Various mugs of tea, along with lemons and a jug of cream

Getting Through An Alcohol Detox

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For anyone who wants to recover from a substance use disorder, discontinuing use can be one of the scariest first steps.

That looks different for different people and different substances—for some, it means intense psychological cravings and fatigue. For those addicted to dependency-producing substances, physical withdrawals add another difficult and painful component. Alcohol withdrawal in particular offers serious problems—both serious discomfort, and serious medical risks. But it is possible to detox from alcohol at home, and WorkIt Health now offers a program to help patients begin this crucial first-step if they are seeking alcohol abstinence.

What Are the Risks?

It’s important for those who wish to pursue abstinence from alcohol to realize that alcohol withdrawal, unlike the average opioid withdrawal, can be life-threatening, including seizures. Delirium tremens (DTs) are another highly dangerous symptom of alcohol withdrawal, which occur in about 5% of patients, and can produce hallucinations, delirium, racing heart, high blood pressure, and fever. People with a history of experiencing DTs or withdrawal-induced seizures are not able to participate in the WorkIt Health monitored home detox program. For these patients, it is suggested they attend a medically supervised inpatient detox program. Inpatient programs often monitor patients while utilizing a combination of seizure prevention meds like benzodiazepines.

If an inpatient detox is inaccessible, it is possible for heavy or high-risk drinkers to taper their alcohol use at home. This is not part of the WorkIt Health protocol, and it is recommended they not attempt this alone, or at least keep in contact with a trusted friend. From “Tapering, if that’s your goal, should be done with the aim of avoiding withdrawal, not getting intoxicated. So drinkers should consume only as much beer as is absolutely necessary to hold off shaking and sweating.”

Milder symptoms of withdrawal include tremors, sweating, anxiety, vomiting, and insomnia. These symptoms do not disqualify a patient from the WorkIt Health home detox program and are generally expected of patients who have an alcohol dependency. Although WorkIt Health will monitor patients for short daily periods, it is recommended that anyone attempting a home detox have a trusted friend or family member present to help monitor them and make sure that a medical professional can be reached should they begin to experience more serious withdrawal symptoms.

How Can Withdrawal Discomfort Be Alleviated?

Unlike opioids, there is not an alcohol-based substitution therapy that fills the same receptors as alcohol and helps prevent withdrawal. Tapering alcohol can help prevent withdrawal by gradually lower one’s alcohol intake, but can be difficult to accomplish for those who have trouble controlling their alcohol intake. The time it takes to fully detox varies by person, but can last up to five days.

During withdrawal, it is helpful to stay in a quiet, calm environment away from lots of people. Have plenty of fluids on hand (and a container to suddenly discharge them in). Music, television, books, or other forms of entertainment can be great for helping get through insomnia without spiraling too deeply into your thoughts and anxiety—but some people may prefer quiet and solitude. It’s really up to the individual.

WorkIt Health patients may be offered gabapentin, which is a nerve-pain medicine that acts on the gaba receptors and has calming properties, as well as naltrexone, which helps block the effects of alcohol. Patients who take naltrexone cannot have any type of active opioid dependency, or it will produce severe precipitated opioid withdrawal. Patients who cannot take naltrexone because they have opioids in their system may be offered Librium instead.

For patients who are not participating in a medically supervised detox, it is important to stay hydrated with water, and electrolyte drinks like coconut water or sports drinks. Healthy food can also help keep your body functioning. You may not feel like eating, but if you can make yourself eat a few pieces of fruit or something simple like yogurt or soup, it will help keep your body as healthy as possible during this time. Anyone who begins to experience significant hallucinations or seizures should seek emergency medical assistance immediately.

Elizabeth Brico is a freelance writer with an MFA in Writing & Poetics from Naropa University. She is a journalism fellow with TalkPoverty and a recipient of the 2021/22 Unicorn Fund. She is also a regular contributing writer for HealthyPlace’s trauma blog. Her work has appeared on Vice, Vox, Stat News, The Fix, and others. When she isn’t working, she can usually be found reading, writing, or watching speculative fiction.

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