Drug & Alcohol Detox
In 2018, more than 21 million Americans, ages 12 or older, needed substance abuse treatment. Approximately 3.7 million of those in need of drug or alcohol treatment received such care.1 These numbers no doubt include many who would benefit from detox and withdrawal management services. Throughout the country in 2018, nearly 3000 treatment facilities offered varying types of detoxification services.2 Many people require medical detox at the start of additional addiction treatment programming and aftercare. Such detox services may take place in a detox center or as part of a larger drug rehab program.
What is Detox?
Detox is the process of facilitating the safe clearance of drugs or alcohol from a person’s body. Often taking place in the early stages of many types of addiction treatment, a supervised, medically managed detox may be essential for treatment and recovery to progress. Depending on the substance of abuse, the detox process commonly lasts anywhere from a few days to weeks.
Abruptly quitting alcohol or the use of certain drugs on your own can be both unnecessarily difficult and problematic, particularly when severe physiological substance dependence as developed. With substances such as opioids or alcohol, many people will experience characteristic symptoms of physical withdrawal such as anxiety, nausea, vomiting, and tremors.3,7 More severe withdrawal symptoms or withdrawal complications, such as marked agitation and seizures, can occur depending on the substance of use.3
It’s worth noting that there may be a difference in the levels of detox services available. In some cases, detox may not necessarily mean medical detox. While many places may offer a supportive or social detox setting, not all facilities are equipped to medically manage certain types of withdrawal. While in a medical detox program, you may be given medications to help control the severity of withdrawal symptoms and minimize cravings to use. You may also have extensive medical monitoring, in case you experience complications from withdrawal.3
The Detoxification Process
- Though precise detox experiences will vary, when a person seeks professional detoxification services, they are likely to encounter three elements important to the early recovery process:3
- Evaluation: During the evaluation, a patient undergoes a complete mental and medical health assessment, including various tests to identify which drugs are in the patient’s system. These tests help determine what level of care and which medications – if any – are needed.
- Stabilization: Stabilization involves bringing a person into a substance-free state as safely and comfortably as possible. Several strategies can be used, including the administration of medications, various psychosocial interventions, and involving a patient’s family with treatment to help motivate the patient. In addition, staff members will work with patients to familiarize them with treatment and what to expect in the next stages.
- Transitioning to Treatment: Facilitating a transition into additional rehabilitation or substance use disorder treatment. Admission into treatment is an important goal of a professional detoxification program. Getting the drugs or alcohol out of a person’s body is not the end of treatment, nor does detox guarantee long-term recovery or sobriety.
What is Medical Detox?
Medically supervised detox usually involves 24/7 monitoring and care from nurses, doctors, and other members of the treatment team. Medical detox is commonly utilized for managing potentially severe withdrawal syndromes, such as those associated with opioids. To keep people safe and minimize the risk of withdrawal complications, detoxing from alcohol and other central nervous system depressants such as benzodiazepines (e.g., Xanax, Klonopin, and Valium) may also be necessary.
When a person has developed significant levels of dependence with substances such as alcohol or benzodiazepines, sudden withdrawal can result in serious side effects, including marked agitation, delirium, and potentially-fatal seizures.3
In some cases, medical detox may involve using medications to help with the side effects associated with withdrawal. For instance, opioid withdrawal symptoms can be reduced by using suboxone during the withdrawal process.
Detox Side Effects
When you go through detox, you may experience uncomfortable symptoms. Symptom type and severity may vary from one person to another and also depend on the type of drug(s) from which you are withdrawing. 4,5 For instance, some of the troublesome withdrawal effects associated with an opioid detox could include:3,4
- Runny nose.
- Bone and body aches.
Detox from a stimulant like cocaine or methamphetamine might usher in a completely different set of symptoms—characteristically one with more of an intensely psychological, yet still difficult-to-endure nature than that of a withdrawal syndrome associated with opioids or depressants like alcohol and benzodiazepines. Such stimulant detox effects may include symptoms such as:3
- Sleep problems (hypersomnia or insomnia).
- Increased appetite.
- Poor concentration.
- Impaired cognition.
- Slowed speech.
- Decreased movement.
- Intense drug cravings.
Symptoms may vary in intensity from one person to another. You should not underestimate how severe some of these symptoms of withdrawal can be, especially if you were to try to detox on your own without the support of professional treatment. Left unmanaged, a difficult withdrawal experience can increase the risk of immediate relapse.
How Long Does Detox Take?
The timetable of detox can vary from person to person and will be influenced by factors such as the chronicity of substance use and the associated magnitude of physical dependence. In general, different substance withdrawal timelines might resemble the following:3,5,8
- Heroin: First symptoms arrive within 12 hours of last use, peak within 1-3 days, then gradually resolve over the course of 5-7 days.
