Detox to Start Healing

Table of Contents

What is Detox?

You may have heard of someone with substance abuse problems going through “detox”. While it is widely known that detoxification is the first step in substance abuse treatment, what is detox? This article will explain what detoxification is, the treatments involved, and differences in the detoxification process for the abuse of different substances.
Detox, short for detoxification, is a process in which substances such as alcohol or drugs are removed from the body. This process involves a series of treatments that are aimed at managing the acute symptoms of intoxication and withdrawal from substances. Detoxification is not the same as treatment for substance abuse but is often the first step of the overall treatment process.

3 Parts of Detox

According to Treatment Improvement Protocol 45 from the United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), detoxification has three components:1

Evaluation

This process identifies the presence of substances in the body, any other medical conditions present, and the person’s social and living situation for program placement once detoxification is completed.

Stabilization

The second step is the actual process of assisting an individual through withdrawal as substances are removed from the body. Medications may be used to assist this process.

Fostering Readiness and Entry into Treatment

The last step of detoxification introduces the individual to the treatment process and stresses the importance of follow-through as the individual enters a treatment program.

It is important to stress that detoxification is not a treatment for substance abuse. Detox is the first step toward treatment, as treatment is difficult when substances are still active in the body.

Where Do You Detox?

Detoxification can occur in either an inpatient or outpatient setting. Here are a few of the differences between these two settings:2

Inpatient Detox

  • The patient is admitted to the hospital and stays there until detoxification is completed
  • The three components of detoxification above all occur while the patient is staying at the hospital
  • The length of treatment varies, but usually lasts from 5 to 14 days

Outpatient Detox

  • The patient travels to the hospital or treatment center daily
  • The initial detoxification intake session lasts 1 to 2 hours, followed by treatment sessions that last about 30 minutes daily
  • The length of treatment also varies, but usually lasts from 3 to 14 days
  • An intensive outpatient program provides more support, with a minimum of 9 hours of service per week. This type of program is just as effective as inpatient programs for people who do not require 24-hour supervision during detox.3
The duration of detoxification and the specific treatments used vary depending on the type of substance that must be removed from the body. Now let’s take a look at more specific information on detoxification for alcohol addiction, dependence on opioids, and dependence on stimulants.

Detox for Alcohol Addiction

The following are statistics for PTSD and Substance use disorder as it affects combat veterans and domestic abuse survivors:
The withdrawal that occurs from quitting drinking is one of the most commonly experienced of all substances. Here are some details about detoxification for alcohol addiction.4

How Long Does It Take to Detox from Alcohol?

This varies depending on the amount of alcohol consumed every day, how long the person has been drinking, and if the person has been through alcohol detox before. The average length of time for withdrawal symptoms to decrease is 4 to 5 days.

Withdrawal Symptoms

  • Irritability
  • Anxiety
  • Nausea
  • Sweating
  • Rapid heart rate
  • Tremors

Side Effects

A severe form of withdrawal called delirium tremens (DTs) is possible during alcohol detoxification. This condition may occur if a person is severely dehydrated with low sodium, potassium and blood platelet levels. Symptoms include:
  • Fever
  • Hallucinations
  • Delusions
  • Paranoia
  • Seizures

Medications and Treatments

Benzodiazepines

These medications are used to reduce the possibility of seizures during withdrawal.

Neuroleptic Medications

Also called antipsychotic medications, these are used to help lower nervous system activity, reducing anxiety and the possibility of seizures.

Beta Blockers

These are often used to treat high blood pressure associated with withdrawal.

Vitamins

Nutritional supplements are frequently prescribed during alcohol detoxification to assist with withdrawal symptoms and correct problems with nutrition caused by alcohol consumption.

Medications to Reduce Cravings

Specialized medications may be prescribed once alcohol detoxification is completed to reduce the chance of resuming alcohol use.

Detox for Addiction to Opioids

Opioids, including natural opiates derived from the opium poppy and synthetic opioids, are drugs that are primarily used to relieve severe pain. They may be taken legally with a prescription or obtained illegally. A few examples of opioids include heroin, morphine, Oxycontin®, and Vicodin®. If these drugs are taken for more than a short period, severe physical and mental addiction can occur.5

How Long Does It Take to Detox from Opioids?

This depends on how long it takes for withdrawal symptoms to appear. Opioids metabolize in the body at different rates. It will take less time to detox from an opioid that metabolizes faster, such as heroin, than an opioid that metabolizes slower, such as Oxycontin®. Most withdrawal symptoms subside within a week from their appearance.

