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For every person who chooses to undertake the journey to recovery, the specifics of treatment, including the period of intense detox that occurs in the first weeks after cessation of drug and alcohol use, will vary widely. Some of the factors that can impact a person’s experience in drug detox specifically include:
Managing acute mental health symptoms as well as the physical withdrawal symptoms that often characterize drug and alcohol detox is often the primary focus for clients in the first weeks of recovery. Medical care and monitoring are provided to ensure the safety of the client during this process as well as to increase comfort and, in some cases, assist the client in stabilizing rapidly while also helping to avoid relapse. It may be helpful to take advantage of the pharmacological options available in recovery, but that will depend upon all the factors listed above and whether or not there is a medication that is appropriate in a client’s individual circumstance. As detox is winding down, the client will be prepared to transition into the intensive therapeutic treatment necessary to grab a firm hold of a new life in recovery.
It’s important to note that:
Medically assisted detox programs have the resources to provide clients with everything they need to navigate the initial phase of treatment for drug and alcohol addiction safely and stabilize in recovery. There are different styles of detox – for example, some are inpatient and some are outpatient – that offer a different range of services from very basic medical care to a deeply comprehensive and layered treatment program that leads into long-term therapeutic treatment. The type and style of detox that will be most appropriate will depend upon the client’s personal circumstance, history with addiction treatment, co-occurring mental health disorders, and goals for recovery. Often, however, a medically assisted detox program will offer the following services:
Comparatively, at-home detox attempts offer none of the above. When those who wish to stop using their drug of choice try at-home detox, they are gambling that they will not experience any significant medical issues that require immediate medical intervention and that they will be able to avoid relapse. These are both risky assumptions given the unpredictable nature of addiction and the harsh impact that chronic abuse of drugs and alcohol can have on the brain and body. Even with the best of intentions and armed with as much knowledge as possible about what to expect, the urge to relapse and manage the uncomfortable withdrawal symptoms can be powerful and ultimately endanger the person’s health, often resulting in overdose.
No matter what the drug of choice, medical care and treatment starting with a medically assisted detox program are recommended when addiction is the issue.
The length of time spent experiencing withdrawal symptoms as well as the specific treatment options that will be most effective during detox will vary based on the details of the client’s experience, including drug of choice and all the issues listed above. In general, however, individuals can expect the following timeline to define their experience in drug detox:
Do all drugs cause withdrawal symptoms?
Addiction is in part defined by the psychological and physical withdrawal symptoms that occur when the person abruptly stops using the drug of choice. Though not all drugs trigger long-term and intense physical withdrawal symptoms, all cause psychological withdrawal symptoms, including cravings and a strong impulse to relapse and use the drug of choice. It’s not uncommon for someone in detox from any substance of abuse to additionally experience other withdrawal symptoms, including:
Most drugs of abuse, however, trigger intensive physical withdrawal symptoms as well as psychological withdrawal and even those who enter detox citing the same drug of choice will have an exceedingly different experience during detox. For example, alcohol withdrawal symptoms can be mild for some but life-threatening for others. In general, withdrawal symptoms begin within a few hours of taking the last drink, peak in the first few days, and then continue for weeks on end. In addition to the issues above, they may include:
Most clients in detox for alcohol abuse will experience some variation of the symptoms above at different levels of intensity, but the most severe cases are called delirium tremens and may be defined by the above as well as:
The range of possible withdrawal symptoms and the unpredictable level of severity experienced by each individual are some of the reasons why professional medical detox is recommended.
Can medication help?
Just as all aspects of addiction treatment should be determined based on the needs of the individual, so too should the choice regarding use of medication be based on the client’s individual circumstances. Not all drugs of abuse have a corresponding pharmacological option that will improve the detox experience. Even if a medication is available that can help to mitigate cravings or address other aspects of detox, it is not necessarily appropriate in all cases.
