# I want to stop drinking - tell me about detox **URL:** \ **Category:** In My Humble Opinion\ **Created:** [March 2, 2016, 3:58am UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704 "2016-03-02T03:58:38Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![Rachellelogram](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rachellelogram/32/8689_2.png) [@Rachellelogram](https://boards.straightdope.com/u/Rachellelogram)\ **Post date:** [March 5, 2016, 2:01pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/61 "2016-03-05T14:01:45Z")
> [@cher3](#): > > Yes, basically. It’s hard to taper off a substance that reduces your “willpower” as soon as you ingest it. Also, as I mentioned, years of hard drinking do more to your body than get you addicted to alcohol. Medical supervision can treat nutritional issues, anxiety and other side effects. Thanks! I’ve been addicted to not-alcohol before, so I wasn’t sure of the difference. ---
**Author:** ![Kamakiri](https://avatars.discourse-cdn.com/v4/letter/k/f04885/32.png) [@Kamakiri](https://boards.straightdope.com/u/Kamakiri)\ **Post date:** [March 5, 2016, 3:44pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/62 "2016-03-05T15:44:30Z")
> [@Rachellelogram](#): > > Is there a reason simply tapering off gradually would be a bad idea? I’d like to know why medically-supervised detox is being recommended as a first-line solution when I (fortunately having never experienced alcohol addiction firsthand) would consider it a last resort. Is it a willpower issue? It’s what I mentioned close to Page 1. I’d say the only reason NOT to do it our way (tapering) would be a lack of complete understanding of the process. Anything that could conceivably end in seizures or even death— the possibilities of which are no matter how vanishingly remote—should not be tried by anyone without a near-medical understanding of the process. And most people will not have a near-medical understanding of the process. Thus: the professionals. It might be compared, albeit clumsily, to taking your first skydiving jump solo, instead of availing yourself of a tandem jump instructor. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 5, 2016, 3:56pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/63 "2016-03-05T15:56:09Z")
We had a lovely chat in [this thread about alcohol withdrawal](http://boards.straightdope.com/sdmb/showthread.php?t=745738) where a few posters tried to argue that the dangers were hyped and overblown, but were rebutted by myself and others. Botton line: Delerium Tremens can occur in about 5-12% of people who are physiologically alcohol-dependent, and the mortality rate for untreated DTs can go as high as 40%. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 5, 2016, 4:30pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/64 "2016-03-05T16:30:33Z")
Isn’t cutting 1-2 drinks out a day considered the go to method of detox at home? if you are drinking 20 drinks a day, cut 1-2 out a day until you are down to 0. It’ll take 10-20 days, but it should make it much easier. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 5, 2016, 4:46pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/65 "2016-03-05T16:46:42Z")
> [@Wesley\_Clark](#): > > Isn’t cutting 1-2 drinks out a day considered the go to method of detox at home? if you are drinking 20 drinks a day, cut 1-2 out a day until you are down to 0. It’ll take 10-20 days, but it should make it much easier. Also I know detoxing w/o treatment carries a real risk of death (something in the 1-5% range, I can’t recall). However, realistically, what % of the human race has access to the best medical treatment when quitting alcohol? Maybe 10-20%? If that? Has the step down method been studied as a way to reduce mortality among people who, for whatever reason, cannot get proper medical care? If so what are the results? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 5, 2016, 5:08pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/66 "2016-03-05T17:08:02Z")
> [@Wesley\_Clark](#): > > Has the step down method been studied as a way to reduce mortality among people who, for whatever reason, cannot get proper medical care? If so what are the results? Studies of the step down method have shown that people who drink alcoholically (i.e. the people who need to ‘step down’) are seldom able to adhere to it due to their alcoholism. If it’s done under constraint/medical supervision so it’s adhered to, mortality and morbidity are reduced significantly, but not as much as by using benzodiazepines instead of alcohol. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 5, 2016, 5:23pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/67 "2016-03-05T17:23:11Z")
Thanks ---
