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Face it, if you are dependent on alcohol, quitting is going to be hell. Of course, what do they say; “if you have to go through hell, don’t stop, keep going.” Yes, it’s a New Year, so perhaps one of your New Year’s Resolutions is to stop drinking, or maybe you just want to cut back substantially. If you are already an alcoholic, you know you are going to have to quit completely. You are probably wondering if that is even possible?

Well, it is possible, but you probably won’t be able to pull-it-off by yourself. You are going to need some support from friends and family, and perhaps some professional assistance, especially if you want it to stick. In fact, 90% of do-it-yourself alcohol detox successes relapse in less than four years. Most of those in the first 3-6 months. Okay so, 100% minus 90% = a 10% success rate for do-it-yourself alcohol detox.

Another interesting fact is that after so many tries and so many failures, dependent alcohol users stop believing they can quit or that it is even possible. That’s another depressing and sad fact.

Do-It-Yourself Alcohol Detox Can Be Dangerous to Your Health

Most people that try a Do-It-Yourself detox attempt to quit Cold Turkey. If you’ve been drinking for a while and consume a large amount of alcohol, chances are your body has become tolerant to the effects of the alcohol (poison, neurotoxin). Your body has become used to it, adjusted to it, and it has rewired your brain and your system.

If you abruptly take it away, your body can no longer function without it. That’s when all hell can break loose. This phenomenon is more than just overwhelming withdrawal symptoms. It’s literally shutting down your internal organs. This could lead to kidney failure, heart attack, lung problems, delirium tremens, ketoacidosis, brain damage, even death (cite below).

The Romanticism of the Cold Turkey Tough Guy Bravado

So, why do so many people try and fail at their do-it-yourself detox New Year’s Resolutions and goals? Well, if you’ve tried and failed in the past you certainly are not alone. You shouldn’t beat yourself up about it, or dwell on your failure. It’s not that you lack the will or character to see it through. The real problem is your body can’t handle it. Look, no matter how tough you think you are, or how much pain you can force yourself through – there is still the reality behind the alcohol use disorder.

If you want to quit and do it without further damaging your health, you’ll need some professional medical help. Yes, you’ll still need family support, and yes, you’ll still need to change your lifestyle and various hobbies, perhaps some friends too. Yes, even after you are over the withdrawal symptoms and done with rehab, you’ll still need to join a local AA group and stick with it (cite 1).

Why do you need professional medical help? First, because everyone’s situation is a little different. Your consumption levels may be more or less than someone else. You may have been drinking longer, perhaps all your life. Your alcohol consumption may involve all aspects of your life, your work, relationships, and social affairs. Your age also matters, so too does your current health status. Thus, you need a doctor who can customize your alcohol detox program.

Second, an addiction specialist with a medical background can best prescribe you substitute drugs that take the place of alcohol. This allows your body to get what it needs to function in place of the dependency on alcohol. This in no way means it will be a walk in the park, but it will prevent seizures and organ failure, and reduce withdrawal extremes.

Why Are Residential Alcohol Treatment Centers Best?

Residential alcohol treatment centers have a better success rate than alcohol treatment centers which only see a patient for a few hours at a time. This is because when you visit a clinic, you then go back home, to the same place and environment that is enabling your drinking, perhaps causing you the stress causing you to want to have a drink.

Also, at a residential alcohol treatment center, it’s a more relaxed atmosphere, where addiction specialists can observe your progress, offer assistance and be there for you during the most intense periods of alcohol withdrawal and all the raw emotions that go along with the process (cite: 2).

Are you beginning to understand why do-it-yourself detox rarely works? Maybe you can see why a little investment now will give you your life back and pay dividends for the rest of its duration. The price of residential rehabs are quite expensive, and yes, addiction clinics much cheaper, but if you have a relapse you could hurt your health and you’ve wasted all the money you spent at the cheaper clinic.

References:

1.) “Alcoholics Anonymous Outcomes and Benefits,” by J. Scott Tonigan. Published in Recent Developments in Alcoholism pp 357-371, on June 30, 2008.

2.) “Determinants of suggestions for alcohol treatment,” by Robin Room, Susan Bondy, and Jacqueline Ferris. First published: May 1996.

