Key takeaways:

  • Detox is different for everyone and can be influenced by what type of substances have been abused and for what extent of time. This is the same for withdrawal symptoms themselves and people will experience varying degrees of severity
  • Managing withdrawal symptoms is a large part of the detox process and can be painful, uncomfortable, and in some cases, dangerous. This is why having medically supervised detoxification is so important
  • It is strongly advised that detox should not be attempted alone or at home for people withdrawing from alcohol or benzodiazepines, as these can lead to serious health issues and even death

Often referred to as 'the cleanse', detox from drugs and alcohol can be dangerous, causing both physical and psychological stress and discomfort. Depending on the substance you are detoxing from and how much and how often you used it, you may benefit from a medically supervised detox. Most times, this is provided in an inpatient treatment facility and the aim is to help keep you comfortable while the drug leaves your system.

What is detoxification?

Detoxification, better known as detox or 'the cleanse', is the process where the body adjusts to no longer having drugs or alcohol in its system and clears all traces of substance abuse. The purpose of detoxing is to manage withdrawal symptoms and purge the body so recovery from addiction and abuse can begin. 

Detox is different for everyone and can be influenced by what type of substances have been abused and for what extent of time. This is the same for withdrawal symptoms themselves and people will experience varying degrees of severity. 

Medication is often used for inpatient detox to help manage withdrawal symptoms and to reduce cravings for certain substances. They can also help with long-term addiction recovery in some cases. 

The timeline for withdrawal symptoms differs greatly, as does detox. Depending on the type of substance abused it can take days or months to fully go through the full effects of withdrawal. Other factors can also play a part in the length of withdrawal symptoms, such as:

  • Type of substance the user is addicted to

  • How much and how often the substance was used

  • The length of time the person has been using

  • Method of abuse (snorting, smoking, injecting, or swallowing)

  • The amount of a substance the user takes at one time

  • Family history and genetic makeup

  • Underlying mental health or medical conditions

  • Any other drug or medications the user takes regularly 

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Get help during Covid-19

At Recovered, we recognize the impact COVID-19 has had and the continued challenges it poses to getting advice and treatment for substance use disorders. SAMHSA has a wealth of information and resources to assist providers, individuals, communities, and states during this difficult time and is ready to help in any way possible.

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The process of detoxification

Though everyone’s detox needs will be different, those attending an inpatient detox program will normally go through a series of tests and assessments to ascertain the level of care they need. [3] These will often follow the below structure.

Evaluation

For the short-term care part of the evaluation, the medical team may assess the patient's blood or urine to verify what drugs are in the system and what their levels are before starting the detox process. In some cases, medication will be recommended to safely manage withdrawal symptoms or to help keep a person comfortable by minimizing withdrawals. 

During the evaluation, it’s also routine to screen the patient to determine their physical and mental health, and to ask about any other medications or drug use. This information is used to create an initial treatment recommendation for the patient and to develop a long-term plan for treatment.

Stabilization

The stabilization process involves a series of medical and psychological therapies in order to ensure the patient is safe, comfortable, and stable during the initial detox. Prescription medication may be used at this stage to ensure patients aren’t in any distress and that withdrawal symptoms are managed in a safe way. In some cases (like with alcohol or benzodiazepine withdrawal), a medical professional may monitor the patient to ensure they are stable during the first days of drug detoxification.

Preparing for treatment

Detox is usually offered in residential treatment settings and is short-term in nature. For most drugs, the process may last a few days or a week, but can sometimes be a little longer. Because detox is only the first step in substance abuse treatment, most detox facilities will help to arrange aftercare for a person. Receiving outpatient addiction treatment or entering into a more long-term treatment program offers the best chance of a successful recovery.

Side effects of detox

Managing withdrawal symptoms is a large part of the detox process and can be painful, uncomfortable, and in some cases, dangerous. This is why having medically supervised detoxification is so important. Having the level of care provided under a medical detox allows patients to go through withdrawal symptoms in a safe and comfortable environment. The level of care and supervision provided differs between inpatient and outpatient treatment types. [3]

While medical detox provides the safest space to manage withdrawal and cleanse the system, there are some symptoms that are unavoidable. While the best care and medical attention will be provided through detox, some patients can expect the following symptoms. [1]

  • Nervousness or anxiety

  • Insomnia

  • Nausea

  • Body discomfort

  • Mood swings

  • Poor sleep

  • Difficulty concentrating

Can I detox at home?

