charge on a sliding fee scale or accept Medicare or Medicaid. Alcohol and drug addiction affects the entire family. It is important to understand how substance abuse treatment works, how family interventions can be a first step to recovery, and how to help children from families affected by alcohol and drug abuse. For additional resources, visit the SAMHSA store.
Alcohol detoxificationis the process of gradually reducing alcohol consumption and managing withdrawal symptoms.
Some people fear stopping drinking because of withdrawal symptoms, but it is an important part of the recovery process. Outpatient detoxification of patients with addiction to alcohol or other drugs is increasingly being carried out. This type of treatment is appropriate for patients in stage I or stage II abstinence who do not have significant comorbid conditions and have a support person willing to monitor their progress. Adequate doses of the right substitute drugs are important for successful detoxification. In addition, comorbid psychiatric, personality and medical disorders must be managed, and social and environmental concerns must be addressed.
By providing supportive, non-judgmental and assertive care, the family doctor can facilitate the best possible chance for the patient to recover successfully. The revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-AR) scale is a validated 10-item evaluation tool that can be used to quantify the severity of alcohol withdrawal syndrome and to monitor and medicate patients undergoing alcohol abstinence.7,8Chronic exposure to alcohol results in a compensatory decrease in the GABA-A neuroreceptor response to GABA, evidenced by increased tolerance to the effects of alcohol. Drug treatment of alcohol withdrawal syndrome involves the use of drugs that are cross-tolerant to alcohol. The ASAM Alcohol Withdrawal Management Guide assists physicians in clinical decision making and management of patients experiencing alcohol withdrawal syndrome in both hospitalized and outpatient settings. In the outpatient setting, brief interventions are useful in patients with alcohol abuse21, but more intensive interventions are required in patients with alcohol dependence. An overview of medications for the treatment of alcohol withdrawal and alcohol dependence, with an emphasis on the use of older and newer anticonvulsants, suggests that anticonvulsants such as carbamazepine, oxcarbazepine and divalproex may be useful in the treatment of alcohol dependence by reducing the desire to consume alcohol and in the treatment of AWS through its anti-ignition effect. Due to the severity of some withdrawal symptoms, alcohol detoxification should be monitored by a medical professional. Usually, alcohol withdrawal symptoms are proportionally related to the amount of alcohol consumption and the duration of the patient's recent drinking habit.
The alcohol detoxification phase can involve withdrawal symptoms ranging from mild to life-threatening. When treating alcohol detoxification in an inpatient rehabilitation center, different medications can be used to help reduce uncomfortable withdrawal symptoms. Alcohol detoxification usually lasts about 72 hours; however, withdrawal symptoms and delirium tremens can last from one to several weeks. Screening patients for alcohol abuse can be revealing and beneficial for some patients when it comes to changing their drinking habits before any complications arise, such as alcohol withdrawal syndrome.
Although detoxification occurs in the patient's home, the medical staff supervises the detoxification by contacting the patient and regular visits to the clinic as needed. Abrupt cessation of alcohol exposure results in cerebral hyperexcitability, because receptors previously inhibited by alcohol are no longer inhibited. By providing supportive care during this process, physicians can help ensure that patients have a successful recovery from alcoholism.