Eliminating existing substances or alcohol from the system is an initial and a very important step to start recovery from addiction. Drugs contain chemicals that remain in the bloodstream even for weeks after consumption. Detox or detoxification is the process of getting rid of the drugs from the body. It can be done in various settings; outpatient clinic, inpatient clinic or at home. However, it is usually very effective in a residential medical facility.
During detox, the urge to consume the drug decreases, and thus chances of relapse are significantly reduced. Drugs damage almost every part of the body and by removing the ones left behind, you prevent any further damage. It assists the addict to regain their ability to think well and make the right decisions again. Length of the detoxification plan varies among st individuals and depends on the drug one is addicted to, how long they have been addicted, and many other factors.
The process can be dangerous and painful. Hence it is advisable to consult a doctor before you quit any substance. The withdrawal symptoms can to lead to death. Medics help in managing them by prescribing drugs that mimic the effects of the drugs. Also, therapies are offered to help the patient relax.
Process of Detox
Every patient has got different needs that should be addressed during the process for effective recovery. The process is personalized and basically involves the following three steps;
- Evaluation
This is the first step. The medical team evaluates all the physical and mental health conditions that the patient could be having. Screening of the blood is conducted to measure the amount of the substances in the patient’s bloodstream. The tests assist in determining the medications to be administered. Also, the physician conducts medical and psychiatric histories to help in devising a long term plan for addiction recovery.
- Stabilization
This is done to prevent harm to the patient during the treatment plan. Medicines and therapies are given to stabilize the person. Also, they help in preventing complications and manage the withdrawal symptoms.
- Preparation to start treatment
It is the final step of detoxification. It prepares the patient to start a treatment plan. The medic team familiarizes the person with the entire treatment process. Everything that one needs to know, starting from medicines, therapies and the side effects that they should expect. Also, they tell you what they expect from you for an effective plan.
First Stage of Detox
The first days of detoxification are the toughest. They can be very intense for many people. However, if the process is medically supervised, specialists and psychiatric staff will be there to provide the support and motivation that you require. For instance, for heroin addicts, after the last dosage of the drug, one may experience anxiety, muscle pain, sweating, insomnia, and runny nose.
Though the symptoms are not deadly, they can be very uncomfortable and one can be tempted to take the drug again. Various issues come up as you continue with the detox and they are addressed immediately they occur. The issues are dealt with according to the urgency, one by one until the patient stabilizes fully. The following are some of the issues that occur;
- Violence
Some drugs like synthetic cathinones increase violent behaviors in people who use them. The user is most likely to hurt themselves or people around them. Patients who pose dangers to others may require sedation to protect them and the medical team or are isolated. This only done if his/her physical behavior is uncontrollable and they have attempted to harm the staff.
- Injury
Some addicted people hurt themselves while under the influence of the substance. Others, due to their violent behavior they are physically hurt or sexually abused before they enter the detox plan. For an instance, phencyclidine is a strong dissociative substance which can cause feelings of increased energy and invulnerability. Therefore, its consumers put themselves at danger because of the impression that they will not be hurt.
Additionally, they are more likely to have suicidal thoughts that can hurt them if the suicidal act is not successful. All physical injuries on any part of the body should be treated first before one starts the treatment process.
- Diseases
Many individuals who suffer from chronic pain usually use opioids to relieve the pain. Though the painkillers are recommended by the doctor, they can develop dependence towards them. As one starts to detox from the painkillers, the chronic pain reoccurs together with other painful withdrawal symptoms
Thus, the doctor should evaluate the medical condition and treat all its symptoms and the pain in the right way before starting the detox process.
- Signs of Psychosis
Psychosis is a severe complication due to the impacts of substances like cocaine. If one consumes excess cocaine, they experience paranoia even before they experience the total blown psychosis. The symptoms include hallucinations, both auditory and visual and delusional thinking. Psychosis can also be as a result of other co-occurring mental conditions such as insomnia and schizophrenia.
Patients of psychosis can be very unpredictable. Before you proceed with the detoxification, address all underlying mental conditions appropriately.
- Threat to oneself
Withdrawal from drugs and especially opioids can cause severe depression that might be accompanied by suicidal thoughts. If a person portrays signs of suicidal thoughts, they should be monitored all the time. If such issues are determined during the first step of detox evaluation, they are treated until the patient is stable enough to go through the process.
Drug Detox Withdrawal symptoms
The withdrawal symptoms during the detox process can be very painful and life-threatening. This is the reason why addicted people are usually advised to consider medical detox. The environment at the medical facility is safe and comfortable. Though the extent of medical supervision varies with the plan, it will help in managing the complications of detox.
Researcher’s state that an instant quit to drugs has multiple symptoms depending on the drug that one was addicted to. Also, the severity of the withdrawal symptoms is different among individuals. The following are some factors that might influence the severity of the symptoms;
- The length of the addiction- obviously, if you have been addicted for three years, you can’t expect to experience the same intensity of withdrawal symptoms as a person who has been addicted for one year. Daily use of a substance for a long period, can lead to high levels of tolerance and dependence on the substance. Moreover, the withdrawal symptoms can be severe too.
