If you’re experiencing chemical dependence on a substance or are addicted to it, detoxification from drugs and alcohol is normally the first step of addiction treatment. Detox, which is medically controlled withdrawal from a substance, allows you to rid your body of the substance and its physical impacts. If you’re experiencing a chemical dependency following prescription medication, detox will be the start and end of your treatment. If you have a deeper substance use disorder with psychological and behavioral symptoms, detox is the start of your treatment.
Today, some 18.5 million Americans struggle with drug and alcohol addiction. Just 4.2 million people received treatment – or 23.4% of the total people who need treatment. Barriers often include fear of treatment, concern over costs, and concern over withdrawal. Detox smooths out withdrawal, helping you to overcome withdrawal symptoms, to get early psychological support and treatment, and to prevent major side effects and life-threatening symptoms. While the medical support you receive varies considerably depending on the substance you’re using, the treatment center you seek out, and the type of support you opt into.
Your detox experience will always depend on your mental health, your physical health, your emotional state, the substance you’re addicted to, and how long you’ve been addicted. But you can use the following article to set expectations for how detox will go.
Getting Into Drug and Alcohol Detox
The first step to getting detox is to apply for a program, either as medical detox at a hospital or as part of a larger recovery program, which is normally handled at a clinic.
- Finding a Detox Center – Some people look for local detox programs, which they can attend within their state or city. In some cases, this isn’t the best option. Others, especially those looking for a 30-90 day stay in rehab, prefer to look for out of state options. These allow for more privacy and can remove you from stressful environments or allow you to experience a holiday destination, like beaches during your stay.
- Paying for Detox – The Affordable Care Act (ACA) mandates that insurance cover detox and rehab. This means that your insurance should cover at least part of the cost of detox. In most cases, you can contact the detox center or contact your premium provider to see which detox centers they cover.
- Admission – Once you’re accepted into a program, you’re normally asked to go as quickly as possible. The admissions process will normally involve answering questions, sharing your medical history, undergoing a physical health examination, and filling out a mental health questionnaire. This data will be supplemented as you move through detox. In most cases, you’ll also have to sign a written agreement to have your belongings searched, to have any drugs or alcohol taken away from you, and to accept treatment while you are in the facility.
Depending on the substance you’re using, you might have been asked to quit before coming or to have your last drink before coming. That’s often mandatory for illicit drugs. However, for prescription medication like benzodiazepines, you’ll likely be on a tapering schedule, or you’ll receive medication to reduce withdrawal symptoms – so you won’t be asked to ensure you haven’t taken any when you walk in. However, you should always communicate with your detox center about expectations.
Starting Drug Detox
Drug detox normally begins anywhere from 4-24 hours after you walk in the door. This will be sped up or slowed down depending on the drug or substance you’re taking and when you took your last dose. For example, if withdrawal symptoms are already becoming severe, you’ll likely quickly move through the onboarding process and into treatment. Once you do, you’ll normally receive social or medically supported detox. Some detox centers also offer “rapid detox”.
Social Detox – This is a form of detox which does not normally use medication. Here, you’re monitored by a medical team and only given medication when you begin to have problems. This allows you to detox as naturally as possible, without relying on other medication. Some people prefer this method for the psychological impact of going drug free.
Medication Supported Detox – In medication supported detox, you’re given short-term prescription medication to ease withdrawal symptoms. In some cases, this is medically necessary. For example, if you develop delirium tremens, if you have severe withdrawal side effects to amphetamines, or if you’re trying to quit benzodiazepines over a course of weeks instead of months. Medication supported detox is also extremely common for opiate addiction, because switching to buprenorphine or methadone in Medication Assisted Treatment programs (MAT) is increasingly seen as one of the best ways to ensure long-term recovery.
Rapid Recovery – Rapid detox uses medication to speed up the detox process, normally shifting a process that takes weeks to one that takes a few days. This is ideal for professionals who need to move through treatment as quickly as possible. It’s also ideal for anyone who might have significant psychological problems during detox but who is otherwise physically healthy. Rapid detox is not available everywhere.
Drug and alcohol detox normally takes 3-14 days depending on the substance, type of detox, and personal factors like duration of use, genetics, weight, gender, and metabolism. Without medication to speed things up, you can expect the following detox timelines:
- Stimulants – 48 hours
- Benzodiazepines – 4-days to 4 weeks
- Opioids – 4-7 days
- Long-acting Opioids – 1-2 weeks
- Heroin – 4-7 days
- Alcohol – 1-2 weeks
- Marijuana – 4-7 days
Detox Withdrawal Symptoms
Withdrawal symptoms will vary based on which drug or substance you are taking. If you’re receiving medication to mitigate symptoms, you’ll also have fewer or no symptoms. However, most people detoxing from drugs or alcohol experience the following range of symptoms:
- General malaise (muscle pain, general feeling bad)
- Cold/flu symptoms (runny nose, watering eyes, stuffy head)
- Sweating and fever
- Anxiety and panic attacks
- Tremors or shaking
- Short term concentration and memory problems
- Nausea and vomiting
- Stomach pain
- Heart palpitations or arrhythmia
What’s Included in Detox?
Detox is the medical management of withdrawal symptoms. This will include social support, medical support for physical symptoms, medical monitoring, and emotional support. In most cases, you’ll also begin to get early psychological support and group therapy in detox – but mostly geared towards motivation and determining what problems you have. That’s because most people cannot be treated for drug or alcohol use disorder while addicted, because the addiction gets in the way of treatment.
- Medical Monitoring – Medical monitoring means supervision and monitoring by registered nurses, who can diagnose and react when things go wrong. This may also mean frequent checkups with a physician to determine how detox is progressing, if you are experiencing complications, and if you need help moving through.
- Medication – Medication can be administered for clinical comfort, to reduce withdrawal symptoms, or to reduce symptoms like seizures. In most cases, your doctor will determine this on a case-by-case basis, based on your preferences, the detox center, and how they administer treatment.
- Therapy and Counseling – You’ll almost always have access to therapy, counseling, and emotional support during detox. This is important because detox can be fairly traumatic, even if you’re on medication. Counseling and support can help you to change your mindset as you move through detox. They can also help you to cope with sudden shifts in lifestyle, departure from friends and family, and psychological cravings for the substance.
Detox is the first and one of the most important steps of recovery. That’s true whether you’re struggling with chemical dependence or have a substance use disorder. Hopefully this outline of what to expect during detox helps you or a loved one make the choice to go so you can get the medical help you need to recover.
At the same time, detox is not enough to recover from a substance use disorder. If you or a loved one is experiencing addiction, you need rehab and addiction treatment, not just detox.