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What to Expect in Detox

One sunny June I decided enough was enough and took myself into the hills for self-imposed isolation and detoxification. Oh boy. Three days later, having confidently set off for a mountain walk, I made it 200 yards before starting to feel weird and soon afterwards collapsed in the campsite car park. I also collapsed outside Lancaster hospital after we got there. And I collapsed at home twice. I was getting very good at collapsing.

All this matters because every time I keeled over it was during unsupervised detox. I was going from 30-50 units a day to zero, without support. Stupidity driven by desperation.

So the first thing you need to expect is that it will go wrong if you don’t do it sensibly. The point is your body will cease working right without alcohol and you can “rattle” big style. Serious shakes, twitching and convulsions; constant vomiting until your stomach is empty and what comes out is blood and liver fluid; an inability to stand without passing out and hallucinations that will scare the living Jesus out of you. Do not test this theory.

Now I have your attention, this are some of the things you should expect if you do it right.

1. Expect to prepare

You will need to give thought to time and place, and to the team around you.

You can’t start all this on a whim because you need to be confident you really are ready for it. If you are not you risk wasting everybody’s time. Detox is largely a miserable experience and you really do not want to do it twice. It is time to be humble, to accept what is coming, and go through the fire. I have known (past tense deliberate) people who went from end of detox to back where they were in days. This is not a good thing. Also, you will probably drink down to reduce the physical risk of withdrawal. This MUST be done in a supervised way (for example I went from north of 35 units a day down to about 12 over a fortnight).

Your basic choice of location is between entering a detox centre or being at home. There are lots of places you can go, for a fee, and where all your real needs can be well taken care of. If you have the money, and if family life has complications, this might be the right option for you. Sadly, family members can be either brilliant or dangerous to you. This is harsh but true. Not everybody understands. (We write elsewhere about this). The same may apply to your GP. Even today, some just don’t “get” addiction and are not well placed to support you. I was lucky, and was able to choose to stay at home. My wife is brilliant (think Galadriel with attitude) and my GP was forward looking and engaged. I also paid privately for a support worker (which cleaned me out of spare funds for rehab!). This gave me a strong team but with home comforts.

2. Expect to be controlled quite closely

It is not a holiday.

Wherever you are, if you do it properly you need to expect to be told what to do and when, and if you are with good people, they will be watching you like particularly diligent hawks. Restless hawks with nothing else to do except watch your every move because they know all the tricks, and check your physical symptoms very regularly, give you bugger all time alone, and keep an eye on your thinking and your emptions.

You will feel down at times and it is all too easy to give up, get side-tracked, and basically blow the gig. In detox, you need to stay focused on the process and nothing else. This may be the crux for you – and also for those around you that love you. You need to be selfish. Forget the bloody washing up. If you win this battle everybody will benefit so immerse yourself totally. If it helps, pick easy, engrossing leisure activities that distract you from the wider world. Read, play computer games, flick chickens, whatever. Don’t look ahead. Don’t worry about anybody else.

If you are in a residential setting for detox, prior intelligence is at a premium. Depending on who is running the show and big is the tab, you might be pandered at one extreme or all but abandoned at the other. Neither is good! If the process is being managed well, you will almost certainly have to sacrifice some daily freedoms and have a degree of structure placed around you. This is for you own good but if you are suffering a surfeit of pride and don’t like being told what to do then be prepared for this.

3. Expect the reality to be different for you

The devil is in the detail.

On the basis of my own experience and many conversations I am confident of everything I have said so far. But I don’t know you. We are not all the same and in the margins you will need to respond to things in ways that work best for you. I have no idea what, in your case, but make sure you are open and honest about things with whoever you are working with.

I found I did not struggle doing very little and just lounging around focusing on myself (but then I never did anyway!). Neither did I worry about the end of the process over much or have any doubts about what I was doing. I think it really was the right time for me. I was genuinely scared by the extent of my physical dependency and this focused my mind somewhat…

But, it just so happens, I did struggle with the detailed plans for the drink down, and with the withdrawal medication. I couldn’t drink down as far as I wanted, and had hoped to be well down in to single figures. We talked about it day by day and I just had to roll with it. (Do not use this as an excuse).

We all react differently to medication. After the first few days I found codeine more helpful than Librium in terms of state of mind, but in the early days we ramped up the Librium until withdrawal symptoms were under control. That is after all the point of the Librium! The specific plan for Librium that the GP would give you is essentially generic and it is not wrong to modify it in a controlled way.

(Post detox I also failed to make sense of Acamprosate (the craving reduction wonder drug). It did not work for me at all – might as well shoot ping pong balls at a Sherman tank. But other people find it helpful. All this is why recovery expertise needs to complement medical views).

4. Do not expect to be cured

Yes, I am serious. This is important.

Detox is part of the wider, longer process of conquering alcohol, or some other drug. It is not the whole of it. It is not a silver bullet in itself, any more than a bottle of Dr Fab McNab’s Anti Booze Pills. But unlike quack remedies and psychobabble (we also write elsewhere on this!), it does play a in crucial role in breaking the vicious cycle and moving safely to an initial state of non-consumption. For many it is a necessary first step. It is not the last.

In an institutional setting it is commonly followed by a period of rehabilitation, essentially supporting someone readjust to a sober life before casting them adrift – back int the fray with the rest of us. IN a home setting too there can be a supported period perhaps of several months where someone is on the end of a phone and able to talk, and also visit.

The post-detox experience can be rocky. It certainly was for me. It is very important to keep your eyes on the prize – and perhaps even to work out what that prize should be now that you are thinking more clearly. So don’t get cocky. Expect to need to stay on your guard and be strong.

Now it makes more sense to get Busy. You will need to recover physically from withdrawal and regain some strength (you may not be eating well at this point. Then get off your backside! You need to be doing things to start rebuilding a sense of worth and a place in the wider world (let’s be honest here – you have got used to feeling lonely and useless). Me – I did the garden, built sheds, and spent some time on other people (remember them?).

You may even be able to give something back. This could even be directly into the recovery community, where others may find your experiences helpful and illuminating. You might even be able to work again. The thing that helped me more than anything else in the world at this stage was starting work in support of a severely disabled young lady. It nailed humility into me and I would not change it for anything.

It doesn’t matter what you do. So long as it is something. If detox has helped you break the mould, you now need a new one.

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