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Detox Treatment for Withdrawal

Drug and alcohol addiction are serious and growing problems in the United States. Statistics show that more than 20 million people struggle with a substance use disorder.1  Of those more than 20 million people struggling with a substance abuse disorder, 15 million struggle with alcohol use disorder, 8 million struggle with illicit drug use disorder, and 2 million struggle with some form of opioid use disorder which involves the misuse of prescription drugs.1

Further, relatively few people with substance use disorders receive treatment. In 2018, for example, roughly 17% of people aged 12 and older who needed substance abuse treatment received that treatment.1  And while many may seek treatment, they may be unprepared for the crucial first step: detox.

Many may not even know what detox entails. Detoxification, or detox for short, is the first stage of treating many types of drug and alcohol addiction and commonly precedes additional substance rehabilitation efforts. Detox helps a person make it through the first phase of recovery, as acute intoxication and any lingering toxic influence of drugs and/or alcohol subside .2 (p.4) Understanding detox and the importance it has in the success of substance abuse treatment is important for those seeking to obtain long-term recovery.

Detox & Medical Detox

In brief, detox refers to several potential interventions used to help manage withdrawal in early recovery. Medical detox involves medical oversight and the potential for pharmaceutical intervention to manage symptoms of withdrawal and address any complications to arise. While detox is often the first step in substance abuse treatment, it is important to understand that detox is not a substitute for more comprehensive substance abuse treatment in and of itself. 2

Medical detox is recommended depending on the severity of your addiction and the type of substance for with you are withdrawing from. Most often, medical detox is provided to support the severe--and sometimes life-threatening--withdrawal symptoms associated with benzodiazepine or alcohol withdrawal and the supervision associated with it is typically 24/7. As part of a medically monitored inpatient program, physicians are available at all times during the day, at least by phone, and nursing staff is present at all times to assess and monitor the person who is undergoing detox.2(17, 1st column)

Why Professional Detox is Helpful

At times, people eager to begin their sobriety journey may contemplate just abruptly stopping any additional drug or alcohol use on their own. While detox from alcohol and certain types of drugs is commonly done under medical supervision, you may have heard of stories of people going “cold turkey” and stopping the use of a substance at home. However, withdrawal from certain substances, such as opioids, can be severely unpleasant and, for other substances, like alcohol and other central nervous system depressants, unmanaged withdrawal can be dangerous. In some cases, unmanaged withdrawal could also lead to immediate relapse as the withdrawing individual seeks to put a stop to the unpleasant symptoms. While withdrawal experiences vary widely from one substance to the next, some signs and symptoms of acute opioid withdrawal include: 2(p. 67, figure 4.4)

  • Stomach cramps.
  • Nausea and vomiting.
  • Excessive tears and runny nose.
  • Bone and muscle aches and pains.
  • Muscle spasms.

Given symptoms such as these, it’s clear that opioid withdrawal can be quite an unpleasant and challenging hurdle to early recovery. As mentioned, abruptly quitting certain other substances on your own may also be dangerous. Detoxing from substances such as alcohol and benzodiazepines can result in seizures, agitation, confusion, hallucinations, or even death. 2(p. 75, 1st column; p. 52-54)  Because of the significant risk of severe and/or complicated withdrawal with substances such as these, many individuals require supervision and medical care while detoxing. 

The use of medication in a professional detox program can help make withdrawal symptoms more manageable. Medications for opioid addiction, for example, include opioid agonists such as methadone and buprenorphine to stabilize someone experiencing withdrawal from heroin or prescription opioids, as well as clonidine for additional symptom relief. 2 (68, column 2).

