How to Detox from Alcohol Safely

If you are struggling with alcohol use disorder (AUD) but want to stop drinking, the first stop on your road to recovery may be alcohol detoxification, or what is more commonly known as “detox”.

Alcohol detox involves allowing the body to clear itself of alcohol and other addictive substances, which usually triggers the onset of uncomfortable (and potentially dangerous) withdrawal symptoms.¹ In some cases, these symptoms can quickly become life-threatening if you attempt to detox from alcohol on your own without medical supervision.¹ Therefore, having the support of trained clinical professionals can help make this part of the recovery process more manageable while also keeping you safe at the same time.

What Happens During Alcohol Withdrawal?

When a person suddenly stops drinking or significantly reduces their alcohol use, withdrawal symptoms can develop as the body and brain adjust to functioning without alcohol.² This most often happens in people who have been drinking heavily and regularly over a long period of time, which can lead to alcohol dependence.³

Alcohol dependence develops as the body and brain adapt to the ongoing presence of alcohol and begin to rely on it to function normally.⁴ Withdrawal is the body's response when alcohol is no longer present, resulting in a range of physical and psychological withdrawal symptoms.⁴

These symptoms can range from mild discomfort to serious, life-threatening complications. Because these symptoms can be difficult to manage, many people return to drinking in an attempt to find relief. While this may temporarily reduce withdrawal symptoms, it can also make it harder to break the cycle of alcohol dependence.

Common Alcohol Withdrawal Symptoms

If you've been drinking heavily for a long time, stopping suddenly can cause your body to react in different ways. Some withdrawal symptoms may be uncomfortable, while others can pose serious health risks if certain medical interventions are not given in a timely manner.²

Alcohol withdrawal symptoms may include:²

• Sweating.
• Rapid heart rate (tachycardia).
• Tremors or shaking.
• Nausea.
• Vomiting.
• Insomnia.
• Anxiety.
• Visual, tactile, or auditory hallucinations.
• Agitation.
• Seizures.

Risk Factors for Severe Withdrawal Symptoms

Although fewer than 10% of people who experience alcohol withdrawal develop severe symptoms, complications such as seizures and delirium tremens (DTs) can become life-threatening without proper treatment.² The challenge is that it can be difficult to predict how your body will respond when you stop drinking, especially without a proper medical evaluation.

You may be at greater risk for severe alcohol withdrawal if one or more of the following apply to you:⁵

• You are 65+
• You have engaged in long-term, heavy alcohol use
• You have a history of alcohol withdrawal seizures, delirium tremens (DTs), or previous withdrawal episodes
• You have one or more co-occurring mental health conditions
• You have one or more co-occurring medical conditions, such as traumatic brain injury (TBI)
• You also use other addictive substances (particularly central nervous system depressant drugs like benzodiazepines or barbiturates)

Because withdrawal severity is not always predictable, a professional assessment is one of the most important steps you can take before alcohol detoxification. Medical professionals can evaluate your risk factors, monitor your symptoms, and help ensure you receive the safest level of care possible throughout the withdrawal process.

How Is Alcohol Withdrawal Managed?

Alcohol withdrawal can be managed in several treatment settings depending on your symptoms, medical history, and overall health.¹ The American Society of Addiction Medicine (ASAM) outlines five levels of withdrawal management:^1,5

• Level 1: Outpatient withdrawal management without on-site monitoring, often provided through a doctor's office
• Level 2: Outpatient withdrawal management with extended on-site monitoring, such as a day treatment program
• Level 3.2: Clinically managed residential withdrawal management with 24-hour support and monitoring
• Level 3.7: Medically monitored inpatient detox, where you receive around-the-clock medical supervision in a setting such as a detox center
• Level 4: Medically managed intensive inpatient detox, typically provided in a hospital or psychiatric facility

At every level of care, healthcare professionals monitor your progress and provide support. Once you're medically stable and able to participate with additional rehabilitation or recovery efforts, your treatment team may begin discussing recovery goals, ongoing treatment options, and available support services.⁵

Medications for Alcohol Withdrawal Symptoms

While counseling and other support services are important parts of recovery, safely managing withdrawal symptoms is the first clinical priority during alcohol detox.

If medication is appropriate for your situation, your care team will determine which medications may help and monitor your response throughout the withdrawal process.