In some cases, a medication-assisted detox that uses a medication may be used to treat the withdrawal symptoms related to detox and help the person to slowly taper down a high-dose addiction while under medical supervision. For example, benzodiazepines may be a positive choice to treat those who are experiencing severe alcohol withdrawal symptoms, and methadone and Suboxone are both often used to help people manage withdrawal symptoms associated with heroin detox. Though both are addictive medications, a slowly lowered dose may diminish the discomfort experienced during detox, which in turn can contribute to a lower risk of relapse as well as a lesser risk of medical complications. Coupled with long-term intensive therapeutic intervention, these options can be exceedingly effective, especially in treating those who have been living with a long-term addiction disorder.
Depending upon the drug of choice and the type of medication chosen during detox, medications may serve any of the following purposes:
It cannot be emphasized enough, however, that there is no magic pill that will make detox easy if withdrawal symptoms are a significant issue. There are, however, a number of medications that may be helpful in easing the severity of these symptoms and empowering the individual to more quickly begin therapeutic treatment.
Can you die from withdrawal symptoms?
Withdrawal symptoms can be severe, and in some cases, with high-dose addictions to alcohol or benzodiazepines, for example, it is possible to experience medical complications that result in death. This risk is increased if there are underlying medical disorders that have gone undiagnosed and untreated during active addiction or if the person relapses during an attempted detox. The risk is diminished when emergency medical care is on standby and the person enrolls in detox at a medically assisted detox program that provides 24-hour supervision and monitoring.
What is ‘cold turkey’ detox?
Cold turkey detox is a term used to describe the process of abrupt cessation of use of all drugs and alcohol with no medical assistance of any kind. It is often a choice made by people who would like to get through detox as rapidly as possible since no long-term medications are used that may prolong the experience.
The use of non-addictive medications to help address specific symptoms (e.g., sleep aids for the purposes of treating insomnia or over-the-counter painkillers for bone and muscle pain or headaches) may help to make the person more comfortable in cold turkey detox.
Is there medical supervision during detox?
When a client enrolls in a professional drug detox program, medical supervision will be provided from the first day to the last. Medical care is a necessary part of the detox process even if physical withdrawal symptoms are not significant, to ensure the safety of the client at all times. Clients may expect:
How long do withdrawal symptoms last?
The length of time that withdrawal symptoms last in detox will vary based on a number of different factors. In most cases, they begin within a few hours of the last dose or drink, and then increase in type and severity until they peak and then slowly fade over the following weeks, though in some cases, psychological withdrawal symptoms can last for months or return every few months.
Factors that have an impact on how long withdrawal symptoms last include:
It’s also important to note that while the focus may be primarily on the physical withdrawal symptoms experienced during the first weeks of detox, the psychological withdrawal symptoms can linger for months. In the case of some drugs, too, cravings can resurface after almost a year or more of sobriety; thus, a state of continued detox and awareness through ongoing connection with treatment is recommended.
What happens after detox?
Detox is just the first part of a comprehensive treatment program for addiction. After detox, clients have the opportunity to learn how to make lifestyle and behavior changes that will increase their ability to remain drug-free for the long-term. Through intensive cognitive and behavioral therapeutic interventions, the client has the chance to explore underlying assumptions and perceptions that may be contributing to the impulse to use drugs and alcohol, and make adjustments where necessary. Additionally, alternative and holistic healing options provide stress management assistance and techniques that can help to manage overall stress levels and provide coping mechanisms that can be applied in tough moments.
A well-rounded treatment plan will utilize a unique combination of traditional, alternative, and holistic treatment options according to the needs of the individual. Like the treatment choices made in detox, the determination of which therapies will be useful should be based on:
Not only should therapy take place during the addiction treatment period immediately following detox, but the therapeutic interventions that most resonate with each client should be continued in aftercare as well, as the person begins the process of transitioning into an independent life in recovery. Though the specific therapies chosen will vary from person to person according to need, some positive options may include:
The specifics of what an individual needs to safely and effectively navigate detox and addiction treatment is very personal. It is recommended that all who begin the detox process do so with medical care and supervision through a professional substance abuse and addiction treatment program.