Alcohol and Drug Detox: A Complete Guide

Drug addiction and alcohol addiction are very serious problems in our country.

In fact, statistics tell us that there are 23.5 million people in the United States who are addicted to some type of substance, and only 11% of those with addictions ever receive treatment to recover. [1] With so many different options for drug and alcohol treatment, and because there have been so many advances in the way that professionals approach addiction treatment over the years, the fact is that help is available to anyone who needs it.

Addiction itself is very complex, and so, it really should come as no surprise that the methods for treating it can also be complex. However, experts have now come to agree that detox is highly recommended for many different types of addiction, including alcohol and several different drugs.


Explaining Alcohol and Drug Detoxification

Going through drug and alcohol detox[2] wasn't always considered to be necessary when it came to getting addiction treatment. In fact, many people opted to move right into rehab because they felt as though the extra step of detoxification wasn't generally needed. While there are still some people who believe that way, experts now know that detox is a step that almost everyone should consider to be a part of the recovery process when it comes to drug addiction.

To put it into simplified terms, detoxification refers to the process of eliminating substances from the body. This can refer to both the use of alcohol and drugs. The chronic nature of addiction cannot be ignored, and this is exactly why detoxification is so important. Experts have discovered in recent years that addiction is a relapsing brain disease, and this disease is identified by noting compulsive, drug seeking behaviors and ongoing use, despite the harmful consequences that usually result from it.[3]

Addiction has a way of becoming a cycle unless something is introduced that will interrupt that cycle. For example, a drug user may use for a period of time, and then decide that he or she doesn't want to continue to use. In an effort to quit, the user refrains from using drugs until withdrawal symptoms kick in. At that point, the only way to find relief is to go back to using.

Detox disrupts the cycle that so many addicts find themselves living in. When that addiction cycle is disrupted, the chance for recovery increases significantly.

Drug and Alcohol Detox Guide

Drug Types that Require Medical Detox

It was once believed that only certain substances could really benefit from going through a detox program, and so, detoxification wasn't always recommended for every type of addiction. There are drugs that are not considered to be physically addictive, and these are thought of as more mentally or psychologically addictive. Even though this is the case, research has shown that these drugs can still lead to physical withdrawal symptoms when they are stopped. As a result, detoxification began to be recommended to anyone who has almost any type of addiction as an option that could help them through the withdrawal phase.

Regardless of the type of alcohol that is consumed, alcohol in general is the most dangerous substance to detox from, which is why professional supervision during detoxification is so highly recommended. Other types of drugs that benefit from detoxification include:

  • Opioids or Opiates
  • Morphine
  • Oxycodone
  • Vicodin
  • Heroin
  • Club Drugs
  • GHB
  • Ketamine
  • PCP
  • LSD
  • MDMA/Ecstasy
  • Synthetic Drugs
  • Synthetic marijuana
  • Spice
  • K2
  • Benzodiazepines
  • Ativan
  • Xanax
  • Valium
  • Stimulants
  • Amphetamines
  • Cocaine

The Process of Detox within the Body

Today, detox is widely believed to be the first step in the addiction treatment process for those with almost any type of addiction. However, that does not mean that is an easy process to go through. For the addict who has spent months or years of his life being dependent on a substance to get him through each day, or to ease the mental pain and anguish that is often associated with addiction, detox can present deep burdens that are difficult to cope with. The psychological component of detoxification should not be ignored, and typically, drug users feel:

  • Fearful because of the loss of the drug as a part of their lives.
  • Worried because of the physical effects that withdrawal may have on their bodies.
  • Concerned about the emotional effects that not partaking in their drug of choice may cause.
  • Troubled by the thought that mental illnesses that they had been self-medicating for years may re-emerge and wreak havoc in their lives.
  • Remorseful because of agreeing to give up something that had once meant so much to them.

Great care should be taken to ensure that patients are receiving medical supervision during the course of the detoxification process. At any time, medical complications can arise, and some of these can become life threatening unless prompt treatment is received right away. Even so, it is important to note that alcohol and drug detox does reduce the need for medical intervention because of complications, which is another reason why this method is so beneficial for those who have drug addictions.

