Alcohol may be legal, but it can be dangerous when it begins to affect your work, family, and life. Alcohol is probably the most abused substance in the world. While men were traditionally more impacted by addiction to alcohol, now women are catching up. When you become dependent on alcohol or addicted to it, it not only affects you physically, but you may also begin to experience psychological issues. Dependence on alcohol can lead to severe withdrawal when attempts are made to stop alcohol use. Alcohol withdrawal can also be dangerous as it can lead to seizures, stroke or even death. So, treatment for alcohol dependence and alcohol addiction should always take place under medical supervision.
Outpatient Alcohol Detox
Outpatient alcohol detox is not new, but inpatient alcohol detox and rehab has been the traditional way to perform alcohol detox due to the wrong belief that addiction is a behavioral problem or moral failure. Outpatient alcohol detox is a more recent trend, based on the belief that addiction is a disease and not a behavioral issue. In the past, people had no other option but to book themselves or their family members into rehab, as addiction was viewed as a behavioral problem.
Now, however, an increasing number of individuals are preferring outpatient detox. The reasons are simple: firstly, outcomes are better because it integrates the living environment into treatment rather than isolating from it; Secondly it is minimally disruptive to daily life and allows individuals to be largely functional in their home environment and work life. Also, the introduction of various medication options to effectively treat withdrawal symptoms and cravings makes it easier to stay abstinent in the home environment than even a decade ago. It is important to note that the alcohol detox medication protocols at CNT’s outpatient detox program in NJ is the same as inpatient treatment.
Addiction is a chronic brain disease but it carries stigma – and inpatient addiction treatment adds to the stigma by treating addiction as a behavioral problem or moral failure. Outpatient Detox in New Jersey for alcohol aligns treatment for addiction with the disease model by making the most acute level of addiction treatment accessible on an outpatient basis. Afterall, treatment for other chronic disease like diabetes, hypertension or even contagious HIV does not take place in an inpatient setting. So why single out addiction alone and attach stigma to it?
Understanding Alcohol Withdrawal
These are the set of symptoms, physical and psychological, an individual experiences when they stop alcohol use abruptly after a long stint of alcohol dependence. Alcohol, like most other drugs, is a central nervous system suppressant affecting neurotransmitters in the brain. While it helps you relax and be at ease, excessive alcohol consumption increases tolerance and makes you chemically dependent on alcohol.
Here’s how alcohol dependence alters your brain function: The brain usually releases a certain amount of the pleasure neurotransmitter, dopamine in response to normal life stimuli such as hobbies, food or sex, sending pleasure waves through a person. Alcohol or other drugs, artificially stimulate a surge of dopamine and “take over” the brain! Consequently, the brain gradually loses its ability to respond optimally to regular life stimuli, instead waiting for stimulus for alcohol or drugs. This change in the brain is the reason addiction is called a disease, and not regarded as a behavioral issue or moral failure. And, addiction is a chronic disease because the brain does not return back to functioning normally immediately after stopping drug or alcohol abuse. It takes years! And during that time individuals suffering from alcohol addiction experience subnormal moods that make them vulnerable to a relapse as they crave a hit of dopamine that will make them feel normal.
Alcohol Withdrawal Can Lead to Seizures, or Even Stroke
Alcohol withdrawal symptoms can range from mild to dangerous. The severity of the symptoms depends on the length of use and the intensity of use. It does not take much time after stopping alcohol use for the symptoms to show up. Mild symptoms could be experienced as quickly as 6 hours after the last drink. They can include:
- Hand tremors or shake
- Headache
- Nausea
- Vomiting
- Insomnia
- Sweating
- Anxiety
- Panic
However, for heavy drinkers, the issues could be much more serious and, sometimes, life-threatening. Hallucinations could occur about 12 to 24 hours after the last alcoholic drink. Seizures are also a possibility within 48 hours or 2 days. Delirium Tremens (DT) usually starts about 2-3 days after the last drink. DT is the rapid onset of confusion caused during alcohol treatment. However, only a small proportion of people suffer from DT. Delirium Tremens could be accompanied by a racing heart, high blood pressure, and fever.
The stages of alcohol withdrawal symptoms
The overarching theme about alcohol withdrawal symptoms is that they are dangerous and immediate medical attention must be sought when a person who has become alcohol dependent decides to stop consuming alcohol.
- Stage 1 (Mild Symptoms)
A few hours after the last alcoholic drink, an individual suffering from alcohol dependence may experience mild withdrawal symptoms, which can be discomforting. Nervousness, anxiety, and behavioural changes like mood swings are common. You may also experience physical side effects such as dilated pupils, headaches, tremors, and sweating. The symptoms in this stage closely resemble that of a hangover, and immediate medical intervention is necessary.
