What is Drug Detoxification?

Learn more about what drug detoxification is, what symptoms and side effects you can expect from detox and withdrawal, and how to best navigate the process.

What is drug Detoxification?

Drug detoxification is the process of allowing a substance to leave your system after you have developed a physical dependence on it. One of the criteria for addiction in the DSM-5 involves tolerance and dependence. This means that your body becomes accustomed to the substance, often requiring an increased amount to achieve the desired effect. In order to no longer be dependent upon the drug, the body must go through the drug detoxification process.

There are two widely known methods to detox from a drug: cold turkey and tapering. It’s worth noting that with some substances, abruptly stopping can be extremely dangerous and therefore requires drug withdrawal treatment.

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Cold Turkey

In terms of substance use and detox, cold turkey simply means stopping and abstaining use of a substance immediately and completely. Typically, quitting cold turkey will result in severe drug withdrawal symptoms that can be extremely uncomfortable and, at times, dangerous. However, depending on the type of substance and with the right support, a cold turkey drug detox can be effective.1

Tapering

Tapering often involves either slowly lowering the dose of a drug or the use of medications to alleviate drug withdrawal. For example, many outpatient opioid detoxification and inpatient opioid detoxification programs will use a combination of medications to help someone taper off of opioids. These medications may include anti-anxiety medications like benzodiazepines, anti-nausea medication, and/or medication-assisted treatments (MAT) like suboxone to minimize withdrawal symptoms.

Why Inpatient Drug Detox?

An inpatient or residential detoxification program can be important for addicted individuals in order to safely manage withdrawal symptoms and work toward sustainable recovery. Many people continue to use or return to using in order to avoid the discomfort associated with detoxing from their substance of choice.

Despite the detox process being uncomfortable, drug detoxification is essential for both physical and mental health. Since drugs and alcohol can have an extremely negative impact on both physical and mental health, allowing the body to detox from substances it has become dependent on is crucial to finding stability to begin the journey toward a sober way of life. 

Understanding Withdrawal Symptoms and Timelines

Drug detox and withdrawal timelines depend on the type of drug taken. Drug and alcohol detox times can vary for many reasons, including the substance, the dose and duration it has been used, and the person’s age, weight, metabolism, and/or overall health. More detailed information about how detox timelines and processes may differ by substance is described below.

Opioids

For short-acting opioids such as heroin, an individual may start to experience drug detox symptoms as soon as a few hours after their last use. Typically, withdrawal symptoms peak around forty-eight to seventy-two hours and may continue for five to ten days. For more long-acting opioids, such as Methadone, the onset of the opioid detoxification symptoms often start around forty-eight hours after last use, peak around day three, and may take up to twenty-one days to resolve.2

Understanding Opioid Withdrawal

Alcohol

For alcohol withdrawal, minor withdrawal symptoms such as tremors, sweats, and anxiety will often start between five and ten hours after the last drink. Within twelve to twenty-four hours, symptoms of delirium tremens may start to occur. These symptoms often include hallucinations and can last up to two days.

Between twenty-four and forty-eight hours, alcohol withdrawal seizures may occur if not properly medicated and monitored. These can be extremely dangerous and fatal. After seventy-two hours, alcohol withdrawal symptoms tend to improve and may continue for up to five days.3

Stimulants

With stimulants such as cocaine and methamphetamine, the drug detoxification symptoms of agitation or anxiety may occur immediately after the person stops taking the drug. Around twelve hours after the last use, the initial “crash” phase typically occurs. After this introductory period, signs of stimulant withdrawal can continue to occur between ninety-six hours to several weeks.

Sedatives

Sedatives, often called benzodiazepines or “benzos,” have a withdrawal timeline that usually starts twenty-four hours after the last use. Acute drug withdrawal generally begins within a few days after the initial withdrawal period. From there, people may continue to experience withdrawal symptoms that last between five to twenty-eight days. Though in some instances, symptoms may last for several months.4

Post-Acute Withdrawal Syndrome (PAWS)

Post-acute withdrawal syndrome, or PAWS, refers to symptoms of withdrawal one may continue to experience for weeks or even months after abstaining from a substance of abuse. PAWS most often occurs after the initial withdrawal period for alcohol, benzodiazepines, and opioids. Some of the symptoms of PAWS may include difficulty concentrating or remembering, mild hand tremors, increased anxiety or depression, or irritability. 5

What Is the Process for Drug Detox?

