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Alcohol Withdrawal

Alcohol kills more people than opioids each year. While the opioid crisis is well-deserving of the attention it receives, society still allows for thousands of people to harm themselves and others by drinking alcohol. Totals from 2006-2010 in the United States show that over 100,000 people died from alcohol-related causes. From liver disease to various types of cancer, chronic alcohol use is associated with a host of serious health issues. Numbers from 2010 estimate the economic burden in the United States was around $249 billion.

Unfortunately, the numbers also show how few people actually get the help they need. Overall around less than 10% of the people needing treatment are able to benefit from quality detox followed by a long-term treatment program to address their substance use, as well as the underlying factors.

What Is Alcohol?

Alcohol is produced when certain combinations of grains, fruits, or other sources of sugar are fermented. The process of fermentation results in carbon dioxide (the bubbles in alcoholic beverages) and ethanol, which produces the intoxication effect after drinking it.

Almost all cultures and modern societies have rituals around the use and enjoyment of alcohol. In the United States, it’s legal and regulated, but it’s important to know when you or someone you love has become unable to control their drinking.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the standard tool for clinical professionals and researchers for the classification of mental health and substance use disorders. The DSM-5 includes Alcohol in its “Substance-Related and Addictive Disorders” category and outlines the dangers of use, abuse, and dependence.

Review some of the following to see if they apply to you, or someone you love:

  • Has alcohol been consumed in larger amounts, or over longer periods of time than intended?
  • Have attempts to stop on your own have been unsuccessful?
  • Are there cravings or strong urges to use?
  • Is there continued use despite negative social, financial, emotional or physical consequences?

The central nervous system (CNS) consists of the brain and the spinal cord. It is constantly communicating with cells and organs to ensure the body is functioning properly. The brain and the body are constantly seeking harmony in order to function well. The medical term is homeostasis, and it means that when anything disrupts the CNS, efforts must be made to return to a certain level of stability. For example, when the body becomes hot from exercise or being outside in the sun, we sweat in an effort to cool off or reach the previous level of homeostasis.

Over time, alcohol use will interfere with the CNS’ ability to return to a balanced state.

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How Alcohol Affects the Brain

Everything we do affects our central nervous system. The foods we eat, how much sleep we get, the quality of the air and water we ingest, and even things like stress and unseen toxins in cleaning products will have some kind of an effect.

Alcohol enters the bloodstream, and from there, it travels to the other systems like the heart, the liver, and the brain where the depressive effects are most noticeable. The alcohol will slow the response times of neurotransmitters that send signals for functions like heart rate and breathing. The liver is the workhorse of the body and alcohol is metabolized through the liver. A healthy human liver can process one unit of alcohol per 60-90 minutes. That means roughly one pint of beer, one standard glass of wine, or one alcoholic beverage with a one ounce shot per hour.

When alcohol is taken in addition to other substances like opioids, the side effects of alcohol intoxication can range from manageable to life-threatening such as: slurred speech, impairment in attention or memory, depressed breathing, slowed heart rate, stupor or even coma. For example, both alcohol and opioids have depressive effects on breathing and heart rate, so combining the two can be lethal.

Alcohol poisoning is the result of too much alcohol present in the bloodstream. Everyone will react differently to an excessive amount of alcohol; therefore it’s important to recognize the warning signs of potential alcohol poisoning and know what to do.

Some signs to be concerned about: cold, clammy skin, vomiting, seizures, slowed breathing. Do not let someone “sleep it off” if you’re worried they may have alcohol poisoning, as their breathing and heart rate could stop in their sleep. They could also vomit and not be able to clear it from their throat, causing them to choke on the vomit and die from lack of oxygen. Call 911 if you are worried someone might be suffering from alcohol poisoning.

What You Can Expect From Alcohol Withdrawal

A Timeline of Withdrawal Symptoms

Alcohol withdrawal can be fatal and should not be undertaken alone. The extent and severity of the withdrawal symptoms will depend on the type, frequency and amount of alcohol used by the individual. Typically the experience of withdrawal involves the opposite of the effect the drug produced. For example, because we know alcohol suppresses the heart rate, one might experience a racing heartbeat when they stop drinking.

Withdrawal symptoms can be acute or chronic. Acute withdrawal symptoms usually begin within four to twelve hours after reduction in use and can include:

  • Nausea or vomiting
  • Sweating
  • Increased heart rate (over 100 bpm)
  • Psychomotor agitation
  • Insomnia
  • Anxiety or depression
  • Tremors
  • Temporary visual, tactile, or auditory hallucinations
  • Seizures

In extreme cases, chronic withdrawal symptoms can begin days after the last drink, continue for 14 days or more after the last use, and will often be a less severe experience of the symptoms that occurred during the acute phase.

In some cases, some withdrawal symptoms can continue to a lesser degree for months after stopping use of alcohol. Sleeping problems, for example, can persist long after someone has stopped drinking.

