<h2>What is Drug Detox?</h2>
The concept of detoxification, or medically managed withdrawal, describes the set of interventions designed to safely manage the physical and psychological symptoms that some people experience when withdrawing from certain drugs.1 There are distinct withdrawal syndromes associated with different types of drugs, alcohol, and some prescription medications. The purpose of drug detox is to keep you as safe and comfortable as possible while your body clears itself of the substances you've been using.8

If you've been misusing drugs or alcohol for a long time, you may be at risk for having developed enough physiological dependence to these substances that you will experience significant withdrawal when trying to stop. Medical detox should not be seen as a substitute for comprehensive substance use disorder treatment, but rather the period of supervision and any needed interventions to safely manage withdrawal, while better preparing you to transition for continued <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/decide-for-rehab/">rehabilitation or treatment.</a> 8
<h2>Drug and Alcohol Withdrawal</h2>
When it comes to drug detox and withdrawal, the symptoms and side effects can vary significantly, depending on specific type of substance dependence. Across a range of substances, some common withdrawal symptoms include:1
<ul>
 	<li>Gastrointestinal disturbances like nausea, vomiting, and diarrhea.</li>
 	<li>Changes in appetite.</li>
 	<li>Sleep problems including both insomnia and hypersomnia.</li>
 	<li>Movement changes such as shakiness or tremors.</li>
 	<li>Body aches and pains.</li>
 	<li>Changes in mood, nervousness, and irritability.</li>
 	<li>Cravings.</li>
</ul>
<h3>Alcohol Withdrawl Risks</h3>
Amongst all the various substance withdrawal syndromes, <a href="https://alcoholrehab.com/alcohol-treatment/types-of-treatment/alcohol-detox/">acute alcohol withdrawal</a> can be particularly troublesome due to the risk of certain severe symptoms and withdrawal complications. Some of these include: 1
<ul>
 	<li>Nervous system instability.</li>
 	<li>Dysregulation of body temp, heart rate, and blood pressure.</li>
 	<li>Marked anxiety and agitation.</li>
 	<li>Hallucinations and delusions.</li>
 	<li>Grand mal seizures.</li>
 	<li>Delirium Tremens (commonly called DTs).2</li>
 	<li>Seizures.</li>
</ul>
It is important to note, each person may experience different side effects and varying intensities. Because of the considerable risks faced during alcohol withdrawal, medical detox may be necessary. In the case of certain other types of substances, for which a severely unpleasant or complicated withdrawal may be possible—for instance, opioids, benzodiazepines, and other sedatives—some form of inpatient medical detox may also be the most appropriate level of care at this point in early recovery from those substances.
<h2>How Long Does Drug Detox Last?</h2>
The following factors may influence the severity of the withdrawal and detox needs:
<ul>
 	<li>Substance used: Though individual differences may influence the onset and duration of withdrawal; many substances have somewhat characteristic withdrawal time frames. For instance, alcohol withdrawal symptoms may begin within 6 hours of the last drink, peak in severity over the course of the next 36 to 72 hours and resolve over the course of 2 to 10 days. 3 Withdrawal from relatively short-acting opioids like heroin may begin within 8 hours to a day of the last use, but then last for another 4 to 10 days.3</li>
 	<li>Level of Dependence: How often, how much, and how long you’ve been using the drug can lead to various magnitudes of physical dependence. The more frequently you use a certain drug and the higher your dosage, the worse your withdrawal symptoms may be.3</li>
 	<li>Medical history: Having other medical issues may complicate the withdrawal process.1</li>
</ul>
<h2>Drug Detox Process</h2>
Your treatment team will develop an individualized program for you based on your unique needs. Though the precise detox protocol that you encounter may differ somewhat from the next person, professional detoxification from alcohol and other drugs commonly involves three essential components, including:1
<ul>
 	<li>Evaluation. You receive a comprehensive evaluation to screen for any substances remaining in the bloodstream, as well as to assess your overall health needs and social situation to determine both your detox needs and the most appropriate level of post-detox treatment.</li>
 	<li>Stabilization. This is the active detox phase where you will detox with medical supervision and support and, when needed, medications for safe and comfortable withdrawal management.</li>
 	<li>Fostering entry to treatment. Detox is an important step toward recovery, but it’s not the only step. Your treatment team will emphasize the importance of continued treatment efforts once your withdrawal period has been successfully managed and will help to arrange for the transition to an appropriate substance abuse treatment setting once detox is complete.</li>
</ul>
<h2>Can I Quit Drugs Cold Turkey?</h2>
Quitting drugs or alcohol cold turkey can, in some cases, be dangerous. For example, alcohol, when stopped abruptly after chronic, long-term use, can result in seizures, delirium, and sometimes death. 1.  Although opioid withdrawal symptoms are rarely life-threatening, they can be intensely uncomfortable and difficult to stop on your own. A medically supervised detox, to keep you as safe and comfortable as possible, may be the appropriate choice in early recovery.
<h2>How Much Does Detox Cost?</h2>
Detox costs may vary depending on the specific facility chosen and the level of care needed. Because detox is medical/behavioral health treatment, your insurance companies may help pay for your care. If you are enrolled in the Medicaid program, they may be able to assist you with payment.7 There may be free and assisted rehab and detox programs available, depending on your location. Work with your insurance provider to determine what resources are available for you.
<h2>What Happens After Detox?</h2>
The goal of medical detox is to get your body free of substances and help start your recovery. Detox alone is rarely sufficient in helping a person achieve long-term recovery and is only the first stage of addiction treatment. Often, patients decide to enter a substance abuse rehabilitation program once they’re finished with their detox program. While in detox, you will work with your providers to develop a treatment plan and identify resources available for you. Over the longer term, comprehensive treatment for substance use disorders may involve inpatient treatment, outpatient treatment, or a combination of both.8 
<ul>
 	<li> Inpatient treatment: You may opt to participate in an inpatient treatment program upon completing detox. These programs offer 24/7 care and can last for a few weeks to a few months, as needed. You will learn skills for remaining sober and address any co-occurring issues you may have.</li>
 	<li>Outpatient treatment: You may engage in psychotherapy, medication treatment, and substance abuse treatment on an outpatient basis. You may take part in a program that you attend daily, or once or twice a week.</li>
 	<li>Support groups: Commonly integrated into professional treatment programs, support groups (e.g., Alcoholics Anonymous and Narcotics Anonymous) offer ongoing support to those trying to recover from substance abuse. Continued meeting attendance is an important element of many aftercare plans for long-term recovery.</li>
</ul>
It’s important that you continue to pursue <a href="https://alcoholrehab.com/alcohol-recovery/">long-term recovery</a> following detox from drugs. Your medical provider can help you choose which option is best for you.

