Withdrawal from drugs and alcohol makes detoxes a necessity in the field of addiction treatment. When someone stops taking a chemical substance they’ve become dependent on, withdrawal occurs. It is not an imagined condition or simply a matter of drug cravings. Withdrawal symptoms consist of physical and mental changes that can be highly uncomfortable and even deadly.
Detoxes are designed to help patients through these symptoms to become stable off drugs and ready to begin treatment.
TIPS: If you are going to detox
- Never stop taking medication without consulting a doctor.
- Get a professional assessment to determine if you need medical detox.
- Do not abruptly stop using large amounts of alcohol or certain drugs without consulting a medical professional.
- Get medical support through medical detox or advice from your doctor when detoxing from alcohol, opioids, and benzodiazepines.
- Holistic detox approaches can be effective, especially when withdrawal symptoms are mild and do not require medication assistance.
- Make sure to eat healthy foods and get plenty of sleep to help your body heal.
When is Detox Needed?
Detox is an aspect of substance use treatment that isn’t always necessary. A detox may not be warranted if the person isn’t abusing substances known to cause severe withdrawal symptoms. Similarly, if they aren’t using heavily or frequently, it may be determined that they can begin treatment without first attending detox.
But detox is recommended when withdrawal symptoms are expected to be potentially dangerous or uncomfortable enough to make the process unnecessarily challenging. Many treatment facilities will not accept patients attempting to quit certain drugs without them first completing a detox stay.
Different Types of Detox
There are two main types of detoxes: social and medical. Social detox is commonly referred to simply as “detox,” while medical detox may be shortened to “med detox.”
A social detox facility can’t administer most narcotic medications. Social detoxes are a lower level of care than medical detoxes. While they can provide some medical care, it is usually limited to monitoring and treating minor symptoms as they arise. Staff members in social detoxes may not be counselors but are qualified to observe and report symptoms to medical professionals and clinicians. For these reasons, patients who may experience life-threatening withdrawal symptoms are better suited for medical detox.
Medical detoxes are fully staffed facilities with trained practitioners who can administer any needed medications to prevent or treat withdrawal symptoms, including tapering the person off narcotics to a point where they can safely cease consuming them. They can handle patients at a higher risk than social detoxes. However, the process of medical detoxification is more expensive and can prolong withdrawal, making for a longer stay.
What's Next?
ASK A PROFESSIONAL
No, but a medical detox can be beneficial regardless of whether it is required. Alcohol, opiates, and benzodiazepines usually need a medical detox if an individual has taken large amounts or been on them for an extended period, as the withdrawal can be life-threatening. Drugs like methamphetamines do not require a medical detox, but medical intervention can go a long way in keeping someone comfortable during the withdrawal process.
Detox should be used when someone uses drugs in large amounts or for a long duration. Adverse reactions can be expected whenever someone stops using a substance, they have developed a physical dependence on. Withdrawal symptoms vary depending on the individual and the substance used, so always consult a medical professional to determine if detox is required.
The time it takes to complete detox varies depending on the substance, how long it’s been used, and how much a person uses. Most people who require detox can expect a minimum stay of 72 hours. Depending on the severity and duration of their symptoms, patients are usually discharged once acute withdrawal symptoms have diminished, generally occurring within 5- 7 days. Those withdrawing from substances that produce severe and dangerous symptoms can expect their stay in a detox center to take longer than a week.
Immediately after being in a detox center, the patient should transition directly to some form of inpatient treatment. Detox is only the beginning of the drug rehab process and is better viewed as a preparatory step since detoxes prepare patients to receive treatment. Patients craving and feeling ill from withdrawal symptoms experience far less benefit from rehabilitation services if they can complete them. That’s why detox services originated. They bridge the gap between active addiction and abstinence so treatment can be delivered.
The main difference between the two types of detox is the amount of medical oversite and the use of medication to treat symptoms. If the person is attending a medical detox facility, they can expect a hospital-like setting where they will live and have their symptoms monitored for the duration of their stay. They are medications to help alleviate some withdrawal symptoms, making the process safer and more tolerable. Non-medical detoxes generally consist of symptoms monitoring and reporting, along with the support and encouragement of the detox staff.
The questions from Addicted.org’s “Ask a Professional” are answered by Michael Leach, CCMA. If you need further clarification on any of the questions above or have any other questions you can contact him directly at [email protected].
What to Expect from Detox
Detoxes can either be stand-alone facilities or a part of a larger substance use treatment center. Stand-alone detoxes are becoming less common because they enable patients to use the service to substitute for complete addiction treatment easily. Many people don’t want to commit to a full rehabilitation program and think that if they can just get off the drugs, they can stop for good.
Sadly, this often leads to them staying in detox for just long enough to lose their tolerance. And without subsequent treatment to give them the tools to stay drug-free, relapse is virtually inevitable. Now, with no natural defense against the toxins, they can easily overdose and die. Most treatment programs now offer on-site detox facilities to prevent this issue.
