Inpatient Alcohol Detox vs. Outpatient Alcohol Detox

Inpatient Alcohol Detox vs. Outpatient Alcohol Detox

Alcohol detox can present serious health challenges depending upon the length of the addiction, the amount of alcohol consumed on a regular basis, and the person’s general emotional and physical health. There varying are levels of the severity of alcohol detox, which are determined by the factors mentioned above.

Symptoms, when detoxing from alcohol, can range from mild tremors to withdrawal seizures. Closely monitored medical detox (inpatient alcohol detox) is used to avoid immediate negative withdrawal symptoms and to avoid cumulative effects if future withdrawals should occur. The number of times one goes through alcohol detox can determine the severity of withdrawal symptoms.

Outpatient Alcohol Detox

While most people initially want to stay at home to detox, but it is usually not always the best option either in the short term or the long term. Detox is the process through which the toxins in the brain and body (a result of drug and alcohol abuse and dependence) are eliminated. Oftentimes, people will opt to detox at home utilizing outpatient detox procedures. Generally this means the addict will go to a clinic, perhaps they will receive medication to be taken at a specific time of day and then are expected to manage the withdrawal symptoms at home. Withdrawal symptoms can be mild, moderate or severe. The clinics may use a scoring method known as the Clinical Institute of Withdrawal Assessment for Alcohol to determine the level of withdrawal intensity which in turn will determine the medications prescribed or not prescribed.

The idea of outpatient detox and treatment is based upon the assumption that the addict can manage cravings, feelings, medical symptoms and environmental triggers on their own.

The idea of outpatient detox and treatment is based upon the assumption that the addict can manage cravings, feelings, medical symptoms and environmental triggers on their own. It is promoted by some organizations as a reasonable alternative to medically monitored inpatient detox and treatment. Outpatient detox and treatment rely upon the patient’s ability to participate in accurate self reporting. This can be a flawed process as the emotional responses to withdrawal can be created by the drug, or the patient may be in denial or simply not understand his or her own behaviors. or medical symptoms.

Within the context of outpatient detox and self reporting, there is no opportunity for independent observation to challenge the addict and his or her perceptions. Furthermore, the addict must rely upon a strong support system, the ability to focus, the desire to keep moving forward through detox regardless of the physical and emotional discomforts, and the ability to avoid people, places, and things associated with alcohol consumption.

Symptoms of alcohol withdrawal can begin anywhere from 6 to 48 hours after the last drink and can last up to a week. Post-acute withdrawals symptoms can linger for months at a time. It is generally considered prudent to monitor vital signs with regularity, something that may not happen in outpatient alcohol detox. Furthermore, a complete physical evaluation and regularly updated reports need to be done to keep abreast of the potential problems associated with poor health, poor eating habits, and alcohol abuse. For example, the alcoholic may have changes in the digestive system which prevent the absorption of nutrients into the blood stream resulting in malnutrition.

Patients with mild withdrawal symptoms may be able to handle the stressors associated with outpatient alcohol detox. However, for those with moderate to severe withdrawal symptoms, inpatient treatment is the safest and wisest form of detox.

Relative Indications for Inpatient Alcohol Detoxification

• History of severe withdrawal symptoms.
• History of alcohol withdrawal seizures or delirium tremens.
• Multiple past detoxifications.
• Concomitant medical or psychiatric illness.
• Recent high levels of alcohol consumption.
• Lack of reliable support network.
• Pregnancy.

(Source: http://pubs.niaaa.nih.gov/publications/arh22-1/38-43.pdf)

Generally, the drugs used for alcohol detox, part of the short and intermediate acting benzodiazepine group such as Serax, Ativan, Librium and diazepam, are used most often in the inpatient setting, as well as Haldol or other antipsychotic medications, to treat the DTs (delirium tremors or shaking frenzy). Further rationale for inpatient treatment is related to the issue of seizures and the DTs. The NIAAA report states that one-third of patients suffering from untreated primary seizures subsequently develop DTs.

Understanding the differences between inpatient alcohol detox and outpatient detox is significant as it can mean the difference between completing detox and moving on to treatment or leaving uncompleted. In such cases, the addict returns to drinking or binge drinking with the body having gone through withdrawal. As stated above, multiple withdrawal episodes from alcohol can intensify the symptoms and future health consequences. Whenever possible inpatient, medically monitored detox should be sought followed immediately by a medically based best practices alcohol treatment program.