Drug detoxification, or detox, is the first step in a comprehensive rehabilitation program that offers all the tools required for recovery. Detox can prevent unpleasant or fatal consequences resulting from sudden cessation of use and can aid the patient in becoming abstinent from drugs.
The goal of any detox program is physiological healing after long-term drug addiction – first through stabilization, then through a period of detoxification. According to the National Institute on Drug Abuse (NIDA), after stabilization the focus of detox shifts to the monitoring and support of the various processes of the body as it rids itself of the drug, and to the managing the often unpleasant withdrawal symptoms that result.
Comprehensive Detox Treatment
It’s important to note that detox is not a whole treatment for drug addiction, no matter what the drug of choice. Because addiction is both psychological and physical, patients benefit from psychotherapeutic treatment to address the issues of cravings and changes made in the brain as a result of long-standing substance abuse. Detox alone might help the patient to stop abusing drugs and alcohol in the short term, but without follow-up care and therapy, the risk of relapse into problematic use increases greatly.
To learn more about the detox and addiction treatment resources available or to receive assistance determining which type of rehab program will best treat specific situations, contact us today. Our treatment support team is available around the clock. Don’t wait to start a new life free from drugs and alcohol. Call (602) 535-8200 right away to speak with a rehab placement advisor about drug detox and addiction recovery programs available to you.
First Stage of Drug Detox
The initial period of detoxification can be intense for many patients, and medical and psychiatric staff members will be on hand constantly to provide effective support. For example, within several hours after the last dose of heroin, those suffering from an addiction to the opioid will often experience some of the following withdrawal symptoms:
Increasing watering of the eyes
Although these symptoms aren’t life-threatening, they can be quite uncomfortable, which is why it’s beneficial for these patients to receive psychiatric and medical care while detoxing from drugs. A number of issues can come up for patients in their first few hours of detox. The most urgent need will be addressed first, followed by the next and the next until full stabilization has been established. Some examples of possible issues include:
Violence. Some drugs can increase violent behaviors in users. For example, people who abuse synthetic cathinones, or “bath salts,” might be more at risk of hurting themselves or others. Patients who are a danger to others might require sedation or restraint to protect them and medical providers. These measures are only necessary if the patient becomes physically aggressive and attempts to harm staff members.
Symptoms of psychosis. Psychosis is a dangerous complication brought on by the effects of some drugs, such as cocaine. If someone uses excessive amounts of cocaine, they can become paranoid and even experience full-blown psychosis. Symptoms include visual and auditory hallucinations and delusional thinking. Other reasons for psychosis include the presence of a co-occurring mental health disorder, such as schizophrenia, or a lack of sleep due to stimulant use. Someone who is suffering from psychosis can behave erratically and become unpredictable. It’s important to address this issue and treat the patient appropriately before proceeding with further interventions.
Injury. In some cases, patients may have hurt themselves while under the influence of drugs or been physically or sexually assaulted before entering detox. For example, phencyclidine, or PCP, is a powerful dissociative drug that can cause feelings of increased strength and invulnerability. Due to this misconception, PCP users are likely to put themselves in harm’s way because they’re under the impression that they won’t get hurt. They’re also at an increased risk for suicidal behaviors, which can result in injury if suicide is not completed. Any physical injury must be treated immediately before addiction treatment is provided.
Medical illness. Many people who suffer from chronic, debilitating pain are prescribed opioid painkillers. Unfortunately, it’s possible to develop a dependence and subsequent addiction to these medications. As the patient begins to detox from the prescription opioid, their severe pain will return in addition to uncomfortable withdrawal symptoms. It’s important to be aware of the individual’s medical history and treat the symptoms of pain appropriately before proceeding.
Threat to self. Withdrawal from opioids and other substances can be associated with severe depressive symptoms that might be connected to suicide attempts and completed suicides. Patients who exhibit suicidal behaviors or thoughts must be protected at all times. Once these acute issues have been assessed and identified during evaluation, they’ll immediately be treated until they have passed or the patient has been stabilized. At that time, attention and focus can turn to dealing with withdrawal symptoms associated with detox.
Drug Detoxification Withdrawal Symptoms
According to research on drug withdrawal, the abrupt cessation of different classes of drugs will result in very different sets of withdrawal symptoms. Additionally, the symptoms experienced and their intensity will also vary from person to person. Factors that influence individual experiences with withdrawal include:
– The length of addiction. Daily use for an extended period of time can cause lead to high levels of tolerance and more severe withdrawal symptoms.
