Outpatient Detox for Alcohol Use Disorder (Alcoholism)
The term Alcoholism has changed over the years. It used to also be called Alcohol Dependence, but the current and official name for the condition is Alcohol Use Disorder, according to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), which is published by The American Psychiatric Association.
The degree to which Alcohol Use Disorder impacts our society is tremendous. Thousands die in this country each year and millions more have their lives very negatively affected by from condition. In fact, about ten percent of the deaths within working adults aged 20-64 are directly related to excessive consumption of alcohol.
How Much Alcohol is Contained in Drinks?
For consistency, there is a definition of what is considered to be one, single drink. The phrase: “One Beverage Alcohol Equivalent” is used as a measure to describe a drink of alcohol. Specifically, a beverage alcohol equivalent is approximately the same as either a four ounce glass of wine, a twelve ounce can/bottle/glass of beer or an ounce/shot of whiskey or hard liquor. There can be variabilities depending on how the percent or “proof” of the alcohol content. As such, wine is usually about twelve percent alcohol; beer commonly contains about five percent alcohol; and liquor is 40% alcohol. The “proof” is double the alcohol content. So for example, a Vodka that’s 80 proof is also 40% alcohol. Pure Grain Alcohol is 190 proof, or 95% alcohol content by volume. Other examples of liquor include Tequila, Gin, Scotch and Rum. The terms Bourbon and Whiskey are often used interchangeably. Connoisseurs will say that Bourbon can only come from Kentucky and that other similar such liquor from other parts are actually Whiskey.
How Much Alcohol is Too Much?
It is first good to know that women, because of their size and weight compared to men; are equally effected compared to men while consuming about half the amount of alcohol over a given period of time. This means that a woman will have the same effect by drinking one beer per hour as a man drinking two similar such beers in an hour.
The amount of alcohol consumed which is considered to be excessive has been officially defined. Technically speaking, it is considered to be excessive drinking if any alcohol is consumed by a person under the legal drinking age of 21 or if consumed by a pregnant woman.
If a man drinks five or more, or a woman consumes four or more beverage alcohol equivalents in a single setting; that is referred to as Binge drinking. When a man drinks fifteen or more, or a woman drinks eight or more beverage alcohol equivalents per week; that is known as Heavy drinking.
It should be noted that most folks who engage in excessive drinking do not qualify as having Alcohol Use Disorder.
What Does Qualify as Having Alcohol Use Disorder (aka Alcoholism)?
According to the DSM-5, Alcohol Use Disorder is as follows:
Why is it Bad to Drink Too Much?
It is not good to have Alcohol Use Disorder. Alcohol adversely affects every single organ system in the body (except, interestingly, the Kidneys). There are both short-term and long-term health risks to consuming excessive amounts of alcohol. These include problems with one’s physical health and well-being, plus all of the other problems associated with drinking which affects one’s psychosocial status. For example, excessive drinking can cause acute liver failure as well as cause problems in an individual’s marriage and/or job. Too much drinking can lead to a DUI legal charge plus cause brain damage. A developing fetus exposed to alcohol can be born with birth defects. It is now known that excessive drinking is associated with cancer, especially involving the mouth, throat, esophagus, stomach, liver and colon. Teenage drinking leads to drunken driving fatalities every year. Alcohol in excess can damage the brain causing learning and memory problems.
Can a Person Drink So Much That They Can Die?
The answer is yes, one can drink so much to cause death. That is called Alcohol Poisoning. Acute Alcohol Poisoning needs to be attended to at an Emergency Department of a hospital. People die all the time from drinking too much alcohol and/or drinking it too quickly. A common fad easily found on any beach in this country over spring break is a device known as a “Beer Bong.” A beer bong is basically a funnel connected to a long tube. The funnel is positioned many feet above the person, who inserts the lower end of the tube into his or her mouth. Then, another person, say on a ladder from above, pours a large amount of beer into the funnel very quickly, causing all of the beer to flow into the person all at once. According the Centers for Disease Control (CDC), there are over 2,200 alcohol poisoning deaths each and every year in the US. That amounts to about six per day, or one every four hours, day in and day out, 24/7/365.
Does Alcohol Really Cause Problems in Society?
Everyone knows not to drink and drive, but it still happens, killing thousands of innocent people every year. In fact, about one-third of all motor vehicle accidents resulting in fatalities are alcohol related. In 2014, that amounted to almost ten thousand people killed in alcohol-related car crashes.
Alcohol is known to lead to violent and aggressive behaviors, whereby an intoxicated person may do or say things that they wouldn’t normally do if not intoxicated. In fact, a person can drink so much that they are in what is known as a “Black Out.” During and alcohol-induced black out, a person may even commit a murder and not remember anything about it later. More commonly, individuals engage in disinhibited sexual activity while intoxicated, and wake up the next morning in a strange bed, not remembering much of the previous evening. It’s not hard to imagine, how such activity contributed to unwanted pregnancies as in One Night Stand, as well as the spread of sexually transmitted diseases.
