Alcohol and drug detox programs are recommended as part of a comprehensive, individualized addiction recovery treatment plan. Detoxification helps individuals safely eliminate drugs and alcohol from their bodies and is an important first step in the overall addiction treatment process.
Physical withdrawal symptoms can vary depending on the substance of abuse and can potentially be dangerous, and even deadly. Due to these potential risks, it’s crucial that people understand what happens during detox and what to expect.1
This article will answer the following questions:
- What is detox?
- How does the detox process work?
- What are the different types of detox?
- What should I expect during detox?
- How can I find a detox program near me?
What is Detoxification?
Drug and alcohol detoxification (or “detox”) is the process of ridding your body from all addictive substances, so your brain and body can slowly heal as you begin your journey to recovery. Medical detox is designed to help you through the withdrawal process in a safe and supervised setting to reduce any physical symptoms that can occur when withdrawing from alcohol or drugs.1
What Are Withdrawal Symptoms?
Withdrawal symptoms can occur when an individual is dependent on drugs or alcohol and either stops or reduces their drinking habits or drug use.2 The onset, duration, and types of withdrawal symptoms vary depending on the substance being used.1 A few common physical withdrawal symptoms that may be experienced with different substances include:1
- Gastrointestinal upset.
- Muscle pain.
- Hot flashes.
Where Does Detox Occur?
Detox can occur in a variety of settings and at varying treatment intensity levels, depending on a person’s needs. It is important for people to undergo a formal assessment in order to receive the appropriate level of care during detox.1
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the success rate for detox partially depends on whether a person continues addiction treatment program once they complete the initial detox phase.
Detox is the initial part of a continuum of care for substance use disorders and is typically followed by further long-term addiction treatment.1 Long-term addiction treatment teaches healthy coping skills and relapse prevention skills and typically provides psychotherapy and medications to set a strong foundation for lifelong recovery.
What is the Alcohol and Drug Detox Process?
The detox process can vary based on individual needs and the substance of abuse, but involves the following three steps:1
- Evaluation: A full assessment of a person’s past and current medical and psychological conditions and social history. This step also involves testing a person for the presence of addictive substances. This information is used to determine the appropriate level of care that the individual will need.
- Stabilization: This involves managing acute intoxication and withdrawal in a safe and supervised setting. Medications are often administered during this phase to help alleviate any physical withdrawal symptoms.1 Treatment professionals will also help you understand what to expect during detox and other treatments during this stage.
- Preparation for further treatment: Treatment professionals will encourage continued treatment to support successful recovery outcomes.
How Long Does Detox Last?
The length of detox can vary depending on the individual and the substance they are detoxing from. The initial phase of detox is focused on ridding the body of substances, but some withdrawal symptoms can last for a few days, while others can last months or longer.5 Each individual will need to be assessed to determine the proper length of time for detox and continuing addiction treatment.
There are many factors that can affect the length of withdrawal. These can include:1
- Substance of abuse.
- Duration of use.
- Route of administration (snorting, smoking, injecting, etc.).
- The severity of the addiction.
- Family history of addiction.
- Level of willingness to change.
- Current level of family/social support.
- Presence of co-occurring medical or psychiatric conditions.
- Risk of developing severe withdrawal symptoms.
- History of previous relapses.
- History of previous withdrawals.
The risk of uncomfortable or dangerous withdrawal symptoms is possible for many substances of abuse. Therefore, it is important to have immediate access to medical staff who can help manage symptoms and administer medications if necessary. Due to these potential risks, it’s not advised to undergo detox at home and without medical supervision.
Types of Drug Detox
Detox can take place in a variety of treatment settings that involve different levels of care. Your initial assessment will guide treatment staff in determining your best level of care.1
Medically-monitored Inpatient Detoxification
Medically-monitored inpatient detoxification is a beneficial level of care for people who are currently intoxicated or have a high risk of severe withdrawal.3 Medically-monitored inpatient detox provides 24/7 medical care, and monitoring and access to life saving devices. This is considered the highest level of care and takes place in a hospital setting. The goals of inpatient detox include the following:3
- Medical stabilization, which often involves medications and fluids to ease withdrawal symptoms.
- Address co-occurring medical or psychiatric disorders
- Connect with addiction treatment providers for follow-up long term treatment after acute detox
Clinically-managed Residential Detox
Clinically-managed residential detox takes place in residential facilities where individuals are monitored 24/7 by clinical staff. They provide a number of services that may include behavioral therapy and 24-hour living support and structure.
Medications are often administered in these settings to help ease withdrawal effects. However, acutely ill patients who are at risk of life-threatening withdrawals are often admitted to medically monitored inpatient detoxification. The goal of residential detox is to help ease withdrawal effects by providing supervision, observation and support.1, 3
Intensive Outpatient (IOP)/Partial Hospitalization (PHP) Detox programs
Intensive outpatient and partial hospitalization are two different levels of care that provide detox programs in outpatient facilities to people who do not need to be supervised 24/7. Both levels of care can provide psychotherapy and medication management. A person can live at home and travel to an outpatient treatment facility on a regular basis. They will likely need to be onsite for several hours per day or multiple times a week, depending on their level of care.3
This setting may be appropriate for those with mild to moderate withdrawal symptoms. If more severe symptoms arise, you can be placed in a hospital or another setting that offers a higher level of care.
