Drug detox refers to how an individual abstains from using a drug to rid the substance from their body. When this happens, a wide range of withdrawal symptoms may appear that make the process of becoming sober very uncomfortable and, in some cases, dangerous. If the detox process is not occurring under medical supervision in a facility that takes the patient away from the availability of the substance they use, relapse is much more likely to occur. Individuals may wish to seek treatment during and following the detox process to ensure lasting recovery.
The National Center for Drug Abuse Statistics has released the following data on drug addiction in the United States:
Depending on which drug a person is using and to what extent, they may be physically dependent, psychologically dependent, or both. The difference between the two is that physical dependence affects the body while psychological dependence affects behavior and mood. There are certain drugs that cause more physical dependence than others, in which case medically assisted detox treatment is needed for managing dangerous withdrawal symptoms.
Drugs that cause fatal withdrawal include alcohol, benzodiazepines, and barbiturates. In these cases, there are select medications used during detox and withdrawal that can manage symptoms and prevent relapse.
Tolerance happens when a person is no longer responding to the dose that once got them high, and they find themselves needing to take more of the drug to achieve the same effects. In the instance of heroin users, their first high is so intense, they often feel as though they are using just to recreate that first one -- and always failing. An individual will know that they are physically dependent if they try to stop using the drug and physical or psychological withdrawal symptoms occur.
Medically assisted drug detox treatment refers to the medical supervision and care provided to individuals with substance use disorders who wish to rid their bodies of substances in a safe procedure with trusted medical professionals. The length of stay in a medically assisted detox treatment facility could last as short as a few days to as long as a few months. The severity of withdrawal symptoms heavily depends on the substance used as well as the length and extent of the individual's dependence and addiction. The purpose of medically assisted detox is to carefully monitor and treat withdrawal symptoms. This treatment looks different between inpatient and outpatient programs.
As listed above, certain drugs like alcohol and benzodiazepines have withdrawal symptoms that can cause death. As such, it is necessary that people addicted to these substances receive treatment during detox, and it is never recommended that they detox without medical supervision. Other drugs, like methamphetamines and other stimulants like cocaine, can cause very intense psychological symptoms like depression and suicidal ideation. In these cases, individuals can be a danger to themselves and others and could benefit from detox treatment at a facility that can monitor their symptoms, manage side effects, and keep them safe during the detox process.
In all cases of drug and alcohol addiction, supervised or medically assisted detox can be incredibly beneficial to long-term recovery as it removes stressors and access to drugs and alcohol and provides treatment in a positive, supportive environment. The risks involved with going “cold turkey” or attempting detox from home could be incredibly dangerous to a person's body, as they could experience seizures or severe dehydration that can lead to serious health complications or death.
Because benzodiazepines alter the functioning of the GABA receptors in the brain, withdrawal symptoms from these prescription sedatives show a lot of similarities to that of alcohol withdrawal. Benzodiazepines are one of the only other drugs whose withdrawal symptoms can cause death. That is why at-home detox is never recommended for people with a benzodiazepine use disorder.
Symptoms of withdrawal of benzodiazepines can begin within 6 to 8 hours of the last use and last over 15 days. They include:
Benzodiazepine detox without supervision is never recommended as it is also considered medically dangerous. Treatment for benzodiazepine addiction should begin with a gradual tapering off of the drug, as an abrupt stop could be very dangerous and carry a lasting negative impact on an individual's health. During this tapering-off period, medical professionals may begin prescribing less and less of a drug and then switch to a benzodiazepine with a longer half-life or one whose effects are released slower. Anti-convulsants and anti-depressants could be prescribed as well to manage symptoms.
Withdrawal signs and symptoms from opioids vary in severity, time of onset, and duration of symptomology depending on the opioid used. For the most part, however, all drugs in the opioid category produce similar withdrawal symptoms. For example, withdrawal symptoms for short-acting opioids, like heroin, begin to occur 8 to 24 hours after the last use, and these symptoms can last between 4 and 10 days. For long-acting opioids, withdrawal symptoms can begin within the first 12 and 24 hours and can last as long as 20 days.
Opioid withdrawal symptoms include:
Uncomplicated opioid withdrawal is not life-threatening or considered medically dangerous. However, the withdrawal symptoms can be incredibly uncomfortable and painful, so managing these symptoms through detox treatment can be beneficial to reaching long-term recovery and avoiding intense cravings and relapse.
Methadone is the most popularly used prescription medication during detox from opioids, and it is only available through medical detox facilities. Clonidine has also been used for opioid withdrawal as it treats symptoms without producing opioid intoxication. Buprenorphine has also been FDA approved to be prescribed for opioid detox.
Depression is one of the most concerning withdrawal symptoms of methamphetamine (meth) because of the surge of dopamine that the drug regularly supplies its users with. Once the presence of meth leaves the body, the brain may experience an emotional crash.
Symptoms of meth withdrawal include:
Meth withdrawal symptoms may begin within the first 24 hours of the last use and can last up to 72 hours or more.
Withdrawal symptoms from cocaine are also mostly psychological in nature. Many people who have been using cocaine will feel a strong need to eat or sleep, as they may have been depriving themselves of food or rest while under the influence of cocaine. Because the effects of cocaine are immediate and don't last long, the withdrawal symptoms can begin within 90 minutes of the last use. These symptoms can last between 7 and 10 days.
Withdrawal symptoms from cocaine include:
There are no medications specifically approved for cocaine detox, as most of the withdrawal symptoms are psychological in nature. Many patients will be prescribed anti-depressants or anti-anxiety medication to help manage these symptoms. It is also important that they are monitored for chest pain or headaches, as they could be signs of cardiac complications or cerebrovascular disease. Learn more about cocaine detox here.
When a person attempts to stop their drug use and is only met with uncomfortable and potentially dangerous withdrawal symptoms, they may find themselves unable to stay clean. In these situations, it is important that they reach out to their doctor or a medical professional for advice on how to receive treatment for their substance use disorder. There are often stages to recovery treatment and detox, including evaluation, stabilization, and long-term treatment.
Evaluation: During the evaluation, a clinical professional will assess the intensity and longevity of a person's substance use disorder by evaluating the use as well as the psychological and physical conditions of the patient. The professional will also look at the medical history of the patient to ensure safe detox. From this, professionals will determine a detox plan that will fit an individual's needs throughout the process.
Stabilization: The stabilization period refers to the time in which the patient enters their detox care plan and begins taking medications to assist in minimizing withdrawal symptoms as well as beginning individual or group therapy. Patients will be monitored around the clock as symptoms can be very dangerous during this time.
Long-term substance abuse treatment: This kind of treatment refers to inpatient, intensive outpatient, individual and group therapy, and 12-Step programs. During this phase of treatment, patients will receive psychological care, help with developing effective coping strategies, and support throughout their recovery.