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The Ultimate Guide To Drug And Alcohol Detoxification

Drugs and alcohol detoxDrug and alcohol detoxification, otherwise referred to as an addiction detox, is usually the first step in a more comprehensive treatment and rehabilitation program. As such, it is usually designed to provide you with all the tools you need as you start the journey to recovery and sobriety.

In most cases, detox helps prevent most of the fatal or unpleasant consequences that tend to arise when you suddenly stop using alcohol and drugs. It may also assist you become abstinent from these addictive substances.

That said, the goal of every drug and alcohol detox program is to provide you with physiological healing from addiction, substance use disorders, and some of the resultant or causal co-occurring disorders.

NIDA (the National Institute on Drug Abuse) reports that after stabilization, detox will shift its focus to the support and monitoring of your various body processes. In this way, the program will help you body get rid of the substances it was addicted to, as well as manage the withdrawal symptoms that tend to result when you stop using.

Understanding Detoxification

Drug and alcohol detoxification, which is commonly abbreviated as detox, refers to the process of helping the body get rid of the drugs, alcohol, and other harmful and addictive chemicals that it has become used to (or dependent on). As such, the primary purpose of undergoing detox is to ensure that the facility you attend helps you manage any resultant withdrawal symptoms - which arise when one stops taking alcohol and drugs.

That said, every addict will have a different experience when they undergo detox. In particular, the length of time you were using as well as the type of alcohol or drugs you used to take may affect how your detox will pan out.

To this end, detox facilities typically use a variety of medications to keep you comfortable, safe, and in good hands as the drugs/substances leave your body. This process might take days, weeks, or months until your body overcomes these withdrawal symptoms.

In general, drug and alcohol detox can be divided into two separate types:

a) Medical Detox

Otherwise referred to as medically supervised or medically assisted detox, this type of treatment is usually performed under the care, direction, and supervision of mental health and medical professionals.

The observation so provided is essential in increasing the patient's comfort and safety levels - particularly when the patient is undergoing the potentially painful and severe withdrawal symptoms and any other medical complication that might arise after a long period of substance abuse.

At times, therefore, the doctors might administer medications to help ease the withdrawal process as well as to reduce most of the strong cravings you may develop for the drug/alcohol you were dependent on.

b) Clinically Managed Detox

Clinically managed detox is also referred to as a type of social detoxification. This style tends to be relatively short term and mostly uses non-medical strategies to help addicts end their substance use, tolerance, dependence, and addiction.

That said, most social detoxification settings may only provide you with room for the process to take place. Others, on the other hand, will take a hands-on approach to the treatment - including but not limited to such facets of detox as professional support and peer encouragement during the duration you undergo treatment.

The best option for you will mostly depend on a variety of factors. These include, but are not limited to the substance you used to abuse, your current level of psychological and physical dependence, as well as your need or desire to either use or not use medically-assisted techniques.

Typical Detox Durations

So, exactly how long should drug and alcohol detox take? To answer this question, you need to understand that there are no set time frames for you to complete detoxification. For some addicts, the process may only take a couple of hours or a few days. However, other patients might have to undergo detox for several weeks before their body is completely clear of the substances it was addicted to.

Some of the factors that will dictate how long a detox takes may include:

  • Your preferred drug/substance of abuse
  • The duration, dose, and rate of use
  • The presence of poly-substance abuse
  • The detoxification environment and setting
  • Your personal goals and preferences
  • The nature of any previous attempts at a detox
  • Your health condition

According to SAMHSA (the Substance Abuse and Mental Health Services Administration), however, the average duration of most detoxification stints may turn out to be fewer than a week or 8 days.

Still, if you are addicted to certain specific substances - like buprenorphine and methadone - it might take longer for your body to clear itself of these drugs. This is because such drugs tend to be longer acting than others. In these instances, therefore, you may have to undergo slow tapering procedures meaning that the length of time you will spend in the detox facility may be longer.