The detoxification process usually includes receiving an evaluation, getting stabilized, and possible continued treatment programs. The process of evaluation may include assessments and tests to determine the severity of substance use. This is done by a medical provider or trained professional. From there, the goal is to get the individual stabilized by being drug-free.
After the process of stabilization, the individual is prepared for follow-up or continued treatment. Many people who go through the drug addiction detoxification process are then recommended to continue treatment either through a drug and alcohol residential program or outpatient program.

Drug Detox Symptoms And Side Effects

Drug Detoxification
The drug detox symptoms and side effects vary depending on the type of substance used. Drug detox stages can range from mild to severe. Some mild symptoms may include anxiety, tremors, sweats, or chills, while severe symptoms might include seizures, dehydration, or delirium tremens.

Alcohol Detox Symptoms

Alcohol detox side effects might include:6
  • Gastrointestinal upset, such as nausea, vomiting, and/or diarrhea
  • Insomnia
  • Excessive sweating
  • Increased pulse
  • Increased blood pressure
  • Tremors, especially in the hands
  • Hallucinations
  • Seizures
  • Confusion
  • Delirium tremens, which involves sudden and severe changes in the nervous system

Opioid Detox Symptoms

Opioid detoxification may include:
  • Muscle aches and pain
  • Goosebumps
  • Fever
  • Excessive sweating
  • Gastrointestinal upset, such as nausea, vomiting, and diarrhea
  • Watery eyes and runny nose
  • Irritability
  • Anxiety
  • Depressed mood
  • Sleep problems, such as insomnia
  • Excessive yawning

Sedative Detox Symptoms

Detox for drugs like Xanax, Ativan, and Valium often include symptoms such as:
  • Increased anxiety or panic attacks
  • Insomnia
  • Repetitive movements, such as pacing
  • Nausea and vomiting
  • Increased pulse rate
  • Excessive sweating
  • Tremors
  • Hallucinations
  • Seizures

Stimulant Detox Symptoms

Stimulant drugs include methamphetamine, cocaine, and amphetamines like Ritalin and Adderall. The withdrawal symptoms from stimulants may include:

  • Increased fatigue
  • Insomnia or hypersomnia
  • Nightmares
  • Depression
  • Suicidal thoughts or behaviors
  • Increased anxiety
  • Increased appetite
  • Slowed movements or thoughts
  • Lethargy
  • Anhedonia
Drug detoxification side effects and symptoms are not entirely avoidable, and the length and severity of the symptoms are often determined by the duration and amount of use. Higher doses and for a longer length of time will likely result in more severe withdrawal symptoms. The increased dose and length of use may all affect the duration of the withdrawal symptoms. However, a detoxification program can help lessen the severity.

Drug Detox Stages

Typically, there are three stages to a drug detoxification timeline. These stages are related to the experiences that are common among people who move through drug and alcohol withdrawal. These stages include the crash, withdrawal, and extinction.

The “Crash”

The “crash” occurs rapidly after abruptly stopping the use of the substance. This may be the stage in which mild withdrawal symptoms start to appear, such as anxiety, irritability, fatigue, and a decreased craving to use. At this stage, most people feel bad enough that they no longer want to use and desire to stop, but not so badly that they seek to alleviate the discomfort.

Withdrawal

Phase two is the withdrawal stage. At this stage, more severe withdrawal symptoms start to emerge, including physical discomfort, gastrointestinal distress, seizures, hallucinations, and an increase in use.
The desire to use may increase at this stage due to the extreme feelings of discomfort and wanting to alleviate those feelings.

Extinction

Phase three is the extinction stage. At this point, the symptoms of detoxification are mostly eliminated. However, the cravings to use tend to linger, especially when combined with a triggering event.

Can I Detox Myself?

