Drug detox is the process through which drugs and their toxins are safely removed from the body of a person using them. The circumstances of a drug detox depend heavily on the individual and the drug(s) involved in the process. For individuals who abuse drugs of any kind and have become addicted, an addiction treatment program is highly recommended immediately after detox can be completed.
Detox is not only for addicted individuals who struggle with drug abuse. Other circumstances involve those who are dependent because they have been taking medications for an extended period of time and are ready to discontinue use.
Drugs involved in a detox can include virtually any substance or combination of multiple drugs, the most commonly treated being:
Drug detox is a crucial first step in recovery from addiction and drug abuse, but it is not the same as addiction treatment and should not be the only action taken to abstain from further drug abuse. The reason detox alone, is insufficient in recovery from addiction is because the process only addresses the removal of the drug from someone’s system and does not address the actual addiction, which is the cause of continued abuse.
Drug detox is generally not life-threatening, especially with medical supervision and treatment. The medical necessity for drug detox depends heavily on two things: (1) the drug of abuse; and (2), the personal health and potential medical complications of the individual to be detoxed.
The primary goal of drug detox is to safely remove drugs from an individual’s system, but it aims to do so by managing as many withdrawal symptoms as possible during the process. The length of time it takes a drug to be naturally expelled from the body depends on the drug and the individual’s metabolic process. Generally, drug detox can be completed in a time frame of three to fourteen days, and the specific length of time depends on individual circumstances.
The detox process is complete once all drugs have been safely removed from the body and the individual is medically stable. There is generally no process used to expedite the removal of drugs from someone’s system; detox is allowed to take place based on the body’s natural process of substance expulsion.
So, if drugs are removed from the system naturally, some may wonder, why is detox necessary?
The reason drug detox is necessary is because there is more to it, than a natural process of expulsion. Drug detox addresses withdrawal symptoms, intense cravings among them, which present uncomfortable, and sometimes dangerous complications, over the course of the drug making its way out of the system.
The two main classes of drugs most commonly treated in drug detox are stimulants and depressants. Each class has a unique set of addictive effects on the person using them, thereby creating a unique set of withdrawal symptoms during detox.
The specific symptoms vary by type of drug, and the severity of the symptoms depend on individual circumstances, including:
During drug detox, all medical and mental health conditions can be treated and monitored, so it is very important to seek medical consultation prior to the detox process. Many symptoms of drug detox are common across all drugs of abuse, but there are some symptoms that are unique to certain types of drugs.
In general, depressant drugs such as opioid painkillers, heroin, sedative-hypnotics (benzodiazepines and sleeping pills), and alcohol have physically and psychologically addictive qualities. This means that anyone who is dependent on or addicted to any drug within this class will experience physical withdrawal symptoms in addition to psychological symptoms as well.
Opioid drugs such as heroin and prescription painkillers are depressant drugs, with effects like shallow breathing, slowed heart rate, and drowsiness. Leading up to and throughout detox, users experience a series of physical and psychological withdrawal symptoms. Although detox from opioids is not considered life-threatening, the withdrawal symptoms are extremely uncomfortable and are among the most feared set of consequences for opioid detox. It’s extremely common that withdrawal symptoms are the main reason for addicted individuals to engage in drug-seeking behavior, to find any means to “get well.”
Starting with a runny nose and increasingly frequent yawning, opioid withdrawal symptoms can begin within several hours after the last dose.
Additional symptoms of withdrawal include the following:
The time it takes for the onset of opioid withdrawal symptoms depends on the severity of abuse, as the higher an individual’s tolerance is to opioids, the faster withdrawal symptoms will begin to present. In most cases, opioid withdrawal symptoms peak around twenty-four to thirty-six hours and begin to subside around seventy-two hours into the process.
With exception to health conditions and personal circumstances potentially lengthening the time, opioid drug detox generally takes between ten and fourteen days to complete and is not life-threatening. Medical supervision and treatment during drug detox is recommended, as some medications can be provided for the purpose of easing some anxiety and insomnia as well as lowering blood pressure. Additionally, a controlled setting for opioid detox provides strong encouragement for the individual to see it through.
