Alcohol Withdrawal and Blood Pressure Risks

Alcohol dependency creeps in stealthily, like a thief in the night. What might have begun as an evening relaxation ritual slowly encroached into your daily life. As tolerance to the effects of the alcohol increased, higher consumption seemed to follow. Over time, what started out as a panacea for stress or emotional issues became its own serious problem.

When facing the prospect of getting treatment for an alcohol use disorder, the thought of going through the detox and withdrawal stage may seem daunting. This initial hurdle, one that is essential to recovery, may be so dreaded that it becomes a serious barrier to treatment. In this event it is important to take the long view, to envision detox as just a short-lived challenge to overcome in order to enjoy a life free from the grip of alcohol.

Alcohol detox and withdrawal, however, does come with some risks. Although alcohol withdrawal symptoms can vary significantly from one individual to another, ranging from mild to severe, because of the unpredictable nature of these symptoms it is always advisable to obtain a medically monitored detox. Alcohol withdrawal and blood pressure elevation, or any one of several other serious symptoms, can evolve quickly into a medical emergency.

About Alcohol Use Disorder

Alcoholism is a chronic relapsing disease that impacts brain chemistry and the central nervous system. Once the body has become accustomed to the daily consumption of alcohol it will react when alcohol is withheld, initiating withdrawal symptoms that send you right back to the alcohol for relief. The symptoms of alcohol addiction or chemical dependence include:

• Unable to stop drinking once started, never feeling sated
• Being able to drink increasing levels of alcohol
• Blacking out, having no memory of actions, whereabouts, or conversations
• Lying about your level of drinking
• Hiding alcohol from family members
• Neglecting responsibilities at home or work
• Relationship problems caused by excessive drinking
• Attempting to stop drinking but cannot
• Withdrawal symptoms emerge when attempting to stop

Alcohol use disorder has the potential to cause a slew of significant disruptions and negative consequences in one’s life. These might include:

• Loss of employment
• Damage to professional reputation
• Legal problems, such as getting a DUI
• Interpersonal problems, divorce
• Social withdrawal and isolation
• Financial problems
• A co-occurring mental health disorder may develop

There are many reasons to take that first step toward sobriety. When facing down the detox and withdrawal phase of recovery, it is best to view it as a necessary first step to a new, healthy, and productive life.

The Importance of a Medically Monitored Detox

When someone with an alcohol use disorder decides to get sober there are some important things to consider. First, it is generally considered a bad idea to attempt to detox without a trained detox team supervising the process. The spectrum of withdrawal symptoms during alcohol detox is wide, from minor tremors and insomnia to the delirium tremens (DTs). Because of the potential for a serious medical emergency occurring during detox and withdrawal, it is usually recommended that the individual have a medically monitored detox.  This type of detox will provide the appropriate medical attention should alcohol withdrawal and blood pressure increases team up to cause a serious medical condition.

A medical detox provides the safest route to sobriety, where trained detox medical providers monitor the detox and withdrawal phase of early recovery. While supervising the process, the detox professional will utilize various medical and holistic interventions to help alleviate the painful withdrawal symptoms. Without this support, the difficulty experienced during detox can derail recovery right at the outset. The detox support team will provide medications, such as benzodiazepines, to assist with anxiety and insomnia, which can also help with alcohol withdrawal and blood pressure spikes, as these drugs are sedatives. In addition, they will access over-the-counter medications to help with fever and chills, nausea and vomiting, diarrhea, and other symptoms. The psychological support provided by a medical detox team is critical to helping the individual get through the challenging detox process and then safely transition to active treatment.

What to Expect During Alcohol Detox and Withdrawal

Upon entering the residential program a thorough intake interview will be conducted.  Health status, addiction history, and mental health history will be assessed in an effort for the provider to anticipate any potential risks during the detox process. The severity of symptoms is determined by various factors identified during the initial evaluation.

These factors include:

• The age of the individual
• The general health status, if there are any medical conditions present
• The length of history of the alcohol use disorder
• The usual amount of alcohol consumed on a daily basis
• The existence of another substance use disorder
• The existence of a co-occurring mental health disorder

When an individual abruptly discontinues alcohol intake they will begin to experience withdrawal symptoms within 6-8 hours. Withdrawal symptoms are in response to the brain and central nervous system having made adjustments over time in response to the alcohol. Brain hyper-excitability ensues when the alcohol is withheld, leading to a range of highly uncomfortable symptoms.

