Detoxification, or detox, as it is commonly shortened to, has two meanings. The first is the textbook definition: the act of clearing the body of addictive, toxic, and harmful substances like drugs and alcohol to stop the physical and psychological damage caused by extended substance abuse.
The other meaning of detox refers to the process itself as it’s carried out by medical detox facilities and other treatment centers: a form of addiction treatment that provides medical support, resources, and interventions to help manage acute intoxication and the withdrawal symptoms that follow the stoppage of drug or alcohol use.
The purpose of alcohol and drug detox is to both ensure that these substances are completely removed from someone’s system and that they manage to make it through withdrawal safely while minimizing discomfort. Medical detox is administered by doctors and healthcare professionals who are experienced and well-trained in the field of addiction.
While undergoing detox is rarely ever a pleasant experience, it is still the necessary first step to essentially all forms of recovery from substance use disorders.
Someone cannot expect to get sober and start their recovery while they still have drugs or alcohol in their systems. They also cannot effectively start the recovery process while dealing with the withdrawal symptoms caused by stopping drug or alcohol use, which can be uncomfortable and distracting at best and potentially life-threatening at worst.
The above two reasons highlight why detox has to happen before someone can begin an addiction recovery treatment program. Some people might be under the mistaken impression that detox is unnecessary or that they can just stop using alcohol or drugs all at once on their own without any serious consequences.
This is not the case though, as the long-term effects of chronic drug and alcohol use make it extremely difficult for someone to stop using on their own since their body and brain have become dependent. It also means that if and when they do stop using, there are going to be inescapable physical and mental effects. Depending on the severity of someone’s dependence, the substance they were abusing, and how long they were abusing it for, exact withdrawal symptoms will vary from person to person.
Some common mild withdrawal symptoms that almost anyone stopping the use of drugs or alcohol and can expect to experience include:
However, there are other symptoms that, while still very common, are much more severe and difficult to manage, including:
These symptoms can be much more unpredictable and difficult to manage. If someone attempts to quit using drugs or alcohol that they have become addicted to “cold turkey” rather than through medical detox, they are extremely likely to experience symptoms like suicidal thoughts and seizures due to the immense shock to the system that quitting all at once triggers. The body and brain are suddenly deprived of something they have become dependent on and now are struggling to function without it.
While some substances will have milder withdrawals, there are others that are known to have withdrawal periods so intense and possibly dangerous that they should always be stopped via a carefully planned detox. These substances include:
Attempting to detox on your own creates a lot of unnecessary risks and means leaving yourself open to the consequences of some of the symptoms outlined above, like seizures or delirium tremens. Maryland House Detox offers drug and alcohol addiction treatment programs which can help you through the process.
It also is much less likely to be successful, as many people find the symptoms of withdrawal associated with drug and alcohol detox too much to handle and will often relapse mid-detox. This also raises the risk of accidentally overdosing, which frequently occurs when someone relapses and takes a much larger dose of a substance than they usually would to try and find relief from extreme withdrawal symptoms.
Choosing medical detoxification at a professional rehab or detox center removes these potential problems by having dedicated staff available to administer medications that can help ease the symptoms of withdrawal and make them more manageable. Through medical maintenance therapy, the withdrawal process can be made much more achievable, with the minimal amount of pain or discomfort.
If someone chooses an inpatient medical detox specifically, it also eliminates the possibility of a mid-detox relapse, as they will be removed from their environment and placed under 24-7 monitoring.
Undergoing medical detox at a professional treatment center also means that a doctor can utilize a tapering schedule to slowly wean people off the substance they have become dependent on. Instead of trying to quit cold turkey and enduring the stress this puts on the body, tapering instead carefully lowers the dosage over time until it is safe to stop using drugs or alcohol without the danger of triggering a seizure or other medical complication.
While it is understandable to feel frustrated by tapering’s lengthier detox process, it is the safest and most effective way to do a drug and alcohol detox. Some opt instead for a method known as “rapid detox,” which involves being placed under general anesthetic and given medications intravenously in order to speed the detox process up from days or weeks to as little as four to six hours.
However, rapid detox is expensive, typically not covered by insurance, and often extremely risky. Numerous studies have questioned the actual effectiveness of rapid detox and documented heart attacks, seizures, and other severe complications, many of which have been fatal.
Traditional medical detox may take longer, but it is the best way to ensure a safe, successful detoxification without any unnecessary discomfort that leaves people ready to continue on to the next phase of treatment.