It is strongly advised that detox should not be attempted alone or at home for people withdrawing from alcohol or benzodiazepines, as these can lead to serious health issues and even death. In some cases, people withdrawing from other drugs (like heroin or other opioids, meth or cocaine) may choose to enter detox to help ease withdrawals and jumpstart their recovery in a safe, drug-free setting.

There is a myriad of inpatient and outpatient treatment options for detox and by opting for a detox treatment program you will greatly reduce the risk of complications during withdrawal. Inpatient detox offers 24-hour medical supervision that may be necessary for those suffering from intense addiction as the withdrawal process can be fatal (for opioid withdrawal, for instance). Other inpatient programs can accommodate people with less serious symptoms of withdrawal, and may even offer treatment after the acute withdrawals have ended.

Drug detox during pregnancy

When a woman abuses drugs and alcohol during pregnancy, the chemicals in these substances pass through the placenta and into the fetus, which can potentially cause severe medical complications. This is why expecting mothers often have a strong motive to quit abusing substances. Though cutting out substances is beneficial for both mother and child, doing so cold turkey can cause fetal distress on the unborn child, as well as preterm labor. 

Regardless of what stage of pregnancy a woman is in, attending a medically supervised detox is of the utmost importance. Withdrawal symptoms, especially from opiates and alcohol, can be extremely harmful to a fetus and the mother. Medical detox will manage the health of both mother and child, with doctors providing medication to stabilize both, and provides the greatest chance of a full recovery from substance addiction.

Detox from different drug types

Detox is often stressful and uncomfortable but the difficulty experienced will often differ depending on the substance a patient has abused. Withdrawal symptoms may be more or less severe in different substances, presenting various physical and psychological stresses in each individual. Withdrawal symptoms are also heightened and complicated if the person has abused multiple substances. 

For example, Alcohol withdrawal can cause delirium tremens, an intense form of shakes that can cause seizures. Benzodiazepine withdrawals (from medications like Xanax or Klonipin) can also lead to dangerous withdrawals and can require medical detox. 

Cocaine withdrawal is mostly psychological with patients often experiencing anxiety and mood swings during detox. Opiates such as heroin can cause intense muscle aches and cramps that are very uncomfortable and painful. Doctors will often use less potent opiates such as methadone to manage these withdrawal symptoms. 

Medications can also help manage co-occurring conditions, such as depression, to help patients detox without exacerbating underlying conditions. While not everyone requires medical detox when they stop using a substance, these programs can be beneficial to many people looking to start their recovery.

Risks of rapid and ultra-rapid detox

Rapid and ultra-rapid detox methods have become increasingly popular as they reduce the time taken to remove drugs from the system and how long a person will experience withdrawal symptoms and their severity. 

Not only is rapid detox expensive, it can be extremely dangerous as well. During rapid detox, the patient is sedated with anesthesia and their body is flooded with medication targeted at replacing the drugs in the system in order to cleanse it. Originally developed for those suffering from intense opiate addictions, such as heroin, the risks of rapid detox often far outweigh the benefits. 

Risks of rapid and ultra-rapid detox include:

  • Heart attack

  • Paranoia

  • High body temperature

  • Infection

  • Nausea

  • Vomiting

  • Aspiration

  • Choking

  • Death

Rapid detox programs can often be completed in as little as two or three days and are far more expensive than traditional detox methods. Most rapid treatment programs cost around $10,000 and are not typically covered by insurance. Ultra-rapid detox can be completed in just a few hours and is even more expensive. With this increased speed comes greater risk, with 1 in 500 people approx dying from ultra-rapid detox, according to the Coleman Institute. 

While withdrawal symptoms are reduced for rapid and ultra-rapid detox, many who complete them report still feeling some of the adverse effects of withdrawal. Patients who have these types of detox are also far less likely to continue treatment, having not attained the long-term treatment plans outlined by inpatient or outpatient rehab programs. This also means they are at greater risk of relapse, having not worked on tools to help with relapse prevention, at identifying underlying or co-occurring conditions, nor establishing support networks and long-term planning for recovery.

What comes after detox?

While detox can be intense, it is just the first part of the recovery process. While detox can help cleanse the body of substances and allow the patient to safely get through withdrawal, it is insufficient for a full recovery. 

People suffering from addiction need to be able to identify and understand the root causes of their addiction in order to successfully manage it, and also benefit from learning new, healthier methods of coping. This can often only be achieved through therapy, support groups, inpatient rehab, and other treatments that provide those suffering from addiction with the best chance at long-term sobriety. 

Contact a treatment center today to find the best inpatient rehab programs to help you beat addiction.