Detoxification from chronic high alcohol consumption has to be done very carefully under medical supervision. Otherwise the process can be very uncomfortable and there is a risk of seizures.
In the early days of Alcoholics Anonymous, they often used progressively reducing quantities of alcohol itself. Nowadays a drug such as Librium (Chlordiazepoxide) is used reliably and safely. The detox process is comfortable when it is done under gentle supervision over five to ten days.
Care has to be taken to ensure that pharmaceutical drugs, such as antidepressants, tranquillisers and sleeping tablets, do not become a substitute addiction.
When the individual has also used recreational drugs, such as heroin or cocaine, detoxification from them can be done at the same time.
A persistently high alcohol consumption results in a dependency that is both physiological and psychological, affecting both body and mind.
Physical dependency can be significant. The brain can become deficient in the essential nutrients for its natural function. Korsakoff’s psychosis (wet brain) may develop. To protect against this, Thiamine (Vitamin B1) needs to be taken for some months after the acute withdrawal of alcohol.
Sometimes an acute psychosis may develop, in which hallucinations and paranoid thoughts may occur. These may need to be treated, in the short term, with anti-psychotic medication.
‘Cold turkey’, the sudden cessation of drinking in order to exert control, is very unpleasant as well as being both dangerous and inadequate.
The most common symptoms of acute withdrawal are shivers and shakes, headaches, sweats and chills. None of these symptoms should occur to any significant degree when detoxification is done under medical supervision.
Mere abstinence is not a sufficient treatment for alcohol dependence. Relapse prevention is vital. This cannot be achieved simply by pouring the booze down the sink or by getting family members or friends to keep a close watch. The psychological cravings will be overwhelming. There will be a risk of suicide. A chronic alcoholic may not be able to live with alcohol, because of the damaging consequences of its use, but may also feel that he or she is not able to live without it.
Intensive therapy in an inpatient alcohol rehab centre or, more confidentially and more focused, in private sessions with an addiction rehabilitation specialist, even on an outpatient basis, may be able to dispel the clouds of depression and raise poor self-esteem.
The alternative mood-altering process that takes the place of alcohol dependency, and which has no damaging side-effects, is to work the Twelve Step programme of Alcoholics Anonymous on a continuing daily basis. Also there is the obvious need for ‘a higher power than self’ – because left to ourselves we cause terrible destruction in the lives of other people and in our own. This is a human spiritual, rather than religious programme. Many atheists and agnostics are comfortable in AA.
The end result is freedom from obsession and a healthy physical, emotional, mental and spiritual life. There is a renewed sense of well-being and hope – and it costs nothing.