If you’re struggling with addiction to drugs or alcohol and are ready to stop using and get started on the path to recovery, the first step you need to take is to remove the substance from your body through the process of medical detoxification.
You might be unsure whether detox is necessary for you, or are unnerved at the thought of going through the often painful process of withdrawal. You’re not alone: In 2015, more than 20 million Americans aged 12 or older were reported as having a drug or alcohol addiction and in need of treatment, but less than 11 percent of them sought out treatment.
Still, however scary the process of detox may appear, if you don’t seek treatment, the alternative can be far worse. In 2016, the U.S. Centers for Disease Control and Prevention reported that more than 64,000 deaths in the nation involved overdose.
Detoxification can be that vital first step in saving your life or the life of a loved one. It also makes a significant difference in the success of addiction recovery. According to a study conducted by the Journal of General Internal Medicine, 61 percent of people were able to complete outpatient treatment programs after first going through detox.
Detoxification is a process aimed at managing acute substance addiction and withdrawal. The goal is to clear the substance from your body to minimize the damage caused by substance abuse and make it past the initial withdrawal stages as painlessly as possible so you can move on to more comprehensive addiction treatment.
Detox helps you gain a more substantial footing in the recovery process than someone who attempts rehab without first detoxing because you can focus more on the issues and causes of your addiction and less on the symptoms of withdrawal, which can cause someone to relapse even while they’re in recovery.
That said, detox can only provide these advantages if it is completed safely and successfully in a professional, carefully monitored and controlled environment. Detox is a complex and often difficult medical process, even at a detox treatment center. Attempting to detox on your own can be harrowing, dangerous, and life-threatening.
While some people may think it doesn’t matter where or how they detox, just so long as they stop using, this is very much not the case. Abruptly stopping the use of drugs or alcohol, otherwise known as “going cold turkey”.
This can throw the body into shock and bring on intense withdrawal symptoms such as anxiety, depression, chills, fever, muscle pain, nausea, seizures, hallucinations, tremors, and more. These can last anywhere from a few hours to days or even a week or more.
It is difficult to predict the length and severity of these symptoms, especially without medical assistance. Even if you can manage the extreme discomfort, withdrawal from certain substances can be fatal without professional supervision, such as alcohol or benzodiazepines. Detoxing at a medical detox treatment center means there is someone to make sure you are safe who can also administer medications to keep you from suffering a needlessly uncomfortable withdrawal.
So now that we’ve highlighted the importance of detoxing in a controlled medical environment, there is still the question of which detox treatment will work best for you: inpatient or outpatient? One major deciding factor is the severity of the addiction. If you have been using for a long time in dangerously high amounts, then an inpatient treatment is the best option for your safety. However, if your dependency is less severe, you could opt for outpatient treatment.
Inpatient treatment can be available in hospitals, residential rehab facilities, and specialized detox centers. Some things to keep in mind when deciding if inpatient treatment is right for you are:
For outpatient treatments, you will typically go to an outpatient detox clinic initially on a daily basis to get medication. It is recommended that you also enroll in an outpatient addiction treatment program during your detox for additional support. Some key factors to remember when considering outpatient treatment include:
Whether you choose to undergo inpatient or outpatient treatment, detoxing at a medical drug detox centers ensures you will be treated with medical professionals, equipment, and methods that have been proven to help get you on the path to recovery.
The detox process consists of 3 distinct phases: evaluation, stabilization, and preparation for transition into treatment.
The goal of this first stage of detox is to get a full, comprehensive assessment of the patient’s situation, which will include:
Stabilization is the longest and most involved portion of detoxification, encompassing the early stages where the substance leaves your body as well as the preceding days of withdrawal symptoms.
Clients are often given medication to ease withdrawal symptoms so that they make it through the stabilization process as painlessly as possible. Their vitals are carefully monitored, and they are provided with proper nutrition and vitamin supplements to counteract the common side effects of detox, which include nausea, diarrhea, vomiting, dehydration, and loss of appetite.
The length of time spent in the stabilization phase will vary based on the following factors:
Typically, this period lasts about three to seven days, but it can sometimes last as long as 10 days or more. Certain withdrawal symptoms, such as depression and anxiety, will generally persist even after this period ends. This can complicate the process for those struggling with mental health disorders, which applies to many people seeking addiction treatment. Roughly 37 percent of people who are dependent on alcohol and 53 percent of people addicted to drugs have a coexisting mental health condition.