- The combination with other drugs- depending on various drugs can lead to terrible withdrawal symptoms. Every drug has got its specific withdrawal symptoms which will be addressed separately and it might take a long time before stabilization is achieved.
- The dosage of the drug- the amount of the substance that one takes immediately before starting detox can affect the intensity of the withdrawal symptoms. As one begins to use drugs, a small dosage is required to achieve the effects. But with the time, the body develops tolerance. One requires more and more dosage to achieve similar effects. This is known as tolerance. The larger the amount of the substance, the more likely that the symptoms will be more painful.
- The existence of other co-occurring mental or physical conditions- if a person is having other mental health conditions like anxiety, stress or depression the withdrawal symptoms could be more intense. Also, if one has physical disorders like chronic pain, they might experience significant stress and more painful symptoms.
- The half-time of the substance- generally, if a drug has a short half-life its withdrawal symptoms are short-lived. On the other hand, if it has a long half-time the withdrawal symptoms might take a longer time to disappear.
Various drugs cause different withdrawal symptoms, but the following are common;
- Mood swings- this makes the patient very unpredictable and hard to deal with. The moods disturbances can include irritability or agitation.
- Insomnia- probably, one has been depending on the drug to sleep. Once it is withdrawn from the system, you might have sleep disturbances and excess fatigue.
- Physical problems- the body suffers physically either through nausea, severe headaches, runny nose, vomiting, sweating, colds or tremors. Although they some might look minor, they can be very uncomfortable.
- Strong cravings- the withdrawal symptoms are traumatizing, and the urge to take the drug in order to avoid them is strong than ever.
Drugs and their Specific Withdrawal Symptoms
Each drug has got specific withdrawal symptoms. Listed below are some specific withdrawal symptoms for drugs that require medical detox.
- Alcohol
The withdrawal symptoms of alcohol can be very severe and deadly. However, there are various medications and therapies administered to help in relieving them. They can be physical and psychological, but how often and how much, and for how long you have been drinking influences the intensity of the withdrawal symptoms. Heavy drinkers might experience extreme symptoms.
Withdrawal symptoms of alcohol
Nausea, vomiting, nightmares, shakiness, headaches, irritability, depression, tremors, and seizures are some of the symptoms of alcohol withdrawal. Also, some patients may experience delirium tremens. This is an intense withdrawal symptom that causes confusion, hallucinations, and tremors.
Delirium can lead to death if not immediately treated. It can cause heart complications and severe injuries as a result of sudden seizures. It is estimated that out of 20 people who are undergoing alcohol detox, one suffers from delirium tremens.
Duration of the withdrawal symptoms
One experiences the first withdrawal symptoms 5-10 hours after taking the last drink. Tremors are the immediate signs of alcohol withdrawal. After some time, seizures and hallucinations occur. Although it can be terrible in the first days, as you progress with medication, the symptoms subsidize gradually.
Physical symptoms can disappear faster than the psychological ones. Also, long term impacts such as sleep disturbances and depression can take even a year before they taper off. In the first twelve hours during detox, the patient may experience insomnia, sweating, rapid heartbeat, and increased blood pressure.
Symptoms become more intense after 1-2 days of alcohol withdrawal. They may include night terrors, seizures, and panic attacks. In 3-5 days one may have mood swings and delirium tremens. After detox, usually, more than 6 days after the last drink, the symptoms such as insomnia, irritability, and anxiety may persist.
- Heroin
Individuals who are struggling with heroin addiction keep on using it to avoid its painful withdrawal symptoms. They are felt twelve hours after the last intake of the dose. Withdrawal of heroin feels like the worst flu ever with severe pain and discomforts.
Withdrawal symptoms may include muscle pains, sweating, agitation, diarrhea, anxiety, insomnia, and many others. The duration of the symptoms depends on the length of use. Long use of heroin alters the brain’s components which affect the mood and behavior. This can last for months. Some symptoms that can last include insomnia, fatigue, and depression.
Heroin withdrawal timeline
6 hours after consumption of the last dosage of heroin, one might feel pain on the muscles. The pain gets severe with time over the first two days. You may also experience shaking, diarrhea, and panic attacks within the first 2 days. After 3-5 days abdominal cramps, sweating, vomiting, and shivers may occur.
After a week, all the acute symptoms of withdrawal such as muscle aches and nausea disappear. One might feel normal, but still weak and tired. However, some heroin addicts experience post-acute withdrawal syndrome (PAWS). This is due to the alteration of the central nervous system function. These symptoms can include depression, anxiety, and irritability.
- Benzodiazepine
Taking high dosage of benzos for a long period can lead to tolerance. When one quits using the substance, withdrawal symptoms emerge, whether they were prescriptions or you were abusing them. Recently, doctors have reduced prescribing benzos to patients due to their high addictive power and severe withdrawal symptoms.
