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Alcohol Detox Medication

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What Does it Mean to ‘Detox’ From Alcohol?

Detoxification (detox) is the process by which the body rids itself from toxins, including alcohol and drugs. 

Chronic alcohol use changes body chemistry, which may have negative effects on how the body looks and functions. Some of these changes are reversible when a person quits drinking. Others will just stop progressing, but do not reverse. However, some changes will continue to progress even after stopping drinking.

Alcohol detoxification is the first step of effective treatment for alcohol abuse. Without it, people can suffer from severe alcohol withdrawal symptoms if they try to stop drinking abruptly.

Alcohol withdrawal is a serious condition that must be treated in a medical detox program.

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Types of Alcohol Detoxification Programs

Even minimal alcohol use can cause acute alcohol withdrawal symptoms. 

For more severe alcohol use disorders (AUDs), symptoms of alcohol withdrawal can turn serious and or even fatal. Because of this, treatment providers suggest various levels of alcohol detoxification:

Outpatient Detox

Outpatient detox is a type of treatment that allows you to manage alcohol withdrawal from the comfort of your own home.

During outpatient detox, a treatment provider will assess the level of care you need and determine the need for medication(s) to ease symptoms and help you recover.

Outpatient detox has several benefits, including added social support and the ability to travel freely to and from the treatment facility.3

It’s important to understand that outpatient detox should only be used to treat mild symptoms of alcohol withdrawal. These include:

  • Nausea
  • Vomiting
  • Hand tremors
  • Anxiety
  • Diarrhea
  • Insomnia 

Medical Detox

Medical detox treatment is an ideal option for those with severe alcohol dependence and withdrawal symptoms.

One primary symptom to look out for is delirium tremens (DTs), which is a sign of severe alcohol withdrawal. During DTs, cessation of alcohol impacts the central nervous system (CNS).5 

Long term alcohol consumption increases the chances of delirium tremens occurring. It also typically worsens withdrawal severity.

Other symptoms of withdrawal in this stage include:

  • Seizures
  • Hallucinations
  • Delirium
  • Confusion
  • Agitation
  • Tachycardia, or increased heart rate
  • High blood pressure
  • Fevers
  • Shaking

What to Expect During Alcohol Detox

The type of treatment you receive will depend on the severity of withdrawal symptoms you experience, your level of alcohol abuse, and how long you’ve been living with alcohol addiction. It’s best to consult your doctor or treatment facility for medical advice.

During outpatient detox and medical detox, you may receive medication-assisted treatment (MAT) to manage alcohol withdrawal symptoms. 

In an outpatient treatment setting, sessions usually last about an hour. During this time, you will:

  • Take medications to manage symptoms
  • Receive monitoring from a medical treatment team
  • Return home or continue day therapy

Time spent in therapy can span over a couple of hours. Studies show that combining psychotherapy with outpatient detox is effective at helping sustain abstinence from alcohol. 6

During medical detox, you will not receive therapy or group counseling. Instead, a provider will monitor your health by:

  • Taking vital signs
  • Monitoring your bowel movements
  • Observing your food intake
  • Administering daily assessments 
  • Conducting rounds and wellness checks every couple of hours

People with more severe withdrawal symptoms might not have the energy to even get out of bed, much less attend group sessions. Medical detox programs accommodate these needs by ensuring severe symptoms do not turn more serious.

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4 Medications That Can Treat Alcohol Withdrawal

Medication is commonly used to help alleviate both mild symptoms and severe symptoms of acute alcohol withdrawal. These medications help manage symptoms and treat co-occurring disorders alongside AUD.

Here are four medications that are approved to treat alcohol withdrawal symptoms:

1. Benzodiazepines 

Benzodiazepines (benzos), like Ativan and Lorazepam, can reduce the risk of alcohol withdrawal seizures. They help manage alcohol withdrawal symptoms like anxiety, fast heart rate, and high blood pressure.

Benzos can also help treat co-occurring disorders of AUD such as anxiety and post-traumatic stress disorder (PTSD).

Although benzos can help during alcohol detox, the sudden cessation of these medications can also induce seizures. Follow your treatment provider’s instructions and take these medicines as prescribed.

2. Naltrexone

Naltrexone reduces cravings in people with AUD. This is an important part of upholding sobriety.8 Naltrexone can be taken orally once or twice a day in pill form. This pill is sold under the name Revia.

Vivitrol can also be administered via injection. This injectable version is known as Vivitrol. It can be taken once every four weeks. 

Naltrexone reduces the “pleasure” associated with alcohol, making it easier for people to:

  • Reduce alcohol cravings
  • Reduce the need to drink alcohol 9
  • Stop drinking more easily

3. Disulfiram

This medication is commonly known as Antabuse. It is an FDA-approved medication that has helped people with AUD quit drinking since the 1950s. 

The medication works by reducing the liver’s ability to process alcohol. This leads to negative side effects that discourage people from drinking. 10 Side effects include:

  • Nausea
  • Upset stomach
  • Racing heart
  • Hot flashes
  • Vertigo

Disulfiram is administered 12 hours after someone’s last drink. It is given in pill form once a day and is effective for one to two daysafter the last dose. 

4. Acamprosate

Acamprosate is sold under the name Capral. It is a drug approved by the FDA to reduce the negative effects of alcohol withdrawal. Studies show that Acamprosate reduces the risk of relapse and increases the number of days of abstinence from alcohol.11

This medication is administered via two pills, three times a day. It is administered more often than Naltrexone and Disulfiram and is a safe medication for people with liver disease. It is also well-tolerated.

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How Long Does Alcohol Detox Take?

The length of detox depends on the person’s level of dependence. In general, studies have shown the average length of detox in an outpatient setting is 6.5 days. However, for people with more severe symptoms, treatment lasted, on average, between 9.5 and 10 days.

After detox, people still must attend recovery groups and meetings to maintain sobriety and get to the root cause of their alcoholism.

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Updated on May 26, 2022
11 sources cited
  1. U.S. National Library of Medicine. (1 Jan. 1970). 1 overview, essential concepts, and definitions in detoxification. Detoxification and Substance Abuse Treatment [Internet].
  2. Trevisan, L. A., Boutros, N., Petrakis, I. L., & Krystal, J. H. . Complications of alcohol withdrawal: Pathophysiological Insights. Alcohol health and research world. 
  3. Hayashida, M. . An overview of outpatient and inpatient detoxification. Alcohol health and research world. 
  4. U.S. National Library of Medicine. (n.d.). Delirium tremens: Medlineplus medical encyclopedia. MedlinePlus. 
  5. ML;, M. (n.d.). [delirium tremens. recent neurophysiologic concepts and therapeutic outlook]. Cahiers d'anesthesiologie. 
  6. Soyka, Michael & Horak, Michael. . Outpatient Alcohol Detoxification: Implementation Efficacy and Outcome Effectiveness of a Model Project. European addiction research. 10. 180-7. 10.1159/000079840. 
  7. Sachdeva, A., Choudhary, M., & Chandra, M. (Sept. 2015). Alcohol withdrawal syndrome: Benzodiazepines and beyond. Journal of clinical and diagnostic research : JCDR. 
  8. Naltrexone for alcoholism. American Family Physician. (15 Mar. 2000). 
  9. What Is Vivitrol? Psychiatric Research Institute (PRI), University of Arkansas for Medical Sciences.
  10. Stokes, Maranda. (1 Nov. 2021). Disulfiram. StatPearls [Internet].
  11. Witkiewitz, K., Saville, K., & Hamreus, K. . Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility. Therapeutics and clinical risk management, 8, 45–53.

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