Even without medical complications playing a role during the detox process, withdrawal symptoms can be difficult to manage. Fortunately, both holistic detox and medical detox address withdrawal symptoms, and there are methods that are able to reduce them significantly, or even eliminate them entirely. This results in a much smoother withdrawal period that's easier to cope with. It also allows patients to feel more at ease about stopping their use of drugs, both physically and mentally.

Signs of Drug Addiction Withdrawal by Drug Type

The symptoms of drug addiction withdrawal generally vary depending on which type of substance is being used, although there are some signs of withdrawal that are very similar for most addictions. Some of the more common withdrawal symptoms based on drug type include:

Withdrawal Symptoms for Alcohol:

  • Chronic, painful headaches
  • Nausea with or without vomiting
  • A shaky feeling in the body
  • Loss of appetite
  • Anxiety or general feelings of nervousness
  • An increased heart rate
  • High risk of seizures
  • High risk of hallucinations

Withdrawal Symptoms for Opioids:

  • Achiness in the muscles
  • Profuse hot or cold sweats
  • Becoming easily agitated
  • Experiencing stomach pains or abdominal cramping
  • Bouts of nausea, diarrhea and vomiting

Withdrawal Symptoms for Benzodiazepines:

  • Experiencing heart palpitations
  • The onset of hand tremors
  • Hot or cold sweats
  • Anxiety or panic attacks
  • Insomnia or other sleep disturbances
  • Becoming heavily sedated, or having the appearance of sedation

Withdrawal Symptoms for Stimulants:

  • Having pain in the muscles of the body
  • Onset of anxiety symptoms
  • Experiencing tremors
  • Extreme sleepiness or lethargy
  • Heart complications or problems
  • Becoming suicidal

Withdrawal Symptoms for Synthetic Drugs:

  • Intense cravings for the drug
  • Bouts of extreme depression
  • Uncontrollable nausea, vomiting and diarrhea
  • Possibility of frequent psychotic episodes
  • Suicidal thoughts or gestures

Withdrawal Symptoms for Club Drugs:

  • Serious problems with sleeping
  • Severe intermittent tachycardia
  • Blood pressure changes
  • Risk of delirium and hallucinations
  • Moderate to severe anxiety and panic attacks

In general, withdrawal symptoms tend to be mild in the beginning, and this is what most users experience when they accidentally run out of their drugs, or they're not able to use for a period of time. They fail to recognize that the mild withdrawal symptoms they encounter will only increase in intensity as time goes on.

As far as how long withdrawal symptoms last, because everyone is different as far as their tolerance levels and their genetics, there is no way to tell. There are some users who feel much better within a week after they have gone through withdrawal. There are other users who will go through withdrawal for as long as 2 weeks until their symptoms begin to subside. It is important to remember that there is always the risk of symptoms returning, and rebound withdrawal symptoms occur quite frequently with a number of different addictions. In fact, rebound symptoms have been known to happen months or even years down the road, after people have stopped using and stayed consistent.

What is Medically Managed Detox?

Medically managed alcohol and drug detox[4] refers to the use of medications to help patients through the detoxification process. It is believed that the use of medications isn't always necessary, but according to SAMHSA,[5] great care should be made to ensure that patients receive the proper assessment prior to administering any type of detox protocol. This involves separating patients into specific categories in order to determine what they need. These categories are:

  • Those who have histories of extreme forms of withdrawal, such as seizures or delirium. This group requires treatment with medications as soon as possible.
  • Those who are currently experiencing withdrawal symptoms, whether they are moderate or severe. This group also requires immediate medication intervention.
  • Those who could still be under the influence, and who have not yet shown signs of withdrawal. In these cases, observing patients for withdrawal symptoms over the next six to eight hours is recommended, and delaying a decision to treat them with medication is warranted.

Some medication types that are commonly used during detoxification include:

  • Antipsychotic medications
  • Anticonvulsant medications
  • Medications in the barbiturate category
  • Beta blockers or alpha adrenergic agonists
  • Relapse prevention medications

Common Methods Used in Medical Detox

There are generally two different methods that are currently used to manage drug and alcohol detox. While some experts are beginning to shy away from the idea of using medications to help their patients through withdrawal, there are others who believe it is still the best course of action. Therefore, medical detox is a method that is still widely practiced in the United States, and there are those who have found it to be very effective at helping people stop their use of drugs.

