Alcohol Detoxification

People undergoing alcohol detoxification show withdrawal symptoms in the process. Around 71% of individuals undergoing treatment show symptoms of alcohol withdrawal. Withdrawal affects people who are in the habit of drinking alcohol and they have suddenly decreased their alcohol intake or decided to stop drinking completely.  

Alcoholics experience withdrawal syndrome because alcohol enhances gamma-aminobutyric acid’s (GABA) inhibitory effects on signal receiving neurons. As a result, this lowers neuronal activity, which leads to an increase in excitatory glutamate receptors. With continued alcohol use, the user developed tolerance as GABA receptors become less responsive to neurotransmitters, and more alcohol is required to produce the same inhibitory effect.  

Thus, when an individual undergoes alcohol detoxification, he/she will still have the same number of excitatory glutamate receptors but without the suppressive GABA effect. This is due to the removal of the alcohol, which causes the signs and symptoms of alcohol withdrawal. 

Alcohol withdrawal symptoms appear within hours of cessation or decreasing alcohol intake. Symptoms include tremor, craving for alcohol, insomnia, vivid dreams, anxiety, hyperactive vigilance, and agitation, and irritability, loss of appetite, nausea, vomiting, headache and sweating. However, these symptoms will disappear within hours to days even without treatment. 

However, symptoms that should be a cause for concern for family members or close friends of patients are hallucinations, delirium tremens (DTs), and seizures. Visual hallucinations can occur within the first 2 days of decreasing or discontinuing alcohol intake during alcohol detoxification. This symptom can occur separately from DTs. DTs can occur within 2 to 4 days of the last drink. Moreover, this symptom can last up to 3 to 4 days. People experiencing DT’s feel disoriented. They have persistent visual and auditory hallucinations, agitation and tremulousness, and autonomic signs resulting from the activation of stress related hormones. These signs can include tachycardia, hypertension and fevers. 

People show different degrees in their withdrawal symptoms. Thus, an assessment of the patient should be done first before treatment. The assessment should include an assessment of the patient’s medical condition, coexisting medical and psychiatric conditions and severity of previous withdrawal symptoms, and the risk factors for withdrawal complications during alcohol detoxification. 

For healthy patients, who are experiencing mild to moderate withdrawal during treatment, can undergo treatment in their homes, but families have to make sure that patients do not have serious psychiatric illness.  

However, for patients who have a history of severe withdrawal syndrome, seizures or delirium, have serious psychiatric or medical illness, and they lack reliable support network in their family or friends, they should be treated in a clinic or hospital during alcohol detoxification. 

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