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Drug and Alcohol Detox Guide

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Detox can be an important first step in the substance use treatment process. It can be intense and uncomfortable for many people. But going through medical detox is a critical moment. It is considered the entry point into treatment of substance use disorders (SUDs)—the moment where uncontrollable substance use ends and the body and mind are prepared and ready for change.

Understanding the details of drug and alcohol treatment can feel overwhelming, but it doesn’t have to. In this article, you’ll learn more about the detox process and why it’s important. Knowing more about what to expect can help you feel ready to reach out and get the support you need.

What is Detox?

Detoxification (“detox” for short) is the process of clearing your body of substances of misuse.1 It is where your treatment team works to help safely and humanely manage withdrawal symptoms.1 For many, it is only the first step in their treatment journey. While detox helps clear your body of drug and alcohol toxins, most people need extra treatments as they work toward long-term recovery.

For many people with an SUD, the fear of how bad withdrawal symptoms will be keeps them from finding help. Detox can feel like a major hurdle to achieving recovery. But medical detox can help keep you as safe and as comfortable as possible during withdrawal and positions your feet on solid ground as you begin your journey toward recovery.

Why Is Detox Important?

When you take certain substances (alcohol, prescription or illegal drug) regularly over a period of time, your body makes small changes, getting used to the presence of that substance. As these changes continue, a person must increase the amount of the substance in order to feel its effects.

Then, when you stop taking it, the body doesn’t know right away how to reverse the changes it made, so it begins to go through withdrawal. This state is called dependence.3 Withdrawal symptoms differ from person to person and depend on:1

  • Your age.
  • How long you were taking the substance.
  • The types of substances you were taking.
  • Your physical and mental health.

Withdrawal symptoms can start as soon as a few hours or up to 4 days after your last use.1 Symptoms can be mild to severe and can last from hours to days, and in some cases even longer.1 Withdrawal symptoms vary widely. But in general, a person going through withdrawal from a substance will feel effects that are opposite of the effects of the substance. For example, if you were taking stimulants, you may feel tired and depressed. If you were taking opioids or other sedatives, you may feel on edge, unable to sleep, and feel more aches and pains. Common withdrawal symptoms include:1,2

  • Trouble falling or staying asleep (insomnia).
  • Sleeping too much (hypersomnia).
  • Anxiety or feeling “on edge.”
  • Shakiness.
  • Depressed mood.
  • Nausea (feeling sick to your stomach) and vomiting (throwing up).
  • Belly pain and diarrhea (loose, watery stools).
  • Bone, joint, and muscle pain.
  • Mood swings.
  • Fatigue (feeling tired all over) or exhaustion.
  • Increased drug craving.
  • Weight loss and anorexia (loss of interest in eating food).
  • Increased heart rate (tachycardia), blood pressure (hypertension), and body temperature.

The symptoms listed above can be very uncomfortable but aren’t usually life-threatening. More severe and sometimes fatal symptoms can and do happen with substances such as alcohol and benzodiazepines. These symptoms can include:1,2

  • Hallucinations (seeing and hearing things that aren’t there).
  • Delirium (sudden, severe confusion and disorientation).
  • Psychosis (when you believe things that aren’t true and don’t know these ideas aren’t based in reality).
  • Seizures.
  • Delirium tremens (a rare but serious form of alcohol withdrawal).

What Happens During Detox?

The goals of detox are to manage withdrawal symptoms, keep you safe and comfortable, and to prepare you for ongoing treatment for your substance use disorder.1 Before starting detox, your care team will ask you questions about your health and substance use. Together, you’ll use this info to make a personal treatment plan that fits your goals and needs.

For many people, detox takes about 3 to 7 days.4 The exact length will depend on what substance(s) you use, how long you were taking it, the type of treatment you choose, and what type of withdrawal symptoms you have. Depending on these factors, doctors may give you certain medicines to help ease any discomfort and control cravings.

Types of Detox Programs

What each person needs in detox is different. Two key factors for choosing the most appropriate detox program include the intensity of medical care you need as well as the care setting.1,5

Medical Detox and Withdrawal Management

In this detox setting, you get medical care and support. Doctors and clinical staff give prescription medicine as needed, closely watch your progress, and keep you as safe and as comfortable as possible during the withdrawal process.1 Medical detox can take place in a variety of settings, from an inpatient hospital or residential treatment program to a doctor’s office or treatment center on an outpatient basis with close medical oversight.

Inpatient or Residential Detox

There is a wide range of inpatient detox settings, including residential drug treatment programs, general hospitals, mental health hospitals, freestanding emergency departments and urgent care clinics, as well as standalone detox, substance abuse, and mental health centers. Medical detox in an acute care (for example, a hospital) inpatient setting is typically the most intensive care setting.1

Non-medical, social detox programs that seldom or never use prescription medicines also exist, often in a residential detox setting.1 The level of medical oversight as well as options for medical care in these types of programs vary widely.

Outpatient Detox

Outpatient detox is often a less medically intensive type of detox setting compared to inpatient or residential detox.1 Depending on patient needs, a person may get outpatient detox treatment through standalone or hospital outpatient clinics, freestanding emergency departments or urgent care centers, doctor’s offices, or substance abuse treatment centers. It may or may not include prescription medicines to manage symptoms or reduce drug cravings.

Outpatient detox may not be a good fit if you are at risk of severe withdrawal symptoms, have been through detox before, have multiple SUDs or other health issues, or have an unsupportive or unsafe home.1 If you are unsure of your withdrawal risks, talk to your doctor. They can help you choose a detox setting that fits your unique needs.

Paying for Detox

The cost of detox depends on the level of medical care and the setting for the program you choose. It also depends on:

  • Location. City detox centers often cost more than rural ones. If you live far away from the detox program, you may also need to consider travel costs.
  • Length of program. Many programs charge by the day, so the longer the detox, the higher the cost.
  • Your insurance. Detox programs differ in which types of insurance plans they accept. And each insurance plan offers different levels of coverage for detox. Make sure you ask your insurance company what they cover when you’re deciding which detox program to attend.

If your insurance doesn’t cover all of the detox costs or if you don’t have insurance, there are other ways to pay. Many treatment centers take federal insurance like Medicaid and Medicare. Most treatment centers also offer payment plans, scholarships, and sliding-scale fees based on income. Some states offer grants to help with the cost of detox.

How to Safely Detox

If you are thinking about detox, talk to your doctor. They can help you assess your withdrawal risks and help you choose the right level and setting of detox care.

When you’re ready, or if you don’t have a primary care doctor, American Addiction Centers can help you detox safely at one of our medical detox centers. By calling our confidential detox hotline at 1-888-509-8965 Who Answers? , you can speak to a caring staff member who will answer your questions and offer support. Call today and take the first step in your recovery journey.

Sources

  1. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment.
  2. Australian Government Department of Health. (n.d.). Addiction withdrawal symptoms.
  3. National Institute on Drug Abuse. (2018). The science of drug use and addiction: The basics.
  4. S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Facing addiction in America: The surgeon general’s report on alcohol, drugs, and health.
  5. Hayashida, M. (1998). An overview of outpatient and inpatient detoxification. Alcohol Health & Research World, 22(1), 44–46.

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