"I knew I had the problem for years. But it plays tricks with your head. Very cunning and baffling is alcohol." --Ringo Star

If the words above resonate inside you with an uncomfortable truth, or if you see them reflected in the actions and sentiments of someone close to you, it may be time to seek help. When contemplating the possibility of recovery from the chasm of alcoholism, many feel that there is no possibility of climbing out of the abyss. There is always hope, however; millions of people have recovered from alcoholism. Sometimes the most difficult step is admitting that it's time to try.

First and foremost, it is important to recognize alcoholism, also known as Alcohol Use Disorder, as the medical condition that it is. You wouldn't blame someone for developing a deadly form of cancer, so why condemn an alcoholic as a criminal or masochist? This disease is not a choice; it is an illness. Recognizing this fact is absolutely necessary in order to begin the journey towards recovery and sobriety.

The journey will not be an easy one; recovery from Alcohol Use Disorder is described by many as "the hardest thing I have ever done." Because it is so very difficult, you'll need to make sure that you have the right information and support system in place before you begin. The first leg of the recovery journey is alcohol detox.

Intro to Alcohol Detox

Alcoholism is a very serious condition that affects so many people in the United States. In fact, according to the National Institute on Alcohol Abuse and Alcoholism:

Although they are often confused for the same thing, alcohol detox is a separate process from alcohol rehabilitation. Detox is the process of ridding your mind and body of the toxic effects brought on by long-term alcohol abuse. During alcohol detox, the body of an alcoholic will undergo alcohol withdrawal and end its dependence to alcohol, also called ethanol.

Alcohol rehab, on the other hand, describes the longer undertaking of treating psychological dependence to alcohol, as well as the causes and effects of alcohol addiction.

While detox is is a temporary program that lasts only as long as alcohol withdrawal, rehab is the long-term treatment of Alcohol Use Disorder and (hopefully) helps the patient to achieve a healthy, sustainable, and sober lifestyle.

Since you have read this far, it is safe to assume that you or someone you care about is suffering from the degradations of alcoholism. Continue reading to learn about the process of alcohol detox, the information and preparation you will need on hand before you begin, and what to expect during and after an alcohol detox program. The first step is alcohol detox, and the final reward is the rest of your life.

The Timeline of Alcohol Withdrawal

Alcohol withdrawal happens when the brain and body have forgotten how to function normally without the presence of alcohol. The body works to rid itself of toxic quantities of ethanol and reestablish chemical balances in the brain, a process that results in a wide array of painful symptoms. Here is a basic timeline of the alcohol withdrawal process, although it may vary from one case to another:

As many as 15% of those who develop delirium tremens die from its symptoms. This is the primary reason that medically trained professionals should be close-by during alcohol detox. Someone who is trained to recognize the signs of delirium tremens could detect and treat the condition before it became deadly.

What Goes On Inside the Body During Alcohol Withdrawal?

People with Alcohol Use Disorder generally drink anywhere from 4 to 10 or more alcoholic drinks each day. This means that their bodies are rarely (if ever) given the chance to cleanse aways the toxins that run through their veins. When an alcoholic suddenly becomes sober, the body is thrown into a state of confusion and chaos.

First, the brain is inundated with excitatory chemicals that have no counteracting sedative neurotransmitters to balance them out. This imbalance causes the mental and emotional symptoms associated with withdrawal, like muddled thought processes, anxiety, insomnia, seizures, and mood swings.

Meanwhile, without the pain-relieving effect of ethanol to soothe them, the esophagus and stomach begin to ache in response to the corrosive effect of long-term alcohol abuse. The liver and kidneys kick into high gear, working to cleanse toxic ethanol from the blood, organs, and tissues. This process results in a variety of aches and pains, heavy sweating, vomiting, headaches, and heart palpitations.

If it sounds like a harrowing experience, that's because it is; however, alcohol detox and withdrawal are the most important steps in eradicating physical dependence to alcohol. Once the physical addiction has been defeated, you will be ready for the psychological rehabilitation process.

How to Detox from Alcohol Safely: Managing Alcohol Withdrawal Symptoms

Is It Safe to Detox from Home?

The short answer is no, it is not recommended to perform alcohol detox at home. Yes, some people have done it and a few have even completed the process successfully, but the vast majority of those who try, fail. Alcohol detox is so unpleasant and difficult that most who attempt to do it at home cannot resist the temptation to relieve the pain with "just a touch" of alcohol. Of course, this counterproductive methodology almost always ends in failure.

