detoxification is medically supervised withdrawal. Medically supervised withdrawal is accomplished by giving a long acting drug that works on the same receptor system as alcohol. The drug is given in tapering doses down over a period of a few days to a week.
DO I ACTUALLY NEED DETOX?: Many patients come to their first appointment asking for detox. Frequently, after doing a history and exam with vital signs, we find that detox is not needed. Alcohol withdrawal is diagnosed for the most part by hand tremors, abnormal vital signs (elevated heart rate and elevated blood pressure), feeling generally ill, anxious, and irritable. In order to develop a withdrawal syndrome, the body needs to have a physical dependence on alcohol. With physical dependence, a characteristic withdrawal syndrome will develop as the blood alcohol level progressively goes down to zero. Physical dependence to alcohol develops when a person drinks throughout the day and evening. Many of the patients that come to see me only start drinking after work. They do not drink during the day, so they do not become physically dependent on alcohol. Isolated complaints of anxiety and irritability are not symptoms that require treatment with a Librium taper. These symptoms do require treatment with other types of medications, which do not have the risk of overdose when combining a benzodiazepine with alcohol in the event of a relapse
ALCOHOL WITHDRAWAL IS A SERIOUS MEDICAL CONDITION: Alcohol withdrawal should be taken very seriously and treated with caution. The first and most important reason for detox is to try and prevent life and limb threatening complications. Two life-threatening complications of alcohol withdrawal are grand-mal withdrawal seizures and delirium tremens (“DT’s”). Delirium tremens is alcohol withdrawal with hallucinations and unstable vital signs. Outpatient medical detox from alcohol is not safe for everyone. If you are interested in outpatient detoxification from alcohol.