Outpatient Detox: Managing Alcohol Withdrawal at Home

Alcohol withdrawal symptoms can occur when a person stops or cuts back on drinking after a long period of regular or heavy use. Because withdrawal symptoms can be painful, uncomfortable, and sometimes severe or life-threatening, many people choose to detox under medical supervision in a hospital, inpatient facility, or outpatient detox program.¹

What Are the Symptoms of Alcohol Withdrawal?

You may start to experience alcohol withdrawal symptoms within eight hours of your last drink. Symptoms usually peak within 24-72 hours, but some withdrawal symptoms can linger for weeks.¹

Some commonly reported alcohol withdrawal symptoms include:¹

• Sweating
• Clammy skin
• Rapid heart rate
• Pale skin
• Tremors
• Nausea
• Vomiting
• Headache
• Insomnia
• Irritability
• Anxiety or nervousness
• Depression
• Loss of appetite
• Fatigue
• Jumpiness
• Mood swings
• Nightmares
• Confusion
• Impaired cognition

Delirium tremens (DT) is the most severe form of alcohol withdrawal syndrome than can occur. DT is characterized by the following symptoms:¹

• Fever
• Agitation
• Severe confusion
• Hallucinations
• Seizures

What Is Outpatient Detox?

Outpatient detox refers to medically assisted detox taking place in an outpatient setting. This involves daily visits to a physician’s office or an outpatient addiction treatment center. Sometimes outpatient detox can be provided in a person’s home through a qualified home health agency.

The goal of outpatient detox is to reduce withdrawal symptoms, prevent complications, and help get people into alcohol addiction treatment programs to obtain long-term recovery and abstinence.¹

What to Expect in Outpatient Detox

When you first begin outpatient detox, your provider will perform a physical exam, take blood and urine samples, and possibly perform a toxicology screen. Your detox team may also observe you for the following symptoms:¹

• Fever
• Rapid breathing
• Rapid heart rate or abnormal heart rhythms
• Abnormal eye movements
• Dehydration
• Shakiness

You will likely need to make daily visits to your medical provider until you complete the withdrawal period. Someone should accompany you and keep an eye on you through the process.¹

Alcohol Detox Medications

Depending on the severity of your symptoms, you may be given certain medications to help you through the detox process. Sedative medications are often administered to help ease and control withdrawal symptoms, reduce or prevent seizures, and make you feel more comfortable^.1

The FDA has approved acamprosate specifically for alcohol detox.

Some other commonly administered medications for alcohol detox include:^{2, 5}

• Benzodiazepines
• Carbamazepine
• Oxcarbazepine
• Gabapentin
• Valproic acid
• Atenolol
• Clonidine
• Baclofen
• Haloperidol

You may also be given certain vitamins during your detox period, such as thiamine, folic acid, and magnesium, to lower your risk of alcohol-related brain damage and other complications.^3,5

In milder cases of withdrawal, detox medications may not be needed, but typically vitamins are still recommended to help support your body and prevent your condition from worsening.⁴

It is also vital to understand that some medications like benzodiazepines may not be the best option for long-term abstinence since they have a strong potential for addiction and increased risks when combined with alcohol.⁴ Talk with your provider about which medication is best for you.

Outpatient Detox Treatment and Modalities

The goal of detox treatment is not only to detox you safely and comfortably but also to help you achieve abstinence and sustain long-term recovery. You may be offered individual counseling or family therapy at your outpatient detox center to discuss the long-term adverse effects of alcohol use disorder (AUD) and provide you with tools to help you stop or cut back on drinking.¹

Your medical team may also perform additional medical testing and possibly treatment for any medical conditions you may have, linked to your alcohol use^.1

Outpatient Detox Schedule

Your outpatient detox schedule may vary greatly depending on where you receive detox services. However, alcohol detox almost always involves daily visits to your physician’s office or detox center for monitoring and administering medications. You may also be responsible to take some oral medications on your own at home.

Depending on your treatment plan, your detox schedule may include segues into addiction treatment, such as regular counseling visits and attendance at support groups as well.

What Are the Benefits of Outpatient Detox?

Generally, outpatient treatment is just as effective at treating alcohol detox as inpatient detox for those with mild to moderate withdrawal symptoms.²

Outpatient detox requires less interruption from daily life and is typically a more affordable option than inpatient detox, partial hospitalization, or intensive outpatient services.³

Who Is the Best Candidate for Outpatient Detox?

People with mild to moderate alcohol withdrawal symptoms can often get treated in an outpatient detox setting.¹ However, outpatient detox is generally only considered appropriate when you have a positive and supportive social network. Family support is critical to the success of outpatient treatment.³

It is also vital that you have reliable transportation to and from the facility daily and that you are able and willing to follow treatment guidelines. Outpatient detox is often preferred by people with small children at home to care for or those who have work or school obligations to attend to outside of treatment.

Outpatient detox is generally not the best option for those with: ^2,3,5

• History of seizures, delirium tremens, or severe withdrawal symptoms
• Co-occurring medical conditions
• Co-occurring substance use disorders
• History of psychosis or suicidal thoughts

How Is Outpatient Detox Different from Other Programs?

While the ultimate goal of all detox programs is the same, there are key differences between inpatient and outpatient detox and partial hospitalization (PHP) and intensive outpatient detox (IOP).

Inpatient Detox

Inpatient detox takes place in a hospital or other inpatient setting where the patient resides in the facility 24-7 until the detox period is complete. Inpatient detox is typically the best option for people with moderate to severe withdrawal symptoms and those with increased risk of complications who need more intensive care, monitoring, and support.¹

Intensive Outpatient Programs and Partial Hospitalization Programs

Intensive outpatient detox and partial hospitalization programs offer more intensive care than standard outpatient detox, but these programs are still best suited for those with mild to moderate withdrawal symptoms because people with more severe withdrawal symptoms usually still require 24-7care.²

Intensive outpatient detox and partial hospitalization programs are different than detoxing in a physician’s office in that they usually provide you with a multidisciplinary medical team who can provide and facilitate a wide range of medically assisted detox services as well as link you to other community and treatment resources for which your primary physician may not be aware.²

While partial hospitalization programs may occupy the same setting as inpatient detox in hospitals, the care is different in that the person’s symptoms do not require 24-hour care and observation, and that person can reside at home and come to the hospital for daily appointments.

Partial hospitalization is generally a good option for those with moderate symptoms and risk of complications who need more intensive care than outpatient detox can provide, but they are still stable enough to administer oral medications at home, follow treatment guidelines, and arrive for daily appointments. ²

If you or someone you love is experiencing alcohol withdrawal symptoms when trying to quit or cut back on use, call 800-996-6135(Who Answers?) today to speak with an addiction treatment specialist about outpatient detox treatment options near you.

Resources

1. U.S. National Library of Medicine. (2021, January 17). Alcohol Withdrawal.
2. Substance Abuse and Mental Health Services Administration (SAMHSA). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol.
3. Muncie, H., Yasninian, Y., & Oge, L. (2013, November 1). Outpatient Management of Alcohol Withdrawal Syndrome. American Family Physician, 88(9), 589-595.
4. Diaper, A., Law, F., & Melichar, J. (2014, January 22). Pharmacological Strategies for Detoxification. British Journal of Clinical Pharmacology, 77(2), 302-314.
5. DeSimone, E., Tilleman, J., Powell, T. (2014, November 17). Treatment of Alcohol Withdrawal Syndrome. U.S. Pharmacist Journal, 39(11), 38-41.