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<h3>Sources</h3>
<ol>
 	<li>Substance Abuse and Mental Health Services Administration. <a href="https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4131.pdf">TIP 45: Detoxification and Substance Abuse Treatment | SAMHSA Publications and Digital Products.</a></li>
 	<li>Bayard, M., McIntyre, J., Hill, K., &amp; Woodside, J. (2004). <a href="https://www.aafp.org/afp/2004/0315/p1443.html">Alcohol Withdrawal Syndrome.</a> American Family Physician, 69(6), 1443–1450.</li>
 	<li>World Health Organization. (2009). <a href="https://www.ncbi.nlm.nih.gov/books/NBK310654/pdf/Bookshelf_NBK310654.pdf">Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.</a></li>
 	<li>Diaper, A. M., Law, F. D., &amp; Melichar, J. K. (2014). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014033/pdf/bcp0077-0302.pdf">Pharmacological strategies for detoxification.</a> British Journal of Clinical Pharmacology, 77(2), 302–314.</li>
 	<li>Hayashida, M. (1998). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761814/">An Overview of Outpatient and Inpatient Detoxification.</a> Alcohol Health and Research World, 22(1), 44–46.</li>
 	<li>gov. <a href="https://www.medicaid.gov/medicaid/benefits/behavioral-health-services/parity/index.html">Substance Use Disorders | Medicaid.</a></li>
 	<li>National Institute on Drug Abuse. <a href="https://www.drugabuse.gov/download/675/principles-drug-addiction-treatment-research-based-guide-third-edition.pdf?v=74dad603627bab89b93193918330c223">Types of Treatment Programs.</a></li>
 	<li>National Institute on Drug Abuse. <a href="https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment">Principles of Effective Treatment.</a></li>
</ol>

Medical Detox

<h2>Diseases Caused by Alcohol Abuse</h2>
Alcohol misuse is a pattern of unhealthy alcohol consumption that can be harmful to your health and relationships.