It should also be stated that there are some instances when introducing another drug would not be beneficial to a patient at all, depending on the circumstance. For example, considering the fact that research shows that there have been as many 22 million people in the United States that have used prescription drugs for recreational purposes, it is not always a good idea for everyone to take these medications, even for detox.[6] In cases like these, where prescribing medications to help with detoxification is not recommended, a medical tapering of the drug may occur.

Medical tapering involves giving patients doses of their usual drugs in smaller doses over a period of time until they are completely drug free. This is done based on a schedule that is created for each specific patient who requires this type of detox. Research has shown that medical tapering can greatly reduce instances of withdrawal symptoms, but it should only be done under direct supervision by medical personnel.

Detox and Withdrawals

Medications to Assist with Withdrawals

While there is no cure for addiction, and no magic pill that will allow the detox process to proceed without experiencing some type of withdrawal, there are certain medications that have been approved by the FDA for the purpose of detoxification. Medications should always make the process safer and more tolerable for the drug user, and unpleasant withdrawal symptoms should be effectively managed when the correct medications are administered. A few examples of medications that are commonly given during drug detox might include the following.

For Alcohol Withdrawal

Benzodiazepines provide a sedative affect that aids in reducing anxiety that is often linked with alcohol withdrawal symptoms. Anticonvulsants and anti-seizure medications may also be used in addition to benzodiazepines.

For Opiate Withdrawal

Buprenorphine and methadone (also known as Suboxone[7] and Subutex) are frequently given to help patients through this type of withdrawal.

For Benzodiazepine Withdrawal

Patients are often able to switch to a different benzodiazepine medication, or they may benefit by taking a phenobarbital substitution medication. Quite often, the medical tapering method is utilized when patients present with benzodiazepine addictions, and this seems to be very effective.

For Stimulant Withdrawal

Even though the FDA has not specifically approved certain medications to help patients through stimulant withdrawal symptoms, there are some addictions that are able to be treated with benzodiazepines. For patients who present with cocaine and methamphetamine addictions, this is a great option. Benzodiazepines are addictive, but they also tend to counteract the effects of stimulants, and they serve to calm the effects of stimulant withdrawal because of their sedative properties.

Managing Detoxification Through Holistic Methods

Holistic detox[8] is a method that is beginning to get a lot of attention in the medical world. It promises a recovery that is much easier that medical detox because of the fact that no addictive medications are introduced during holistic detox.

When a patient undergoes holistic detox, he or she experiences a deep cleanse of the body from all toxins related to the addiction, but in a natural way. The human body was made to remove toxins on its own, but when it hasn't been treated in a healthy way, this process can become delayed. During holistic detox, the health of the patient is improved in dramatic ways, which allows the body to do what it was designed to do.

There are a number of ways that holistic detox can be done, and these methods are used in detox clinics all across the country. Holistic detox can be achieved by:

  • Making significant improvements in patients' diets
  • Introducing physical fitness and exercise as a part of patients' daily routines
  • Providing relaxation and stretching activities such as Yoga
  • Introducing various types of massage
  • Offering meditation exercises
  • Providing alternate forms of psychotherapy, such as art or equine therapy

Holistic detox is a very different approach to detoxification when it is compared with medical detox. However, it is a method that has been proven to be very effective by the increasing success rates that many detox clinics have released.

Choosing to Quit Drugs or Alcohol without Professional Help

Many people who are regular drug users or drug addicts endure short-term withdrawal symptoms. This can occur when they find that their supply is gone, or when they have to refrain from using for a short time for another reason. Unfortunately, this means that they believe they understand what withdrawal is, and so, they have a misunderstanding of what it will mean for them once they decide to stop using drugs permanently. This experience with withdrawal mistakenly leads people to believe that they can stop using on their own, whenever they are ready to do so.