Alternatives to traditional opioid detox allow addicted individuals to bypass most of the discomfort and pain of withdrawal symptoms. Known as long-term maintenance or medically assisted treatment (MAT), medications like buprenorphine and methadone can be prescribed to an addicted person, and treatment can begin approximately twelve to twenty-four hours into the detox process. Once a proper dosage has been established by an opioid treatment provider (OTP) physician, either methadone or buprenorphine can be taken once a day, preventing further withdrawal symptoms and staving off opioid cravings.
While no singular approach will be the best for every person suffering from opioid addiction, methadone and buprenorphine provide a much faster detox process from opioids of abuse. The one caveat to these forms of detox is that both buprenorphine and methadone are opioids, and as such do not rid the system of drugs, contrary to the stated purpose of detox. These drugs are a safe and fast way to move an addicted individual away from problem opioids. The maintenance portion of these treatments is recommended to last at least twelve months, and the medications must be given as part of an addiction treatment program.
Although these medications are still opioids, methadone and buprenorphine treatments are provided with eventual detox in mind. When agreed upon by the individual and their physician, both drugs are slowly tapered down in the strength of dosage until such time that a complete cessation is possible with minimal symptoms.
One of the more potentially dangerous drug detoxes is one from benzodiazepines. Also known as sedative-hypnotic medications, benzodiazepines are typically used as antianxiety, antiseizure, or sleeping aid medications. Also in the depressant class of drugs, benzodiazepines are central nervous system (CNS) depressants and have a particularly sedating set of effects, including drowsiness, confusion, dizziness, difficulty breathing, slurred speech, and lack of coordination. Detox from benzodiazepines can be dangerous, especially when attempted cold turkey and without any medical assistance or monitoring.
Contrary to what might seem to make sense, benzodiazepine withdrawal symptoms during drug detox are treated with benzodiazepines. In most cases, longer acting benzodiazepines are used, but the safest way to withdraw from this class of drugs is to slowly taper down dosage. In the event of sudden cessation of benzodiazepines, the withdrawal symptoms can be very uncomfortable and should always be monitored by medical professionals.
Detox from benzodiazepines has been described to manifest in three potential sets of symptoms. The first is considered to be “rebound anxiety” and insomnia, during which symptoms of severe anxiety present with difficult sleep disturbances.
The second pattern is full-blown withdrawal syndrome, potentially presenting the full range of withdrawal symptoms, which include:
Third is the aftereffect, which is very common among all drugs of abuse. This period is marked by the return of anxiety and possibly other symptoms that the benzodiazepines were intended to treat. This readjustment period is the brain’s attempt to restore balance and natural function. Very uncomfortable for some, it can be especially intense for those who have a long history of drug abuse.2 Not everyone who becomes dependent on benzodiazepines will experience the same levels of withdrawal symptoms, but the chances of more severe symptoms increase with more frequent and higher amounts of shorter-acting benzodiazepines.
With exception to medical and mental health conditions, drug detox from benzodiazepines can take between ten and fourteen days, with the possibility of some symptoms lingering for several weeks or months thereafter. Many people may need to detox from benzodiazepines after safely using medications for an extended period of time, in which case, it may not be necessary to attend a drug treatment program. However, for individuals who have abused and become addicted to benzodiazepines, a new way of life free from drug abuse is imperative, and time in a treatment program is the best way to achieve lasting sobriety.
Alcohol is one substance from which a drug detox can turn deadly, particularly in cases of severe alcoholism and a lack of medical assistance. Not every person in need of alcohol treatment will experience life-threatening withdrawal symptoms during detox, but alcohol’s depressant effects can create a brutal detox experience. Unlike benzodiazepines, alcohol detox does not involve a tapering down of alcohol consumption, but many of the withdrawal symptoms are effectively managed with benzodiazepines.
The most common withdrawal symptoms can begin within six hours after the last drink, and they include:
These symptoms are representative of a mild to moderate alcohol withdrawal, which is the extent of symptoms for many. Severe alcohol withdrawal, or delirium tremens, occurs in less than 5 percent of the population who experience alcohol detox.3 However, that does not mean that alcohol detox should be attempted without medical attention. There are other risks inherent in alcohol detox that should be taken into consideration.
Alcohol withdrawal symptoms typically peak between ten and thirty hours, so early symptoms are likely to become more severe, and there is no DIY barometer to determine just how severe they may become. Assessments of the severity of alcohol withdrawal can be determined by medical staff, in a clinical setting, using the CIWA-Ar (Clinical Institute of Withdrawal Assessment of Alcohol scale).
