Drug & Alcohol Detox Guide
Addiction is an unfortunate part of reality today. There is a strong possibility that you may know someone who suffers from addiction to drugs and alcohol; it is estimated that more than 23 million Americans struggle with problematic drug use in the country.1Unfortunately, many of them do not receive the help they need.
For many people, the prospect of detox may serve as a deterrent to getting the help they need. Detoxification—the process by which substances are expelled from the body—is the initial phase of the recovery process. This phase of treatment carries the potential for uncomfortable withdrawal symptoms. A formal detox process in a substance abuse treatment center can help lessen the experience of withdrawal symptoms and increase your chance of a safe detox.
What is Detoxification?
While detox does not address the behavioral, social, and psychological changes needed to sustain a life in recovery, it is the first step in the process.2 The objective of detox is to safely eliminate drugs from your body so that you can move on to the next phase of rehabilitation. It involves many different types of interventions to help you along the recovery continuum.
After you develop a physical dependence on a substance, the body experiences withdrawal symptoms when the substance is removed. Withdrawal symptoms can be physical or mental; they can mimic illnesses like the flu as well as mental health disorders such as anxiety. Withdrawal symptoms can be mild, moderate, or severe. Some specific factors that may contribute to the severity and type of your withdrawal symptoms include your age, the type of substance you used, the last time of use, the amount of substances used, and underlying physical and mental health disorders.
Common symptoms of withdrawal include:3
- Mood swings.
- Poor appetite.
- Difficulty falling and staying asleep.
- Increased heart rate.
- Increased blood pressure.
Types of Detox Treatment
Detox can occur in a variety of settings, including inpatient medical detox, outpatient detox, rapid detox, and at-home detox. Regardless of the environment, detox aims to achieve 3 objectives: evaluation, stabilization, and fostering your entry into substance abuse treatment. 4 These objectives will be explored further below.
Inpatient Medical Detox
Inpatient medical detox is the most restrictive detox environment. Medical professionals, including nurses and doctors, monitor and supervise you throughout the process to help reduce withdrawal symptoms and increase the likelihood of a safe and successful detox. In inpatient medical detox, medications approved by the Food and Drug Administration and other supplements can be administered to help reduce the severity of alcohol and opioid withdrawal symptoms.
For alcohol use disorder, benzodiazepines have been shown to be effective in reducing the severity of withdrawal symptoms and their associated risks. Research indicates that benzodiazepines are highly effective in curbing and eliminating alcohol withdrawal symptoms when given in fixed doses at specific points throughout the detox process (called tapering).5 Buprenorphine, naltrexone, and methadone are approved medications that can be taken for days and weeks to help manage the symptoms of uncomfortable opioid withdrawal symptoms and prevent relapse.6
Inpatient medical detox usually occurs within a substance abuse treatment facility or a hospital. In this type of setting, you will be constantly monitored and can receive medications to help curb the severity of symptoms, greatly reducing your risk of relapse and increasing your chances of a successful detox experience.
Outpatient detox is less restrictive than inpatient medical detox. You are not constantly monitored by medical professionals or addiction specialists, which can increase the risk of relapse. You may be expected to travel to the substance abuse treatment facility or hospital on a daily basis. The initial session, which includes evaluation, can last a few hours. Subsequent sessions usually last around 30 minutes over the course of 3-14 days.7
While research is somewhat limited for rapid detox, an emerging form of detox met with significant scrutiny, studies show that it may be effective—particularly for people struggling with opioid use disorder. During the process, withdrawal symptoms are medically induced, and patients are then put under general anesthesia. The symptoms are intense, but their duration is shorter than they would be with standard detox.8
Rapid detox occurs within a medical setting such as a hospital’s intensive care unit. The process itself usually lasts around 24 hours. Medication is prescribed upon discharge from the facility to promote comfort and reduce the experience of withdrawal symptoms.
At-home detox is fairly self-explanatory. It is generally not recommended, because you would not be professionally monitored and would not receive the benefits of medication-assisted treatment. Because withdrawal symptoms can be severe, the risk of relapse can be high. Talk to your doctor before enrolling in any type of detox. A medical professional can help determine your risks and recommend a detox program that is appropriate for you and your specific needs.