Benzodiazepines

Benzodiazepines are considered the first-line treatment for alcohol withdrawal.⁶ Fast-acting medications such as Ativan (lorazepam) and Valium (diazepam) can help reduce withdrawal symptoms and are particularly effective at preventing or treating serious complications like seizures and delirium, as well as managing seizure activity that has already developed.⁶

Anticonvulsants

Anticonvulsant medications such as gabapentin, carbamazepine, and valproic acid may help reduce withdrawal-related discomfort. However, they are generally less effective than benzodiazepines or phenobarbital for managing progressively severe withdrawal symptoms, including seizures and delirium.⁵

Phenobarbital

Phenobarbital, an anti-seizure medication, may also be used during alcohol detox.⁶ Because it must be carefully titrated to minimize oversedation, respiratory slowing, and overdose risks, it should only be administered by an experienced medical professional in a closely monitored setting.^6,7

Alpha-2 Agonists and Beta-Blockers

Alpha-2 adrenergic agonists (such as clonidine) and beta-blockers may be used to help manage symptoms related to an overactive nervous system.⁶ These medications can help reduce sweating, rapid heart rate, high blood pressure, and fever.⁶

Although these medications are commonly used during alcohol detox, they should only be taken under the supervision of qualified medical professionals.

Dangers of Alcohol Detox

The most serious risks of alcohol detox are seizures and delirium tremens (DTs). Without prompt treatment, both can become life-threatening.⁸

Alcohol Withdrawal Seizures

Your risk for having one or more seizures may be higher if you've experienced alcohol withdrawal seizures or delirium tremens in the past. However, seizures can occur even if you have no history of severe withdrawal symptoms.⁵

Because of these risks, medical supervision during detox is strongly recommended. Healthcare professionals can help you avoid seizures by monitoring for symptoms of potentially impending seizures, as well as provide immediate treatment if and when it is needed.⁵

Alcohol withdrawal seizures most commonly occur within 8 to 48 hours after a person's last drink.⁵ As alcohol levels in the bloodstream drop, changes in brain activity can occur, increasing the risk of a seizure during this period.

Delirium Tremens (DTs)

Delirium tremens, often called the “DTs,” is the most severe form of alcohol withdrawal syndrome.⁸ It can occur when someone who has been drinking heavily and regularly for a long time suddenly stops drinking.

Symptoms can develop rapidly and may include:⁸

• Trouble focusing or shifting attention.
• Reduced awareness of surroundings.
• Memory problems.
• Impaired perception or spatial awareness.
• Hallucinations.
• Tremors.
• Agitation.
• Seizures.
• Heavy sweating.

Delirium tremens is a medical emergency and should be treated right away. Without proper care, it can lead to serious complications, including severe dehydration, dangerous electrolyte imbalances, heart problems, very high body temperature, organ failure, and death.^6,9,10

Can You Detox From Alcohol at Home?

Detoxing from alcohol at home can come with serious risks, which is why it’s generally not recommended without getting a medical assessment first.⁶

When you detox on your own, you may not have access to important forms of support, including:

• Supervision from doctors, nurses, and other healthcare professionals.
• Medications that can help ease withdrawal symptoms and improve your level of comfort.
• Immediate medical attention should a seizure or another serious withdrawal complication develop.
• Clinical support to help manage symptoms, stay hydrated, and monitor your overall health.

Detoxing in a professional setting provides you the opportunity to learn about ongoing treatment and recovery options. For example, staff can answer questions, provide referrals, and help connect you with continued care if needed. While you can still gather this information on your own, having direct access to experienced professionals can make the detox process much easier.

That said, detoxing from alcohol at home can be an option for some at relatively low risk for experiencing withdrawal complications. Many people are medically cleared to complete detox at home, either on their own or with check-ins and support from a nurse or other healthcare provider.⁶ The difference is that these individuals have been evaluated by healthcare professionals and have a plan in place that includes medical guidance and support, medications when indicated, and access to more intensive withdrawal management services should they be needed.

Discover Long-Term Recovery After Detox

While detox is an essential step for many, it is only one stage of addiction treatment and is rarely effective in changing long-term substance use.¹¹ Receiving addiction treatment for longer periods of time outside of detox is what promotes long-term recovery, along with other forms of support.¹¹ In fact, research shows that most people need at least three months of treatment to stop their substance use or drastically reduce it.¹¹

Once detox is completed, it is common to move into a more formal treatment program. This can include more intensive treatment programs like inpatient treatment or partial hospitalization programs (PHPs) to less involved programs like intensive outpatient programs(IOPs) and standard outpatient treatment.

Through these programs, several evidence-based therapies are provided, often including cognitive behavioral therapy (CBT), family therapy, group therapy, and more. The length of time spent in treatment is adjusted based on your needs, and you may find yourself participating in one or more levels of care throughout your journey.

With the proper care in detox, followed by the support and guidance offered in treatment, you can build a foundation for lasting, long-term recovery from alcohol use disorder.

Get Help For Yourself or A Loved One Today

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