Is There a Safe Level of Drinking?
Some say that overall, it may be preferable to avoid alcohol entirely, especially if one takes medications on a regular basis. There are some recent studies which suggest that drinking at a moderate level can reduce the risk of having a heart attack. That amount of alcohol is considered to be up to five drinks per week, and no more. As such, a single glass of wine at dinner can be even beneficial to one’s overall health.
Why Would Somebody Need to be Detoxed to Get Off Alcohol?
If the average person drinks to excess (five or more) every day, for at least one month and then tried to stop abruptly; that person may develop what are known as Alcohol Withdrawal Symptoms. For example, let’s say a guy drinks a half pint of liquor or about eight beers every day for a couple of months. Then, the person stops drinking all at once. What is likely to happen is, within one to three days, the individual will become shaky and will have tremors and will feel quite ill. Usually, such a situation leads to the person resuming drinking to alleviate such withdrawal symptoms. If a person didn’t resume their drinking, the withdrawal symptoms can progress to a point when there can be hallucinations and confusion and disorientation. That is called Delirium Tremens or the “DTs.” A person with DTs could easily place themselves in a very dangerous situation. In addition to the DTs, such a person who abruptly stops drinking can have Seizures, or shaking Epileptic Fits. A seizure can cause a person to stop breathing, which can cause death.
How does the outpatient detox treatment work?
At The Drug and Alcohol Detox Clinic of South Mississippi, we are proud to be the only facility in South Mississippi to be able to offer outpatient detox from alcohol. We begin by always carefully screening by phone, anyone calling to setup an Initial New Patient Assessment. That way, we know what to expect before the new patient is seen for the very first time.
There are certain instances, when we may decide that the person is not a suitable candidate for outpatient detox. These can include the person being in poor health or having a severe, underlying medical condition. For such patients to be safely detoxed, they may require admission to an inpatient facility, like a hospital or behavioral treatment center. In most cases, we are able to accept the individual for outpatient detox treatment.
The Detox Phase
The Initial Treatment Plan for Alcohol Use Disorder at The Drug and Alcohol Detox Clinic of South Mississippi includes taking a prescription psychiatric medication around the clock over four days. The purpose of that is to reduce withdrawal symptoms AND to prevent a withdrawal seizure. Preventing a seizure is of utmost importance, as a seizure can result in stopping a person’s breathing. This can cause a stroke or can even be fatal. (To date, none of our patients have ever had a withdrawal seizure from coming off of alcohol.)
All patients undergoing outpatient alcohol detox need to have someone with them at all times, during the four day period when the patient takes the detox medication. That person must also accompany each new patient to their first appointment, so that the home alcohol detox procedure can be carefully explained and reviewed with both the “sitter” and the patient.
During the first appointment for alcohol detox, all patients are drug tested to help insure the detox procedure will be safe, as well as to identify any other substance abuse issues.
During the alcohol detox procedure, the patient is not to drive and must stay at home with the sitter at all times for four days until the treatment is completed. Our physician will be in contact with the patient and the sitter thoughout the process. Then, the patient returns to the clinic to begin the rehab phase of the treatment process.
The Rehab Phase
As soon as patient has been detoxed from alcohol, (again, a procedure which generally takes about four days); then the “real treatment” begins. Getting off alcohol is one thing, staying off alcohol is a completely different matter. Because we know how to do it, at The Drug and Alcohol Detox Clinic of South Mississippi we believe that it’s relatively easy to get patients off of alcohol, but it can be quite difficult to keep our patients off of alcohol. In fact, we must admit that we do not know how to actually keep someone from drinking, if they want to drink. We are absolutely committed to helping our patients in every way we know how, to have them maintain their sobriety goals.
In addition to helping our patients maintain long-term sobriety, we are also interested in providing Psychiatric Treatment when indicated.
Medications for Alcohol Use Disorder Treatment
There currently are three FDA approved medications for the treatment of Alcohol Use Disorder. They are:
1. Antabuse (or Disulfiram)
2. Naltrexone (or Revia or Vivitrol)
3. Campral (or acamprosate)
At our clinic, all three of those medications are used as clinically indicated, either individually or in combinations. In addition, there are other medications which have been scientifically studied and found to be effective for Alcoholism, but which are not FDA approved. All of the various treatment options are always reviewed, carefully explained and individualized for each new patient.
At The Drug and Alcohol Detox Clinic of South Mississippi, we take patient’s privacy very seriously. It is not even possible for anyone to find out you come to our clinic, unless you give us your written permission. We maintain complete compliance with HIPPA and all laws and statutes regarding patient confidentiality. Your call is completely confidential.
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