In addition to the ever-present temptation of drinking, there are a range of other reasons that detoxing from alcohol at home may be a bad idea, or even dangerous:

• With no medical doctors on hand to prescribe medications that relieve the symptoms of alcohol withdrawal, the symptoms of withdrawal will be most severe.
• Mental confusion, anxiety, and hallucinations could lead to bad decisions or unsafe behavior
• Anyone who has experienced depression, anxiety, or suicidal thoughts in the past may be more likely to undergo intense suicidal feelings that were not previously present before alcohol detox.
• If alcohol is available or only a short drive away, relapse is much more likely.
• The potential onset of delirium tremens is a real danger. The condition can cause seizures, heart failure, or death. Delirium tremens would likely be detected and treated in the presence of trained medical staff.

Supervised Alcohol Detox

Types of Supervised Detox Programs

The type of alcohol detox program you choose will depend largely on the severity of your addiction and the limitations of budget. Here are the most common options:

What Make Alcohol Withdrawal So Painful?

Alcohol withdrawal is famous for being one of the worst withdrawal processes to go through. This is because of what alcohol does to the brain. The alcoholic brain has become accustomed to the steady influx of ethanol and its sedative effects. In response, it has answered with a response of excitatory neurotransmitters in an attempt to keep some balance.

Take away the ethanol, and the brain is suddenly flooded with excitatory neurotransmitters - the very chemicals responsible for anxiety, excitement, and pain - but without any sedative neurotransmitters to counteract them. All of the brain's soothing, calming chemicals have been depleted by the constant stream of alcohol and what's left is a chaotic overabundance of stimulating chemicals. The result is a wide range of uncontrollable and agonizing withdrawal symptoms that rack the body until the brain can achieve some semblance of balance and normalcy once again.

"It is difficult to feel sympathy for these people. It is difficult to regard some bawdy drunk and see them as sick and powerless. It is difficult to suffer the selfishness of a drug addict who will lie to you and steal from you and forgive them and offer them help. Can there be any other disease that renders its victims so unappealing? Would Great Ormond Street be so attractive a cause if its beds were riddled with obnoxious little criminals that had "brought it on themselves?"
-Russell Brand

Alcohol Rehabilitation

Alcohol detox only addresses the physical aspects of addiction. Once it's completed, alcohol rehab is necessary to treat the psychological aspects of addiction and the establishment of a sober lifestyle. The Substance Abuse and Rehabilitation Journal states that completing rehab and attending regular therapy can boost recovery success rates from 17% (for detox alone) to 67%.

A wide range of issues are addressed during the alcohol rehab process, such as:

• The underlying causes of addiction
• Addiction triggers and how to cope with them
• Other mental health disorders that may attribute to addiction
• Damaged relationships with loved ones
• Combating addiction in day-to-day life
• Finding positive new outlets, such as hobbies or interests to redirect energy and focus

These topics are approached in a variety of ways that force the individual to confront every aspect of their past, present, and future. This is accomplished through group therapy, psychiatric care, family therapy, classes, and workshops. The goal of this process is to learn to live a healthy, productive life of sobriety and avoid relapse in the future.

Why is Alcohol Addictive?

Like most addictions, alcohol addiction is caused by the disruptive effects of intoxicating substances on the delicate chemical balance of the brain. This is how it works:

• All feelings - happiness, anxiety, sadness, anger, etc. - are caused by the release of chemicals, known as neurotransmitters, inside the brain.
• When someone drinks alcohol, the ethanol passes into the blood and, from there, directly through the blood brain barrier and into brain cells.
• Once inside the brain, ethanol triggers the release of the neurotransmitter dopamine while simultaneously binding to GABA neurotransmitter receptors. This has two effects - first to stimulate the pleasure centers of the brain and second to depress the Central Nervous System (CNS), causing feelings of euphoria, relaxation, and drowsiness.

The result of this process is that the human body only knows how to function under the influence of alcohol, and when a person tries to become sober, the imbalanced brain no longer remembers how to function normally. At this point the now alcoholic will go into alcohol withdrawal - a variety of unpleasant symptoms such as hand tremors (the shakes), headaches, insomnia, stomach pain, and high anxiety. These are known as alcohol withdrawal symptoms and will only set in if the body and brain have formed a physical dependence to alcohol.

