What is Detox? And How Does It Work?
Detoxification from drugs or alcohol refers to the act of detoxing from a substance that has caused a physical and psychological addiction. The process of detoxing from drugs or alcohol involves clearing the body of the substances and managing withdrawal symptoms. The entire detox process may take anywhere from a few days to several weeks. The severity of addiction and the extent of withdrawal symptoms determine what method of detox is required. Also, the length of time needed for detox depends on which substance was abused, if multiple substances were abused, and how often the user abused the substance.
Additionally, how much of the substance the user took, the presence of underlying medical conditions, the drug users age, and their gender. Typically, an addiction assessment could determine the extent of detox and what treatment resources are needed. Overall, detox programs are designed to assist individuals during the process of withdrawal. Detox should be considered the first phase of treatment, and it should not be considered the last. Detox programs do not provide adequate counseling and therapy. The next phase of treatment involves attending an inpatient or outpatient drug rehabilitation program.
Detox alone does not address the psychological, social, and behavioral problems associated with substance abuse. The length of time needed for detox is different for each person, but following detox, the next phase of treatment should be counseling or therapy. Unfortunately, many drug users feel that detox is all they need; however if there is no further treatment, the risk of relapse increases. Also, the risk of overdose increases because the drug user has detoxed and is partially clean from drugs; they no longer have the same tolerance. For example, opioid addiction creates an intense physical and psychological dependence. However, when an opiate user stops using these drugs, their body no longer has the ability to manage the same amount as when they were abusing opiates.
When is the Best Time to Attend Detox?
Detox is the first approach that any addict should take before treatment, and it should not be considered the last. However, it may be difficult to determine when to attend detox because it is not uncommon to attempt detox at home. Some drug users are willing to attend detox without intervention, whereas other circumstances involve family intervention to convince a drug user to attend treatment. The best time to attend detox is whenever the decision is made to receive help. Also, if a drug user does decide to detox on their own, they may need detox to manage withdrawal symptoms and cravings before they relapse.
Different substances stay in the body for differing periods of time. Severe withdrawal symptoms may occur within 24 hours or three to five days, depending on the substance. Overall, a person can detox from substances they are taking within one week. Some of the withdrawal symptoms are more serious than others—Detox could be medically supervised or a traditional detox. Most addiction treatment professionals encourage medical detox for opiate addiction, severe alcoholism, or an addiction involving prescription drugs.
When someone is detoxing from alcohol, withdrawal symptoms begin within the first 24 to 48 hours. Some of the withdrawal symptoms include anxiety, insomnia, and shaking. Within three to five days, symptoms peak within 72 hours—symptoms include seizures, fever, and even hallucinations. After the first week, the physical withdrawal symptoms begin to taper off, and after the first week, the alcohol user may experience cravings until they work through proper treatment. Within the first 24 to 48 hours of not using heroin or other opioids, a drug user would experience muscle pain, anxiety, teary eyes, runny nose, sweating, insomnia, and vomiting.
Over the next three to five days, the withdrawal symptoms peak and include diarrhea, nausea, vomiting, abdominal cramps, blurry vision, and rapid heartbeat. It is only after the first week when withdrawal symptoms begin to taper off, and medical detox programs provide the best care when managing heroin addiction. When prescription drugs are misused, the withdrawal symptoms occur within the first 24 to 48 hours. Withdrawal symptoms include anxiety, insomnia, shaking, and depending on the strength of the dose and severity of abuse. The symptoms may peak after the first few days, but they could linger. Inpatient medical detox programs are the best option for someone addicted to prescription medication.
Someone who is withdrawing from cocaine or other stimulants will experience a crash within 24 to 48 hours after using it. The drug user will experience fatigue, body aches, irritability, and an altered mood. The brain damage caused by stimulant abuse may lead to depressive or psychotic symptoms. After the first week during withdrawal, the person will experience lethargy, erratic sleep, intense drug cravings, depression, and poor concentration. Overall, drug cravings are the most difficult part of overcoming addiction. The psychological and even physical cravings may linger, which is why well-rounded treatment is necessary.
What Happens During Detox and What Approaches are used?
