Millions of adolescents and adults in the United States suffer from substance abuse and mental health problems, contributing significantly to the nation’s disease burden. The drug crisis in the United States is multifaceted. Although examining the face of addiction is important, the next phase is to determine whether individuals with substance use disorder (SUD) are making their way into recovery. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 20.1 million people aged 12 and above needed care for a substance use disorder in 2016, but only 3.8 million received treatment in specialty centers. Drug abuse also carries a societal stigma, and it’s a disease usually battled in silence. Although the need for treatment is undeniable, many people either struggle to get the help they require or fully comprehend the nature of addiction.
Anyone who has ever received addiction treatment knows that detoxification is the first step in the recovery process. It’s a critical component of recovery as well as the most physically demanding. Detox is based on the concept that someone who is medically impaired will have a hard time dealing with addiction’s underlying mental health issues. As a result, the goal of detox is to treat the physical aspects of addiction. And thus enabling patients to address the psychological aspects thereafter as part of a comprehensive addiction treatment program. So what is drug detox? And what does the process entail?
What Is a Drug Detox?
Detoxification is the process of removing any traces of alcohol and drugs from the body, ensuring that an individual is physically stable and ready to begin treatment.
People’s bodies get used to having these addictive substances in their systems due to alcohol or drug addiction and dependence. When these substances are eventually removed during detox, the brain must adjust to the abrupt decrease in these chemicals. And this usually results in a series of unpleasant symptoms defined as “withdrawal symptoms.”
The detox procedure is designed to reduce the negative impact of withdrawal symptoms while also making one’s experience as comfortable and safe as possible. Detoxification that is medically assisted and supported by a medical team is the most successful. And this is usually done in a specialized detox center or medical facility under the supervision of physicians, nurses, and other medical professionals. Attempting to detox on your own is seldom effective, and people are likely to suffer unnecessary withdrawal symptoms and feel demotivated due to several unsuccessful attempts.
The Detoxification Process
Everyone’s detox experience and requirements are different. In most cases, the drug detoxification process consists of the following steps:
Medical assessment: The first step in a medically supervised detox is to undergo a comprehensive medical evaluation to get an accurate understanding of their individual needs. During this evaluation, the medical staff may gather information about a patient’s medical history and details about their addiction. The information gathered will be used to create a customized detox plan.
The stabilization process: The purpose of stabilization is to keep the patient safe from harm. Doctors may prescribe addiction treatment medications to reduce withdrawal symptoms and prevent complications.
Preparing for entry into treatment: The next step of detox is to prepare for a substance abuse treatment program. Doctors educate patients about the treatment plan and what to expect. Inpatient rehabs offer the best chances of success after medical detox.
Research indicates that supportive and compassionate care is almost as critical as medication to enable successful detox and the best possible results for patients. As a result, each patient undergoing detox will be closely monitored 24 hours a day, seven days a week.
How Long Is a Drug Detoxification Program?
The detox process generally lasts between seven to 10 days on average. Nevertheless, the detox timeline varies from person to person and is determined by many variables, including:
- The dose of drugs used
- Polydrug use
- Types of substances used
- The half-life of the drug
- Length of time using drugs
- Pre-existing mental or physical health conditions
- A person’s overall health
- History of relapses
Patients will be ready to enter an alcohol or drug rehab program after detox, where they can undergo comprehensive psychological therapy. Alcohol and drug detox is often offered as part of a 28-day addiction treatment regimen.
Drug Detox Timeline
According to the National Institute on Drug Abuse (NIDA), over 70,000 Americans died from a drug-involved overdose in 2019, suggesting the magnitude of substance abuse in the country. And the most commonly abused substances in the U.S. and their detox timelines are as follows:
- Alcohol (approximately one week): Within the first eight hours after the last drink, patients will experience alcohol withdrawal symptoms such as depression, nausea, and sweating. By the time you reach the 24-hour point, you may start experiencing hallucinations that can last for days. Seizures and delirium tremens are the most dangerous withdrawal symptoms associated with alcohol, which require medical attention. The whole process lasts around a week, with the more severe withdrawal symptoms peaking around day four.
- Heroin and Opiates (approximately seven days): Opioid withdrawal symptoms appear six to twelve hours after the last drug dose and peak around day three of detox. Opiate withdrawal typically lasts no more than five or seven days. Medications such as methadone and Buprenorphine are used if necessary during opioid detox and maintenance treatment.
- Stimulants (approximately seven days): During cocaine and amphetamine detox, patients experience withdrawal symptoms such as mood swings and insomnia in the days and weeks following drug discontinuation. Patients will experience a wave of depression within the first 72 hours of withdrawal, accompanied by the infamous crash, leaving them feeling exhausted. Cravings for these drugs subside during the first week of detox but return during the first month for many people.
- Benzodiazepines (few days to several months): Irritability, anxiety, and nausea with dry heaving are all typical side effects of benzo detox. Benzo detox can involve the use of barbiturates or other long-acting benzos to help users taper off the medication. Benzodiazepine withdrawals typically subside within a few weeks, but some people experience complications for many months.
- Marijuana (around two weeks): Marijuana detox is less complicated than detoxing from other drugs. Restlessness, chills, lack of appetite, headache, and other withdrawal symptoms can occur. While most signs appear one to three days after the last use and disappear within two weeks, some people may experience insomnia and exhaustion for up to a month.
