How Does Detoxing from Drugs and Alcohol Work?
Detoxing from drugs and alcohol can take place in a number of settings, and while it may be tempting to try it at home, a medically-supervised detoxification can help minimize unpleasant withdrawal symptoms and address any withdrawal complications that arise—keeping a person as safe and comfortable as possible during detox.
Addiction often involves physical dependence, so in order to break the cycle of drug and alcohol addiction, an individual must first address their dependence and safely get through the acute withdrawal period.
This first phase of treatment is referred to as detoxification and includes a set of interventions aimed at managing acute intoxication and symptoms of withdrawal.1 During this phase, toxins are cleared from the body from those who are intoxicated and/or dependent on drugs or alcohol and to which physiological dependence has developed.1
What Does Professional Detox Involve?
Professional detox may involve various interventions to ease the discomfort and dangers associated with drug withdrawal.1, 2
For the safety and comfort of the recovering individual, drug detox often takes place under the care of a team of trained professionals able to medically manage the withdrawal period.1, 2
After assessment during the intake process your treatment team will outline a comprehensive withdrawal management plan. This plan may be reassessed throughout your recovery process, with any needed treatment adjustments according to the progress you’re making.
How to Detox from Drugs and Alcohol Safely
Detoxing at home or otherwise without appropriate withdrawal management may not be safe with some types of substance dependence. In certain cases, and with certain substances (such as alcohol), abruptly quitting without medical withdrawal management can be risky.
In the event you experience progressively severe withdrawal symptoms and/or complications without medical care or assistance, detoxing at home can be dangerous. For example, left unmanaged, detox from alcohol can bring about withdrawal symptoms such as seizures or delirium tremens that can lead to death.1 Also, the chance for relapse could increase if a person is subjected to an unpleasant withdrawal and no plan for medical assistance.
To begin a safe detox, be sure to consult with a medical professional, preferably one with addiction treatment or withdrawal management experience. This specialist can provide a thorough assessment of your status and risks.
In determining an appropriate treatment plan for you, he or she may ask you questions about:1, 2
- The type or types of substances you use regularly and whether you are currently intoxicated.
- The frequency, dose, and duration of your use.
- Any preexisting and concurrent mental health symptoms.
- Your physical health/medical history.
- Previous withdrawal and detox attempts.
- How much support you have at home.
Your answers to these questions will help to determine an appropriate level of care.1
In very limited instances, natural (or “cold turkey”) detox may be an option for a healthy person with no significant physical dependence or with a history of use of a substance not typically associated with dangerous withdrawal symptoms (e.g., hallucinogens, some inhalants).
Thorough physician evaluation and full disclosure of one’s substance use history should take place prior to the decision to detox.
Outpatient detox programs may benefit individuals whose withdrawal symptoms do not require intense supervision and around-the-clock monitoring only available through a residential or inpatient environment. This option may also benefit people who have family and community support in their recovery, as the recovering individual is able to return home after each treatment session.
Inpatient programs can benefit those with a history of substance use involving alcohol, heroin or other opioids, and prescription sedatives and who require around-the-clock medical support and withdrawal management medications.
Outpatient Medical Detoxification
If during your evaluation, your clinician deems you to be at relatively low risk for a severe or complicated withdrawal, an outpatient detox program may provide an appropriate level of care for you in early recovery. In contrast to more intensive/inpatient treatment programs, outpatient detox can be carried out with regular visits to a doctor’s office or an outpatient treatment center.1
In some cases, a healthcare agency can even come to your home to provide treatment and track your progress.1 Appointments will involve ongoing assessment of your vital signs, your comfort level, and any complaints you may have. Your treatment will be continually tailored to address your symptoms.1
As part of outpatient treatment, the provider will offer support and encouragement to help increase your motivation to continue and complete detox and to prevent relapse.