Professional detox also can help keep someone as safe and comfortable as possible during benzodiazepine withdrawal. Detox protocols for sedative drugs such as these may first involve the substitution of a relatively long-acting benzodiazepine, which is then used to slowly taper a person off entirely. 2(76)

Detoxing During Pregnancy

Detox is possible during pregnancy with careful medical oversight. While the exact number of pregnant women who undergo detox each year is hard to locate, 22% of substance use treatment programs have specialized tracks for pregnant women.5 There are numerous protocols for detox from benzodiazepines, alcohol, opioids, and other substances. Some of the dangers of a detox while pregnant can include miscarriage and fetal death so, before starting a detox program, clinicians will carefully discuss with the patient and weight the risks and benefits of detoxification at each woman’s particular stage of pregnancy.2(105-108)

The Detoxification Process

Though precise detoxification protocols may vary, there are three essential components common to different detox and withdrawal management programs:2(4-5)

  • Evaluation—A thorough assessment will be conducted to determine your specific needs for the best course of treatment. You may undergo drug testing and speak to a variety of staff, including doctors, nurses, and counselors. Your length of drug or alcohol use, the severity of your addiction, and your underlying emotional and medical conditions will all be taken under consideration during evaluation.
  • Stabilization—May include both medical and psychological interventions to help manage intoxication and withdrawal. Medications may be administered when needed to manage symptoms of withdrawal as well as any complications to arise. Ideally, this is the time in detox where you also learn about the process of treatment; your family may also be involved in your treatment.
  • Fostering patient entry into additional treatment—An important component of any detox program will be preparing a patient for and facilitating the transfer to additional rehabilitation programming. The importance of continuing treatment after detox cannot be stressed enough, especially for someone who has previously fallen into the trap of undergoing detox and then not completing treatment.

How Long Does Detox Take?

The length of detox varies from person to person, based on the substances used and other factors. For example, a rough timeline for alcohol detox may progress over the course of one week from the time of the last drink, with the peak of withdrawal occurring at around three days.3 (p. 68) The withdrawal timeline for opioids varies based on factors including the type of opioid used and how much was used. 2(p 58) Opioids with a shorter half-life, such as heroin, may give rise to withdrawal symptoms within 8 to 24 hours after last use, with symptoms largely resolving by 10 days out. Withdrawal for those substances with a longer half-life, such as methadone, may progress a bit more slowly, with the most acute symptoms showing up within 12 to 48 hours after the last use and potentially persisting for as long as 20 days.4, section 4.3

Is At-Home-Detox Possible?

Some people may undergo a detox program on an outpatient basis, but the decision to do so should be made only with the careful evaluation and guidance from a trained addiction treatment professional. In many cases of alcohol, sedative-hypnotic (e.g., benzodiazepine), and opioid dependence, hospitalization or some other form of inpatient or residential medical detox program will be the preferred setting of care to minimize the potential for unnecessarily unpleasant symptoms or the potential for serious withdrawal complications. 2(xvi, 2nd column)

How to Find the Best Detox Program

Hundreds of detox centers throughout the United States provide medically supervised detox. American Addiction Centers (AAC) is a leading provider of detox and inpatient treatment in the United States, with several locations across the country. As a leading provider of drug detox treatment in the United States, AAC can provide you with the latest in effective detox treatments. AAC is committed to treating drug and alcohol addiction with a perspective toward the whole person. Additionally,  AAC provides the latest technology to help increase your safety during alcohol and drug detox. This includes EarlySense, a cutting-edge program that provides early detection of irregular heartbeat and breathing issues, increasing the likelihood of a safe withdrawal.

If you are ready to take the next step in getting help, we operate a confidential 24/7 hotline can start you on your journey to recovery from addiction. We can be reached at 1-888-935-1318Who Answers?.

Sources

  1. Substance Abuse and Mental Health and Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.
  2. Substance Abuse and Mental Health and Services Administration. (2015). Detoxification and substance abuse treatment.
  3. Gortney, J.S., Raub, J.N., Patel, P., Kokoska, L., Hannawa, M., & Argyris, A. (2016). Alcohol withdrawal syndrome in medical patientsCleveland Clinic Journal of Medicine83(1), 67.
  4. World Health Organization. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings.
  5. Substance Abuse and Mental Health Services Administration. (2017). 2017 state profile—United States and other jurisdictions, National Survey of Substance Abuse Treatment Services (N-SSATS).