- Nicotine (several days to weeks): Depending on how long you’ve been smoking and how many cigarettes you smoked every day, nicotine withdrawal symptoms can last anywhere from a few days to several weeks. Nicotine withdrawal symptoms involve physical, mental, and emotional manifestations. The first week is often more challenging (especially on days three to five). When nicotine completely leaves the system, you may experience headaches, cravings, and insomnia. Most relapses occur during the first two weeks of quitting.
Side Effects of Detoxification
Detoxing from drugs can be a painful and dangerous process. And this is why medicinal detox is crucial. Patients should detox under medical care in a safe and supportive setting. The level of supervision varies among inpatient and outpatient detox programs.
A medically monitored detoxification prevents the potentially debilitating complications of drug and alcohol withdrawal syndromes. Though medical detoxification reduces or alleviates certain withdrawal symptoms, some symptoms are unavoidable. The following are some of the more common side effects during the drug detox period:
- Body discomfort
- Nervousness or anxiety
- Mood swings
- Difficulty concentrating
- Poor sleep
- Muscle aches
Medications can help manage these common withdrawal symptoms and reduce the risk of a relapse.
What Is Rapid and Ultra-Rapid Detox?
Rapid detox was first introduced in the 1980s. And is formally known as anesthesia-assisted opiate detoxification. This form of detox aims to end the withdrawal process as quickly as possible to reduce the overall amount of time spent detoxing from opioids.
Since older detoxification procedures were painful, rapid detox was introduced to alleviate discomfort, maximize success rate, and minimize the risk of relapse. There are two methods for accelerating the detox process:
Rapid detox: A patient is provided with medicine to speed up the initiation and process of detox, followed by several other medicines to relieve withdrawal symptoms that arise during detox. Rapid detox can cause:
- High body temperature
- Runny nose
- Heart attack
Ultra-rapid detox: The patient is sedated with general anesthesia. Doctors will administer an opioid antagonist once the anesthesia has taken effect. The opioid blocker causes the body to start detoxing. In theory, most of the unpleasant symptoms should have subsided by the time the patient awakens from sedation.
Usually, the rapid detoxification period lasts six to eight hours. However, as there has been little research on these methods, no one is certain if the advantages exceed the costs. As a result, these detox strategies remain somewhat questionable.
Is it Safe to Detox at Home?
This is a common question among those looking for the quickest, simplest route to recovery. Detoxing at home is possible. However, there are many reasons why it’s not always the best option:
- Lack of medical attention can lead to fatal complications.
- Increases the risk of relapse.
- Certain withdrawal symptoms can make you a risk to yourself and those around you.
When individuals develop a physical dependence on a drug or alcohol, their body alters their natural production of certain chemicals and starts to rely on the chemical effects of drugs and alcohol instead. Painful withdrawal symptoms are the result of an abrupt chemical imbalance created during abrupt cessation or reduction. These withdrawal symptoms can vary in intensity from person to person.
Due to the unpredictable nature of withdrawal symptoms during detoxification, patients can have mild symptoms at one moment and suddenly shift to severe symptoms. This unpredictability is the reason why patients are advised against detoxing alone. Individuals detoxing at home must be under the constant care and supervision of a loved one to avoid potentially fatal complications.
If you wish to overcome your addiction or dependence on a certain substance, seek advice from a medical professional. Depending on the severity of your condition, your physician can advise you on the best course of action.
Medications Used During Drug Detox
According to the National Institute on Drug Abuse (NIDA), a range of care with a customized treatment program and follow-up options can be crucial to long-term success. Thus, detox and treatment should include both medical and mental health services as needed.
Drug detox programs incorporate medications to alleviate unpleasant withdrawal symptoms while maintaining your safety through medical care and supervision in a dedicated detox unit. An effective detox program is comprehensive and may include psychotherapies to help you start the recovery process.
The U.S. Food and Drug Administration (FDA) has approved certain medications to manage withdrawal symptoms during detox and recovery.
Lofexidine: Sold under the brand name Lucemyra, it’s an oral tablet designed to manage common opioid withdrawal symptoms.
Methadone: This medication is used to treat opioid addiction. Methadone is highly restricted and is only dispensed through a licensed methadone clinic.
Buprenorphine: Available by prescription from physicians licensed to dispense the medication. Buprenorphine is a partial opioid agonist authorized for opioid addiction treatment.
Naltrexone: Naltrexone attaches to opioid receptors in the brain, blocking the effects of opioid drugs that would otherwise cause the patient to feel high. Since the medication no longer provides rewarding effects, it discourages people from relapsing.
Acamprosate: This medication addresses post-acute withdrawal symptoms of drugs and alcohol, such as insomnia, anxiety, and restlessness.
Drug Detoxification During Pregnancy
Detoxing while pregnant is not only possible but also highly recommended. And the less you and your baby are exposed to drugs, the better the result will be for both of you.
When pregnant, the purpose of detoxing is to get rid of any addictive drugs in your bloodstream. This procedure can take a few days to a week, based on the type of substance you were abusing, how much you were using at a time, and how long you were exploiting it.
Due to the complications that can arise, drug detox during pregnancy must be carried out under close supervision and monitoring by medical practitioners to maintain the safety of the mother and child.
The consequences of drug addiction and dependence are far-reaching. But the important thing to remember is that you’re not alone. There are many facilities across the U.S. dedicated to helping you find the treatment you need. Consult an addiction specialist or your physician for support and guidance.