What Is an Alcohol or Drug Detox?As noted, detoxification (detox) is the process of clearing drugs or alcohol from the body. While it is the most critical hurdle in the recovery process to overcome, detox alone is not treatment. After completion of detox, patients should strongly consider entering a rehab program.
Why Is Detox Necessary?Prolonged use of certain drugs or alcohol can result in physical and emotional dependence. Abruptly discontinuing the use of certain substances can lead to a withdrawal syndrome that, in some cases, can be life-threatening. Although detox from stimulants and opioids is typically not dangerous, detoxing without medical supervision may lead to extremely unpleasant withdrawal symptoms that can compel a person to relapse. Worse yet, severe depression and anxiety can result in suicidal thoughts and behaviors. Moreover, a medical detox program has the following benefits:
- It offers relief of the discomfort of withdrawal
- It provides immediate medical treatment for any serious medical complications that may arise
- It is the smoothest path for someone to navigate this difficult period immediately following the cessation of drug or alcohol use
- It can reduce the risk of continued drug use or the temptation to relapse due to a painful withdrawal
Which Drugs Require Detoxification?Several drugs require medically-supervised detox without exceptions. Withdrawal from these substances can cause a person to become dangerously agitated or experience potentially life-threatening seizures/convulsions. These drugs include:
- Benzodiazepines (e.g., Ativan, Valium, and Xanax)
- Opioids – including illicit drugs, such as heroin, and prescription painkillers, such as hydrocodone
- Stimulants – including methamphetamine, cocaine, and prescription stimulants, such as Adderall and Ritalin.
Quitting Suddenly or “Cold Turkey”Attempting to quit a substance abruptly without medical intervention can result in severe and life-threatening risks. These risks may be especially likely for those experiencing acute alcohol, benzodiazepine, or barbiturate withdrawal.
Risks of Quitting Cold Turkey
- Needlessly unpleasant withdrawal
- Increased chance of relapse
- Increased risk of an overdose after relapse due to reduced tolerance to the drug
- Death, often from uncontrolled seizures or convulsions
What Is the Detox Process Like?According to the Substance Abuse and Mental Health Services Administration, the alcohol and drug detox process typically consists of three steps: evaluation, stabilization, and transition to treatment. Evaluation During an evaluation, treatment providers collect information about the patient to help with treatment planning. This data includes the following:
- Blood tests
- Screening for co-occurring physical and mental health conditions
- A comprehensive assessment of a person’s medical and psychological status
- Assessment of the person’s social situation
- Risk assessment for withdrawal severity and the need for medical supervision
- Medication to relieve withdrawal symptoms
- Proper diet and nutrition
- Familiarizing the patient with what to expect during treatment and recovery
- Including friends and family when suitable
Which Medications Are Used?
- Benzodiazepines, such as Diazepam (Valium) and Lorazepam (Ativan)
- Chlordiazepoxide (Librium)
For OpiatesClonidine is an anti-hypertensive medication effective in reducing some but not all of the unpleasant symptoms of opioid withdrawal. Buprenorphine is a partial opioid agonist, meaning that effects such as euphoria are significantly lower than with other opioids, such as heroin. It’s use can diminish the effects of physical dependence on other opioid drugs, including withdrawal symptoms and cravings. Naloxone is an opioid antagonist used in emergency overdose situations and often combined with other drugs, such as buprenorphine, to lower the risk of overdose if abused. Suboxone is a popular example of this combination. Naltrexone is useful in opioid and alcohol recovery due to its ability to curb much of the drug’s rewarding effects.
- Desipramine (Norpramin) is an antidepressant used for severe withdrawal symptoms.
- Benzodiazepine sedatives have also been used to manage meth and cocaine withdrawal.
Choosing a Drug Detox ProgramDetox can occur in a variety of medical environments. These settings can be broken into two formats: inpatient and outpatient. Inpatient Studies have revealed inpatient detox to be the most effective treatment method. It offers the most support and best quality of care with staff available around-the-clock. Patients are monitored closely and treated for other medical conditions. Also, inpatient clients are removed from dangerous, trigger-filled environments, reducing the risk of relapse. Outpatient In outpatient detox clinics, typically, patients visit the clinic daily to receive medication or visit a doctor’s office monthly to obtain a prescription. Those undergoing outpatient detox should also participate in an outpatient addiction treatment program afterward to address cravings and receive additional support. The benefits of this program include lower cost and increased flexibility with schedule.
How Long Does a Drug Detox Take?The duration of detox varies from a few days to two weeks and is dependent on several factors, including the substance used, average dosage, and duration in which the drug was abused. In the case of benzodiazepines, detox may require a slow tapering schedule and take much longer. The cost of detox depends on factors such as:
- Type of detox
- Inpatient vs. outpatient
- Private or publically funded facility
- Medication (pharmacotherapy)
- Out-of-pocket, including payment plans
- Sliding scale fees, meaning the cost varies depending on the patient’s ability to pay
- Government assistance
- Financing (loans, credit cards, selling assets, borrowing money, etc.)
What Happens After Detox?: Addiction TreatmentOptions for treatment following detox include:
- Partial hospitalization program (PHP)
- Intensive outpatient
- Individual, group, and family counseling
- Support groups
- 12-Step programs
- Sober living homes