Issues Arising During Detox Treatment

As you consider detox, or undergo it, it is essential that you remember that it is not designed as a comprehensive treatment for drug and alcohol addiction - irrespective of the substance you used to abuse.

Since addiction is both physical and psychological, therefore, you are more likely to benefit from long term psychotherapeutic treatment and rehabilitation. This will address any issues you have with brain changes and substance cravings resulting from long-standing abuse.

On its own, therefore, detox might only help you to stop abusing alcohol and drugs over the short term. However, you still need further treatment, rehabilitation, follow-up care, and therapy to reduce the risk of a relapse and improve your chances at maintaining your sobriety and addiction recovery.

The first stage of the detox tends to be intense for most patients. Luckily, you will have psychiatric and medical staff members on hand to constantly provide you with the support you need.

For instance, a couple of hours after you took your last heroin dose, anyone addicted to this opioid may experience some withdrawal symptoms.

Heroin withdrawal symptoms include, but are not limited to:

  • Agitation
  • Anxiety
  • Excessive yawning
  • Insomnia
  • Muscle aches
  • Runny nose
  • Sweating
  • Watering of the eyes

Even though most of these symptoms are not exactly life-threatening, they might prove to be quite uncomfortable. This is why it is usually beneficial for anyone undergoing heroin withdrawal to receive both medical care and psychiatric care while detoxing from the drug.

That said, a variety of issues might arise for recovering addictions during the first couple of hours of a detox. The team taking care of you will address the most urgent of these needs first, and move on to the next, and the next one after that until you reach full stabilization.

Some of the drug or alcohol withdrawal issues that might arise include:

a) Violence

Some addictive substances tend to increase violent behavior among users. For instance, if you abuse bath salts or synthetic cathinones, you might be at risk of hurting others or yourself.

If you are a danger to yourself or to others, the detox facility might restrain or sedate you to protect you from yourself and others around you (including the medical providers who are helping you).

However, these measures will only be applied if you show signs of attempting to harm others, or become physically aggressive.

b) Psychotic Symptoms

Addiction withdrawalPsychosis is one of the dangerous complications that arise as a direct effect of abusing some drugs - like cocaine. If you use excessive amounts of these drugs, you may become paranoid and experience full-blown psychosis.

Some of the psychotic symptoms you may display include delusional thinking and auditory and visual hallucinations. The other reasons behind the psychosis can include the presence of co-occurring mental health disorders - such as lack of sleep or schizophrenia - arising from the regular use of the stimulant.

People suffering from psychosis tend to behave erratically and may be unpredictable. To this end, the detox facility will address these issues and provide you with appropriate treatments before the staff members move on to other additional interventions.

c) Injury

In some cases, you may have hurt yourself while under the influence of the addictive substance or have been sexually or physically assaulted before you entered the detox facility.

For instance, PCP (or phencyclidine) is one of the most powerful dissociative drugs. This drug tends to cause feelings of invulnerability and increased strength among regular users.

On account of these misconceptions, most PCP users tend to put themselves in the way of harm because they feel that they are not going to get hurt. Regular use also contributes to an increase in the risk for suicidal ideation and behavior - which may result in serious injury if you are unable to complete the suicide attempt.

Therefore, you may have to be treated for any physical injuries during your detox before the team starts providing you with further addiction treatment.

d) Medical Illness

Most of the people suffering from chronic and debilitating pain tend to be issued with prescriptions for opioid painkillers. However, you may eventually become dependent and even addicted to such prescription medications.

As you start on the journey to recovery by undergoing drug and alcohol detox, therefore, it is highly likely that the severe pain you used to feel before you started taking the prescription will return - in addition to and over and above the withdrawal symptoms resulting from the cessation of the drug use.

The staff at the detox facility will ask you for your medical history and ensure that they treat the pain and any other arising symptoms before they proceed with the detoxification regimen.

e) Threat to Self

Withdrawal from such substances as opioids is often associated with severe depression and depressive symptoms. These symptoms are sometimes connected to completed and attempted suicides.