People who misuse alcohol to the extent that they cannot control their alcohol consumption, despite the negative consequences may be diagnosed with an Alcohol Use Disorder (AUD). The criteria for diagnosis of an AUD may include:
<ul>
 	<li>The inability to control or cut down on your drinking.</li>
 	<li>Continued use despite negative consequences.</li>
 	<li>Pre-occupation with using alcohol, including cravings.</li>
 	<li>Increased tolerance, which is defined as having to drink more to get the same effect.</li>
</ul>
Alcohol misuse is the primary contributing factor in certain diseases such as:
<ul>
 	<li>Alcoholic Cardiomyopathy (weakened heart muscle). Alcohol misuse weakens and thins the muscles of the heart. When your heart muscle is weakened, it can’t pump blood to your organs efficiently. This can lead to shortness of breath, fatigue, weakness, and can eventually lead to heart failure.3</li>
 	<li>Alcoholic Gastritis. Inflammation of the stomach lining due to alcohol use can potentially result in stomach ulcers.3</li>
 	<li>Alcoholic Liver Disease. This includes fatty liver, alcoholic hepatitis, and cirrhosis.6 </li>
 	<li>Alcohol-Induced Pancreatitis (acute or chronic). Inflammation of the pancreas that results in abdominal pain, nausea, vomiting, weight loss, and if severe enough, diabetes.4</li>
</ul>
<h2>Alcohol and the Heart</h2>
High blood pressure, obesity, and diabetes are also linked to excessive alcohol use and contribute to the development of <a href="https://alcoholrehab.com/alcoholism/effects/alcohol-effects-on-the-heart/">heart disease</a>.

Heavy alcohol use can be a contributing factor to obesity. Alcohol is high in calories with little nutritional value. People often consume alcohol in combination with meals, increasing the calories consumed. Alcohol is also high in sugar, which can contribute to problems with regulating blood sugar or even developing diabetes.6,7 Consuming alcohol outside of meals can significantly raise blood pressure and increase your risk of having a heart attack or stroke.8
<h2>Alcohol and the Liver</h2>
One of the long-term effects of alcohol misuse is a high risk of <a href="https://alcoholrehab.com/alcoholism/effects/alcoholic-liver-disease/">liver disease</a>. Alcohol use is directly responsible for approximately half of the incidents of liver disease worldwide.10 Liver disease often follows a progression of conditions from fatty liver to alcoholic hepatitis to cirrhosis of the liver, if alcohol misuse is continued:
<ul>
 	<li>Fatty Liver. Alcoholic fatty liver disease is caused by a buildup of fat in the liver, primarily caused by heavy use of alcohol, obesity, or diabetes. It is possible to stop or reverse this condition with continued abstinence from alcohol.11</li>
 	<li>Alcoholic hepatitis. Excessive drinking overloads the liver and causes inflammation, which will eventually turn into scar tissue. 11 Alcoholic hepatitis is inflammation of the liver. Abdominal pain, nausea, or vomiting bright red or dark (coffee ground appearing) blood are usually the first noticeable symptoms. Mild alcoholic hepatitis can be reversible by stopping alcohol misuse, but if alcohol misuse continues it can progress to severe alcoholic hepatitis which can result in cirrhosis.</li>
 	<li>Cirrhosis of the liver. Cirrhosis of the liver occurs when scar tissue builds up on your liver, causing the liver not to function effectively. Healthy liver tissue makes protein, helps to fight infections, cleans the blood, and helps digest food. Cirrhosis of the liver is irreversible. However, quitting alcohol can stop it from getting worse. If too much scar tissue forms, in some cases, you may need a liver transplant. 11</li>
</ul>
<h2>Alcohol and the Brain</h2>
Alcohol can affect the brain in many ways. When you are intoxicated, you may have trouble walking, uninhibited behavior, slurred speech, blurred vision, and blackouts (short-term memory loss). Excessive drinking, over time, can cause long-term damage to the brain that can result in memory deficits and behavioral changes .12

