What Detoxification Really Means to an Alcoholic
The medical definition of detoxification is subjective but based on reported physical symptoms. This can lead to problems when the individual is unable, or unwilling to express the effects that alcohol withdrawal are having on their system.
Symptoms Of Alcohol DependenceMany people assume that their strong desire for alcohol means they are alcohol-dependent but this is not necessarily the case. One of the symptoms of alcohol dependency is a deep to overwhelming desire to consume alcohol but it is only one of a constellation of symptoms that need to be elicited before dependence can be defined by the medical community.
The most defined symptom is, paradoxically, evidence that the drinker is unable to manage the symptoms that emerge when they cease to drink
The basic symptoms are, in increasing order of risk and severity:
- Nausea (may or may not include vomiting)
- Trembling (not as pronounced as tremor)
- Craving alcohol
- Inability to keep food down
- Delirium tremens (DTs)
Three or more of these symptoms may be considered as requiring detox, while many medical professionals feel that the last three, when present together, nearly always necessitate medically supervised detoxification. People who have had, or begin to develop, DTs should always be medically supervised if they try to stop their drinking or reduce consumption. In addition, the effects of alcohol withdrawal in an individual who has experienced DTs can continue to affect the system for at least a year.
When an alcohol dependent drinker ceases to drink their physical symptoms will usually last for up to seven days, although a craving for alcohol may persist for weeks or months.
Detox, Rehab Or Home Withdrawal?A percentage of people are able to undergo an alcohol detoxification process at home, although it can be demanding not only of them but of those who help them through the process. The choice of whether to detox at home, in a detox unit or to go through a complete rehabilitation process should be made with medical guidance, as the dependent drinker is rarely in a position to make good choices about long-term sobriety whilst still consuming alcohol.
Many doctors will prescribe a medicine that will be used as a short-term treatment for anxiety to help the drinker over the initial symptoms and one key feature of detox failure is the tendency of alcohol-dependent drinkers to continue with this anxiety medication (often diazepam or something similar) for months or even years after the detox is complete. Usually the prescription is made to provide for reduced dosage to be taken over days or, at most, weeks, but it is relatively common for detoxing drinkers to remain on medication for much longer, thus transferring a part of their physical dependency from alcohol to a drug regime.
If this seems a likely problem or is something the drinker has experienced in the past, it is important to consider a medically supervised detox which may provide a more structured environment in which to reduce pharmaceutical dependency.
If a home detox is planned, encouragement and reinforcement are as important as the physical presence of a friend or family member who will help the drinker to get through the withdrawal process. If the chosen supporter or supporters are likely to ‘give in’ when the drinker starts begging for alcohol, or to minimise the effects that alcohol has played in the drinker’s life, they are not the right people to take part in detox at home. It is important that those who work with a home detoxing drinker can be supportive but firm and can themselves commit to not drinking during the detox period, as the presence or smell of alcohol can trigger full blown symptoms in the detoxing drinker and also cause emotional upset and even trigger rage. Regular encouragement to continue the detox and strong reinforcement of the benefits the drinker will obtain are essential to success.
Post Detox ProblemsMany successful detoxers then lapse almost as soon as they leave their homes because they have not given enough attention to restructuring and redefining their lives, post-alcohol. From the simple behaviours such as changing a route home so that you don’t pass a favourite pub or off-licence through to the complex demands of rebuilding a social life when all your friends and haunts are alcohol-related, ambushes and pitfalls await the newly-sober person at every turn. Successful detoxers undertake this theoretical work in advance. The theory is reinforced by constant discussion with and support from family and friends during detox so that by the time they are over their withdrawal symptoms, they have a clear picture of their future life, without alcohol, and a plan for living that has removed many of the risk elements associated with their old habits and behaviours.
A good support system includes buddying with others who agree not to drink on the night they are with you, not to talk about alcohol and to enjoy a non-alcohol related behaviour in your company, so that the drinker gets the habit of living, and liking, a sober lifestyle.
One often under-regarded cause of failure is the tendency for a single individual to take the whole burden of supporting a dexoter. If the individual themselves drinks, sooner or later they will end up drinking, talking about drinking or recovering from alcohol in the presence of the detoxer, which can lead to a relapse, and even if they don’t drink, the intense mental and emotional strain, not to mention the physical hard work, involved in looking after a detoxer can cause another individual to give up, become ill or simply walk away during the detox process.