The risk for seizures is not one only associated with severe alcohol withdrawal, or delirium tremens. Individuals going through alcohol detox are at higher risk for a seizure between twelve and forty-eight hours.
It is important to seek medical advice before attempting an alcohol detox to allow a determination of the potential severity of withdrawal symptoms. In confirmed mild cases of alcohol withdrawal, symptoms may be manageable at home, with support, medical consultation, and medications to manage some symptoms.
The time it takes to complete alcohol detox depends heavily on the individual, the severity of symptoms, and any preexisting medical conditions or co-occurring mental health issues. Exclusionary of complicating factors, alcohol detox can be completed in three to ten days.
All stimulant drugs like cocaine, crystal meth, amphetamines, and crack cocaine can have serious effects on users and present dangerous, life-threatening effects when abused. Despite the current opioid crisis in the United States, millions of Americans continue to struggle with addiction to stimulant drugs.
Stimulant drug detox is not life-threatening and generally takes between three and seven days to complete. Some serious medical or mental health conditions may cause complications in the detox process, although these are largely manageable with medical attention. Due to a lack of clear evidence of physical withdrawal symptoms from stimulants, as are present with depressant drugs, it is not so obviously notable that an individual is detoxing from a stimulant drug.4 Although stimulant drugs do not cause the same physical dependence and withdrawal symptoms as depressant drugs, the psychological turmoil and dependence often make detox from stimulants extremely uncomfortable and challenging.
The main concern of drug detox involving stimulant substances is the mental stability of individuals throughout the process.
Among the intense cravings for more of the drug are other psychological symptoms, which can be severe and include the following:
The symptoms of stimulant drug withdrawal may not seem all that severe, but for many people who have become addicted to these drugs, the cravings alone are enough to prompt an immediate relapse. Additionally, many symptoms linger for several weeks or months after drug detox has been completed. One of the most common lingering symptoms after detox is anhedonia, or an inability to feel happiness. Another danger inherent in stimulant drug detox is how the psychological symptoms affect the individual going through detox. In cases of dual diagnosis, or the presence of a mental health issue and addiction simultaneously, each condition could exacerbate the other during drug abuse and throughout detox.
Often, stimulant drug detox involves maintaining a stable mental status for patients. The severity of stimulant withdrawal depends on the drug of abuse, the length and severity of abuse, and a positive dual diagnosis. Not everyone detoxing from stimulant drugs will experience the same set of symptoms, and the brain’s ability to adjust to the absence of stimulant drugs determines the length of time it takes for moods to stabilize and for anhedonia to subside.
For any person who is dependent on any drug and wishes to stop the cycle of addiction, drug detox is a necessary first step along the path to recovery, stabilization, and sobriety for the future. There is no path to recovery from addiction to any drug without an initial abstinence from that drug, and drug detox is the start of that abstinence.
Drug detoxes vary from self-managed to highly supervised and medicated, as may be necessary based on individual circumstances. It is important to seek medical consultation prior to beginning a drug detox in order to establish a complete assessment for the needs of a safe and comfortable detox process. Not all drug detoxes require an inpatient hospital stay, nor do all require some kind of medication. The majority of medically assisted drug detox processes do provide some form of medication (usually including benzodiazepines) to ease severe anxiety and promote more sleep. It is important to note that drug detoxes are generally not going to be completely comfortable, but all appropriate steps are taken to ease some of the more severe and discomforting symptoms during this imperative period.
With or without medical attention, drug detox is required to begin an addiction treatment program. Most rehabs include a form of drug detox as a part of their program. This can be inpatient, partial hospitalization, or outpatient detox, depending on the need of each individual entering the program. The most important thing to remember about drug detox is that while it is an important first step to recovery, it is not drug treatment.
Drug detox is crucial, but it is not easy on the brain and body of the individual going through it. Therefore, drug detox should not be repeated multiple times, especially without a treatment plan in place. Drug treatment should immediately follow drug detox and is intended to provide addicted individuals with the tools necessary to remain sober and live a healthy and productive life. Drug detox prepares people to receive the tools and information that treatment programs provide.
If you or a loved one is struggling with addiction to or dependence on any drug of abuse, it is important to seek medical help for a drug detox and to seek options for a drug treatment program to immediately follow detox. Drug detox is the first important step to get life back on track, and a treatment program can help to ensure the lasting effects of detox and the establishment of healthy and sober habits after treatment.
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