It is critical to get the help you need to successfully manage withdrawal symptoms and begin a life without the use of alcohol.

Long-term alcohol use can negatively affect nearly every organ system, notably the gastrointestinal, cardiovascular, immune, and the central and peripheral nervous systems. The risk of certain types of cancer, such as liver, stomach, and breast cancer, increases with prolonged use over time.

When medically managed, most of the severe withdrawal symptoms are alleviated within seven to ten days.

However, it is important to note that treatment following a medically managed detox will result in a better success rate. Safely removing alcohol from the brain and body is only the first step.

There are other psychological, emotional and behavioral issues to address that will set you up for continued sobriety.

What Are the Alcohol Withdrawal Treatment Steps?

When seeking treatment, it’s important to understand the difference between the various levels of care so you can get the most out of your treatment experience.

Medical detoxification, or simply detox, is a medically managed detoxification from alcohol. Following a thorough history and physical examination, the medical staff will determine the best medication protocol to manage your withdrawal symptoms safely. A full detox can take from three to 10 days, depending on the severity and extent of the drinking and is up to the discretion of the medical providers.

Medical complications, using more than one substance, or a history of mental health diagnoses are all examples of when a detox may take longer than usual. Treatment centers will require you to successfully complete detox in order to safely and fully participate in their programs.

Detox can take place in a hospital setting if you have severe or unmanageable medical complications, or it can take place in a standalone detox facility. These standalone, privately run facilities must be staffed 24 hours a day with medical personnel, as well as support staff, to monitor your symptoms and ensure the safest, most comfortable experience possible. Specially trained staff will know how to observe your progress throughout the detox process and will be able to respond to any potentially life-threatening situations.

Residential treatment typically follows a successful detox and involves living on site and participating in a variety of therapy. Individual sessions with a trained therapist, as well as group and family therapy sessions, are some of what is required at each residential facility. It’s during this time you will be examining patterns of thoughts, emotions, and behaviors that may have contributed to your substance use. Residential treatment length of stay will vary depending on your needs, but can typically last from 30 – 90 days following the detox.

Outpatient treatment is intended for those individuals who are in a more stable position medically, physically, and emotionally. After the support from detox and residential care, the activities of daily living on your own are more manageable, and you will remain involved with outpatient treatment to continue your journey of recovery.

You will continue to participate in therapy on a less frequent basis and maintain connections with your support system and therapist. This is an important part of your recovery, as it will allow you to transition to the next phase of your life with the support that played such a beneficial role.

Medication-Assisted Treatment, or MAT, is typically a form of outpatient care. It is intended to support those suffering from opioid or alcohol use disorders with a form of medication administered on a longer term basis than the typical medical detox. FDA-approved medications for the treatment of alcohol use disorder are designed to manage withdrawal symptoms, reduce or eliminate cravings to drink, and help prevent relapse. Naltrexone is a commonly used medication for those who want to stop drinking. Taking naltrexone will block the euphoric effects of drinking.

For these reasons, some studies suggest there are better outcomes for those addicted to alcohol who participate in medication-assisted treatment following detox. Some form of therapy and medical supervision will still take place during MAT, and your provider can assess whether this option is right for you.

In a recovery treatment program, you will be able to address the physical, psychological, medical, and social aspects of the alcohol addiction, learning through various therapeutic tools how to manage your addictive behaviors effectively and maintain long-term sobriety. This is done through a customized treatment plan, which you will customize with your therapist, and may include some of the following common treatment modalities:

Again, it is critical to note the best outcomes for the treatment of alcohol addiction are associated with participating in the full spectrum of care. A detox treatment alone won’t give you the benefits or the support of a full continuum of therapy. There are many reasons that substance use may have grown into an addiction, but what’s most important is focusing on the resources and solutions that will help you find a new life free from alcohol use.

If You’re Suffering from Alcohol Addiction, We Can Help

If you or a loved one is struggling with alcohol abuse or addiction, it is important that you treat it with the seriousness it requires and get help before it is too late.

At California Highlands Addiction Treatment, we offer quality detox as well as residential treatment and can provide the resources, support, and specialized treatment needed to get you or your loved one back on your feet and on the path to lasting sobriety.

Call (855) 905-0828 now for a free and confidential consultation with one of our specialists, who are available around the clock to help you navigate your treatment options, verify insurance, and answer any questions you might have. Call now or contact us online for more information.

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Alcohol Facts and Statistics. (2018, August). from

Baylor, C. (2015, July 21). Medication-Assisted Treatment (MAT). from

Centers for Disease Control and Prevention. Alcohol Related Disease Impact (ARDI) application, 2013. from

How Is Alcohol Poisoning Defined? (2018, September 13). from

National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. from

National Institute on Drug Abuse. (n.d.). 3: The reward pathway. from

What is Homeostasis? (n.d.) from

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