The Detoxification Process
Evaluation is the initial step in the detox process. Medical professionals and addiction specialists will determine what interventions, such as administration of medications, are appropriate for you. You will also be assessed for the amount of substances in your bloodstream and for any underlying medical and psychological problems. This will help ascertain the next phase of treatment after detox is complete. 4
Stabilization is the active part of detoxification. During this phase, your symptoms are monitored and medications may be administered. The goal is to achieve a medically stable, substance-free state. 4(detoxification) The importance of following through with substance abuse treatment is stressed to foster rehabilitation and recovery. 4(detoxification)
Detox During Pregnancy
Pregnancy is an important factor in the detox process and needs to be addressed as part of the detoxification plan. Pregnant women face potential complications when they decide to detox according to factors such as pregnancy risk, types of substances used, how much substances are used, and underlying medical issues. More research is needed to ascertain the number of pregnant women who go through the detox process. However, research conducted in 2012 shows that 8.5% of pregnant women reported drinking alcohol and 5.9% reported the use of illicit drugs during pregnancy.9
The process of detox can be harmful for the unborn baby. When a mother uses drugs during pregnancy, the baby can develop a dependence on the substance. A variety of complications can occur when the substance is removed from the baby’s body during the detox process. These complications can include:10
- Fetal convulsions.
- Neonatal abstinence syndrome.
- Stunted growth.
- Preterm labor.
- Fetal death.
Medical detox is often recommended; it can significantly reduce these risks and help abate withdrawal symptoms. Methadone and buprenorphine are two approved medications that can be administered to pregnant women struggling with addiction, particularly opioid addiction. Buprenorphine and methadone have the ability to:10(
- Improve long-term health for the baby and the mother.
- Stabilize opioid levels.
- Reduce prenatal withdrawal.
- Reduce the likelihood of transmission of diseases from the mother to the baby.
What Happens After Detox?
After the detox process, you will be strongly encouraged to move forward with substance abuse rehabilitation, which offers many forms of interventions and treatment options. Your treatment plan is based on your unique needs, medical issues, and substance abuse history.
Possible components of post-detox treatment include:
- Inpatient rehabilitation, either long-term or short-term. This focuses on addressing the underlying causes of addiction while teaching strategies to prevent relapse in the future. The formalized and structured nature of this environment can help reduce the risk of relapse.
- Outpatient treatment. Less formalized and structured than inpatient treatment, outpatient treatment offers individual, group, and family therapy services in a non-residential setting so you can go to work and sleep in your own home.
- Support groups. This is considered a maintenance intervention, as opposed to a formalized component of rehabilitation. Support groups are run by people in recovery and not addiction or medical professionals.
Find Your Closest Detox Center
American Addiction Centers (AAC) is a leading provider of detox in Nevada and across the country. AAC works with you and addresses your unique needs to create a personalized treatment plan. With compassionate staff and a confidential helpline that is available to you 24 hours a day, 7 days a week, getting the help you need for an addiction has never been easier or more accessible. If you are struggling with an addiction to drugs or alcohol, contact our free and confidential helpline at 1-888-982-9604.
1.National Institutes of Health. (2015). 10 percent of U.S. adults have drug use disorder at some point in their lives.
2.National Institute on Drug Abuse. (2018). Principles of drug addiction treatment (third edition): Types of treatment programs.
3.National Institute on Drug Abuse. (n.d.). Commonly abused drugs and withdrawal symptoms.
4.National Center for Biotechnology Information. (n.d.). Detoxification and substance abuse treatment.
5.Chandra, M., Choudhary, M., & Sachdeva, A. (2015). Alcohol withdrawal syndrome: benzodiazepines and beyond.Journal of Clinical Diagnostic and Research. 9(9), 01-07.
6.National Drug and Alcohol Research Centre. (n.d.). Yes, people can die from opiate withdrawal.
- Hayashida, M. (1998). An overview of outpatient and inpatient detoxification. Alcohol Health and Research World. 44-46.
8.U.S. National Library of Medicine. (2014). Six-month follow-up study of ultrarapid opiate detoxification with naltrexone.
9.U.S. National Library of Medicine. (2016). Substance use during pregnancy.
10.National Institute on Drug Abuse. (2017). Risks of opioid misuse during pregnancy
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