Once addiction has set in, the body will react negatively - and painfully - to any attempt by the alcoholic to become sober. The body will crave alcohol to relieve the unpleasantness of withdrawal and thus, Alcohol Use Disorder begins, ends, and begins again in an ugly, never-ending cycle.

I knew I had to change my life. But addiction is a fucking tricky thing. I think I relapsed within... three weeks? And within a month it had ramped right back to where it was before. That's what really freaked me out. That's when I knew: I either get help, or I am going to die.
-Eminem

Different Types of Alcohol Use Disorder

Not every alcoholic is created equal. In her moving TED speech on Alcohol Use Disorder recovery, actress Claudia Christian said,

"Addiction is a monster - it affects every ethnicity, social class, sex, race, it doesn't matter...when it gets you, it gets you."

In other words, this disease can affect someone in any walk of life, no matter who or where they are, and alcoholism looks different on different people. Here are the most common types of Alcohol Use Disorder:

• Young adult - Although few from this subset admit that they have a problem, 32% of alcoholics are 25 years old or less. Young adult alcoholics often go on "benders", binge drinking intermittently.
• Young antisocial - Also identified in their mid to late 20s, young antisocial alcoholics drink heavily to overcome feelings of social anxiety. Most exhibit symptoms of antisocial personality disorder.
• Functional - Alcoholics in this subset often go years without treatment because they feel secure in a "successful" lifestyle. A functional alcohol can usually continue to uphold work and family obligations despite having five or more drinks each day.
• Intermediate familial - This type of alcoholic may find recovery difficult because they are or have been living with other people who abuse alcohol use regularly. Intermediate familial alcoholics may include the children, spouses, siblings, or even grandchildren of other alcoholics.
• Chronic severe - The smallest subset of alcoholics is often the most commonly represented in treatment facilities. Although much more rare, chronic severe alcoholics are more often required by law to receive treatment due to mental illness and illegal activity. This is also the most likely set to mix alcohol with other substances.

Discerning the Difference Between Alcohol Addiction and Alcohol Abuse

Although the two behaviors may look similar, alcohol abuse and alcohol addiction (dependence) are two different concepts. Alcohol abuse may certainly lead to addiction, but is defined by the DSM as the continued use of alcohol even after it has persistently created problems for work, family, or social life. Basically, if a drinking habit is causing problems, it is alcohol abuse, but that does not necessarily mean that a dependence to alcohol has formed. Here are some of the major differences between the two terms:

• Tolerance - Alcohol dependence is marked by an increase in tolerance over time, while alcohol abuse is not.
• Withdrawal - When an alcohol addict becomes sober, they begin to feel symptoms of withdrawal, while an alcohol abuser will not. An addict will often to continue to drink simply to avoid these symptoms.
• Out of Control - Someone with an alcohol addiction shows very little control over how much and how often they drink, while someone who abuses alcohol can usually show some control or restraint when necessary.

Even if one insists that "I only drink with friends," or "I only drink on the weekends," if they are drinking more than 4 or 5 drinks in a two-hour period, they are engaging in binge drinking, a risky behavior in and of itself. This kind of heavy drinking leads to dangerous activities like drunk driving or unprotected sex, and can cause a range of problems both socially and professionally.

Whether you're an alcohol addict, alcohol abuser, or binge drinker, any type of heavy drinking - especially if it's on a weekly or monthly basis - is risky. If your drinking habit hasn't begun to cause any problems in your professional or personal life, it probably will soon. These behaviors are also indicators of developing a serious alcohol addiction in the future. Don't wait until alcohol abuse becomes a threat to your health and well-being; put an end to dangerous drinking behaviors and begin your alcohol detox program now.

"Alcohol ruined me financially and morally, broke my heart and the hearts of too many others. Even though it did this to me and it almost killed me and I haven't touched a drop of it in seventeen years, sometimes I wonder if I could get away with drinking some now. I totally subscribe to the notion that alcoholism is a mental illness because thinking like that is clearly insane."
-Craig Ferguson

What Does Alcohol Really Do to Your Body?

Alcohol and the Brain

We've discussed how alcohol crosses the blood brain barrier directly into brain cells. The results are almost immediate as the ethanol affects a range of neurotransmitters, creating a feeling of euphoria while simultaneously producing a sedative effect on the CNS. These chemical reactions have both short-term effects that occur at the very first drink, and long-term effects if an individual drinks heavily over a long period of time.