Alcohol detox typically occurs in three stages. The first stage begins within 8 hours after the last alcoholic beverage and lasts about 24 hours. During this first stage, withdrawal symptoms include sweating, nausea, vomiting, hand tremors, irritability, and sleep difficulties. The second stage occurs on days 2-4 and involves the most intense symptoms, such as increased heart rate, elevated blood pressure and body temperature, mental confusion, mood swings, alcohol cravings, anxiety, and depression. The final stage, starting at day 4 and lasting 3-5 days, is the phase when symptoms begin to subside.

Alcohol withdrawal symptoms may include:

• Shaky hands
• Irritability
• Nausea
• Vomiting
• Sweating
• Headache
• Agitation
• Insomnia
• Anxiety
• Confusion
• Hallucinations
• Disorientation
• Seizures

In some cases, unpredictable withdrawals symptoms can suddenly emerge on days 3-4, called the delirium tremens (DTs). For this reason, having medical personnel available who can manage the DTs is essential during the first 3 or 4 days of detox.

What Are the Delirium Tremens (DTs)?

In a small percentage of individuals, or 3%-5%, a medical emergency called the DTs can present a serious medical condition. The DTs might catch the individual completely off guard, which is why the development is so dangerous. In 5%-15% the DTs can lead to death. Alcohol withdrawal and blood pressure that rises dangerously, in addition to these symptoms, requires immediate medical intervention:

• Grand mal seizures or convulsions
• Delirium
• Hallucinations
• Hypertension
• Very high fever
• Cardiac arrhythmias
• Hyperthermia

Getting help with DTs may mean a hospital stay to help stabilize the individual and improve the outcome. Treatment will involve benzodiazepines and/or barbiturates or phenobarbital, often using IV infusion for quick relief until symptoms stabilized and begin to subside. Dosing is determined by the specific withdrawal signs observed, such as delirium, and will incrementally be reduced over a period of several days once the severe symptoms have stabilized.

How is Alcohol Use Disorder Treated?

Alcohol addiction treatment immediately follows detox and withdrawal, and may involve an extended recovery program. The residential treatment setting provides the highest level of care, with 24-hour support and monitoring and a full schedule of daily treatment elements designed to help the individual overcome the alcohol addiction.

Alcohol recovery elements include:

• Psychotherapy. Psychotherapy is the cornerstone of alcohol recovery, as it helps the individual examine underlying emotional issues or past traumas so these can be worked through. Cognitive behavioral therapy (CBT) provides a roadmap for making core changes in thought-behavior patterns that have kept a person trapped in addiction behaviors. The recovery skills learned in CBT help reframe disordered thinking into more positive, affirming thoughts.
• Group sessions. Meeting with peers or family members to discuss topics related to recovery can help those in recovery learn how to communicate, and listen, more effectively.
• Education. Learning about the impact of alcohol on brain chemistry and structure can be a deterrent to relapse, and includes guiding the individual with relapse prevention strategies and new coping skills.
• Naltrexone. Naltrexone is a non-narcotic medication that can assist in reducing alcohol cravings and relapse for those who meet criteria for usage.
• 12-step or similar programming. The meetings provide important peer support and the opportunity to share experiences, challenges, fears, and goals with others in recovery.
• Adjunctive activities. Rounding out rehabilitation are several activities that augment the evidence-based therapies, including mindfulness training, yoga, massage, art therapy, acupuncture, recreational therapy, EMDR, equine therapy.

The Importance of Aftercare in Recovery

Consider addiction treatment and recovery as an ongoing continuum of care. The detox and withdrawal phase launches recovery, followed by therapy in a residential treatment program. But that is only the beginning of the therapeutic process. Aftercare, or continuing care, in addiction recovery involves ongoing interventions that can help to solidify and support recovery.

Through engagement in activities that reinforce sobriety, the chances of maintaining a sustained recovery are greatly improved. Individuals in early recovery are bound to encounter challenges to sobriety. These challenges may be emotionally overwhelming, possibly triggering a relapse. Aftercare options provide an added safety net where the individual will receive peer and professional support to help navigate these stressors as they occur. Aftercare efforts should include ongoing outpatient therapy, group therapy, and engagement in a recovery community.

Elevation Behavioral Health Provides Medical Detox for Alcohol Use Disorder

Elevation Behavioral Health is a Los Angeles-based residential recovery program that offers medical detox services and comprehensive addiction treatment for individuals with an alcohol use disorder. Our luxury accommodations and stunning setting help to provide comfort and healing while engaging in the comprehensive treatment program. For more information about the program, please contact Elevation Behavioral Health today at (888) 561-0868.