- Alcohol: Symptoms may peak in intensity within a 24-72 hour time window. In many cases, the resolution of many symptoms occurs by 4-5 days.
- Cocaine: Stimulant withdrawal symptoms may develop within a few hours to several days after the last use. Many symptoms disappear within several days after first developing, but may persist to some degree for weeks for some individuals.
Depending on individual circumstances, your detox may be slightly shorter or longer than these average times. However, the symptoms of withdrawal are not the whole picture of what constitutes detox. To adequately stabilize and foster the transition into additional substance rehabilitation can take time, which may itself further influence the length of the detox period.
Rapid Detox & Ultra-Rapid Detox
Rapid detox and ultra-rapid detox are non-standard medical detoxification protocols that have been investigated for their role in managing opioid withdrawal. Rapid opioid detox involves accelerating the onset of withdrawal with an opioid antagonist medication and, next, managing the ensuing withdrawal symptoms with adjuvant medications. Ultra-rapid opioid detox, on the other hand, involves the use of general anesthesia while triggering acute withdrawal.1
Risks associated with rapid detox variants:3,4
- Electrolyte disturbances, dehydration, cardiac arrest, aspiration pneumonia, pulmonary edema, and even fatalities, according to case report evidence from the Centers for Disease Control and Prevention.
- Patients may not be provided with adequate follow-up rehabilitation programming following their brief inpatient stay, which could place them at an increased risk for relapse.
- Ultra-rapid approaches may require an intensive care unit and staff, making this an expensive alternative to traditional medical detox or withdrawal management.
- Insurance companies may not cover this cost based on a lack of evidence that rapid detox is more beneficial than traditional forms of detox.
Medical professionals may discourage the use of ultra-rapid detox because it is no more effective than other methods, yet this anesthesia-assisted procedure may result in dangerous risks.2 Ultra-rapid opioid detoxification doesn’t provide any focus on the psychological side of opioid dependency, nor does it prescribe any behavioral therapeutic interventions to the patient.3 A more comprehensive treatment approach that integrates relapse prevention strategies and counseling may prove to be more effective for lasting recovery.3
In contrast with the rapid approaches, a more gradual supervised detox and withdrawal management protocol remains the current standard of care for managing opioid-dependent patients. This may involve stabilizing with and eventual tapering of opioid agonist medications cautiously and at a slow pace to bypass a marked abstinence syndrome (e.g., over the course of several days to weeks).3
Can I Detox at Home Safely?
The appropriate setting for detoxification, whether it be inpatient or outpatient, should be decided upon with the help of your physician or other treatment professional. The acute withdrawal syndromes associated with opioid drugs like heroin and prescription painkillers, as well as those of substances like alcohol and sedative-hypnotics (e.g., benzodiazepines, barbiturates, prescription sleep medications) can be quite severe and, in the case of CNS depressants, potentially dangerous.
In many of these instances, an inpatient or residential medical detox program may be the most appropriate course of treatment for your safety.3
Home detox attempts may be ill-advised for several reasons, including the potential for an overwhelming craving to use quickly prompting a relapse. Opioid withdrawal, for example, results in some symptoms such as body aches and nausea that many people find too uncomfortable to manage without the help of medical detox interventions.4
Are you Looking For Detox?
You may wonder if you would benefit from detox from drugs or alcohol prior to additional recovery efforts. While each person is different and may not yet be ready to take the path to recovery, professional detox is an important and sometimes medically necessitated period of time that has helped many progress toward their goals of abstinence and long-term recovery. Consider these two questions:
- Are you or someone you love struggling with compulsive substance use that has become an overwhelming part of your daily life?
- Is withdrawal from drugs or alcohol, or the apprehension of such withdrawal, promoting continued drinking or drug-taking or preventing attempts at recovery?
If you answered yes to either of these questions, you might benefit from seeking further help from a treatment professional.
Finding The Best Detox Rehab Centers
Those who have not sought medical detox before may wonder how to go about it. There are many options for inpatient detox treatment in the United States. When looking for a detox center, you should know that American Addiction Centers is a leading provider of inpatient treatment and operates 8 facilities across the nation so there’s always a local option available.
How American Addiction Centers Can Help
American Addiction Centers is a leading provider of detox treatment in the United States. We are committed to providing users the most up-to-date and accurate information about treatment and how to seek it. With supervision, support, and medical withdrawal management throughout detox treatment, AAC can provide you and your loved ones with peace of mind during your stay.
To find out more, or to get started, American Addiction Centers operates a confidential addiction hotline available 24/7 to help people find their path to recovery.