To properly assess an individual with opioid dependency it’s important to know how they became addicted. Was it through pharmaceutical drugs containing Fentanyl? Did their prescription run out, so they went to the street to get ahold of illegal drugs to suffice during excruciating and tormenting times of withdrawal? How much did they take and how long did they take it? What else did they take?

It’s important to know the family history. Are there any other dependencies in the family; alcohol, drugs, etc. Is there any family history of mental illness? What types? Has the patient been previously diagnosed with any mental disorders do they have a history of mental health issues?

It’s important to get a genetic test, as certain genes respond differently to different medications, as often medications are given in place of opioids to help with withdrawal symptoms. These drugs are administered during a specifically timed drawdown, this might take weeks. It’s important to use the right medicines which match the individual’s gene set.

How much damage has been done to the brain’s neurotransmitters, to the patient’s kidneys, and the central nervous system? What is the patient’s health care provider willing to pay to treat the addiction?

How serious is the individual in seeing this through? You cannot help someone against their will, as they will remain dependent still. Has the patient been to a rehab facility previously and relapsed? How many times? What previous medicines have been prescribed in past rehab treatments? Has the patient attempted a do-it-themselves program? Is the family committed, caring, and ‘all-in’ with all their love (cite: 1, 2, 3)?

Opioid Relapse Is All Too Common

When it comes to heroin, only about 28% of the addicts studied in long-term research had stable abstinence after 10-30 years of observation. The 28% is of those who survived, as heroin addicts had 6-20 times more likelihood of dying than the average person in our general population (cite: 6). Those who used medicine replacements/alternatives for the entire duration of the withdrawal period had the best chances of staying clean.

Those who had a co-occurring addiction with meth (Methamphetamine), that is to say, addiction to opioids and meth, had twice the chance of dropping out of a treatment program, thus not even finishing treatment (cite: 4).

A Rutgers University study showed that 46% of those who successfully completed dependency treatment for opioid addiction relapsed within 7-months. Their research also noted that those with a high-risk tolerant personality were most likely to relapse (cite: 8). The Rutgers study was for ‘all’ types of opioid treatment programs, and any situation, bunching it all together. Still, that nears 50%, which is a scary number, and this study is also only for the first seven months. Most of those who were still clean after five years of abstinence were able to maintain a clean life without opioids (cite: 5).

Why is Opioid Addiction Relapse So Common?

Why is opioid relapse so common? Why is it that standard treatments often don’t work? Well, this gets back to our previous statements above. It’s because of how the opioid rewires your brain. And, it’s because most addiction treatment plans don’t take into consideration the patient’s ‘exact situation’.

The best treatment centers spend a significant amount of time doing due diligence, asking the right questions, doing the right tests, and getting to know the patient before preparing a perfect personalized treatment program. No two dependency treatment programs should be the same for the obvious reason; no two situations are completely the same, and no two people are alike. Find a treatment center that pays pay attention to the details.

References:

1.) NIH, National Institute on Drug Abuse website article; “Principles of Effective Drug Treatment (Third Edition),” updated last in January 2018.

2.) “Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs,” by Steven L. Batki, Janice F. Kauffman, Ira Marion, Mark W. Parrino, and George E. Woody, US Department of Health and Human Services, 356 pages.

3.) “An Action Guide for Management of Opioid Dependence: Next Steps for Patients and Families,” by CEPAC, New England Comparative Effectiveness Public Advisory Council, September 2014, part of the “Management of Patients with Opioid Dependence: A Review of Clinical, Delivery System, and Policy Options,” program.

4.) “Long-Term Course of Opioid Addiction,” by Hser, Yih-Ing; Evans, Elizabeth MA; Grella, Christine; Ling, Walter MD; and Anglin, Douglas. published in Harvard Review of Psychiatry: March/April 2015 – Volume 23 – Issue 2 – p 76-89, doi: 10.1097/HRP.0000000000000052.

5.) “Association between methamphetamine use and retention among patients with opioid use disorders treated with buprenorphine,” by Judith Tsui, Jim Mayfield, and Elizabeth Speaker, et. al., published in the Journal of Substance Abuse Treatment.

8.) The Daily Targum, article; “Patients tolerant of risks most often relapse their opioid addictions, Rutgers researchers find,” by Brendan Brightman, published on December 8, 2019.