Alcohol Detox: One Family’s Story
Wednesday, July 27th, 2011

People who have never seen someone undergoing alcohol detox have no idea how severe the symptoms can be.  This is especially true of delirium tremens, which is the most severe form of alcohol withdrawal. Delirium tremens is most common in people who drink the equivalent of 7-8 beers on a daily basis for several months and in people who have been drinking heavily for 10 years or more.

I recently interviewed a married couple who shared the story of their experience with alcohol detox and delirium tremens.  Ann and Steve (not their real names) are the parents of two teenage boys.  Shortly after the birth of their youngest son, Steve became anxious and began to increase his alcohol consumption.  Soon he was consuming 2 six packs of beer per day and getting up in the middle of the night to drink wine.  He stopped eating regular meals and his personal hygiene suffered.

Steve had previously been very athletic and health-conscious, so Ann was naturally concerned about the change in his behavior.  She finally talked him into making an appointment with their family doctor.  The day before his appointment, Steve decided to stop drinking.  Over the next few hours he became increasingly agitated.  He became extremely pale, his hands began to shake and he was nauseous.  Suspecting that Steve was going through severe alcohol detox, Ann took their children to a sitter's house.   When she returned, his condition had worsened.  He had been vomiting and now he had dry heaves.  He decided that a glass of wine would help "calm his nerves."  As he stood up to go to the kitchen he emitted an involuntarily yell and fell to the floor in a grand mal seizure.

Ann recognized what was happening and did what she could to keep Steve from harming himself during the seizure, which lasted just a minute or so but seemed longer.  She then called the doctor's office and was told to get Steve to an emergency room as soon as possible.  Steve was in a dazed state, but with a neighbor's help Ann was able to get him into their van.  (Later she would wonder why she had not called 911).  He lay on the floor during the short drive to the hospital and was unconscious by the time ER workers placed him on a gurney.  In the emergency room, Steve suffered three more grand mal seizures.  Based on comments made by ER personnel, Ann knew his alcoholism was life-threatening situation.

Steve was admitted to the hospital and given medication to help him sleep.  When Ann returned the next day, he was sitting up in bed and talking.  He was far less agitated but was delusional, referring to the hospital as a school and the nurses as teachers.  He remained delusional for the next 24 hours and Ann began to wonder if he had suffered irreversible brain damage.  By the next day he was more rational and though in a weakened state was ready to be released.  Before Steve left the hospital, his neurologist told him that his alcohol detox had nearly been fatal.  If he wanted to see his sons grow up he would have to stop drinking immediately.  The doctor's words affected Steve deeply.  He successfully completed alcohol treatment and has remained sober for more than a decade.

The Role of Stress in Alcohol Substance Abuse
Friday, July 22nd, 2011

Substance abuse studies have found that many people use alcohol to cope with the stress of modern life.  The demands of work, family and finances can be unrelenting, especially for people who have little social support.  Natural disasters and other tragic events in the news add another layer of stress.  Using alcohol to relax and "get away from it all" can be safe in moderation, but attempting to deal with chronic untreated stress by drinking can lead to alcohol substance abuse.

Alcohol Substance Abuse and Early Childhood Experiences

Researchers have found that there appears to be a link between a drinker's early childhood experiences and the use of alcohol to deal with stress.  Exposure to traumatic experiences in infancy and childhood may shape an individual's stress response and contribute to a predisposition for alcohol substance abuse.  The relationship between stress and alcohol abuse is even more marked when healthy coping mechanisms and a strong social support system are not present.

According to the National Institute on Drug Abuse, children and teenagers who experience trauma from violence or a disaster have a greater change for developing drug or alcohol substance abuse problems later in life.  Early intervention for depression and anxiety can help reduce the risk of substance abuse.  The Anxiety Disorders Association of America reports that about 20 percent of Americans who have been diagnosed with an anxiety or depression have a drug or alcohol substance abuse disorder.  Ironically, the symptoms of one disorder can worsen the symptoms of the other.

Stress and Alcoholism Relapse

While there is no evidence that stress alone will lead to alcoholism, stress can be a factor in alcoholism relapse.  Recovering alcoholics who suffer a relapse will often cite chronic stress as the reason that they began drinking again.  One way to avoid this type of relapse is by meeting with other recovered drinkers and creating a network of support.

Getting help for an alcohol substance abuse problem will not eliminate problems related to stress and anxiety.  Both problems should be treated at the same time in order to reduce the chances of alcohol abuse relapse.

Alcoholism and Alcohol Abuse
Tuesday, July 19th, 2011

Alcohol plays an important role in our culture.  From winding down after work with a drink to enjoying a bottle of wine with dinner to toasting a special event with champagne, alcohol is a constant presence in many people's lives.  Because drinking is so familiar, it may not be obvious when someone's use of alcohol has crossed the line from a fun social activity to alcohol substance abuse.

Experts in alcoholism draw a distinction between alcoholism (also known as alcohol dependence) and alcohol substance abuse.  For alcoholics, every aspect of life is affected by their drinking, including relationships, work, finances and health.   Despite the enormous difficulties in their lives caused by alcohol, they continue to drink.  Those who are described as alcohol substances abusers are in an earlier stage of the disease.  Their alcohol use has some self-destructive aspects, but they have some control over the problem and are able to set limits on their drinking.