They can be emotionally and physically traumatizing and can lead to death if not medically addressed properly. Some of these symptoms include dizziness, hallucinations, sweating, seizures, nausea, and irritability. Nevertheless, they are prescribed to treat sleep and anxiety disorders, when one stops using them, they can suffer from restlessness and anxiety.
Benzodiazepine Withdrawal Timeline
The first withdrawal symptoms of shorter acting benzos such as Xanax and Ativan occur 6-8 hours after taking the last dose of the substance. For longer-acting benzos like Valium, Librium, and Klonopin, the symptoms can appear within 24-48 hours after the last dosage. Within those hours, one may experience insomnia and anxiety.
Between 1-4 days after quitting the use of benzos, anxiety and insomnia may intensify. Moreover, the patient might experience increased heartbeat, sweating, and nausea. Individuals, who are addicted to long-acting benzos, experience the first signs during this period. Also, 10-14 days the withdrawal symptoms may begin to peak.
Types of Drug Detox
There are two main types of detox programs. Various factors can influence your choice such substance you are addicted to, length of addiction, support from family and friends, and personal preferences. Some drugs such as alcohol, heroin, and benzos should be constantly supervised during withdrawal.
If you have been addicted for a long period, the withdrawal symptoms can be severe and thus medical supervision is important to ensure effectiveness and prevent relapses. People who have supportive family and friends can detox at home if the addiction is not intense.
- Outpatient detox
Specialists rarely recommend this type of detox, unless in cases where one has been addicted for a short period. It can only be effectual for individuals who are committed to recovery. Treatment sessions are scheduled according to the patient’s availability.
This program is best for people who have obligations at home or job, but they want to recover from substance addiction. One checks in with their doctor for counseling and medication. The program comes in various ways. In day program, one is required to attend treatment sessions 5-7 days in a week.
For IOP (Intensive Outpatient Programs) there are measurable milestones to measure progress. As you achieve each milestone, the commitment is reduced. The other option in the outpatient program is the continuing care. This involves groups such as the Alcoholics Anonymous or Narcotics Anonymous. They assist individuals to maintain sobriety and are managed by a licensed therapist.
Advantages of outpatient detox
Outpatient programs are affordable. Since one stays at home, you can continue with your work. Your source of income isn’t affected. Also, one doesn’t incur costs of accommodation like in the inpatient program. Signing in for outpatient detox program offers you flexibility. You only check with your doctor within the agreed time. One is also able to get support from family and friends since they are always around.
Sadly, it isn’t very effective due to constant triggers.
- Inpatient detox
Not only does inpatient detox program offer24 hour medical support, but also the patient receives emotional and motivation from staff and other patients who are undergoing the same process. They provide the best medical supervised detox. In this program, the patient resides at the treatment facility for a certain period of time. (30 days, 60 days, 90days or even more)
The duration of stay depends on the intensity of addiction, the presence of other co-occurring mental or physical health conditions, and if a person has ever been in a rehab before. Many facilities provide family programs and therapies, where one’s family members can participate. This helps to mend broken trust and identify any dysfunctional relationships that could trigger a relapse.
Before you settle on the inpatient program, consider the following;
- The types of addiction the facility treats.
- Types of therapies offered.
- The type of aftercare programs and sober living home for patients after the recovery.
- Credentials the facility has.
- Peer groups available and the payment options that the facility accepts.
Benefits of inpatient detox
Inpatient detox program is ideal for individuals who are struggling with severe addiction. The environment is safe and free from external triggers. The medical specialists ensure that the process is comfortable.
Methods of drug detox
Depending on the substance one is addicted to, there might be various options to choose from. No method is a sure bet for any person. However, the effectiveness is determined by the drug addicted to, the last dosage consumed before starting detoxification, the length of addiction and if a person has been using other substances. The following are three detox approaches;
- Cold-Turkey detox – this simply means stopping to consume drugs on your own without any medical help. The patient experiences all the withdrawal symptoms no matter how severe they might be or how long they might take. To some drugs, this approach may work since the symptoms can only take days, but to others, it can be very difficult.
- Short-term medicated detox – the patient is given some medicines calm down the withdrawal symptoms. The mediation is often given for a short time to make one relax. For instance, if a person is having problems with sleeping, some non-addictive medicines can be given to help them sleep.
- Long-term medicated detox – this usually recommended to opioid-addicted patients. A patient may be given methadone to reduce the severity of the withdrawal symptoms. The medication is taken until one is totally free from the drug.
Duration of Drug Detox
Detoxification will last as long as the withdrawal symptoms occur. A patient is only free from the drug, if they are stable physically, mentally and emotionally. The detox doesn’t only help in getting rid of the substance but also prepares the patient for the counseling and therapies ahead.
Not all people are successful in the first attempt to detox from drugs. Even if you fail, try again and again, you will surely achieve sobriety.
Conclusion
The decision to quit drugs is a very important decision in an addict’s life. One requires support and encouragement during the entire period. There are two options with which can choose from; inpatient and outpatient detox program. Although the process is painful, medications are given to ease the pain. Some people may opt to do the detox at home, though it is unsafe and there are high chances of a relapse. Also, some withdrawal symptoms are severe and life-threatening.