Medical detoxification is defined as a three-step process the can be broken down in the following manner:
This step involves screening and information-gathering by the detox center’s medical team. During the evaluation process, doctors will:
This initial screening will also serve as the basis for putting together an effective long-term treatment plan post-detox.
The next step is to move on to keeping the person stable during the withdrawal process and preventing them from coming to any form of harm. Some methods used to accomplish this include:
The final step in the medical detox process involves preparing the person for transitioning into long-term substance abuse treatment. This usually involves:
Many people wonder exactly how long their medical detox will take. While there are some established common timelines, detoxing from certain stimulants, for example, can be done in a matter of days, opioids can take a couple of weeks, and benzodiazepines can sometimes take up to a month. The actual length of any given individual’s detox experience is difficult to predict.
The length of time medical detox works for someone’s is affected by factors such as:
There are two main types of drug and alcohol detox programs: inpatient and outpatient. When it comes to choosing the type of medical detox that will work best for someone, that depends on the unique factors that we have previously mentioned, including the severity of their addiction, what substance they’re dependent on, how serious their withdrawal symptoms are, and so on.
Inpatient detox treatment is the more common form of medical detox and involves the person being removed from their regular environment and placed under 24-7 care and supervision, typically at one of the following places:
Along with round-the-clock medical care and support, inpatient detox reduces external triggers that could lead to a mid-detox relapse by taking someone out of their normal life and having them stay in the controlled environment of a treatment center, where they can also more easily transition into continued care once they are done detoxing.
Outpatient detox treatment is much less structured and does not involve living onsite at a treatment facility. Instead, the person continues with their regular life while making regular visits to either a doctor’s office or outpatient detox clinic for medication and support to help them through the withdrawal process.
Obviously, while outpatient treatment is much more flexible and, for many people, both more practical and feasible, the responsibility of avoiding triggers that could lead to relapse is on the individual. Also, outpatient detox is really only recommended if someone’s withdrawal symptoms are mild enough that they do not require continuous medical monitoring.
Within these two categories are five different placement levels of care concerning drug and alcohol withdrawal, as defined by The American Society of Addiction Medicine:
LEVEL ID: AMBULATORY DETOXIFICATION WITHOUT EXTENDED ONSITE MONITORING
Mild withdrawal that requires daily or less-than-daily outpatient supervision and support.
LEVEL IID: AMBULATORY DETOXIFICATION WITH EXTENDED ONSITE MONITORING
Moderate withdrawal that requires all-day onsite support and management, but the person can return home at night provided it is a healthy and supportive living situation.
LEVEL II.2D: CLINICALLY MANAGED RESIDENTIAL DETOXIFICATION
Moderate withdrawal that requires 24-hour onsite support and care in order to increase the likelihood of recovery. This is defined as non-medical support, emphasizing the peer support found in a residential treatment facility.
LEVEL III.7D: MEDICALLY MONITORED INPATIENT DETOXIFICATION
Severe withdrawal that specifically requires medical supervision and care on a 24-hour basis.
LEVEL IVD: MEDICALLY MANAGED INTENSIVE INPATIENT DETOXIFICATION
Severe withdrawal that necessitates 24-hour intensive medical intervention. This is referring to cases of acute withdrawal in which hospitalization has become necessary.
Once someone has successfully completed their detox, the strongly recommended next step is checking into addiction rehabilitation treatment. As we’ve previously mentioned, recovery cannot truly begin without first flushing the substances someone has become dependent on out of their system. However, detox alone is not enough to ensure lasting sobriety and has no effect on the addictive behaviors and mindsets that lead people down the path to substance abuse in the first place.
Most medical detox facilities will be able to offer information on different addiction recovery treatment programs as well as other resources to help aid in the transition from detox to ongoing care.
At a reputable and professional recovery treatment center, an individual will be able to choose from a wide range of different programs and services based on what will most effectively meet their needs. Much like detox, some people may require the more intensive care provided by an inpatient treatment program, while others may find outpatient treatment sufficient. Some common treatment options typically found in both inpatient and outpatient programs include:
No matter which form of treatment someone chooses, they will be able to learn to understand the issues at the root of their addiction and gain the tools and coping skills necessary to help manage it in the long-term.
Many of these recovery centers also have alumni programs, so that graduates of the treatment program can stay connected and provide an outside support network for each other to help avoid relapse and stay committed to their recovery goals.