There are different things to expect during detox, and overall, the experience is unique to the individual going through it. Typically, during detox, the person could expect an intake exam so the detox team can see what kind of support is needed. Also, it would not be uncommon to get blood work done or talk about your health and drug and alcohol consumption history. Some detox facilities would also check your physical and mental health. Detox support may include utilizing medication to control withdrawal symptoms, which is common with opiate or alcohol addiction.
The purpose of detox is to help the person become physically and mentally stable before treatment takes place. A detox facility would also check your temperature, blood pressure, heart rate, and breathing would be checked regularly. Detox facilities would also help the person enter into treatment. Detox should not be considered the only treatment approach because it does not help treat the underlying issues. Detoxification centers do not provide the necessary counseling, therapy, and relapse prevention to treat addiction. When considering detox programs, it is important to think ahead of treatment. Some detox centers are attached to inpatient or outpatient drug rehab centers, which makes a smooth transition.
There are some commonly used options to consider for detox. Inpatient medically supervised detox programs utilize withdrawal management, which is a process of controlling withdrawal symptoms. Medical detox programs are always inpatient because of medical supervision and constant monitoring during dangerous detox. Traditional detox programs are also inpatient because it provides a safe and controlled environment. Most conventional detox programs manage street drug addiction and drugs that do not cause severe withdrawal symptoms. Some detox programs offer outpatient services, where a patient attends treatment daily but lives at home.
Outpatient treatment, especially with detox, is not as effective but could work with some forms of addiction. Residential programs usually offer more services, but it tends to cost more, which is why outpatient treatment centers are more accessible. Overall, when choosing detox, it is important to consider the severity of the addiction. Ideally, it should be a program that is affordable and has licensed and trained staff, and a high success rate. Also, the family should consider what type of insurance they take, how is the staff trained, are they licensed. Usually, some services will be covered by insurance, and what you pay out of pocket depends on your insurance coverage.
Alternative to Traditional Inpatient Detox
Some people may choose to detox at home from drugs or alcohol, while others have no choice but to attend inpatient detox because of the severity of withdrawal symptoms. Home detox is also less expensive if a person cannot afford inpatient treatment. Typically, detoxing at home means withdrawing from substances without medical supervision or professional help. There are some dangers involved with home detox because some drugs cause severe or even life-threatening withdrawal symptoms. For example, chronic heavy alcohol consumption or a physical dependence involving opioids is difficult for a person to manage on their own.
However, detoxing at home could be a viable option for someone that is not physically dependent on drugs and can manage withdrawal symptoms. For example, someone who is withdrawing from cocaine or marijuana may attempt a home detox. If a home detox is the only option or what the person prefers, it is crucial to have reliable friends or family available throughout the withdrawal process. Some people who attempt home detox incorporate additional therapies, such as meditation, yoga, massage, and proper nutrition.
Detox is the First Step and Prevents Overdose
According to the Centers for Disease Control and Prevention, for every drug overdose that results in death, there are many more non-fatal overdoses. Research has shown that people who have had at least one overdose are more likely to have another. In 2018, there were over 67,300 drug overdose deaths, and this increased in 2019 to over 71,000 overdose deaths. Synthetic opioids continue to be the main driver of drug overdose deaths in the country. In 2018, opioids were involved in over 46,800 overdose deaths. During that time, the state with the highest rates of death due to drug overdose was West Virginia, Delaware, Maryland, Pennsylvania, Ohio, and New Hampshire.
Per the National Institute on Drug Abuse, in 2018, the data indicated that every day 128 people in the nation die after overdosing on opioids. Prescription pain medication, heroin, and synthetic opioids like fentanyl continue to be a national crisis that affects public health. Also, more than 30% of overdoses involving opioids also involve benzodiazepines, which is often a prescription. Between 1996 and 2013, the number of adults who filled benzodiazepines prescriptions increased by 67% from 8.1 million to 13.5 million. In 2015, 23% of people who died of an opioid overdose also tested positive for benzodiazepines.
Between 2001 and 2013, the percentage of persons also prescribed benzodiazepines rose 17% in 2013 from 9% in 2001. The combination of opioids and benzodiazepines increases the risk of overdose, but with proper detox and treatment, addiction is overcome successfully. Detox is an essential first step and does save lives. Drug users who successfully complete detox is more able to follow through with inpatient or outpatient substance abuse treatment.
Terminology Used Surrounding Detox
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 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.