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Should I Detox from Alcohol at Home?

If you have been drinking heavily for a long period of time and want to get sober, you may be thinking of detoxing at home.

The prospect of a home detox may be appealing because there's no real cost, it's comforting to be in your own house with your loved ones, and it allows for privacy.

However, alcohol has one of the most dangerous withdrawal syndromes of all substances, so while it may seem like a good idea to stay home, it could be a fatal mistake.

Is Home Detox Safe for Alcohol Withdrawal?

Plenty of online articles suggest that a home alcohol detox will work provided you take their tips, but at-home withdrawal from alcohol is dangerous and generally not recommended. In people with significant physiological alcohol dependence, alcohol withdrawal may involve a slew of mental and physical health symptoms, some of which can threaten the life of the individual.1

Delirium tremens (DTs) is the most severe form of alcohol withdrawal; it involves changes in mental state (such as severe confusion/delirium), hallucinations, stupor, body tremors, agitation or restlessness, and rapid mood changes. These symptoms can occur as soon as 48 hours after the last drink and can last up to 2 weeks.2,4 The development of DTs is a medical emergency that requires immediate care. Someone who develops this severe condition at home will not have the same quick access to medical treatment as someone already in an inpatient medical detox program.

What withdrawal from alcohol feels likeAlcohol withdrawal seizures are another serious symptom that can make it unsafe for you to try detoxing at home. These can occur in the presence or absence of DTs. Seizures are most common in the first 48 hours after your last drink and they may be fatal when not addressed immediately.6

Furthermore, basic body functions like temperature, pulse, and blood pressure can become very dysregulated during alcohol withdrawal, the consequences of which may be severe.6 At home, these vitals won't be monitored and, consequently, any changes may not be addressed, raising the risk of any related complications. Similarly, alcoholics commonly suffer from other serious medical conditions that can become life-threatening if not managed properly, such as cardiomyopathy, liver disease, and gastrointestinal bleeding.6

Who Is Most at Risk for DTs?

The following may increase a person’s risk for developing DTs:2,4,6

  • A history of heavy alcohol use. DTs are common among those with a history of drinking heavily for 10 or more years.
  • Malnutrition.
  • Older age (over 30).
  • Head injury, illness, or other concurrent medical or psychological health issues.
  • Previous episodes of alcohol withdrawal.
  • History of previous DTs or seizures.
  • More than 2 days between the last drink and the onset of withdrawal.

Despite there being known factors that increase the chances of experiencing certain alcohol withdrawal symptoms, it is still impossible to predict with 100% accuracy who will experience life-threatening complications like DTs.6 This uncertainty adds to the risk of detoxing at home.

What Can I Expect During Withdrawal?

There are a variety of physical and psychological signs and symptoms associated with alcohol withdrawal that may arise as soon as 6 to 8 hours after the last drink and last for days to weeks depending on the individual's unique withdrawal experience.1,3,6 Acute alcohol withdrawal symptoms can range from mild to severe, and the intensity of any one person's alcohol withdrawal experience may depend on several factors such as the how long they've been dependent and how much they drink regularly. Other determinants of withdrawal severity include:6

  • Age.
  • General health status.
  • Nutrition.
  • Existing physical or psychological disorders.

Alcohol withdrawal symptoms may include:1,3,6

  • Irritability.
  • Changes in mood such as an increase in feelings of anxiety or depression.
  • Trouble sleeping.
  • Restlessness
  • Shakiness or body tremors.
  • Nausea/vomiting.
  • Increased heart rate and/or palpitations.
  • Sweating.
  • Hallucinations (seeing or hearing things that aren’t there).
  • Seizures.
  • Delirium.

Individuals quitting alcohol can expect withdrawal to begin within the first 48 hours and last approximately 5-7 days, although the specific onset and duration will be unique to each detoxing individual.6

Alcohol cravings are another obstacle that a person may face shortly after they quit drinking. In the early days of recovery and beyond, cravings can compel a person to relapse and start drinking again. Alcohol is legal to purchase, easy to access, and constantly on hand in many households. For someone attempting to detox in their home environment, the temptation to reach for a drink can be overwhelming. Professional detox programs offer not only the peace of mind that comes with knowing medical care is available, if needed, but also the sober environment, structure, and support needed to avoid relapse. Cravings can be addressed in post-detox treatment with therapy (e.g., cognitive-behavioral therapy), mindfulness techniques, and sometimes with medications such as naltrexone.

