Confinement of Alcoholics - Symptoms, Withdrawal, and Measures in Correctional Facilities

Introduction: Alcohol addiction is a disease

Drinking is a common and everyday activity in our society, perceived by many as a social tool and a means to relieve stress. However, when drinking becomes repetitive, difficult to control, and negatively impacts daily life, work, and relationships, it is no longer merely a habit but is medically referred to as 'Alcohol Use Disorder' or alcohol addiction. This condition is not just a matter of willpower or moral failing it is a complex mental and physical disorder accompanied by abnormalities in the brain's reward circuitry and emotional and behavioral distortions. Recently, allegations of alcohol dependence have been raised against politicians, celebrities, and other influential figures, prompting the public to re-examine the boundary between drinking and addiction. Particularly when such individuals become targets of criminal investigation or incarceration, there is a need for an objective understanding of their medical condition beyond simple condemnation. This is because if someone with a history of alcohol use is incarcerated, withdrawal symptoms can pose a threat to their survival. This article comprehensively explains the clinical symptoms of alcohol addiction, the withdrawal process, and the specific measures taken for addicts when they are incarcerated.

Main Point 1: Major Symptoms of Alcohol Addiction and Withdrawal Symptoms

Alcohol addiction goes beyond simply drinking frequently it is a state where the brain's function and behavior patterns have changed. The main characteristics include a strong craving for alcohol, loss of self-control, increasing amounts of drinking (tolerance), and withdrawal symptoms accompanying cessation of drinking. According to diagnostic criteria, if these symptoms persist for more than a year and drinking becomes the focal point of life, it can be considered an addiction. Physically, withdrawal symptoms such as tremors, sweating, palpitations, insomnia, and vomiting appear first. This occurs when alcohol is suddenly stopped, causing the brain, which has been inhibited, to awaken sharply. Alcohol strengthens the action of the inhibitory neurotransmitter GABA, so the brain exposed to alcohol for a long time uses this as a baseline. When alcohol suddenly disappears in this state, the action of excitatory neurotransmitters becomes relatively excessive, triggering a state of nervous system hyperexcitability. Mental symptoms include anxiety, restlessness, depression, and panic reactions. After 12 to 24 hours of cessation, visual hallucinations (e.g., bugs or shadows), auditory hallucinations, and cognitive confusion may occur, classified as a 'withdrawal hallucination' stage where some reality judgment is maintained. Long-term drinkers especially experience repeated blackouts (short-term memory loss) between drinking and abstaining, which over time increases the risk of brain atrophy and alcohol-related dementia. The most serious state is alcohol withdrawal delirium (Delirium Tremens). This can occur within 2 to 4 days after stopping drinking and is a medical emergency accompanied by sudden loss of orientation, confusion, fear, delusions, high fever, convulsions, and autonomic nervous system abnormalities. If untreated, the mortality rate can reach 20%, necessitating immediate hospitalization and medication. Therefore, alcohol addiction should be recognized as a serious condition that is not merely a lifestyle issue but must be diagnosed and treated medically, especially since the withdrawal process can escalate to life-threatening states.

Main Body 2: Procedures for the Treatment of Alcohol Addicts During Incarceration

When an alcoholic is detained or incarcerated due to a criminal case, correctional authorities apply different procedures than those for general inmates. The Ministry of Justice and the Correctional Headquarters have an obligation to protect the physical and mental health of inmates, especially classifying those at high risk of self-harm or those with concerns about physiological withdrawal reactions as "special management individuals." On the first day of incarceration, the inmate undergoes a physical examination and mental health assessment conducted by a medical officer. At this time, their history of alcohol use, addiction history, and recent cessation of drinking are confirmed, and factors for depression or suicidal risk are evaluated through psychological counseling. In cases with a history of addiction or predictable withdrawal symptoms, they are assigned to medical wards or isolation units specifically for psychological observation instead of general inmate facilities. The first 72 hours are the period when withdrawal symptoms are most likely to occur, so continuous observation takes place. If there's a risk of self-harm or seizures, individuals may be isolated in a suicide prevention monitoring room. Medical staff adjusts physical reactions as necessary using benzodiazepine sedatives, antipsychotic medications, and intravenous therapy. If severe symptoms such as breathing difficulties, high fever, or convulsions occur, the individual is immediately transferred to an external hospital, and the correctional facility can support transport and hospitalization as needed. For long-term inmates, participation in addiction recovery programs is facilitated to continuously address substance abuse issues. Inside correctional facilities, there are resources such as Alcoholics Anonymous meetings, psychological counseling, and group therapy programs. Inmates consenting to treatment can also regularly meet with external psychiatric specialists. Furthermore, since the 2020s, the Ministry of Justice has enhanced focused treatment programs for high-risk recidivism groups to reduce recidivism rates for substance abuse within correctional facilities. If an inmate's addiction status does not improve after serving their sentence, post-treatment continues through conditional release supervision or links to social reintegration support centers. In summary, the incarceration of alcoholics is addressed not as merely a separation but as an emergency and ongoing management system for survival and treatment. This reflects a structural response that acknowledges the correctional purpose of not only punishment but also social reintegration and recidivism prevention.

Conclusion: Treatment, understanding, and institutional preparedness are needed before punishment.

Alcohol addiction is not a personal weakness of individuals who drink repeatedly, but a condition that requires clear medical diagnosis and treatment. This condition cannot be overcome by the will of the addict alone and can be worsened through repeated attempts to drink and abstain. Particularly, when these individuals transition to being targets of crime or legal punishment, simply incarcerating them does not solve the issue. Within correctional facilities, there are institutional efforts to recognize this reality and provide a therapeutic environment that protects the lives of addicts and encourages recovery. This goes beyond merely protecting the rights of inmates it is also a rational measure for preventing recidivism and reducing social costs. What alcoholics need is diagnosis and treatment before punishment. Society must correct its perception of addiction and should not stigmatize individuals with repeated drinking problems as immediately being subjects to be isolated from society just because they have entered a facility. Rather, correctional facilities should serve as a starting point where they can finally begin treatment and recovery. Addiction is treatable, and institutions can intervene. The most important thing is accurate understanding and the corresponding actions. Correctional treatment for alcoholics should be implemented based on these standards, which can be considered a prerequisite for our society to progress toward a healthier and safer community.