Some people prefer to detox in the comfort of their own homes. This may be especially more common for individuals with no insurance or who cannot pay for drug detox treatment. It is possible to do a drug detox at home, however, it is often more difficult and more dangerous.
Doing a drug detox at home often involves going cold turkey. However, you can contact a medical provider who may prescribe medications for reducing withdrawal symptoms. Most providers will recommend or refer to a drug detox center for monitoring.

Home Detox Risks

There are several risk factors with doing at-home detoxification of drugs or alcohol. For one, the risk for relapse is significantly higher for those who detox from drugs at home. Relapse is also increased due to not having accountability. You may determine that you feel so much discomfort from the withdrawal symptoms that you end up using just to feel better. Oftentimes, people do not have the support needed to prevent a relapse.
The other major risk factor for the detoxification of drugs at home is the severity of symptoms. Some substances can have severe physical, or even fatal, detoxification side effects. These can include changes in heart rate and blood pressure, hallucinations, seizures, and delirium tremens. If not properly monitored, withdrawal symptoms can become severe enough to result in death. Before deciding to detox at home, contact a medical provider for information and recommendations.

Managing Detox Symptoms at Home

If you decide to engage in detox at home, here are some tips to help manage the withdrawal symptoms:
  • Stay hydrated: Many detox symptoms include dehydration, which can result in increased feelings of fatigue, headaches, dizziness, muscle pains, and nausea. Water can help flush out your system and decrease the severity of some of the symptoms.
  • Get proper nutrients: People sometimes do not eat properly while they are using. This often results in the body lacking the necessary vitamins and nutrients it needs to function properly. If you are detoxing at home, try to eat healthy meals with nutrient-filled foods, as well as take vitamins such as vitamin D, vitamin B, calcium, and magnesium.
  • Engage in physical activity: Physical activity not only has the benefit of increasing mood, but sweating helps to eliminate toxins from the body. This can be difficult when feeling uncomfortable or ill during withdrawal but can help improve symptoms.

Drug Detoxification Risk Factors

There can be several risk factors to consider when going through drug detoxification. The risks to consider when you engage in drug detox are:
  • Overdose: When detoxing from a substance, you are at a higher risk of overdosing if you start using again due to your body no longer being tolerant to the amount used prior to the detox. Therefore, in cases of relapse, returning to using the same amount or dosage can result in an overdose.
  • Drug detox during pregnancy: Unsupervised detox may place the mother and child at risk, but medical detox can be done safely for both the mother and child.
  • Rapid and ultra-rapid detox: Rapid detox involves giving medication to speed up the onset of detox and then administering medications to help treat the withdrawal. Ultra-rapid detox involves being placed under anesthesia and being administered naloxone to quickly flush opiates from the brain’s receptors. The risks for rapid and ultra-rapid detoxes include respiratory distress, rapid breathing, acute renal failure, delirium, or death.

Drug Detox Treatment

Drug addiction and dependence can cause both physical and mental health issues. When going through drug detoxification, you may experience both physical and emotional discomfort that requires treatment. There are several treatment options for drug withdrawal detox.

Drug Rehabilitation

Inpatient or Residential Treatment

Inpatient, or residential treatment, requires individuals to reside in a facility and receive care twenty-four hours a day. An inpatient detoxification program offers round-the-clock medical support, medication, and engagement in therapy.7

In both inpatient detox and residential treatment programs, individuals will be provided with support, individual therapy, group therapy, and family therapy, as well as access to a medical provider for possible medication if needed. Completing a more long-term residential treatment program may be associated with reduced relapse rates as opposed to short detox or outpatient programs.

Inpatient vs. Residential Treatment

There is a difference between inpatient detoxification programs and residential programs. Commonly with inpatient drug detox, an individual completes the detox and then moves into a longer residential program in order to continue treatment and therapy. With a detoxification program, the goal is managing and alleviating withdrawal symptoms with the use of medical support and medication. These programs can last anywhere from three to ten days, depending on the length and severity of the drug detox symptoms.

From an inpatient detox program, an individual may be recommended to move into a residential program. A residential drug treatment program is seen as a step down from detox and is a way for individuals to continue their treatment in a safe, stable, and supportive environment. Most drug residential programs have a length of stay between thirty to ninety days, with some programs offering one year.

