Detoxing from drugs or alcohol can be difficult, uncomfortable, and in some cases, dangerous. If you or someone you care about is struggling with addiction, medically supervised detox helps many people to manage substance withdrawal more safely and comfortably. This article will help you understand the process of a supervised medical detox, and if it is the right option for your recovery journey.
What is Drug Detox?
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 rehabilitation or treatment. 8
Drug and Alcohol Withdrawal
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
- Gastrointestinal disturbances like nausea, vomiting, and diarrhea.
- Changes in appetite.
- Sleep problems including both insomnia and hypersomnia.
- Movement changes such as shakiness or tremors.
- Body aches and pains.
- Changes in mood, nervousness, and irritability.
Alcohol Withdrawl Risks
Amongst all the various substance withdrawal syndromes, acute alcohol withdrawal can be particularly troublesome due to the risk of certain severe symptoms and withdrawal complications. Some of these include: 1
- Nervous system instability.
- Dysregulation of body temp, heart rate, and blood pressure.
- Marked anxiety and agitation.
- Hallucinations and delusions.
- Grand mal seizures.
- Delirium Tremens (commonly called DTs).2
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.
How Long Does Drug Detox Last?
The following factors may influence the severity of the withdrawal and detox needs:
- 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
- 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
- Medical history: Having other medical issues may complicate the withdrawal process.1
Drug Detox Process
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
- 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.
- 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.
- 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.
Can I Quit Drugs Cold Turkey?
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.
How Much Does Detox Cost?
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.
What Happens After Detox?
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
- 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.
- 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.
- 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.
It’s important that you continue to pursue long-term recovery following detox from drugs. Your medical provider can help you choose which option is best for you.
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- Substance Abuse and Mental Health Services Administration. TIP 45: Detoxification and Substance Abuse Treatment | SAMHSA Publications and Digital Products.
- Bayard, M., McIntyre, J., Hill, K., & Woodside, J. (2004). Alcohol Withdrawal Syndrome. American Family Physician, 69(6), 1443–1450.
- World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
- Diaper, A. M., Law, F. D., & Melichar, J. K. (2014). Pharmacological strategies for detoxification. British Journal of Clinical Pharmacology, 77(2), 302–314.
- Hayashida, M. (1998). An Overview of Outpatient and Inpatient Detoxification. Alcohol Health and Research World, 22(1), 44–46.
- gov. Substance Use Disorders | Medicaid.
- National Institute on Drug Abuse. Types of Treatment Programs.
- National Institute on Drug Abuse. Principles of Effective Treatment.