- Stage 2(Moderate Symptoms)
These symptoms begin after about 12 hours after your last drink. The individual suffering from alcohol dependence may begin to exhibit more intense symptoms such as fever, irregular blood pressure, tremors, difficulty breathing, and a faster heartbeat.
- Stage 3 (Severe Symptoms)
At 2–5 days after the last drink, the individual suffering from alcohol dependence will likely experience severe alcohol withdrawal symptoms. These symptoms could include seizures and stroke and may also lead to death. Delirium tremens, or DT, can also occur and so can extreme agitation, confusion, high blood pressure, and hallucinations (feeling, hearing, and seeing things that aren’t there).
Diagnosing Alcohol Withdrawal
Apart from the individual’s drinking history, scales can be used to determine the treatment. CIWA, AWS, etc. are scales that are used to diagnose and quantify withdrawal from alcohol.
A good alcohol treatment facility or an alcohol detox center in New Jersey will utilize all available tools to diagnose and quantify the severity of symptoms, to institute a customized medication protocol to address and manage alcohol withdrawal symptoms and reduce risk of seizures or stroke.
Medication Assisted Treatment, or MAT, for Alcohol Withdrawal
Advances in pharmacology have made it possible to utilize medications to mitigate alcohol withdrawal symptoms and reduce the probability of seizures or stroke.
It is never a good idea to quit alcohol use on your own – always do it under medical supervision, as there is a significant risk of seizures or stroke. Medication-assisted treatment, or MAT, is now available to treat alcohol withdrawal and cravings. Unless the liver is compromised, a Librium taper is often used in conjunction with seizure-preventing medication such as Keppra. For longer-term support for sobriety, Vivitrol, also known as naltrexone can be prescribed.
Men Abuse Alcohol Much More than Women
82 million males aged 21 and older reported using alcohol in the past year. 51% of male college students used alcohol, compared to 53% of female students. 35% of male college students engage in binge drinking, vs. 31% of female students. 21% of men binge drink, compared to 13% of women. 25% of men who binge drink do so more than 5 times per month, consuming over 9 drinks on a single occasion. Alcohol consumption triggers more dopamine release in the male brain, potentially contributing to higher addiction risk. Men have greater dopamine release in the ventral striatum, an area associated with pleasure and addiction.
Women are Abusing Alcohol at An Increasing Rate and Dying from It
Between 2016 and 2021 deaths from excessive drinking rose 27% among men, but 35% among women. Many studies have shown binge drinking is on the rise among middle-aged women. While men are more likely than women to overdrink, 36% to 19%, the rate of women aged 35 to 50 consuming five or more drinks in a row in a 2-week period rose almost twice as fast as that of men between 2012 and 2022 according to a nationwide survey by the University of Michigan.
Also, while men are more likely to die from alcohol related causes than women, the gap is narrowing. According to the Centers for Disease Control,or CDC, deaths from excessive alcohol use increased nearly 27% between 2016 and 2021 among men, but 35% among women.
A spike occurred during the pandemic and the reasons could be a lack of external and social outlets causing women to turn to alcohol as a coping mechanism because they did not have the same opportunities for self-care and social interaction. The “mental load” of motherhood often includes largely invisible stressors like filling out forms, maintaining schedules, shopping for clothes and groceries, and meeting with teachers. Such constant vigilance—the sense that there is always something that needs doing or buying or cleaning—is exhausting.
Finding time for actual self-care is a challenge many women know too well. Even when women are the primary breadwinners, they still tend to devote more time to child care and housework and less time to leisure than their husbands, according to a 2023 Pew Research Center survey.
The circumstances that drive many middle-aged women to drink are also what may prevent them from seeking treatment. A 2023 study published in the journal Drug and Alcohol Dependence found that women often reported “gendered responsibilities,” such as caregiving, as a significant obstacle for seeking treatment. The same study found that women who struggle with substance abuse are “more likely than men to perceive stigma for seeking help.” Many worry that by admitting they have a problem, they could compromise their access to their children—or their standing as a mother.
Studies have shown that women are more likely than men to use alcohol to help cope with stress, and the pandemic was a stressor for sure! For women aged 40-64 alcohol-related hospital visits rose up to 56% during the pandemic. Studies have also shown that women are more vulnerable to alcohol-related health risks than men, including cancer, stroke and liver damage. A study published in the journal Addictive Behaviors in 2021, for example, found that heavy-drinking women were up to two times more likely to have been diagnosed with a “significant medical condition,” including cancer, than heavy-drinking men.
The Secret of Treating Women Addicted to Alcohol
Connection is the secret sauce and, often, the antidote to addiction. Hearing from and communicating with other women in the same situation accelerates the recovery process for women. Apart from connecting with treatment providers, and physical self-help groups such as AA, online groups such as Sober Sis, Luckiest Club and Sober Mom Squad offer ways to connect with women in recovery online. Seeing other women – teachers, mothers, doctors, writers – grappling with their dependence helps people realize that they are not alone.