**Author:** ![Smapti](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smapti/32/17938_2.png) [@Smapti](https://boards.straightdope.com/u/Smapti)\ **Post date:** [March 5, 2016, 5:25pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/68 "2016-03-05T17:25:48Z")
> [@Qadgop\_the\_Mercotan](#): > > Studies of the step down method have shown that people who drink alcoholically (i.e. the people who need to ‘step down’) are seldom able to adhere to it due to their alcoholism. I don’t think I’d be able to stick to it on my own, honestly. There’ve been times I’ve tried to tell myself “I’m only drinking so much today and that’s it”, but I never can keep to that and I just sort of end up “chain-drinking” until either it’s time for me to stop and go to bed, or I realize that I’ve drunk more than I can handle (which usually happens about halfway into the drink after the one that should have been my last). I’m pretty confident that the only way I’m going to break this habit is in a situation where I don’t have access to alcohol - and once I get there, I think it’s going to be easier for me to stay that way. I’m not seeing my GP until next Tuesday, but I’m seeing my gastroenterologist on Monday to follow up on an endoscopy I had last month, and I plan on bringing this up with her also. I’ve been having heartburn/nausea issues for years that meds haven’t resolved, and I thought it was acid reflux, but looking back on things now it occurs to me that the pain is worst when I’m sober and maybe that’s connected to my drinking as well. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 5, 2016, 7:58pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/69 "2016-03-05T19:58:33Z")
> [@Qadgop\_the\_Mercotan](#): > > Studies of the step down method have shown that people who drink alcoholically (i.e. the people who need to ‘step down’) are seldom able to adhere to it due to their alcoholism. > > If it’s done under constraint/medical supervision so it’s adhered to, mortality and morbidity are reduced significantly, but not as much as by using benzodiazepines instead of alcohol. So is a person in African or southeast asia, who probably cannot get an in-patient detox, going to see meaningful reductions in mortality by going to a physician and getting an Rx for benzodiazepines and told to use the step down method? ---
**Author:** ![MichaelEmouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/michaelemouse/32/101_2.png) [@MichaelEmouse](https://boards.straightdope.com/u/MichaelEmouse)\ **Post date:** [March 5, 2016, 8:04pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/70 "2016-03-05T20:04:37Z")
> [@Qadgop\_the\_Mercotan](#): > > If it’s done under constraint/medical supervision so it’s adhered to, mortality and morbidity are reduced significantly, but not as much as by using benzodiazepines instead of alcohol. Why is stepping down with benzo more effective than stepping down with alcohol? What kills people with DT? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 6, 2016, 1:47am UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/71 "2016-03-06T01:47:15Z")
> [@Wesley\_Clark](#): > > So is a person in African or southeast asia, who probably cannot get an in-patient detox, going to see meaningful reductions in mortality by going to a physician and getting an Rx for benzodiazepines and told to use the step down method? How should I know? I doubt such a study has been done. But any treatment which gives control of the alcohol/benzo to the patient who is withdrawing is set up to fail, as such a patient is unlikely to use the substances as prescribed. if they did, they wouldn’t be addicts. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 6, 2016, 1:55am UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/72 "2016-03-06T01:55:43Z")
> [@MichaelEmouse](#): > > Why is stepping down with benzo more effective than stepping down with alcohol? Benzos are much safer drugs than alcohol is. Alcohol is toxic to neurons and to the liver, even in healthy individuals. And benzos are much more calming for excited neurons than reduced levels of alcohol. Benzos are not stepped down either, at least not until the withdrawal has been managed. THEN benzos are tapered. > [@](#): > > What kills people with DT? Fluids and electrolytes are badly disordered. Dehydration, low potassium and magnesium can lead to seizures and fatal dysrhythmias, low phosphorus can contribute to breakdown of muscle tissues, respiratory alkylosis from hyperventilating further screws up the ability of the body to keep blood flowing to the brain and electrolytes like sodium, potassium, chloride in balance. To name a few amongst the many mechanisms that go wrong. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 6, 2016, 2:38am UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/73 "2016-03-06T02:38:30Z")