Short-Term Effects: Because of its impact on the Central Nervous System, alcohol will quickly create feelings of drowsiness and relaxation. This sedative effect also slows the brain's processes and reactions to stimuli, changes decision-making patterns, and impairs short-term memory.

Long-Term Effects: Alcohol abuse that persists over time has much more alarming consequences on the brain. Because of the imbalance of neurotransmitters that ethanol creates in the brain, its physical structure and function can be affected if the inflow of alcohol does not stop. Here are a few of the ways the brain is changed by long-term alcohol abuse:

• Brains cells exhibit marked thiamine deficiency
• Alcohol-induced Wernicke-Korsakoff syndrome can cause encephalopathy and psychosis
• Brain may be damaged or lose function as a result of liver disease
• Dementia or cognitive impairment
• Brain lesions
• Long-term or permanent memory deficits
• Dopaminergic and glutamatergic (neurotransmitter) signaling pathways become altered over time
• New neuron development is inhibited

Alcohol and the Organs

Despite the drastic effects that ethanol has on the brain, most alcohol-related deaths are not caused by damage to the brain. It is alcohol's devastating impact on internal organs that causes the most damage.

Short-Term Effects: Although it is not as obvious from the outside looking in, ethanol can begin to affect the body's organs very quickly. Let us count the ways:

• Highly fluctuating heart rate
• Dehydration
• Acetaldehyde production in the liver - a chemical that has an effect on the brain and stomach as well
• Lack of coordination in body movement and speech patterns
• Slowed physical reaction times
• Irritation in the lining of the esophagus and stomach
• Lack of nutrient absorption throughout the digestive system
• Nausea and dizziness
• Increased production of urine

Long-Term Effects: Unfortunately, the ramifications of long-term alcohol abuse take the heaviest toll on the body and its organs. Organ damage due to alcohol is responsible for the most alcohol-related deaths. For example, heavy drinking over time will:

• Weaken the cardiovascular system and its functions
• Cause a condition called cardiomyopathy, where the heart becomes stretched and drooped
• Destroy liver function, causing hepatitis, fatty buildup, cirrhosis, and eventually death
• Create inflammation of the pancreas, causing pancreatitis
• Heighten risk of heart disease, cancer, type 2 diabetes, kidney failure, stroke, and heart attack

How Long Can Alcohol Remain in the Human Body?

The answer to this question is largely dependent on the quantity of alcohol consumed and in what period of time. While an ounce of alcohol may be flushed out in an hour, it can take up to 6 hours for the bloodstream to cleanse itself of 5 or more drinks consumed within a two-hour period. Ethanol does not stay in the bloodstream, however. It can be detected on the breath for 24 hours, in urine up to 48 hours, and within hair fibers for up to 90 days.

A common misconception is that the body rids itself of alcohol toxins every hour, but this is only true if one ounce of alcohol has been consumed in that hour. In the case of heavy drinking or binge drinking over a short period of time, alcohol can remain active in the blood and brain for 6 - 8 hours. This misconception has been the cause of many bad decisions and dangerous situations.

For example, if one believes that alcohol is flushed out every hour, they may feel it is safe to drive even though their blood alcohol content is still far higher than the legal limit. This kind of erroneous thinking has also been the cause of many a visit to the emergency room. People who believe that their body can digest alcohol quickly may drink dangerous amounts in a two or three hour period, a behavior that can easily result in alcohol poisoning. Six people die every day in the United States from alcohol poisoning.

Since it can take up to 8 hours for alcohol to leave the bloodstream, this is usually the amount of time that passes before alcohol withdrawal symptoms kick in.

Achieving Sobriety After Addiction

Anthony Hopkins described his addiction to alcohol as, "like being possessed by a demon… I couldn't stop."

Claudia Christian called it a monster, and Anthony Hopkins called it a demon. People talk about addiction in this way because, for an alcoholic, the disease is something dark, dangerous, and uncontrollable. In most cases, it is virtually impossible to outrun it or overpower it, to simply "stop drinking" without a great deal of support, help, and hard work.

The first barrier is the pain and misery involved in the alcohol detox process itself. Alcohol withdrawal is so incredibly unpleasant that few people ever get through it without help. Some have compared the experience to dying. If you feel like you're dying and relief is only one sip away, it is easy to see why relapse is so common within the first days of alcohol detox. This is why it is recommended to have a strong support system and, ideally, medical personnel on hand before you begin.