Not everyone who needs to quit drinking gets medical detox. Not everyone who gets medical detox knows they need it. There’s a very fine line between “I should really cut back” and “I need professional support to do this safely,” and when people misjudge it, it’s often to their detriment.
Yet when people fail to recognize the line, it can also be to their detriment as well. Why? Because alcohol is one of the only substances that can actually kill you upon withdrawal. This is not a hyperbole, but a medical fact.
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Difference Between Heavy Drinking and Physical Dependence
Heavy drinking and alcohol dependence are two different things. However, people tend to conflate the two. Someone can be a heavy drinker without having physical dependence. A person might drink multiple nights a week, perhaps more than they should, but their body has not yet acclimated to having them constantly coursing through their bodies.
That’s what physical dependence is: the body has physiologically adjusted how it’s supposed to work to accommodate regular alcohol consumption. The nervous system has adapted; brain chemistry has changed. What a person wants is now required by a body that needs it to function properly.
The biggest sign of physical dependence is withdrawal symptoms when consumption stops or diminishes. We’re not talking about hangovers. Hangovers are avoidable. They’re necessary evils that most people know they’re going to get: headaches, nausea, fatigue, dehydration. But withdrawal is something else entirely.
Signs of Developing Dependence
For example, a morning drink to quell the shakes is never a good sign. A few hours into stopping and someone feels irritable and anxious until they reach for that first drink – this means they’re in mild withdrawal and their body needs the alcohol again to bring them back up to baseline.
Drinking to avoid feeling sick is also problematic. Not because someone is sick from drinking too much; they’re sick because they have not consumed in a while, and their body feels terrible. It’s not about the fun or social proclivity of drinking; it’s about the body’s need for what’s become accustomed.
Increased tolerance is viewed as a positive trait by many people – “I can handle my alcohol better than you.” But tolerance means the body has learned how to process alcohol more optimally – and it comes with dependence as well. This means people have higher tolerance for alcohol and need more drinks for the same effect – and this is not a party trick; it’s a warning sign.
Dependence also presents as sleep issues when there’s no alcohol involved. If a person can’t go to sleep or stay asleep without drinking first, that’s a sure sign that their body relies on its depressant properties. The same goes for drinking when a person is anxious or stressed; it’s one thing to enjoy a drink after work; it’s another thing for a drink to be a necessary component of emotional regulation. In that case, the person is definitely dependent.
If any of these signs resonate, then getting help makes sense. An assessment at facilities offering Alcohol detox NJ can ascertain someone’s dependence and the level of support that’s safest to reduce consumption.
Who Shouldn’t Quit Alone
Not everyone needs professional intervention for quitting. Some people can cut back on their own without medical supervision; they face discomfort and ultimately come out on the other side relatively intact. However, for others, attempting to stop when they don’t have help can put them at risk.
People who should not quit on their own without medical supervision get to that danger zone who have been heavy drinkers (more than 8 drinks per week for women and more than 15 for men) for months if not years. Those who consume daily are at higher risk than those who merely have patterns of weekly consumption. Those who’ve tried quitting before – with bad outcomes – are at-risk if they ever try again.
Yet those who’ve had complications with previous withdrawals are at-risk if they try again on their own another time – whether it’s seizures, tremors, hallucinations or dangerous confusion levels. More severe symptoms happen the longer symptoms are attempted through kindling.
Accompanying medical conditions also add risk factors. Liver disease, cardiovascular concerns, previous head injuries or seizure disorders raise complications with withdrawal. So does old age; anyone over 60 years old has elevated risks with alcohol withdrawal syndrome.
What Alcohol Withdrawal Symptoms Can Do
Mild alcohol withdrawal symptoms are uncomfortable but safe – anxiety, sweatiness, minor tremors, insomnia and headaches occur the most during the first 24 to 48 hours after the last drink before things start getting better.
Moderate complications ramp it up: heart rates increase; blood pressures surge; severe anxiety and panic occur; nausea and vomiting make it hard to keep hydrated; hands shake so much they interfere with gripping anything; confusion sets in with difficulties across tasks or concentrations.
Severe features are life-threatening: seizures manifest within 6 to 48 hours of stoppage – sometimes without warning; delirium tremens – which are fatal – is present between two and five days of quitting; hallucinations, intense confusion, elevated heart rates/blood pressures/high temperatures all render these conditions unsafe without hospitalization; mortality rates are between 5-15% if DTs go untreated.
But here’s the biggest problem: there’s no golden way to predict who will get these severe symptoms – or who’s going to enter withdrawal in general. Some people quit without a hitch; some people who have mild symptoms end up having severe symptoms upon future withdrawals due to kindling – a phenomenon where substances become more addictive the more they’ve been abused.
What Medical Detox Provides At The Outset
Medical detox does not just mean supervision; it means active intervention to make withdrawal safe. Staff possess experience with reduced vitals – and respond accordingly before complications become emergencies.
Medications make the difference: benzodiazepines reduce anxiety and prevent seizures while blood pressure medications keep cardiovascular symptoms in check. Anti-nausea meds can help with discomfort along with sleep aids – these medications are adjusted daily according to symptoms rather than being treated with one-size-fits-all approach.
Hydration comes into play faster than what people think – chronic drinking leads to dehydration/vitamin deficiencies – IV fluids help hydrate quicker than anyone can via the mouth, and vitamin administration can help replenish faster before complications take hold.
Psychological support is crucial as well; dealing with withdrawal is scary – and having medical professionals available to clarify what’s happening, reassure symptoms as normal (or not) helps anyone considerably when their anxiety would increase otherwise.
What To Do When In Doubt
Anyone questioning whether they should get professional help should do so regardless. A medical evaluation is crucial at detox facilities – even if people do not get treatment right away – to figure out dependence versus potential symptom acuity upon quitting.
Questions someone should ask themselves include: How much are you drinking per week? Per day? For how long? Have you tried to quit before? If so, how did it go? Do you experience symptoms if you go without alcohol even for a few hours? What’s your history with quitting – any seizures? Have you ever been hospitalized?
Even a primary care doctor can assess situation first – blood work can assess liver function along with overall health – obviously, if these factors come into play then so do complication probabilities/other disorders which influence whether someone needs outpatient intervention with medication management for milder situations or community referral for detox if dependence is deemed clear.
The Consequences of Not Seeking Help
Attempting quitting without professional support when someone needs it leads to preventable seizures, dangerous dehydration or incredible life-threatening complications related to delirium tremens – which often send people to ERs anyway – but in crisis mode instead of safe intervention.
On the other hand, medical intervention without it being absolutely necessary isn’t harmful; it’s just minutely unnecessary – but there’s nothing wrong with being overly cautious about something that has real-world medical risk.
Taking The First Step
Deciding how to stop drinking is hard enough without worrying about whether a person needs professional help or not. When in doubt, check with someone who knows better – ideally an assessment provides clarity – for most people with legitimate physical dependence know deep down that quitting will be tough – they feel it when they’re out of commissions sober anyway.
Trusting your instinct isn’t embarrassing; seeking appropriate medical intervention isn’t conceding defeat; acknowledging that alcohol dependence has created physiological adaptations requiring medical support for safe navigation isn’t an award for going through dangerous accommodations alone – it’s playing it safe at no cost with far easier results.