What is Alcohol Use Disorder and the Detox Process
Written by: Benjamin Gift, CADC I
Reviewed by: Candice Watts, Clinical Director CADC II
Alcohol Use Disorder (AUD) is a chronic medical condition characterized by an inability to control or stop drinking despite negative consequences. It ranges from mild to severe and can impact physical health, relationships, work, and overall quality of life. Common signs include frequent cravings, increased tolerance, withdrawal symptoms, and continued use despite harm. Early recognition and treatment are essential for long-term recovery and improved well-being.
What is Alcohol Use Disorder (AUD)?
Alcohol use disorder is a medical condition that ranges from mild to severe, depending on the number and intensity of symptoms. People with AUD may experience:
Craving: a strong need or urge to drink
Loss of control: inability to stop drinking once started
Negative emotional state: anxiety or irritability when not drinking
AUD is a significant public health concern, affecting about 18 million adults in the United States. Heavy drinking increases the risk of liver disease, certain cancers, brain damage, and other serious health problems. It also raises the risk of accidents, injuries, and death11.
The Dangers of Alcohol Withdrawal
When someone who has been drinking heavily for a prolonged period suddenly stops, they may experience alcohol withdrawal. Symptoms can range from mild (anxiety, insomnia, tremors) to severe and life-threatening (seizures, hallucinations, delirium tremens)12. Medical supervision is crucial for managing withdrawal safely, as complications can arise quickly and unpredictably.
Early Signs of Alcohol Addiction
Recognizing alcohol addiction early can make a significant difference in treatment and recovery outcomes. The early signs often involve subtle changes in behavior, mood, and physical health. Here are the most common early indicators:
Drinking More or Longer Than Intended: Frequently consuming more alcohol than planned or being unable to cut down even when wanting to67.
Increased Tolerance: Needing to drink greater amounts to feel the same effects is an early warning sign5.
Loss of Control: Difficulty stopping drinking once started or unsuccessful attempts to reduce intake567.
Neglecting Responsibilities: Letting alcohol interfere with work, school, or home duties, or prioritizing drinking over other obligations568.
Drinking in Secret or Alone: Hiding alcohol, drinking alone, or being secretive about the amount or frequency of drinking368.
Mood Swings and Irritability: Experiencing irritability, mood swings, or defensiveness when questioned about drinking habits38.
Frequent Hangovers or Blackouts: Having regular hangovers, memory lapses, or blackouts after drinking346.
Making Excuses for Drinking: Justifying alcohol use as a way to relax, cope with stress, or feel normal38.
Withdrawal Symptoms: Feeling anxious, shaky, or irritable when not drinking, or experiencing physical symptoms like sweating or tremors578.
Social Withdrawal: Pulling away from friends, family, or activities that were once enjoyable, often to drink more or avoid scrutiny368.
If you notice several of these signs in yourself or a loved one, it may indicate the early stages of alcohol addiction. Early intervention and seeking professional help can prevent more severe consequences and support a healthier future235.
The Alcohol Detox Process
The detox process typically involves three main phases:
Evaluation
Medical professionals assess the patient’s health, drinking history, and any co-occurring conditions.
Lab tests may be conducted to determine the level of alcohol in the body and identify any medical complications812.
Stabilization
The primary goal is to achieve a substance-free state while minimizing withdrawal symptoms.
Patients may receive medications (such as benzodiazepines) to reduce the risk of seizures and manage anxiety, insomnia, and other symptoms.
Supportive care includes hydration, nutrition, and monitoring of vital signs81213.
Entry into Ongoing Treatment
After detox, patients are encouraged to begin long-term treatment, which may include counseling, behavioral therapy, and participation in support groups81013.
Settings for Detoxification
Detox can take place in different settings, depending on the severity of AUD and withdrawal risk:
Inpatient (Hospital-Based) Detox
Recommended for individuals at risk of severe withdrawal, those with co-occurring medical or psychiatric conditions, or those without stable support at home.
Provides 24-hour medical supervision, immediate access to emergency care, and a structured environment1213.
Outpatient Detox
Suitable for individuals with mild to moderate withdrawal symptoms and a supportive home environment.
Patients visit a clinic or doctor’s office for regular monitoring and medication management10.
Timeline of Alcohol Withdrawal
The withdrawal timeline varies but generally follows this pattern:
6–12 hours after last drink: Mild symptoms such as anxiety, insomnia, nausea, and tremors may begin.
12–48 hours: Symptoms intensify; risk of seizures increases.
48–72 hours: The peak risk period for severe complications like delirium tremens (DTs), which can include confusion, hallucinations, and dangerously high blood pressure.
After 72 hours: Symptoms typically begin to subside, but some psychological symptoms (cravings, mood swings, fatigue) may persist for weeks12.
Risks and Complications of Detox
Repeated episodes of withdrawal and detoxification can worsen cognitive and emotional impairments, increase cravings, and raise the risk of seizures. Studies show that individuals with multiple detox experiences may have greater difficulty with executive function, emotional regulation, and memory9.