When patients check into detox, they should expect to provide a urine sample for drug testing. This is done to help validate the patient’s self-reported drug history and give the detox an idea of what symptoms to expect. After completing any needed interviews and paperwork, providing the urine sample, and turning in one’s belongings to be searched, patients are usually shown to a room.
Most detoxes resemble a hospital setting, and the patient will likely live in this room for the next several days. If the detox is at a treatment center, detox patients will be kept separate from other patients in later portions of the program. This is done to prevent patients who may be experiencing withdrawal symptoms from becoming overwhelmed or uncomfortable. Until they have completed detox, the only focus is on feeling better.
Detox Do’s and Don’ts
There are a few important things to keep in mind for anyone who will be attending detox. These tips have been formulated into a list of dos and don’ts that can help make the process a success:
Detox Do’s
- Be completely honest. The detox staff must have a complete understanding of your drug and medical history to help ensure your safety. Lying or omitting anything during the intake process can have deadly repercussions.
- Take your time. The detox process can’t be rushed and takes however long it takes for each person to get through any withdrawal symptoms. It’s common for patients to become antsy once they start feeling better and want to get their program started. But rushing on to the next step can easily lead to trouble, as many patients experience post-acute withdrawal symptoms. These residual symptoms can pop up and cause setbacks, particularly if the patient isn’t in the detox facility.
- Try to find a rehab that has on-site detox facilities. This will make the transition easier and more straightforward.
Detox Don’ts
- Don’t use detox in place of rehab. Detoxes do not provide care beyond handling the physical dependence on substances. But the person became addicted at some point in their life, and without counseling and relapse prevention, they are likely to repeat this coping mechanism.
- Don’t return home between detox and rehab. If a stand-alone detox facility is being used, every effort should be made to arrange for immediate transportation to the rehab facility from detox upon discharge. One of the riskiest periods in the treatment process is between detox and rehab when the person has no tolerance to drugs and no tools to prevent relapse.
- Don’t overthink things. While in detox, you will be experiencing a wide range of emotions and discomforts. Withdrawal isn’t limited to physical symptoms, and it’s quite common for the person to want to give up during the process. They’ve often convinced themselves that they no longer need treatment and will not relapse if they just leave and get back to their lives. This rationale is always a delusion fueled by cravings and the subconscious desire to ingest more drugs. Instead of being carried away by one’s thoughts, remember that these feelings are normal and will pass when withdrawal symptoms subside. And they will subside.
- Don’t expect a painless detox. The only way to get off of addictive substances that make people feel good is to feel a little bad. It’s a brutal truth, but there’s no way to transition to being drug-free without experiencing some discomfort. Medications like Suboxone and methadone may make the symptoms less severe. But keep in mind that the person will still experience minor withdrawal symptoms as the dosage is decreased. Tapers prolong the withdrawal process, so instead of three to five days of intense symptoms, it’s closer to 10 to 14 days of mild to moderate discomfort.
Terminology Used Surrounding Detox
| Term | Definition |
|---|---|
| Medical detox | this is a detoxification process that uses medication to control withdrawal symptoms while also providing medical supervision. Some addictions cause dangerous withdrawal symptoms, which could become life-threatening without medical supervision. |
| Conventional detox | a common detoxification process within an inpatient setting is managing drug users addicted to street drugs like cocaine, methamphetamine, or marijuana. Conventional detox does not traditionally offer medical supervision. |
| Withdrawal Management | refers to the medical and psychological care of patients who are experiencing withdrawal symptoms as a result of stopping their drug or alcohol use. |
| Home Detox | is a process of detoxing off drugs and alcohol at home without professional help or supervision. Most addiction professionals can help addicts through a home detox with proper guidance. |
| Medication-Assisted Treatment | MAT is the use of medications in combination with counseling and behavioral therapies to provide a whole-patient approach to the treatment of substance abuse. |
| Withdrawal Symptoms | are the abnormal physical or psychological features that follow the abrupt discontinuation of a drug that produces physical dependence. |
| Drug Toxins | are left behind from drug or alcohol use, and drug toxicity refers to the level of damage that a compound can cause to an organism. The toxic effects of a drug are dose-dependent and can affect an entire system in the body. |
| Delirium Tremens | DT’s are the most severe form of alcohol (ethanol) withdrawal—the problem is manifested by altered mental status and sympathetic overdose, which could progress to cardiovascular collapse. |
| Physical dependence | is the body’s inability to function without the use of drugs or alcohol. Physical addiction to drugs or alcohol occurs when you repeatedly use a drug until you become so dependent on it that your body can no longer function without it. |
| Psychological dependence | is defined as becoming mentally dependent on substances or the behaviors you display as a result of the psychological addiction. Psychological dependence also causes withdrawal symptoms as your body tries to compensate for the lack of chemicals. |