If you exhibit any suicidal behavior or ideation, the drug and alcohol detox facility will strive to protect you at all times. It will also assess and identify these acute issues during your evaluation and immediately treatment them until you have stabilized or they have passed.

After that, the staff members will shift their focus and attention to helping your body deal with the withdrawal symptoms associated with the sudden or tapered stoppage of your substance abuse.

The Detoxification Process

Most people struggling with addiction and substance use disorders might be put off by the sound of drug and alcohol detox. However, the truth of the matter is that the process is one of the first great steps you should before if you are serious about recovering from your addiction in a healthy and safe way.

From there, the team monitoring you will recommend other treatment options - both on a residential and an outpatient setting. The option you choose will mostly depend on your particular addiction, the nature of your substance use disorder, as well as your needs and preferences.

In most addiction centers, however, the drug and alcohol detox process will require that you go through the following:

1. Initial Assessment

Addiction assessmentAfter you arrive at the detox facility, you will typically receive a comprehensive consultation assessment and evaluation. This initial stage is designed to ensure that the team taking charge of your detoxification gets to know you, your personal history with substance abuse, your medical history, any co-occurring disorders, and such.

You will also be welcomed to the facility by a caring intake counselor or therapist and they may ask you specific questions. You should strive to answer these questions as truthfully and as honestly as you can - remembering that the team is there to help you overcome your addiction. These questions are often designed to ensure that the detoxification process is as comfortable and as safe as possible for you.

That said, the initial assessment and evaluation will mostly focus on your history with substance abuse and addiction, any current symptoms you are experiencing, as well as any uneasiness you might be feeling.

At this point in the detox process, however, you should keep in mind that it is quite normal and natural for you to feel uneasy and overwhelmed. However, this should not discourage you or put you off your resolve to get better, overcome your addiction, and proceed to lead a meaningful and fulfilling life. Remember, these initial feelings will eventually pass and the team will help and guide you on every step of your recovery journey.

2. Full Mental Health and Medical Evaluations

After you have gone through the initial consultation, you will be made comfortable before you take part in more comprehensive evaluations provided and performed by mental health and medical professionals.

First, you may receive historical evaluations where the experts will accrue information regarding your medical history. At this juncture, you will be asked for your dietary, mental health, physical, and nutritional history.

After that, the mental health experts will perform psychiatric evaluations to better understand the current status of your psychological health - as well as your history mental health situation. They will also assess you for any medications you are currently taking for one mental health condition or the other.

From there, the medical team will collaborate and create a personalized detoxification treatment plan. This plan will be based on these mental health and medical evaluations.

3. Medically Supervised and Holistic Detox Treatment

At this juncture, the medically supervised and/or holistic detoxification treatment will begin. Since most substance use disorders and addictions tend to take such a heavy toll on the body - both mentally and physically - the detox team will discuss the best treatment methods to reduce any withdrawal symptoms you may experience.

The team will also monitor you on a daily basis and around the clock and make adjustments to ensure that the process is as comfortable and as safe for you, for your body, and for your mental health as possible.

Since alcohol and drug detox is designed to treat more than your physical health, the team may also heavily focus on integrating other holistic treatments into your plan. These treatments are usually designed to heal the spirit, the body, and the mind - all at the same time.

As a patient, you will also undergo group and individual therapy - which will be particularly customized to match and meet all your needs and requirements.

4. Transition to Rehabilitation

Once you have undergone all the steps above successful and you've even stopped displaying drug/alcohol cravings and withdrawal symptoms, you will be transitioned safely into ongoing rehabilitation and addiction treatment.

After the detoxification process is complete, therefore, you are highly likely to feel and look better already. However, this should not be and is never the end of your treatment. Additionally, the detox professionals will have collected more information about your needs - and improved their understanding of your addiction and substance use disorder.

As such, they will help you make the transition from drug and alcohol detox to ongoing treatment. They will also ensure that the next phase of addiction care is highly individualized and specialized to meet your particular needs.

Common Withdrawal Symptoms

According to recent research on drug and alcohol withdrawal, the abrupt cessation of several different classes of addictive substances tends to result in a variety of withdrawal symptoms.