Withdrawal Symptoms

Early withdrawal symptoms, within the first 24 hours
  • Restlessness
  • Anxiety
  • Insomnia
  • Muscle aches
  • Sweating
  • Eyes tearing up
  • Runny nose
  • Excessive yawning
Late withdrawal symptoms, after 24 hours
  • Nausea and vomiting
  • Abdominal cramping
  • Diarrhea
  • Dilated pupils with blurry vision
  • Goose bumps
  • Rapid heartbeat
  • High blood pressure

Side Effects

Vitamins

This can result from repeated vomiting and breathing of vomited material into the lungs.

Irregular Heartbeat

This may result from the loss of electrolytes in the system caused by diarrhea.

Medications and Treatment

Mild Symptoms

  • Acetaminophen or ibuprofen
  • Loperamide (Imodium®) for diarrhea
  • Hydroxyzine (Vistaril®) for nausea
  • Plenty of fluids
  • Rest

Severe Symptoms

  • Hospitalization may be required.
  • Clonidine – reduces the intensity of withdrawal symptoms
  • Suboxone – a combination of buprenorphine (a mild opioid) and naloxone (an opioid blocker) used to shorten the intensity and length of drug detox
  • Methadone – may be used for long term drug detoxification when faster detox methods fail or when opioids must be reduced in the system very gradually

Detox from Stimulant Addiction

Because symptoms of withdrawal from stimulants are usually mild, detoxification may take place at home without medical management. This can result in relapse, however, and outcomes are often poor when medical management of detoxification is not involved. Stimulants that most often require a drug detoxification program include cocaine and methamphetamine.6, 7

How Long Does It Take to Detox from Stimulants?

Detoxification from stimulants involves an early phase of more intense symptoms, followed by a later phase of more mild but possibly more prolonged symptoms. Withdrawal may last up to 5 weeks due to these phases.

Withdrawal Symptoms

  • Depression
  • Fatigue
  • Anxiety
  • Irritability
  • Poor concentration
  • Insomnia or hypersomnia (sleeping too much)
  • Paranoia
  • Psychomotor retardation
  • Increased appetite with carbohydrate cravings
  • Drug cravings

Side Effects

  • Possible cardiac complications during cocaine withdrawal
  • Seizures
  • Persistent headache could be a symptom of bleeding in the brain
  • Possible psychosis, including hallucinations and delusions

Medications and Treatment

Medications are not typically used during drug detox from stimulants. Headaches or insomnia may be treated with medications that target these symptoms. Nutritional intake should be monitored as people addicted to stimulants often have reduced appetites. When appetites return during drug detoxification, this can result in carbohydrate “binges”. It’s recommended when going through drug detoxification to avoid people, situations, or activities that trigger drug cravings.

Dangerous Detox Situations

Detoxification that is completed under the supervision of an inpatient or outpatient drug treatment program ensures the best chance of medical safety and complete removal of drugs from the system. Sometimes this is not the case, however. These detoxification methods are not considered safe and may result in a medical emergency, incomplete removal of substances from the body, and/or a higher chance of relapse.

Detox at Home

Some people attempt to detox by themselves at home. Detoxing at home can be safe for people who have mild substance abuse issues, but it is risky for people with larger, long term problems. Anyone who considers detoxing at home should consult a medical professional about how to detox before doing so.8

Rapid Detox

This method of detoxification involves sedating the patient and then administering medications to start the onset of withdrawal. The theory behind the technique is that the patient sleeps through the worst of the withdrawal symptoms. Studies on the effectiveness of this technique show that it does not speed up the withdrawal period and that the sedation used can increase the risk of adverse side effects.9, 10

Ultra-Rapid Detox

Similar to rapid detox, ultra-rapid detox involves sedating the patient and administering medications to start the onset of withdrawal. While heavy sedation is used during rapid detox, general anesthesia is used during ultra-rapid detoxification. This greatly increases the risk of adverse effects during the detoxification process. An investigation by the New York State Department of Health into deaths and adverse effects resulting from ultra-rapid detox in 2012 resulted in a health alert issued to health care practitioners in the State of New York to avoid the practice.11

The Benefits of Detox at an Addiction Treatment Facility

Detoxification is clearly a process that involves many factors, unknowns and risks. The safest way to detox from substances is under the supervision of a substance abuse treatment program or medical professional. These programs can offer:
  • Evaluation of your status and situation regarding substance abuse
  • Medical management of the entire detoxification process
  • Medications to make withdrawal more comfortable
  • Initial treatment programming for substance abuse
  • A smooth transition into long term substance abuse treatment
The comprehensive programming that addiction treatment facilities offer makes detox and drug treatment more effective, reducing the chances of adverse side effects and increasing the likelihood of a successful recovery. If you know someone who needs help with substance abuse, contact Iris Healing for more information.

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