Alcohol Withdrawal Symptoms, Alcohol Detox and Symptom Management

Alcohol Withdrawal Symptoms, Alcohol Detox, and Symptom Management

Alcohol withdrawal symptoms are the body’s way of telling us there is a problem. A supervised medical detox performed by one qualified nurse clinician over a four to five day period allows clear observation of the withdrawal symptoms the alcohol dependent client is experiencing.  We have had the opportunity to see thousands of clients going through detox in an inpatient detox setting, and have seen hundreds of clients in a one:one home setting. Being with a client twenty-four hours a day for multiple days fine tunes the observational skills.

Alcohol Withdrawal Symptoms

The most obvious symptoms that are observed on the day the client quits drinking is a hand tremor, an elevated pulse and a corresponding elevated blood pressure. There is usually an accompanying anxiety and possibly some agitation. It is important to have an adequate assessment by a qualified physician or nurse practitioner at this time. It is usually necessary to provide medication at this time as well.

Most clients cannot tolerate these these symptoms for long and will resort to a drink in order to decrease the symptoms. An adequate amount of medication will alleviate these symptoms for a period of time. It is important to have ongoing observation to determine the next needed dose of medication and what that dose should be. Having a qualified nurse on site allows for a continual assessment and re-assessment of the client’s condition and response to medication.

Additional alcohol withdrawal symptoms may include diaphoresis or sweating, dry mouth, a clouded sensorium, and often gastric upset. Tremors can be throughout the body or noted in the upper extremities, diaphoresis or sweating may occur later in day one and into day two. The dry mouth is an indication of dehydration; it is very important to hydrate the client throughout the medical detox with water, gatorade, or some other basic hydrating fluid.

A clouded sensorium is an inability to think clearly or concentrate, having trust in your caregiver at this time provides some peace of mind to the client who is not thinking clearly. Gastric upset is common and can occur at the outset or sometime during the first two days of alcohol detox. The stomach lining is often irritated and the anesthetic effects of alcohol is missing, so a pain or irritation is felt in the stomach area.

These additional alcohol withdrawal symptoms can usually be managed with minimal discomfort. It is important to have a qualified clinician observing these symptoms in case they are indicative of a more serious situation. For instance, a clouded sensorium may actually be the beginning of Delirium Tremens – a potentially life threatening syndrome -, gastric upset might actually be a sign of a gastrointestinal bleed. A qualified clinician can assess the symptoms, assess the vital signs, and communicate with a physician to direct the care of the client to the best possible outcome.

Alcohol Detox: The Management of Alcohol Withdrawal Symptoms

There is, naturally, some discomfort to an alcohol detoxification. The discomfort can be minimized by ultra close observation and titration of prescribed medication, usually a benzodiazepine or barbital.  There is a balance between medicating for comfort and the eventual weaning of medication the client is receiving. A home detox with close observation allows the focus to be on comfort. A medical detox in an institutional setting may be adequate and effective, but is not always focused on comfort, rather on protocols.

A five day period of supervised medication management is usually sufficient to provide a stable alcohol detoxification. Additionally, Executive Home Detox prefers to stay with the client for two days after their last medication dosage. That time is used for assessment to be sure the client is stable and is used to set up aftercare the client is willing to engage in. These additional days are optional. 

All of these symptoms can be assessed and treated by a qualified caregiver. Executive Home Detox provides a qualified caregiver; often a certified addictions registered nurse. We always works with a physician or qualified nurse practitioner; preferably the client’s own physician, or we access a physician associated with the American Society of Addiction Medicine (ASAM).