If you have been drinking very heavily most days, your body will have been struggling to deal with all the alcohol. If you begin to reduce or stop drinking you may start to feel ‘withdrawal’ symptoms 3-8 hours after your last drink, as the effect of the alcohol wears off.
The withdrawal symptoms include: feeling sick, trembling, sweating, craving for alcohol, and just feeling awful. Some people – not many – have convulsions (fits). As a result, you may feel that you have to continue to drink alcohol regularly to prevent these symptoms.
Delirium tremens (‘DTs’) is a more severe reaction after stopping drinking alcohol. About 1 in 20 people who have alcohol withdrawal symptoms get about 2-3 days after their last drink. Symptoms include: marked tremor (the shakes) and delirium (agitation, confusion, and seeing and hearing things that are not there). Some people have fits. Complications can develop such as dehydration and other serious physical problems. It is fatal in some cases.
What is detoxification?
Detoxification or ‘detox’ involves taking a short course of a medicine which helps to prevent withdrawal symptoms when you stop drinking alcohol. The most commonly used medicine is chlordiazepoxide (Librium).
Detox with the help of medication is not right for everybody. You need to talk to your GP and get specialist help. If this treatment is right for you then your own GP may suggest you go through a ‘community detoxification’. This would be done with you at home with support from an alcohol worker. A common plan is:
- A GP or doctor will prescribe a dose of medication for the first day that you stop drinking alcohol.
- You then gradually cut down the dose over the next 5-7 days. This usually prevents, or greatly reduces, the unpleasant withdrawal symptoms.
- You must agree not to drink any alcohol when you are going through detox.
- Your GP or an alcohol worker or community practice nurse will usually see you quite often during the time of detox.
- Support from family or friends can be of great help. Often the responsibility for getting the prescription and giving the medicine is shared with a family member or friend. For example, a partner or parent of the person going through detox.
How will I feel going through a detoxification?
Some people manage quite easily. Others find it more difficult. You can expect to:
- Feel quite nervous or anxious for a few days
- Have some difficulty with getting off to sleep for a few nights
- Have some mild withdrawal symptoms but they should not be too bad and a lot less than if you were not taking the medicine
The medication used for detox does not make you stop drinking. You need determination to stop. The medication simply helps you to feel better whilst your body readjusts to not having alcohol. After your detox, you will still have to deal with the issues surrounding you’re drinking.
You are likely to be prescribed vitamins, particularly vitamin B1 (thiamine). This is because many people who drink heavily do not eat properly and can lack certain vitamins. A lack of vitamin B1 is the most common. A lack of this vitamin can cause serious brain conditions.
Detoxification with the help of other health professionals
Some people are referred to a specialist drug and alcohol unit for detox. This is usually better for people who have other physical or mental health problems and for those who have:
- Little home or social support
- A history of severe withdrawal symptoms
- A physical illness caused by alcohol
- Had previous attempts to stop alcohol and have failed
The medicines used for detox in specialist units are much the same as GPs prescribe. However, these units have more staff and expertise for giving support. Some people with serious alcohol related problems are admitted to hospital to detox.
After detoxification and not drinking heavily
After a successful detox, some people go back to drinking heavily again at some point. To help with these problems you may be offered a medication option.
Medication
You may be advised to take a medicine for several months to help you keep off alcohol. These medicines should only be used if you are seeing a doctor regularly. They can be dangerous and even poisonous if they are not used under medical supervision.
- Naltrexone are medicines which may help to ease alcohol cravings.
- Disulfiram (Antabuse) is another medicine which is sometimes used following a detox. When you take it you get very unpleasant symptoms if you drink any alcohol (such as flushing, vomiting, palpitations and headache), so that while you are taking the medicine, it puts you off wanting to drink.
Residential treatment
Residential or rehabilitation treatment (rehab) is normally arranged through one of the community services listed above. There are residential centres all over the country so people can leave their own area for a short time. This can help them to address drinking problems and issues related to their drinking. Rehab’ often starts with a few days of detox (see above) and then people live for 1-6 months with others in the same situation. They also go to support groups and other therapies to help them work towards a life where they can deal with their drinking. This placement is often in a place where no drink is allowed. There is usually a waiting list. Getting private treatment will be quicker but expensive.
Going it alone
If you are drinking very heavily, it can be dangerous to stop drinking on your own.
But about one in three people who have an alcohol problem can cut down their drinking, or stop drinking altogether, without the need for professional help.
There are many self help books, leaflets, and web sites that offer help and advice about how you can stop or cut down your drinking. If you have problems with accommodation there may be hostels that allow you to stay and also drink on the site, but some are what they call ‘dry hostels’.
Important: Coming off alcohol too quickly could be very dangerous. You should get a doctor to give you advice before you try to stop. Talk to your offender manager. Think about what you gain when you stop. Think about what you lose if you start again. If you have stopped before without problems don’t think that there will be no risk this time.
Other health problems
Sometimes drinking alcohol covers up other underlying health problems. For example, people with an alcohol related problem often also have problems with stress, anxiety, depression, or other mental health problems. If you feel you may have a mental health problem, you should see your GP who will be able to describe the options for you. Always remember that heavy drinking increases the risk of other problems getting worse.
