Considerations

• Alcohol withdrawal symptoms can be relatively minor, such as insomnia and tremors, or it can be severe with delirium tremens and seizures. Doctors must get a complete history of the patient and conduct a thorough physical exam so they know who they are dealing with and what to expect. Sometimes patients can be successfully treated on an outpatient basis.
  
  

Medications

• There are a number of medications that can assist a patient during detox. Benzodiazepines are usually the No. 1 choice, and carbamazepine can be used to replace benzodiazepines when the patient is an outpatient. When detox is complex, a physician might prescribe phenytoin, haloperidol, clonidine, or beta blockers along with the benzodiazepines.
  
  

Withdrawal Symptoms

• Withdrawal symptoms often can be experienced as soon as two hours after alcoholics have their last drink. It is unsafe for an alcoholic to try to detox from alcohol without medical supervision. At the very least, the patient will experience anxiety, insomnia, stomach cramps, nausea, headache, heart palpitations and tremors. During detox, many alcoholics suffer from alcoholic hallucinosis, which are hallucinations. They can also suffer from seizures. Doctors can provide medication to help with these symptoms and others such as disorientation, fever, hypertension and agitation. Many of these symptoms do not peak until around the fifth day without alcohol.
  
  

Goals

• Alcohol detox has three goals, according to the American Society of Addiction Medicine: Safe withdrawal from alcohol; maintaining the patient's dignity; and proper preparation for continuing treatment for their alcoholism.
  
  

Treatment Setting

• When mild to moderate symptoms from alcohol withdrawal are expected, it is possible that the patient might opt for outpatient detox because it is more affordable. There are specific patients that should not choose outpatient detox in any situation. Those patients would include those that have a history of severe withdrawal symptoms, withdrawal seizures, delirium tremors, many prior attempts at detox, psychiatric or medical illness, elevated levels of alcohol use and pregnancy. Sometimes when outpatient detox is the chosen option, the patient must be evaluated daily so they can receive their medication in a monitored setting.