Unfortunately, almost everyone who decides to stop using drugs using the "cold turkey"[9] method of quitting ends up failing. They are not prepared for the consequences of trying to stop on their own, and as a result, usually one of two things occur:

  • They enter into a cycle of addiction that leads them to use, stop, withdraw and then begin using all over again. This cycle is dangerous for a number of reasons, but one of the biggest reasons is that it only services to reinforce the idea in their minds that they need drugs to survive.
  • Secondly, those who are on the relapse part of the cycle of addiction are at a much greater risk of overdosing than those who choose to recover from addiction using methods that involve getting support and professional treatment. This occurs because of quickly changing tolerance levels in the body. Once an individual stops using drugs or alcohol, his or her tolerance level decreases. When the same amount, or even a greater amount of drugs is reintroduced into the body, overdose can occur, which can lead to death.

The risks associated with attempting to quit using drugs cold turkey are very real. In fact, drug overdose is now the leading cause of accidental death in the United States. In 2014, there were 47,055 lethal overdoses in the U.S. The number of overdoses per year has been increasing on a regular basis, and the rate in 2008 was nearly four times what it was in 1999.[10]

It is not uncommon for people to decide to attempt to stop using drugs or alcohol cold turkey for at least the first few times they try to quit using. However, they put themselves at a great risk, and the safer method of quitting is to choose drug detox, where they can be monitored and assessed for any medical issues that may develop.

Cold Turkey Quitting Vs. Self-Tapering

Experts are in agreement that suddenly stopping the use of drugs or alcohol is dangerous, and because of this, some people do attempt to try tapering[11] their use of substances on their own. The theory is that this process will reduce the severity of withdrawal symptoms and produce a better outcome than quitting suddenly. Even so, there isn't any research that demonstrates that tapering off reduces the effects of withdrawal, although it can help to guard against medical complications when stopping the use of drugs or alcohol.

Tapering can be done in a number of ways, and these might include:

  • Gradually reducing how often drugs or alcohol are used.
  • Gradually cutting down on the amount of drugs or alcohol used in one day.
  • Replacing drugs or alcohol gradually with another consumable product, such as juice or water.
  • Space out the length of time between each use.
  • If the substance of choice is alcohol, choosing a type of alcohol that isn't the normal or preferred type instead.
  • Using substances that are much weaker, such as mixing drinks that contain less alcohol than normal.

How do You do a Drug Detox at Home?

There are a lot of risks involved with detoxing from drugs at home,[12] depending on the type of drug that is being detoxed from. However, there are still those who want to attempt it, and if this is the case, it is important to have the right supplies on hand.

Generally, detoxing at home can be done as long as the individual is able to get plenty of rest, a lot of fluids, and good, nutritious food. Additional supplies that should be available include:

  • Sleeping medications or over the counter sleeping aids
  • Mild sedatives to help with anxiety
  • Tylenol to help with any aches and pains that may arise
  • Gatorade, soups and broths to aid in hydration
  • Herbal teas to help with relaxation
  • Anti-vomiting medications
  • A blood pressure testing kit
  • A thermometer

Talking with a doctor regarding plans about doing a home drug detox is highly recommended. They are often able to prescribe medications and offer advice that may be very helpful during the process. Also, it is essential to have someone supervising the detoxification process, if at all possible. This individual will need to prepare for approximately three days of withdrawal symptoms, which should begin to diminish by the end of the third day.

The Risks Involved with at Home Detox

It is so important to take the risks of doing a home detox into consideration prior to making the decision to proceed with one. Once physical or psychological dependence on a substance has been established, the body can go into shock when it is suddenly stopped. This often leads to medical complications that do require immediate medical attention and intervention. Serious risks include:

  • Blood pressure fluctuations and instability
  • The risk of cardiac arrest
  • The risk of dehydration
  • Severe nausea and vomiting
  • The possibility of stroke

Whenever possible, ever effort should be made to go through drug or alcohol detox in a facility with trained personnel who understand the risks involved, and who are able to administer proper treatment, and intervene when it is necessary to do so. The individual who is going through the detox needs to be supervised at all times to ensure safety.

Paying for Alcohol or Drug Detox: Is Insurance Coverage Available for Treatment?