Outpatient Treatment

Outpatient drug detox is similar to at-home detox. Attending an outpatient detox program usually involves going to a facility to receive medications to help manage withdrawal symptoms and also engaging in therapy programs. The type of program will determine the hours required to attend treatment.

Additional Outpatient Options

Typically for an outpatient detox program, groups are attended one to two hours per day for three to five days a week. However, once the detox is completed, individuals may be referred to more intense treatment programs, including:
  • Intensive outpatient programs (IOP): IOPs involve attending treatment three to five days a week for a total of around nine hours per week. The treatment may include individual therapy, group therapy, family therapy, and/or medication management.
  • Partial hospitalization programs (PHP): These are more intensive than IOPs and involve attending treatment four to five days a week for a total of twenty hours per week. Most PHPs include individual therapy, group therapy, family therapy, and medication management as requirements for the program.8

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) is the use of medications, most often in combination with behavioral therapies, which is used to treat the withdrawal and cravings of substance abuse. MAT is primarily used for the treatment of addiction to opioids or alcohol. It can be the use of drug detox medications, such as clonidine, to manage withdrawal symptoms or detox drugs like methadone and buprenorphine for more long-term maintenance.
MAT has been shown to be effective in decreasing the need for inpatient drug detox services and increasing retention rates in treatment. MAT medications help to relieve withdrawal symptoms and the psychological cravings caused by chemical imbalances in the brain. The two types of MAT medications are:9
  • Alcohol: Acamprosate, disulfiram, and naltrexone are the most common medications used to treat an alcohol use disorder. These medications do not provide a “cure” for the disorder, but are shown to be effective in reducing cravings and improving engagement in treatment programs.
  • Opioids: Buprenorphine, methadone, and naltrexone. Buprenorphine is commonly known as Subutex and the combination of buprenorphine and naltrexone is commonly known as Suboxone. As with alcohol, these medications do not provide a cure for opioid use disorder, but help to reduce cravings and are used to block the “high” effect that most people seek when using opioids.

Behavioral Therapies

Behavioral therapy is also part of drug detoxification treatment. A variety of therapies have been shown to be effective in treating substance use disorders and are involved in detox treatment programs. Within the detox programs, individuals will engage in individual and group therapy. The most common types of therapy for the treatment of drug detoxification are cognitive behavior therapy, contingency management, and family and/or couples therapy. These therapies consist of:10
  • Cognitive Behavior Therapy: Cognitive behavior therapy involves helping individuals identify and change negative beliefs that may be contributing to maladaptive thoughts, feelings, and behaviors. Cognitive behavior therapy also teaches positive coping skills to use in place of substance use.
  • Contingency Management: Contingency management involves reinforcing positive behavior changes using rewards. This can involve using monetary-based rewards for meeting positive goals, such as continuing to test negative.
  • Family and Couples Therapy: Family and couples therapy are used in treatment in order to help repair and build interpersonal relationships that are often damaged during active substance use.

What to Expect From Therapy

Detoxification Program at Profound Treatment

Seeking treatment for alcohol and substance abuse or addiction can prove to be a daunting task. If you or someone you know is struggling with addiction and is ready to begin the path to sobriety, Profound Treatment is here to help.

Drug Detoxification

Life After Detoxification

Commonly, the best odds for success after detox are to continue treatment in a residential program. Regardless of your decision for treatment after detox, you will need to learn how to live without drugs or alcohol. This may involve finding sober support, attending support meetings, keeping up with your mental health, maintaining appointments, evaluating your living environment, and always being alert for signs of relapse.

Why Choose Us

Profound Treatment provides medically-supervised drug and alcohol detox programs in a safe, comfortable, and healing environment. At Profound, we use evidence-based treatment approaches to provide you with the best health outcomes and reduce rates of relapse. Our goal is to provide individualized care that benefits your physical, mental, and emotional health.

For more information about Profound’s program, contact us 24/7 by phone at 310.929.9546, email us at [email protected], or reach us via our website at https://profoundtreatment.com/contact-us/.