Medications Used in Detox
Benzodiazepines: Commonly prescribed to reduce withdrawal severity and prevent seizures.
Acamprosate: May help modulate brain chemistry and reduce cravings after detox, although its effects on withdrawal symptoms are delayed9.
Other Medications: May be used to address specific symptoms or co-occurring conditions as needed.
The Importance of Medical Supervision
Medical detox is safest when conducted under the care of experienced professionals. Vital signs are closely monitored, and medications are adjusted as needed to ensure patient safety. Medical detox addresses the physical aspects of addiction but must be followed by comprehensive treatment to address psychological and behavioral factors13.
Evidence-Based Treatments for Alcohol Addiction
Behavioral Therapies
Behavioral therapies are often the only available and effective treatments for stimulant addictions18:
Contingency Management (CM) or Motivational Incentives (MI):
Uses a voucher or prize-based system that rewards patients who abstain from cocaine and other drug use18
Particularly useful for helping patients achieve initial abstinence and stay in treatment18
Recently shown to be practical and effective in community treatment programs18
Cognitive-Behavioral Therapy (CBT):
Focused on helping individuals abstain and remain abstinent from cocaine and other substances18
Helps patients recognize, avoid, and cope with situations in which they are most likely to use cocaine18
Compatible with a range of other treatments patients may receive, including pharmacotherapy18
Supportive Care
Hydration and nutrition: Restoring physical health is crucial after periods of poor self-care12
Sleep hygiene: Establishing regular sleep patterns12
Safe, calm environment: Reduces anxiety and agitation12
Psychological Support
Motivational interviewing: Helps patients resolve ambivalence about quitting12
Group therapy and peer support: Reduces isolation and provides encouragement912
The Importance of Aftercare
Detox is only the first step in overcoming cocaine addiction912. Long-term recovery requires ongoing treatment and support to address the underlying causes of addiction and build a fulfilling, drug-free life9.
Inpatient vs. Outpatient Rehabilitation
Inpatient (Residential) Rehab: Provides structured, immersive treatment for those with severe addiction or unstable home environments12
Outpatient Rehab: Allows individuals to receive treatment while maintaining work, school, or family responsibilities1218
Ongoing Therapy and Support
Individual counseling: Addresses personal triggers, trauma, and co-occurring mental health issues12
Family therapy: Improves communication and healing within the family system12
12-step programs (e.g., Cocaine Anonymous): Offers peer support and accountability912
Sober living homes: Provide a drug-free, supportive environment during early recovery12
Relapse Prevention
Relapse is common in addiction recovery but does not signify failure9. Effective relapse prevention includes:
Identifying triggers: Stress, social situations, or emotional distress912
Developing coping skills: Stress management, mindfulness, and healthy hobbies12
Building a support network: Friends, family, therapists, and peer groups912
Regular follow-up: Ongoing check-ins with healthcare providers12
Seeking Help: When and How
If you or someone you know is struggling with opiate use, seek help as soon as possible. Warning signs that professional intervention is needed include:
Inability to stop using despite repeated attempts94
Neglect of personal, work, or family responsibilities94
What to Do:
Contact a healthcare provider: Addiction specialists or mental health professionals can assess the situation and recommend treatment84.
Call a helpline: National helplines provide free, confidential support and referrals.
Reach out to local resources: Community health centers, hospitals, and nonprofit organizations often provide addiction treatment services.
Conclusion
Alcohol use disorder is a serious, chronic disease that requires comprehensive treatment. Detoxification is a vital first step, helping individuals safely manage withdrawal and prepare for ongoing recovery. Medical supervision during detox is essential to minimize risks and complications. Lasting recovery requires a combination of medical, psychological, and social support, tailored to each person's unique needs8101213.
If you or a loved one is seeking compassionate, professional support on the journey to recovery, Solace Health offers personalized addiction services—from detox coordination to sober coaching—tailored to meet your unique needs. Let our experienced team help guide you toward lasting healing and freedom.
References:
NICE Clinical Guideline 115 – Alcohol Dependence
https://www.nice.org.uk/guidance/cg115
NICE Clinical Guideline 100 – Alcohol-Related Physical Complications
https://www.nice.org.uk/guidance/cg100
Alcohol Use Disorder - StatPearls (PubMed/NCBI)
https://pubmed.ncbi.nlm.nih.gov/28613774/
Alcohol Withdrawal Syndrome - StatPearls (NCBI Bookshelf)
https://www.ncbi.nlm.nih.gov/books/NBK441882/
SAMHSA – Medications for Alcohol Use Disorder
https://www.samhsa.gov/substance-use/treatment/options/medications
SAMHSA – Medications for Substance Use Disorders
https://www.samhsa.gov/substance-use/treatment/options
SAMHSA TIP 49: Incorporating Alcohol Pharmacotherapies Into Medical Practice
https://library.samhsa.gov/product/tip-49-incorporating-alcohol-pharmacotherapies-medical-practice/sma13-4380
NICE Full Guideline PDF – Alcohol Use Disorders
https://heeoe.hee.nhs.uk/sites/default/files/alcohol-use_disorders_full_nice_2010.pdf