What Does Inpatient Detox Involve?

The American Society of Addiction Medicine (ASAM) proposes 5 levels of care for substance dependence ranging from outpatient with minimal monitoring to medically managed intensive inpatient care.6 Because it can be difficult to predict who will experience severe or complicated alcohol withdrawal, it is generally not recommended that a person undergo detox without medical care. To be sure, the safest ideal environment will always be an inpatient one. Inpatient detox programs will likely begin with an initial evaluation to determine your individual needs. You may also receive some information on common withdrawal symptoms and what to expect.

Inpatient detox is able to provide round-the-clock supervision and support from a variety of healthcare professionals including doctors and nurses. It is inherently safer than at-home detox since any physical symptoms of withdrawal can be managed in a controlled setting. You might also be prescribed medications to manage your symptoms.

Benzodiazepines are currently the treatment of choice, but treatment may also include the use of barbiturates, beta blockers, antipsychotics, or anticonvulsants.1,4,6 Detox staff may also discuss your options for medication-assisted treatment (the use of medications, such as acamprosate, combined with therapy), though for the most part, detox needs to be complete prior to the initiation of these types of medications.

Female patient talking to doctor, talking about detox conceptInpatient alcohol detox may take place in a hospital or other acute care setting so that you have access to the medical staff and equipment necessary to safely monitor and manage your alcohol withdrawal. This might take place in a general hospital, a psychiatric hospital inpatient center, or an addiction treatment center.6 Most treatment centers have free consultations to help you decide what might be the right program for you.

The UK's National Institute for Health and Care Excellence (NICE) recommends that alcohol detox be part of a structured treatment plan that also includes relapse prevention and support to enhance long-term care.5 Detox is a critical component of recovery but not the only one. One study showed that individuals who attended an abstinence preparation group were more aware of what to expect during medical withdrawal and, as a result, had better outcomes in terms of abstinence rates and aftercare participation.5 In a professional detox program, you will get the information you need about your detox, support from staff, and linkage to the continued treatment so critical for those who wish to move forward in their recovery from alcoholism. The detox program may also incorporate some other facets of treatment to help you begin to address behavioral aspects of your addiction, such as 12-step groups and counseling.

What If I Can't Afford Detox?

Some private insurance plans will cover inpatient detoxification when it is considered medically necessary. If you have Medicare or Medicaid, you will likely qualify for free or low-cost alcohol treatment but there are often restrictions—coverage could vary based on what state you are in or what type of treatment you are seeking. You might also qualify for grants that can cover the cost of treatment.

Considering the severe and sometimes fatal risks of alcohol withdrawal, the price of not getting help can be much higher than the monetary cost.

You can call and verify your benefits with your insurance provider, but many treatment facilities will also help you understand your coverage and determine your eligibility. The main point here is that you know there are options for you to get the alcohol treatment you need in a safe environment that promotes success. Considering the severe and sometimes fatal risks of alcohol withdrawal, the price of not getting help can be much higher than the monetary cost. And there are enough options out there that financial concerns should not be your first priority. If you need help and don't know where to begin, reach out today.

References

  1. Hoffman, R.S., & Weinhouse, G.L. (2017). Management of moderate and severe alcohol withdrawal syndromes.
  2. Hurd, R. (2017). Delirium Tremens.
  3. Hurd, R. (2017). Alcohol Withdrawal.
  4. Kattimani, S., & Bharadwaj, B. (2013). Clinical management of alcohol withdrawal: A systematic review. Industrial Psychiatry Journal, 22(2), 100-108.
  5. Kouimtsidis, C., Sharma, E., Charge, K., & Smith, A. (2016). Structured intervention to prepare dependent drinkers to achieve abstinence: results from a cohort evaluation for six months post-detoxification. Journal of Substance Use, 21(3), 331-334.
  6. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45, pages
  7. Yedlapati, S.H., & Stewart, S.H. (2018). Predictors of Alcohol Withdrawal Readmissions. Alcohol & Alcoholism, 53(4), 448-452.
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