A common concern that people often have is regarding the cost of going to detox, or any type of addiction treatment, for that matter. They usually assume that getting professional help means paying for it themselves, and because most facilities are expensive, they put off getting information about any ways to find help to cover these costs.

The Affordable Care Act[13] has made it possible for people who need addiction help to get the assistance they need, without having to worry about how they will cover the costs associated with addiction treatment. Insurance companies are required to provide benefits to help cover the cost. Anyone who needs to apply for health insurance to receive benefits, should visit HealthCare.gov[14] to do so.

Also, it is important to note that some addiction treatment facilities receive grants[15] to help their patients cover any out of pocket expenses that may remain after health insurance coverage has been exhausted. These grants may also be put toward the total cost for those who are not able to obtain health insurance.

There are many ways to get help to pay for alcohol or drug detox, as well as other forms of addiction treatment. Being unable to get help because of the cost should never be a deterrent for anyone who has an addiction and is interested in recovery.

How Much Does Drug and Alcohol Detox Cost?

Cost is usually a concern for those who need to get addiction treatment. While health insurance might pick up the bill for most of the necessary treatment, there is often a small amount that has to be covered out of pocket. It is difficult to say how much it costs to go to detox because all drug and alcohol treatment centers are different, and each patient varies regarding the type of help that is needed. Some people need mild detox that only requires holistic methods, while others might need medication and a longer period of detoxification before they're ready to move on to drug or alcohol rehab. The cost could be between $1,500 and $5,000.

For those who do have health insurance, their out of pocket payments will vary, depending on their insurance deductibles and co-payment amount requirements. However, most should expect to only pay a few hundred dollars out of pocket, at the most.

Detoxification: It is Not the End of the Road

There are standalone treatment facilities that offer excellent detoxification services, but then they fail to provide referrals to their patients for additional treatment afterwards. This presents a serious problem for patients, because without the proper type of follow-up care, those who choose to only go through drug or alcohol detox are most likely going to experience relapse sometime in the near future. Dr. Mark Willenbring, who is a former director of treatment and recovery research at the National Institute for Alcohol Abuse and Alcoholism states that, "You don't treat a chronic illness for four weeks and then send the patient to a support group. People with a chronic form of addiction need multimodal treatment that is individualized and offered continuously or intermittently for as long as they need it."[16]

While detox is a crucial component of the recovery process for anyone who uses drugs, it must not be treated as the end portion of recovery. To do so puts the patient in jeopardy. Recovery from an addiction is an ongoing process that actually lasts for the rest of the patient's life. A drug addiction is a disease, and like other diseases, continued treatment is necessary in order to successfully avoid a relapse.

Once Detox has Been Completed

Once detoxification has been completed, ongoing care will significantly reduce the risk of relapse. In fact, according to a 2012 study by Johns Hopkins Medicine, relapse rates are as high as 80% in most cases one month after discharge from detox clinics when no other treatment is obtained. However, the study also cited the fact that those who do go on to receive residential treatment that includes an intensive day treatment program were shown to be as much as 10 times more likely to remain abstinent from drug use.[17]

Of course, not every patient is going to be able to commit to an inpatient treatment setting, but there are many different methods of ongoing treatment that should and can be considered. Most importantly, every effort should be made to obtain the appropriate referrals for rehab and treatment so that the healing process can continue. Unless the core issues behind the addiction are addressed in an alcohol or drug rehab[18], relapse is very likely to occur.

What Happens After Drug Rehab?

There are many people who mark the completion of alcohol or drug rehab as the end of their recovery journey. While completing a rehab program is certainly a task worthy of celebrating, it should not be the end of recovery. Because of the fact that an addiction is a disease, treatment should never cease, although it may take on a different form.

Narcotics Anonymous[19] is an organization that offers help, support and encouragement for anyone who is in recovery because of a drug addiction. They hold support groups all over the United States, and these meetings are free to attend. NA meetings will allow patients to continue along in their studies of the 12 Steps, and they will provide an excellent social and support outlet as well.

Similarly, Alcoholics Anonymous[20] has been around for decades, and it has long been thought of as a program that is essential within the life of someone who is recovering from alcoholism. Their support groups are also free to attend, and the only requirement is that the participant has stopped drinking. Support groups are so helpful, and ongoing support is crucial in the life of an addict who wishes to stay sober.

