Do you have to quit cold turkey when you go to alcohol rehabs? No, never. It’s not safe. Alcohol withdrawal is serious. It’s not the same as other drug classes like opioids and amphetamines. Alcohol, benzodiazepines and hypnotics like barbiturates can cause life-threatening complications during the withdrawal process. Don’t worry about going cold turkey during alcohol withdrawal. No reputable rehab or detox would allow this. There may be some lower-level alcohol or benzodiazepine addictions that would be safe to do under outpatient supervision but never cold turkey.
Alcohol and Benzodiazepines
Since alcohol and benzodiazepines both work in similar ways in the same receptor parts of the brain, they tend to produce similar effects. This is also true of barbiturates. Stumbling, sedation, weaving while walking, loss of judgement and inhibitions are common side effects of too much of these drugs. Alcohol is definitely a drug by any definition. It’s more socially acceptable perhaps, but that’s just a general perception. Make no mistake. Alcohol is a drug.
What Causes Alcohol Withdrawal Symptoms?
Like other psychoactive drugs that cross the BBB or blood-brain barrier and enter the brain, alcohol alters brain chemistry and function until it all becomes so deranged that the brain can no longer function without it. With opioids, this dysfunction produces extremely unpleasant and painful symptoms when the drug is suddenly withdrawn. Tapering the dosage first over time often reduces the severity of these symptoms. Opioid withdrawal is rarely life-threatening.
Seizures
However, alcohol causes such serious brain changes that sudden withdrawal from it can be fatal. This is mainly due to the risk of grand mal seizures, the most serious kind. With this comes the risk of aspiration. This is likely to be fatal. Aspiration occurs when stomach contents are inhaled into the lungs during a seizure or state of unconsciousness. It’s the main reason why you must fast for a period of time before any kind of surgical procedure involving general anesthesia. Always place an unconscious person on their side. This reduces the risk of aspiration.
Alcohol Withdrawal
While drug rehab recovery treatment for alcohol will be more or less the same as for any other drug, the detox for it will be quite different. Someone addicted to opioids or amphetamine may choose to withdraw without any medications. It’s probably not advisable and would cause much unnecessary discomfort, but it would be their choice.
This choice is not available to alcoholics in most cases. Withdrawal from this substance can cause hallucinations and the DTs or delirium tremens. These more serious withdrawal symptoms typically occur more often with higher level alcohol addictions, but they are also unpredictable and can happen to anyone. Other alcohol withdrawal symptoms include:
- Agitation
- Depression
- Nausea and vomiting
- Seeing and feeling bugs on the skin
Management of Alcohol Withdrawal
Since benzodiazepines work on the same receptor sites in the brain as alcohol does, withdrawal under medical supervision includes the use of certain benzodiazepines The same is true of the benzodiazepines themselves. Safe withdrawal involves gradually reducing the dose of a long-acting benzodiazepine like diazepam.
What Are Benzodiazepines?
These are tranquilizing drugs in the Valium family. Some of them, such as alprazolam, are short-acting. These are not suitable for management of alcohol or benzodiazepine withdrawal. Not only do they tend to produce more of a euphoric state, they don’t promote steady drug blood levels. This is important to keep possibly dangerous withdrawal symptoms at bay at all times.
Some benzodiazepines like flurazepam are used mainly as hypnotics or sleep aids. So is triazolam; its brand name is Halcion. Lorazepam, or Ativan, is more of a medium-acting benzodiazepine. The most notorious one is probably flunetrazepam. Its brand name is Rohypnol, and it’s commonly used illicitly as a date- rape drug. All benzodiazepines have a tendency to produce some level of amnesia, but this is typically dose-related and subject to individual response. Many date-rape victims dosed with Rohypnol have zero memory of their attack. All of these drugs are analogs or chemical cousins. You may have noticed the same -pam and -lam endings of their generic names.
Diazepam is especially well-suited for alcohol withdrawal treatment because it has a very long half-life of about 24 hours. The half-life of a drug is a measurement of how long it takes the body to eliminate half of the dose taken. A long half-life means the drug is going to have a longer duration of action. This tends to keep drug blood levels on an even keel. As part of the alcohol detox process, the dose of diazepam will be gradually reduced over a period of time ranging from a few days to a few weeks. This time period will be determined by the addiction specialist physician responsible for creating your withdrawal treatment plan.
We Can Help
We’re drug counselors very knowledgeable about alcohol dependence and treatment. We have a wide assortment of resources that we use to individualize our treatment suggestion options for each person’s needs. Call us at 833-820-2922 anytime. We’re here to help.