In the same way, the symptoms you experience - as well as their duration and intensity - will vary greatly from those that another addict with the same substance use disorder will experience.

Some of the common withdrawal symptoms that tend to develop for the vast majority of addictive drugs, alcohol, and other substances include - but are not limited to:

  • Cravings and the persistent desire to start using your drug/substance of choice if only to stop experiencing the withdrawal symptoms
  • Mood disturbances, such as agitation, irritability, and mood swings
  • Physical issues, including shaking, flu-like symptoms, tremors, sweating, chills, vomiting, nausea, headache, and runny nose
  • Sleep disturbances, particularly insomnia even in spite of extreme fatigue

Some of the factors that influence the effects and symptoms drug and alcohol withdrawal include, but are not limited to:

a) Addiction Duration

The length of your addiction will determine the severity and potential fatality of the withdrawal symptoms you are going to experience when you first check into a detoxification facility.

For instance, daily use of drugs for a relatively long period of time may cause or lead to high tolerance levels. This means that when you stop using the preferred substance, you are more likely to experience highly severe withdrawal symptoms.

b) Drug Combinations

In the same way, if you typically combine different addictive substances - including alcohol - you will develop co-morbid dependence on all the drugs you use. This may create a rather unique constellation of severe withdrawal symptoms. Similarly, these symptoms may even exacerbate each other.

c) Substance Dose at the Time of Entry

Additionally, the dose of the addictive substance you had taken before you entered the detox facility will determine the severity of the withdrawal symptoms you are going to experience.

In most cases, tolerance tends to develop over the course of a relatively long period of time during which you were abusing substances on a regular basis. Therefore, you will be forced to increase the dose of the drug to feel the desired effects.

Therefore, the higher the dose you tended to use, the more likely it is that your withdrawal symptoms will be more severe when you check into a drug and alcohol detox facility.

d) Existence of Co-occurring Mental and Physical Disorders

If you suffer from another mental health disorder - such as anxiety or depression - or from physical conditions like chronic or severe pain, it is highly likely that withdrawal will amplify these conditions. This amplification may also cause significant distress to you during your first days in the detox facility.

d) The Half-Life of the Preferred Drug

In general, if you are addicted to a short-acting drug, the withdrawal symptoms may happen more immediately after your last dose. On the other hand, if you tend to abuse longer-acting drugs, then the withdrawal symptoms you experience may be delayed for a couple of days after you check into the detox center.

Common Types Of Drug And Alcohol Detoxification

There are different types of detoxifications. The specific substance you abused, as well as the spectrum of the withdrawal symptoms you experience will influence the type of detox that will be recommended for you.

That said, some of the common choices here include:

1. Outpatient Detox

This is one of the least recommended types of drug and alcohol detox. However, such an outpatient program may prove to be a stellar choice especially for those patients with a relatively less severe case of addiction.

In this case, you will be required to regularly check in with a treatment team. You may also be provided with medication (by prescription) or be referred to a methadone clinic where you will receive an acceptable detox care plan.

If money is an issue or you need to remain engaged at home or at work while also undergoing detox, this may be the most appropriate type of drug and alcohol detox for you.

2. Inpatient Detox

Inpatient detoxIn most cases, however, inpatient detox (which is also referred to as residential drug and alcohol detox) will be recommended. This type of detox is more effective at helping recovering addicts avoid relapse. It also ensures that you receive the medical care you might need in case of any emergency.

That said, most of the detox options you will come across tend to be inpatient in nature. Some of them are stand-alone programs that will arrange for you to seamlessly transfer from the detoxification and straight into an ongoing rehabilitation or treatment program after you complete detox.

Others, however, may be packed alongside inpatient addiction treatment to address all the psychological and physical issues related to your addiction, substance use disorder, and any other co-occurring disorders you are suffering from.

