Alcohol abuse creates many serious health problems in the United States, where around 27 percent of adults fit the criteria for alcohol abuse, according to Mary McKinley in the June 2005 edition of Critical Care Nurse. Many people undergo alcohol detoxification, either voluntarily, on their own or under the guidance of an addiction clinic, or involuntarily, such as during an unplanned hospitalization. Detoxification without medical supervision can have serious, even life-threatening, consequences.
Setting
While many people undergo alcohol detoxification in a planned program under pressure from family members or of their own volition, only 10 to 20 percent of people go through alcohol withdrawal in an inpatient setting, lead author Dr. Max Bayard reported in the March 2004 issue of American Family Physician. If delirium tremens, commonly known as DTs, occur, 1 to 5 percent of patients die in the process of detoxification, Bayard warns, making home treatment without medical supervision dangerous. As many as one in five hospital patients abuse alcohol, McKinley states. Alcohol addiction may not be recognized in hospitalized patients admitted for another diagnosis until severe symptoms occur.
Symptoms
People who drink heavily may notice symptoms within five to 10 hours after their last drink, even though they still have measurable amounts of alcohol in their system. Symptoms of alcohol detoxification include anxiety, clouded thinking, fatigue, shakiness, sleep disturbances, irritability, sweating, nausea and vomiting. Headache, clammy skin and rapid heartbeat can also occur. Severe symptoms include fever, severe agitation, seizures or delirium tremens, characterized by hallucinations, rapid breathing and rapid heart rate, usually beginning around two days after alcohol withdrawal and lasting two to three days.
Methods
Benzodiazepines such as Librium and Valium are most often used in alcohol detoxification, since they prevent or treat the serious side effects of detoxification, such as seizures or delirium, Bayard states. Because most alcoholics are deficient in thiamine, oral or injected thiamine is often given for several days. Beta blockers may be prescribed for people with coronary artery disease, since their hearts may not tolerate the strain of withdrawal. Intravenous fluids help maintain hydration levels.
Risks
While alcohol detoxification has risks, the benefits far outweigh the risks if detoxification occurs in a supervised setting. Close monitoring of vital signs and blood work to assess the effect of detoxification on the body's systems help prevent serious complications such as delirium tremens or seizures.
Prognosis
Follow-up with medical management and programs such as Alcoholics Anonymous or other support group helps an alcoholic refrain from alcohol after detoxification. Changes in sleep patterns, fatigue and mood changes may persist for months after alcohol withdrawal, according to Drexel University College of Medicine. Even people who stop drinking may experience long-term damage to organs such as the liver.