> **[Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/)** > > Alcohol dependence is an increasing and pervasive problem. Alcohol withdrawal symptoms are a part of alcohol dependence syndrome and are commonly encountered in general hospital settings, in most of the departments. Alcohol withdrawal syndrome ranges... > **[Clinical management of alcohol withdrawal: A systematic review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/)** > > Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the... ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 6, 2016, 2:43am UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/74 "2016-03-06T02:43:14Z")
> [@Wesley\_Clark](#): > > [Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond - PMC](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/) > > [Clinical management of alcohol withdrawal: A systematic review - PMC](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085800/) I don’t see any mention of African or southeast Asian patients and availability/lack thereof of inpatient detox units in those locations in your cites. :rolleyes: ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 6, 2016, 5:27pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/75 "2016-03-06T17:27:38Z")
> [@Qadgop\_the\_Mercotan](#): > > I don’t see any mention of African or southeast Asian patients and availability/lack thereof of inpatient detox units in those locations in your cites. :rolleyes: Thats nice. The mention of Africa or Asia was about people who probably cannot get proper medical care. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [March 6, 2016, 5:58pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/76 "2016-03-06T17:58:59Z")
> [@Wesley\_Clark](#): > > Thats nice. The mention of Africa or Asia was about people who probably cannot get proper medical care. There’s tons of folks in the US who can’t get it either. I see a lot of them. It’s maddeningly frustrating. But it actually is improving somewhat with ACA and other reforms. My point is that benzodiazepines are the drug of choice for alcohol withdrawal therapy, and that the chances for success are far far greater if the patient does not control the dosing/intervals for the medication. Whether control is in the hands of a treatment team in an inpatient setting or those of a family member or trusted friend or hired nurse, the control should reside with someone else. I’d use gradually reduced doses of alcohol to treat alcohol withdrawal **only** if more appropriate drugs were unavailable. Because it’s less safe to taper off alcohol. I’ve been taking care of alcoholics and addicts since 1980, and I’ve seen and done a lot of detox; I’ve had to cut corners, make compromises to get patients to engage at all and for harm reduction, etc. I’ve seen people die from it too, when they came in too late, or just got unlucky. ---
**Author:** ![Emiliana](https://avatars.discourse-cdn.com/v4/letter/e/f0a364/32.png) [@Emiliana](https://boards.straightdope.com/u/Emiliana)\ **Post date:** [March 6, 2016, 8:15pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/77 "2016-03-06T20:15:22Z")
This is a funny conversation. I’m trying to imagine being sent home from the detox unit/doctor’s office with a fistful of benzos under my control. Sounds great!! Just not so good for sobriety. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [March 6, 2016, 8:38pm UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/78 "2016-03-06T20:38:39Z")
I was given a refillable script for Ativan and sent home. Of course, I had been using one benzo or another for 5 or so years at the time for sleep. I think I may still have a few of the sleepers which didn’t work. ---
**Author:** ![cher3](https://avatars.discourse-cdn.com/v4/letter/c/da6949/32.png) [@cher3](https://boards.straightdope.com/u/cher3)\ **Post date:** [March 8, 2016, 2:27am UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/79 "2016-03-08T02:27:49Z")
> [@Emiliana](#): > > This is a funny conversation. I’m trying to imagine being sent home from the detox unit/doctor’s office with a fistful of benzos under my control. > > Sounds great!! Just not so good for sobriety. If you just show up in the ER as many people do, they don’t really consider anything beyond keeping you from dying from complications of alcohol detox to be their responsibility. Staying clean and sober is your problem. ---
**Author:** ![Smapti](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smapti/32/17938_2.png) [@Smapti](https://boards.straightdope.com/u/Smapti)\ **Post date:** [March 14, 2016, 6:30am UTC](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704/80 "2016-03-14T06:30:40Z")
Had a seizure in bed this afternoon. Called 911. ER doctor says it looks like DTs. Being admitted to hospital now. I had hoped to do this on my terms, but it looks like it’s happening. [Previous page](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704.md?page=3) [Next page](https://boards.straightdope.com/t/i-want-to-stop-drinking-tell-me-about-detox/747704.md?page=5)