Long-term alcohol misuse can contribute to a severe disorder known as Wernicke -Korsakoff syndrome or <a href="https://alcoholrehab.com/alcoholism/effects/alcoholic-wet-brain/">'Wet Brain'</a>, which may occur due to long-term alcohol misuse or as a complication of severe alcohol withdrawal. A deficiency of thiamine (Vitamin B1) causes Wernicke-Korsakoff syndrome and approximately 80% of individuals with alcohol use disorder have a thiamine deficiency in their bodies.12 Wernicke-Korsakoff is a disease that consists of two separate symptoms:
<ul>
 	<li>Wernicke’s encephalopathy. This manifests as confusion, paralysis of the muscles around the eyes, and problems with coordination. It is common for individuals to only experience one of these three symptoms, making the diagnosis potentially difficult for physicians. Around 80-90% of people who experience Wernicke’s encephalopathy will also experience Korsakoff’s psychosis.</li>
 	<li>Korsakoff’s Psychosis. A persistent mental state that manifests as confusion, forgetfulness, difficulty with walking, and problems with learning. 12 Korsakoff’s Psychosis is a serious condition and causes permanent damage to the brain.</li>

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</ul>
<h2>Mental Health Effects of Alcoholism</h2>
Alcohol misuse can also impact your mental health. <a href="https://alcoholrehab.com/alcoholism/effects/alcohol-induced-anxiety/">Anxiety</a>, depression, and sleep disorders are common in people who misuse alcohol. Examples of co-occurring mental health disorders include:
<ul>
 	<li>Anxiety. Anxiety disorders can be described as a feeling of fear or uneasiness. Some people may use alcohol to cope with anxiety. But alcohol misuse can cause anxiety symptoms and worsen pre-existing anxiety. 13</li>
 	<li>People with an alcohol use disorder are 2.3 times more likely to experience a depressive disorder.13Symptoms of depressive disorders include poor sleep, problems with appetite, poor concentration, feelings of guilt or worthlessness, and thoughts of suicide.</li>
 	<li>Sleep Disorders. Alcohol can disrupt normal sleep cycles resulting in difficulty falling asleep, poor-quality sleep, and not getting enough sleep .15</li>
</ul>
<h2>Find Alcoholism Treatment</h2>
There are a variety of <a href="https://alcoholrehab.com/alcohol-treatment/">treatment options</a> available for alcohol use disorder, from support groups such as 12-step programs to outpatient programs, and <a href="https://www.alcohol.org/treatment/">inpatient residential treatment</a>.