They may also provide medications to limit withdrawal symptoms, improve comfort, and ease the process overall.1, 2 Medication options used during detox might include those listed below.1, 4
Medical Detox for Alcohol
- Benzodiazepines/barbiturates. These are the primary treatment for alcohol withdrawal. The initial effective dose will be tapered over time to reduce the risk of seizures and delirium tremens.
- Anticonvulsants, such as gabapentin (Neurontin).
- Other agents such as clonidine or beta blockers to augment symptom management.
Medical Detox for Opioids
- Methadone or buprenorphine. As opioid agonist medications, these medically prescribed treatment drugs are given in controlled doses to ease cravings and minimize withdrawal distress associated with quitting heroin or prescription painkillers.
- Clonidine or lofexidine (Lucemyra). These alpha-adrenergic agonist medications may be used to help manage treat certain opioid detox symptoms like high blood pressure and irregular heartbeat.
Medical Detox for Benzodiazepines or other Sedatives
- Benzodiazepines/barbiturates. In some cases (for example, if you’re abusing benzodiazepine with a short half-life such as Xanax), you may be first switched to another that has a longer half-life (such as Librium or Valium) or to the barbiturate, phenobarbital. This will limit the likelihood of dangerous withdrawal effects and increase your comfort. The substance will then be slowly tapered until your body is clear of any sedatives.
- Sedating antidepressants, such as trazodone.
The detox process for other substances may be aided with medications that address the secondary symptoms of withdrawal, like nausea or sleeping problems, with other prescription or over-the-counter medications.1
Is Home Detox Ever Safe?
Completing detox from drugs and alcohol at home is only a viable option for substances that don’t produce particularly dangerous withdrawal symptoms.
Remember, however, that while there may be relatively few expected medical dangers, some unexpected dangers may arise. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are several medical complications that can occur during detox, such as nausea and vomiting.
Particularly in scenarios where an altered level of consciousness is a factor, it’s possible individuals may aspirate on their vomit, which can be fatal.
Both the uncomfortable nature of withdrawal symptoms and the presence of accompanying substance cravings can contribute to a relapse or return to drug or alcohol use when withdrawal symptoms aren’t managed.3 Drug cravings can be immensely difficult to resist when withdrawal feels too uncomfortable to handle. Getting professional support can make a big difference in preventing relapse and making it to the next step of treatment.
Social detox is a type of non-medical detox conducted in a structured residential environment.1 This type of program provides support services through aftercare and therapy once you’ve completed the detox process. You’ll have regular check-ins where your health can be monitored, and addiction treatment professionals can provide guidance and support.
Detox and Your Health
With several types of substance dependence (i.e., alcohol, opioids, benzodiazepines, and other sedatives), detox may be best addressed under the care of medical professionals. This level of support and supervision is essential if the individual is to avoid some of the potential risks of drug and alcohol withdrawal.3
People who undergo detoxification may not be prepared for the intensity of the symptoms which can extend into both your physical and mental health. Beyond nausea and vomiting, withdrawal can precipitate potentially life-threatening conditions, such as cardiovascular problems, delirium tremens, and seizures.1, 3
As many as 30% of people detoxing without treatment for sedative withdrawal may experience a grand mal seizure.3 Among those using substances with potentially lethal withdrawal syndromes, there is no way to unequivocally predict who will be severely adversely affected.
Inadequately managed withdrawal can sometimes negatively affect one’s mental health, resulting in:1, 3
- Anger and irritability.
- Depression and suicidal thoughts.
- Delusional thinking and paranoia.
Some of these mental health symptoms can be so severe that the person detoxing threatens harm against themselves or others around them.1, 3 A medically supervised detox can take mental health issues into consideration and certain medications can be prescribed to help.
Get the Help You Need Now
To ensure the best possible outcomes, complete care including behavioral therapies, support groups, educational/employment services, and community supports is needed.
American Addiction Centers is a leading provider in safe drug and alcohol detoxification. Verify your insurance now so that you can get started on the path to recovery.
If you’d like to learn more about your available treatment options, including programs that include detox, contact us for free today at . There are also free drug abuse hotline numbers you can contact.
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