Additionally, there are some patients who require more of a step down approach when it comes to being treated for drug addiction. These individuals would benefit from outpatient treatment, or even from an intensive outpatient drug treatment program that offers a higher level of care that mimics what was experienced during inpatient treatment.

Will Alcohol and Drug Detox Work for You?

After reading through this guide, you may be wondering, Will alcohol and drug detox work for me? The answer to that question is that yes, it can work for you. However, as was previously stated, detoxification should never be considered as the end of the addiction treatment journey. It is an excellent first step, but great care must be taken to follow through with drug rehab; and possibly drug rehab in a step-down approach. For some, that may mean entering into a residential treatment facility, and then transitioning into an intensive outpatient treatment program or traditional outpatient treatment program. For many people, inpatient treatment is the general next step once detoxification has been completed.

The bottom line is that while detox is effective, recovering[21] from a drug or alcohol addiction is something that is always ongoing. It is a lifelong process that has no end because addicts are always at a much higher risk of using than those who have never used drugs before. Even so, detoxification is the best way to begin for most people who have drug or alcohol addictions, and when this first step is taken, research shows that the benefits speak for themselves when it comes to success rates in the long-term.

Citations

[1] New Data Show Millions of Americans with Alcohol and Drug Addiction Could Benefit from HealthCare R. DrugFree.org. September 28, 2010. Accessed December 7, 2016.
[2] Detox Handbook: Withdrawal Information for Each Drug Category. NorthPoint Recovery. September 1, 2016. Accessed December 9, 2016.
[3] Jaclyn Cosgrove. What it's like: To go through medical detox. NewsOK. April 7, 2013. Accessed December 7, 2016.
[4] Why Medical Detox Just Isn't Enough to Beat Addiction. NorthPoint Recovery. October 29, 2016. Accessed December 8, 2016.
[5] Quick Guide for Clinicians: Based on TIP 45, Detoxification and Substance Abuse Treatment. SAMHSA.gov. Accessed December 8, 2016.
[6] State Estimates of Nonmedical Use of Prescription Pain Relievers. SAMHSA. The NSDUH Report. January 8, 2013. Accessed December 7, 2016.
[7] Wait, Now I Need to Detox from Suboxone?. NorthPoint Recovery. November 12, 2016. Accessed December 7, 2016.
[8] Maura Henninger, N.D. A Holistic Approach to Health in Early Recovery: Withdrawal and Insomnia. The Huffington Post. August 4, 2010. Accessed December 7, 2016.
[9] Why Do Some People Need Drug Detox While Others Can Just Quit Cold Turkey?. NorthPoint Recovery. June 15, 2016. Accessed December 7, 2016.
[10] Opioid Addiction 2016 Facts & Figures. ASAM, American Society of Addiction Medicine. 2016. Accessed December 7, 2016.
[11] Buddy T. Can Tapering Off Reduce Alcohol Withdrawal Symptoms? VeryWell.com. August 22, 2016. Accessed December 8, 2016.
[12] George Cranston. How to Do a Drug Detox at Home. HealthGuidance.org. 2016. Accessed December 8, 2016.
[13] Health Financing. SAMHSA.gov. September 25, 2016. Accessed December 8, 2016.
[14] Healthcare.gov. 2016. Accessed December 8, 2016.
[15] Grants. SAMHSA.gov. 2016. Accessed December 8, 2016.
[16] Jane E. Brody. Effective Addiction Treatment. The New York Times. February 4, 2013. Accessed December 7, 2016.
[17] Drug-Free Housing for Substance Abusers Leaving Detox Linked to Fewer Relapses. Johns Hopkins Medicine. February 27,2012. Accessed December 7, 2016.
[18] How to Find the Best Drug Rehab or Detox Facility. NorthPoint Recovery. August 11, 2015. Accessed December 9, 2016.
[19] NarcoticsAnonymous.org. 2016. Accessed December 7, 2016.
[20] AA.org. Accessed December 9, 2016
[21] 7 Things People in Recovery Wish You Knew. NorthPoint Recovery. December 4, 2016. Accessed December 7, 2016



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