When treating alcoholism or drug addiction, the first step is often a medically supervised detox. Everyone has different needs for treatment, however, when someone has been using an excessive amount of alcohol or other substances, the sudden halt of substance use can result in physical and psychological withdrawal symptoms. Ranging from mild to severe, the care a person needs depends on where they fall within that range. Withdrawal related to alcohol or benzodiazepine (e.g. Xanax, Klonopin) use can be particularly dangerous. Birmingham Recovery Center may require a client to complete medical detox prior to admission to ensure their safety and provide a solid foundation to proceed with their recovery.
What is Detox?
According to the Substance Abuse and Mental Health Services Administration, detox can be defined as “a medical intervention that manages an individual’s safety through the process of acute withdrawal” (SAMHSA 2015). The purpose of the detox process is to clear the body of toxins related to substance use, minimize potential physical harm, and allow a more comfortable transition into substance use treatment. Typically, medically-assisted detoxification happens at a specialized facility under the supervision of medical professionals. Detoxing from drugs and alcohol on your own is not recommended due to the potential danger and likelihood that an individual resumes substance use to alleviate withdrawal symptoms.
What Happens During Detox?
While everybody’s detox is different, this process can typically take 3-7 days depending upon types for substances used and how your body responds to withdrawal. What you can expect during the detox process generally occurs in three steps:
Assessment & evaluation
During this phase, individuals will be assessed by a medical professional involving taking vital signs and reviewing history of alcohol and drug use, including durations and amounts of most recent substance use. This will allow the medical staff to determine the best course of treatment and begin addressing any dangerous or uncomfortable withdrawal symptoms.
Detox & stabilization
During this time, individuals will be monitored on an around-the-clock basis under close supervision of medical staff. Often, doctors will administer medications to mitigate severe withdrawal symptoms. Nutrition and hydration management is also provided to replenish vital nutrients and fluids that may have been depleted from the body during active addiction. Therapy and case management may also occur to assist individuals with any emotional symptoms that may occur.
Step-down to treatment
Detox is intended primarily to mitigate withdrawal symptoms and is not designed to resolve the longstanding psychological, social, and behavioral problems associated with alcohol and drug use (SAMHSA 2015). Therefore, after being medically stabilized, the individual can begin the process of substance use treatment where they can address root cause issues, learn new coping skills, and surround themselves with others who are going through a similar experience. Continuing treatment following detox is a critical step in achieving long-term recovery and having a better life.
Withdrawal Symptoms During Detox
Detox can be dangerous, that’s why it’s crucial for individuals to undergo a medical detox. A medical detox can help alleviate some withdrawal symptoms, however, there are others that are unavoidable. The detox process is different for everyone, and symptoms can range from physical to psychological. Depending on the substance some of these withdrawal symptoms can include:
- Cold sweats
- Runny nose
- Anxiety & depression
- Flu-like symptoms
In their most severe form, withdrawal symptoms can include:
- Arrhythmia (heart beating too fast or too slowly)
- Heart attack
Due to the risk of these severe withdrawal symptoms, it is critical for individuals to be assessed and monitored by a medical professional when stopping alcohol and drug use.
Drug Withdrawal Timelines
Different substances affect the body in different ways. Typically, the acute or severe phase of detoxification will last from three to ten days. However, every person’s body is different and the type and duration of withdrawal symptoms will vary depending upon a variety of factors (such as type of substance, amount consumed, and length of use). These are the most common substances associated with uncomfortable and dangerous withdrawal symptoms:
Alcohol withdrawal can be dangerous and fatal for those who have been physically dependent for a long-period of time. Withdrawal symptoms typically begin eight hours after the last use which can include headaches, nausea, and vomiting. After 24 hours, individuals may begin to experience hallucinations. Within 24 to 72 hours symptoms have peaked and may be beginning to resolve. Individuals detoxing from alcohol should be closely monitored as delirium tremens and seizures can happen and may occur even three days after drinking has ceased.
Opiate withdrawal that includes heroin, morphine, and painkillers can begin just six hours after the last dose was taken. Users will experience flu-like symptoms and in addition to muscle aches, restlessness, anxiety, sweating, and high blood pressure. Symptoms are most intense between days two and four and may begin to subside after one week. After the physical withdrawal symptoms have subsided, mental and psychological withdrawal symptoms can still persist including cravings, anxiety, and depression.
Benzodiazepines including Xanax, Klonopin, Ativan, and Valium can cause withdrawal symptoms just hours after the last dose is taken. Between days two and four individuals will feel sleepiness, rapid heartbeat, nausea and vomiting. Those who have used the substance for anxiety symptoms may experience rebound effects, meaning their condition could get worse once they stop taking it. Benzodiazepine withdrawal can also cause seizures and individuals should be closely monitored by medical professionals. After a two week period, symptoms should have subsided, however, those who have been addicted to benzodiazepines long-term may experience withdrawal symptoms for weeks after.
Since cocaine has a short half-life, cocaine withdrawal symptoms can begin just 90 minutes after the last dose is taken and subside after seven to ten days. Upon the initial withdrawal period, users will experience a “crash,” and feel excessive fatigue, sleepiness, aches, pains, and anxiety. These symptoms typically last for up to a week, however users can feel after-effects and post-acute withdrawal symptoms for months after the initial detox.
Amphetamines such as Adderall, speed, or crystal methamphetamine create euphoric highs and increase brain activity. Amphetamine withdrawal can include hallucinations and episodes of psychosis. Initial detox symptoms include extreme fatigue, anxiety, agitation, impaired lack of focus, and inability to experience pleasure. These symptoms can subside after two weeks but post-acute withdrawal symptoms can last up to one year.