Among these, there other sub-categories of drug and alcohol detox. These subcategories include, but are not limited to:

a) Opioid Detox

Opioid detoxification is somewhat different from other options provided for addiction and substance abuse. This is because the FDA (Food and Drug Administration) has specifically approved some medications for the sole treatment of addiction to opioid drugs. These medications have now given rise to a variety of approaches to opioid detoxification and treatment.

That said, whether your opioid of choice was prescription painkillers or you preferred heroin, you will find that you have to check into an inpatient detox facility. This is the only way you will receive the optimum safety, care, and comfort required for opioid detoxification.

The medications used will help to manage your dependence as well as alleviate most of the unpleasant withdrawal symptoms you are going to experience. These medications include methadone and buprenorphine - which are full and partial opioid agonists - and will be administered to stabilize you.

After that, you will be gradually tapered off your preferred opioid to ensure that you do no experience severe withdrawal.

b) Alcohol Detox

When you stop abusing alcohol heavily, you are likely to experience potentially life-threatening and distressing withdrawal symptoms.

Some of these alcohol withdrawal symptoms may include:

  • Anxiety
  • Insomnia
  • Nausea
  • Shivering
  • Slow movements
  • Slow thoughts
  • Sweating
  • Vomiting

You may also experience delirium tremens, a severe type of alcohol withdrawal commonly associated with prolonged and heavy alcohol abuse. This condition is classified as a medical emergency and might lead to death unless it is treatment.

Some of the symptoms of delirium tremens include:

  • Agitation
  • Changes in mental functioning
  • Confusion
  • Deep sleep that may last for a day or more
  • Disorientation or delirium
  • Hallucinations
  • Seizures.

This severe syndrome often requires urgent and immediate medical attention. If you have a severe addiction to alcohol, it is highly recommended that you only undergo medically supervised detox. This will safely remove the alcoholic toxins from your body.

In most cases, the drug and alcohol detox team may use benzodiazepines to treat the seizures, insomnia, and anxiety that you are likely to experience when you stop your excessive alcohol consumption.

Common Detoxification Methods

Depending on your drug of preferences, you may have different options for the detox method that will be used. As such, you need to keep in mind that there is no single universal drug and alcohol detoxification method that works for all addicts.

Rather, your preferred drug, the dose you took before you started detox, the duration of your substance abuse, as well as whether you were using other drugs/alcohol will all determine the most appropriate method that will be used.

That said, the following are the some of the common approaches to detoxification:

a) Cold Turkey Detox

The cold turkey approach means that you will be required to stop using all addictive substances and drugs with nothing more than some medical supervision to help you in case of any immediate emergency.

In such a situation, you will not receive pharmacological assistance. This means that you are going to suffer through the full brunt of any withdrawal symptoms that arise as long as they last.

For some addictive substances, these symptoms may prove to be quite intense or even end up lasting for several weeks. For others, however, cold turkey detoxification may not be as physically disconcerting.

b) Short Term Medical Detox

When you opt for a medical detox, you will stop taking every addictive substance you were used to. However, in case you experience any uncomfortable or dangerous withdrawal symptoms, the detox facility may create a short-term medication plan.

Through this plan, you will take certain medications for a specific period of time to ease your discomfort and alleviate any dangerous withdrawal symptoms. For instance, if you have a hard time sleeping, the medical detox team may prescribe non-addictive sleeping aids.

c) Long Term Medical Detox

Last but not least, you may have to undergo long-term medical detox. This is often the preferred method in the treatment of opioid drug abuse (including such addictive substances as prescription painkillers and heroin).

In this case, you and your provider may decide that you are going to use the drug combination naloxone and buprenorphine (Suboxone) or even methadone to ensure that you do not experience the full brunt of the withdrawal symptoms. With time, however, the dose of the medication will be lowered until you are completely free of your addiction and substance use disorder.


Irrespective of the type of drug and alcohol detox you chose, it is essential that you ensure that you undergo detoxification under the guidance, supervision, and watchful eye of a medical team of professionals. The detox should also be followed by comprehensive psychotherapeutic treatment and rehabilitation. This is the only way you are going to keep away from the drugs/alcohol you used to abuse.

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