Medications, behavioral therapy, and support groups are common treatment strategies used for individuals with an alcohol use disorder.
<ul>
 	<li>Many treatment facilities offer medications that assist with managing cravings and withdrawal symptoms.</li>
 	<li>Behavioral treatments help you develop new skills in managing situations where you might be tempted to drink.</li>
 	<li>Mutual support groups can provide peer support and introduce you to people who have successfully quit drinking alcohol for substantial periods of time.16</li>
</ul>
Alcohol misuse can lead to serious health problems, and as a result, seeking treatment can help resolve some of those issues or prevent them from becoming worse.
<h3>Sources</h3>
<ol>
 	<li>Shield, K. D., Parry, C., &amp; Rehm, J. (2014). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908707" target="_blank" rel="noopener noreferrer">Chronic Diseases and Conditions Related to Alcohol Use</a>. Alcohol Research : Current Reviews, 35(2), 155–171.</li>
 	<li>Center for Disease Control. (2021, May 11). <a href="https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm" target="_blank" rel="noopener noreferrer">Drinking too much alcohol can harm your health. Learn the facts</a></li>
 	<li>Gao B, Bataller R. (2011) <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214974/" target="_blank" rel="noopener noreferrer">Alcoholic liver disease: pathogenesis and new therapeutic targets.</a>Gastroenterology.</li>
 	<li>Klochkov, A., Kudaravalli, P., Lim, Y., &amp; Sun, Y. (2021). <a href="http://www.ncbi.nlm.nih.gov/books/NBK537191/" target="_blank" rel="noopener noreferrer">Alcoholic Pancreatitis.</a> In StatPearls. StatPearls Publishing.</li>
 	<li>American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association, 2013.</li>
 	<li>Emanuele, N. V., Swade, T. F., &amp; Emanuele, M. A. (1998). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761899/" target="_blank" rel="noopener noreferrer">Consequences of Alcohol Use in Diabetics.</a> Alcohol Health and Research World, 22(3), 211–219.</li>
 	<li>Traversy, G., &amp; Chaput, J.-P. (2015). <a href="https://doi.org/10.1007/s13679-014-0129-4" target="_blank" rel="noopener noreferrer">Alcohol Consumption and Obesity: An Update.</a> Current Obesity Reports, 4(1), 122–130.</li>
 	<li>Beilin, L. J., &amp; Puddey, I. B. (2006). <a href="https://doi.org/10.1161/01.HYP.0000218586.21932.3c" target="_blank" rel="noopener noreferrer">Alcohol and Hypertension</a>. Hypertension, 47(6), 1035–1038.</li>
 	<li>Roerecke, M., Vafaei, A., Hasan, O. S., Chrystoja, B. R., Cruz, M., Lee, R., Neuman, M. G., &amp; Rehm, J. (2019). <a href="https://doi.org/10.14309/ajg.0000000000000340" target="_blank" rel="noopener noreferrer">Alcohol consumption and risk of liver cirrhosis: A systematic review and meta-analysis</a>. The American Journal of Gastroenterology, 114(10), 1574–1586.</li>
 	<li>Torruellas, Cara, Samuel W French, and Valentina Medici. <a href="https://doi.org/10.3748/wjg.v20.i33.11684" target="_blank" rel="noopener noreferrer">“Diagnosis of Alcoholic Liver Disease.</a>” World Journal of Gastroenterology : WJG 20, no. 33 (September 7, 2014): 11684–99.</li>
 	<li>Mann, R.E., Smart, R.G., &amp; Govoni, R. (2003). <a href="https://pubs.niaaa.nih.gov/publications/arh27-3/209-219.htm" target="_blank" rel="noopener noreferrer">The Epidemiology of Alcoholic Liver Disease</a>. Alcohol Research &amp; Health, 27(3), 209-219.</li>
 	<li>National Institute on Alcohol Abuse and Alcoholism. <a href="https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm" target="_blank" rel="noopener noreferrer">Alcohol’s Damaging Effects on the Brain.</a></li>
 	<li>Anker, J. J., &amp; Kushner, M. G. (2019). <a href="https://arcr.niaaa.nih.gov/alcohol-use-disorder-and-co-occurring-mental-health-conditions/co-occurring-alcohol-use-disorder-anxiety" target="_blank" rel="noopener noreferrer">Co-Occurring Alcohol Use Disorder and Anxiety: Bridging Psychiatric, Psychological, and Neurobiological Perspectives</a>. Alcohol Research: Current Reviews, 40(1).</li>
 	<li>McHugh, R. K., &amp; Weiss, R. D. (2019). <a href="https://doi.org/10.35946/arcr.v40.1.01" target="_blank" rel="noopener noreferrer">Alcohol Use Disorder and Depressive Disorders</a>. Alcohol Research : Current Reviews, 40(1), arcr.v40.</li>
 	<li>Angarita, G. A., Emadi, N., Hodges, S., &amp; Morgan, P. T. (2016). <a href="https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-016-0056-7" target="_blank" rel="noopener noreferrer">Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: a comprehensive review.</a>Addiction science &amp; clinical practice, 11(1), 9.</li>
 	<li>National Institute on Alcohol Abuse and Alcoholism. <a href="https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help" target="_blank" rel="noopener noreferrer">Treatment for Alcohol Problems: Finding and Getting Help</a></li>
</ol>
 

 

&nbsp;

Tamera Martens, MA

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