Partial hospitalization is a higher level of care compared to intensive outpatient treatment. PHP requires more treatment hours each week (on average, 20 hours per week), whereas IOP treatment provides approximately 9 hours of treatment each week.
Intensive outpatient and partial hospitalization offer detox programs, which are staffed by physicians who provide medical monitoring and nurses who offer care throughout the day. Addiction counselors and clinicians can offer additional interventions if necessary.1
Which Substances Require Detox?
Different substances of abuse are associated with specific withdrawal symptoms. Depending on the substance of abuse, withdrawal symptoms can range from minimal to life-threatening. As previously stated, withdrawal symptoms are physical and mental symptoms that can occur when a person who is dependent on a substance suddenly stops or reduces their substance use.2
Based on principles of safety and humanitarian concerns, SAMHSA advises medically-assisted detox for the following substances:1
- Sedative-hypnotics (such as benzodiazepines)
- Opioids (which includes heroin or prescription narcotics/painkillers)
What Are the Side Effects of Detox?
Detox can cause different side effects depending on the substance of abuse. Withdrawal from certain substances, such as alcohol, barbiturates, and benzodiazepines (sedative-hypnotics), is known for causing more severe and potentially dangerous side effects. Substances like opioids and cocaine can cause unpleasant but not typically life-threatening symptoms. Providing medications in a supervised clinical setting, can help alleviate these side effects.4
Some of the more common detox side effects include:1
- Difficulty sleeping.
- Runny nose.
- Abdominal cramps.
- Muscle pain.
Alcohol or benzodiazepine withdrawal can be potentially life-threatening and cause the following side effects:1
- Delirium tremens: This is a group of severe symptoms that can include delirium, or severe confusion, and autonomic hyperactivity. This can result in life-threatening effects to your nervous system such as raised heart rate, blood pressure, and body temperature.
Is It Safe to Detox at Home?
Due to the potential hazards that may occur during withdrawal from certain substances, it’s best to undergo detox with professional support and supervision.1 If you try to detox at home on your own, you may be putting yourself in a potentially risky situation without having immediate access to medical care.
What Are the Dangers of Rapid or Ultra-Rapid Detox?
People often want to speed up the detox process and make it as short and easy as possible. While there are rapid and ultra-rapid detox programs advertised, there is no evidence to support their benefit, and it can be potentially dangerous.6
While a speedy detox might sound appealing, research has shown that there are many potential symptoms and dangers associated with rapid or ultra-rapid detox, which are usually not found in traditional methods of detox.7
Remember that detox in itself does not equal addiction treatment, but it is the first component of a comprehensive treatment plan. Once you have completed detox, it’s advisable to transition to an addiction treatment program that will help support your long-term recovery.
How to Find Drug Detox Programs
Seeking medical detox is one of the most advisable ways to ensure your safety and comfort as you start the path to recovery. Some of the factors to look for in a reputable detox program include:1, 9
- An individualized detox plan that takes into account all of your unique and specific needs.
- An approach that is sensitive to the needs of people from diverse ethnic and cultural backgrounds.
- An adequate length of detoxification.
- Offering medication if necessary to help a person stay comfortable throughout the withdrawal process.
- Addressing symptoms of any co-occurring medical or psychiatric illnesses.
- Having credentialed or licensed staff who are compassionate and experienced.
- Having the appropriate state or federal licensure, which is especially important if you require certain medications for opioid withdrawal.
- The resources to connect you with appropriate treatment programs once you have successfully completed detox.
If you or a loved one are looking for detox programs and need help finding the right one for your needs, American Addiction Centers (AAC) is here to help. Our caring admissions navigators are available 24/7 at 1-888-319-2606 Helpline Information to provide information about detox programs, including a drug or alcohol detox near you, and other addiction treatment options. They can also help you quickly verify your insurance benefits.
- Center for Substance Abuse Treatment. (2015). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
- World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. 4. Withdrawal Management. Geneva: World Health Organization.
- American Society of Addiction Medicine. (2015). What are the ASAM Levels of Care?
- Gupta, M., Gokarakonda, S. & Attia, F. (2021). Withdrawal Syndromes. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing.
- National Institute on Drug Abuse. (2020). About NIDA: Frequently Asked Questions.
- Collins, E., Kleber, H., Whittington, R. & Heitler, N. (2005). Anesthesia-assisted vs buprenorphine- or clonidine-assisted heroin detoxification and naltrexone induction: a randomized trial. JAMA, 294(8), 903-913.
- National Institute on Drug Abuse. (2006). Study Finds Withdrawal No Easier With Ultrarapid Opiate Detox.
- Berlin, D., Farmer, B., Bao, R., Rella, J., Kunnis, H., Dowell, D…Ridpath, A. (2013). Deaths and Severe Adverse Events Associated with Anesthesia-Assisted Rapid Opioid Detoxification — New York City, 2012. Morbidity and Mortality Weekly Report (MMWR), 62(38), 777-780.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) Principles of Effective Treatment.
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