This final phase of detox is meant to prepare you to enter substance abuse treatment. Detox centers generally will provide you with the information and resources you need to help transition to treatment facilities. These facilities often incorporate an initial period of structured detox into their program design, which creates a more seamless transition from detox to an ongoing treatment program.
Ongoing treatment post-detox will dramatically increase your odds of remaining drug-free. People who choose to continue recovery treatment are 10 times more likely to still be abstinent six months later, as opposed to those who stop after detox, 65 percent to 80 percent of which will relapse within one month.
During the stabilization phase, you will experience intense withdrawal symptoms as your body tries to adjust to the lack of access to the substance on which it has become dependent. While there are symptoms that are specific to each substance, some common symptoms that nearly everyone in detox will experience include:
In many cases, medications are used to alleviate the worst of these symptoms. In the case of drugs such as benzodiazepines and opioids, clients slowly taper off drug usage with milder substitutes, such as buprenorphine for heroin use. Doctors may also prescribe antidepressants as well as to help with co-occurring disorders.
Many detox programs also incorporate alternative methods to be used in conjunction with medical treatment to lessen the effects of the withdrawal process, including:
As previously stated, withdrawal timelines and the length of time these symptoms will persist varies. However, there is a typical detox timeline for each substance:
Withdrawal starts within roughly 12 hours after the last dose, reaching its peak between 24 and 48 hours. It can last anywhere from a week to several months.
Encompassing drugs such as Oxycontin, Vicodin, and Morphine, withdrawal typically begins within eight to 12 hours, peaking between 12 and 48 hours and generally lasting five to 10 days, although methadone can last more than two weeks.
This includes cocaine and methamphetamines and, depending on the length of use and dosage, can begin just a few hours after the last dose, peaking between 48 and 72 hours, and lasting anywhere from a week to 10 weeks.
Alcohol withdrawal can begin as early as within eight hours of the last drink or as late as several days after drinking. It reaches its peak at about 24 to 72 hours and will usually last for at least a few weeks.
Encompassing prescription substances such as Xanax, Valium, and Klonopin, withdrawal begins between one and four days, peaking in roughly two weeks. In the case of protracted withdrawal, withdrawal can last several months.
Many people will look for “detox-quick” alternatives that promise a detox that takes hours rather than days or weeks because they want to get through the process faster and not experience withdrawal. These alternatives are substantially risky as well as unlikely even to work.
The most widely known form of rapid detox is done under anesthesia, advertising itself as essentially painless, with the client sleeping through the withdrawal symptoms. While the thought of being able to speed through the stabilization process might be tempting, rapid detox is incredibly dangerous, and the anesthesia-assisted one specifically has been proven to cause cardiac arrest, grand mal seizures, and death.
Detoxification is only the beginning of your recovery journey, but it can feel like a huge leap to make. Making that leap in the safe and supportive environment of a medical detox center, however, can take the worst out of the process. A medically supervised detox program can provide a strong system of support, administer the right medications to stem withdrawal symptoms, as well as offer nutritional supplements and alternative therapies.
(February, 2012). Drug-Free Housing for Substance Abusers Leaving Detox Linked to Fewer Relapses. Johns Hopkins Medicine from https://www.hopkinsmedicine.org/news/media/releases/drug_free_housing_for_substance_abusers_leaving_detox_linked_to_fewer_relapses
(September, 2013). Deaths and Severe Adverse Events Associated with Anesthesia-Assisted Rapid Opioid Detoxification — New York City, 2012. Centers for Disease Control and Prevention from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a1.htm
(January, 2006). Detoxification and Substance Abuse Treatment. NBBI. from https://www.ncbi.nlm.nih.gov/books/NBK64114/
(August, 2017). Dual Diagnosis. National Alliance on Mental Illness. from https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis
Sack, D, (February, 2014). Home Detox: What’s The Worst That Could Happen?. Psych Central. from https://blogs.psychcentral.com/addiction-recovery/2014/02/home-detox-dangers/
(August, 2018). Overdose Death Rates. National Institute on Drug Abuse. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
Bose, J, (September, 2016).Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. SAMHSA. from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.htm