Many alcohol substance abusers are at high risk of becoming alcoholic. Some alcohol abusers move into alcoholism following a crisis or life-changing event, such as divorce, loss of a job or death of a loved one.  For other alcohol abusers, the shift to alcoholism is gradual.  They begin to drink more as their tolerance for alcohol increases or they start to spend more time focusing on drinking.

Anyone who drinks needs to be aware of the warning signs of alcohol substance abuse:

  • Taking risks with alcohol.  This may include drinking and driving or mixing alcohol with prescription drugs.
  • Ignoring responsibilities and commitments. Due to drinking or a hangover, responsibilities at work, home or school are neglected.
  • Continuing to drink despite problems.  Even though relationships are suffering, the drinker does not change his or her behavior.
  • Needing alcohol to relax. Alcohol once made the drinker feel good, but now is needed to avoid feeling bad.

Alcoholics also exhibit these signs, but in addition they have developed a physical dependence on alcohol.  They need alcohol to function on a daily basis and have a physical urge to drink.  They have developed a tolerance for alcohol, which means that over time they have to increase the amount of alcohol they drink to feel the same effects.  When they stop drinking, they experience physical withdrawal symptoms.  Even if they want to stop drinking, it may not be possible.

There are a wide variety of treatment programs available for alcoholics and alcohol substance abusers who recognize that they have a problem.  Outpatient treatment programs, residential rehab and 12-step support groups are just a few of the options for recovery.  The most important step on the road to recovery is reaching out for help.

The Alcohol Detox and Withdrawal
Friday, July 15th, 2011

When a heavy drinker attempts alcohol detox by quitting cold turkey, he or she can experience a variety of alcohol withdrawal symptoms.  These symptoms may range from minor problems like shakiness and insomnia to more severe symptoms including delirium tremens and seizures.  While detox may seem like an intimidating option, rest assured that doctors in inpatient rehab are very skilled at administering medications that make the detox process safer as well as easier to endure.

Doctors make a diagnosis of alcohol withdrawal when two or more of the following occur within a few hours or a few days after drinking has stopped:

  • Insomnia
  • Hand tremor
  • Heartbeat greater than 100 beats per minute
  • Nausea and vomiting
  • Visual or auditory hallucinations
  • Delusions
  • Anxiety
  • Agitated movement
  • Grand mal seizures

According to the Association of American Family Physicians, alcohol detox can effect long-term changes on neurons in the brain, especially when a drinker undergoes detox more than once.  Recurrent detox episodes are believed to increase alcohol cravings.  It is also believed that withdrawal and detox will become progressively more serious each time it is experienced.

Many people who are undergoing alcohol detox and withdrawal can be treated as outpatients, but severe cases require hospitalization.  When severe symptoms of delirium tremens are present, especially hallucinations and seizures, a doctor should be consulted immediately.  The U.S. National Institutes of Health reports that the mortality rate for delirium tremens is approximately 15%.  Another reason for consulting a doctor during severe alcohol detox is that there is always a chance that what appear to be alcohol detox symptoms are actually indicators of another medical condition, especially if seizures occur more than 48 hours after the last drink was taken.

The goals of treatment for alcohol detox are to help the patient safely complete alcohol withdrawal and to prepare the patient for immediate treatment for alcohol dependence.  Depending on the patient's condition, medication may be administered to lessen the severity of alcohol detox symptoms.  Treatment of withdrawal symptoms alone will not address the underlying disease of addiction or help the patient achieve long-term abstinence from alcohol.


12-Step Alcohol Rehab Centers
Wednesday, July 13th, 2011

The 12-step program for addiction is the oldest and most common form of treatment.  It has been adopted by many alcohol rehab centers for both outpatient and residential inpatient treatment.  The program originated more than 70 years ago when it was developed for Alcoholics Anonymous by Bill Wilson and Dr. Bob Smith.  This widely-used form of alcoholism treatment combines fellowship with a set of principles known as the 12 steps to help recovering alcoholics maintain sobriety.

The 12-step philosophy is based on these principles:

  • Admitting that you are powerless in the face of addiction.
  • Recognizing that there is a Higher Power that can help restore your sanity.
  • Turning your life over to the Higher Power.
  • Examining your life and making amends for past errors.
  • Continually working towards your own and others' recovery.

The concept of support is key to 12-step programs.  It takes the form of support groups that assist in the recovery process and individual sponsors who provide one-on-one guidance.  A sponsor is a successfully recovered alcoholic who acts as a mentor and is available in times of crisis to help a recovering alcoholic avoid relapse.  Rehab centers that use a 12-step program use support groups throughout the treatment process.

Some alcohol rehab centers combine a 12-step approach with other treatment options which may include personalized individual counseling and family therapy.  Holistic treatments like yoga, meditation and nutritional counseling are also provided to help recovering alcoholics develop new life skills and coping mechanisms.

Many recovering alcoholics join Alcoholics Anonymous following release from a rehab center that utilizes a 12-step program.  They are assigned a sponsor and continue with group support sessions at Alcoholic Anonymous meetings.  Studies show that following up rehab center treatment with a program like AA increases the chances of maintaining sobriety over the long term.