– The combination of drugs abused, including alcohol. A comorbid dependence on drugs and alcohol can create a unique constellation of withdrawal symptoms, which might exacerbate one another.
– The dose of the drug when the patient enters detox. Tolerance develops from persistent substance abuse. Thus, doses must be increased in order to feel the desired results. The higher the doses used, the more likely it is that withdrawal symptoms will be severe.
– The existence of co-occurring physical or mental disorders. If a patient suffers from a mental health disorder such as depression or anxiety or a physical condition such as chronic pain, these symptoms could be amplified due to withdrawal and cause significant distress.
– Half-life of the drug. In general, if the drug is short-acting, withdrawal symptoms will occur more immediately after the last dose. If it’s long-acting, withdrawal syndrome may be delayed a few days.
Common withdrawal symptoms that develop in association with a number of drug types include:
– Mood disturbances. This can mean mood swings, irritability, and/or agitation.
– Sleep disturbances. Insomnia despite intense fatigue is common.
– Physical issues. These may include chills, sweating, tremors or shaking, as well as flu-like symptoms, including runny nose and headache, nausea, and vomiting.
– Cravings. The desire to use the drug of choice in order to stop the withdrawal symptoms is strong.
Different drugs can bring about substance-specific withdrawal symptoms in addition to the symptoms listed. Below are symptoms specific to withdrawal from the types of drugs listed:
– Alcohol and benzodiazepines. These drugs have very similar withdrawal syndromes due to their similar mechanisms of action. Withdrawal symptoms can include:
Opioids, such as heroin and painkillers. Withdrawal symptoms from opioids can include:
– Muscle aches
– Bone and joint pain
– Increased sensitivity to pain
– Gastrointestinal distress
Stimulants, such as cocaine and methamphetamines. Withdrawal from stimulants can cause mental health complications such as:
– Suicidal thoughts and behaviors.
Marijuana. Contrary to popular belief, marijuana is addictive and can cause withdrawal symptoms with cessation of use. These symptoms can include:
– Physical symptoms such as fever, sweating, tremors, and stomach pain.
– “Bath salts.” Also known as synthetic cathinones, bath salts can produce a number of unpleasant symptoms when going through detox. These include:
– Sleep disturbances
Ketamine. Although much more research on ketamine withdrawal symptoms is needed, there have been some reports of symptoms including:
No matter what the drug, detox at a medical facility is always the safest choice, especially when co-occurring mental health disorders are an issue. On rare occasions, withdrawal symptoms can lead to complications and serious health issues that require immediate medical attention.
For this reason, it’s rarely recommended that patients attempt detox at home when significant substance abuse issues are present. Instead, enrollment at an inpatient detox program that provides 24-hour medical assistance if necessary, ongoing medical monitoring, and a therapeutic follow-up program is recommended.
Types of Drug Detox
There are different types of detox. The specific types of substances having been abused as well as the spectrum of withdrawal symptoms experienced by the patient will influence which type of detox is appropriate. Some choices include:
Outpatient detox. It’s rare that this is recommended, but an outpatient program might be a good choice in relatively less severe cases of addiction, where regular check-ins with the treatment team and medication available by prescription or a methadone clinic can provide acceptable detox care. In instances where money is an issue or the patient must stay engaged at work or home, coming into an outpatient detox program regularly could provide adequate treatment.
Inpatient detox. In most cases, inpatient or residential detox is recommended in order to help patients avoid relapse and make sure that they have medical care in the event of an emergency. Most detox options are inpatient. Some are stand-alone programs will arrange for a seamless transfer to ongoing substance abuse treatment at detox completion, while others will be packaged with an inpatient addiction treatment program that addresses the psychological issues related to addiction as well.
Opioid Detox. Opioid detox is a bit different from detox options frequently provided for other substances of abuse and addiction. There are medications that have been approved by the Food and Drug Administration (FDA) solely to treat opioid addiction. These new medications have given rise to a number of different opioid detox treatment approaches. Whether heroin or prescription painkillers are the opioid of choice, inpatient care or medication is often recommended for optimum comfort and safety.
Medications used to manage opioid dependence can help to alleviate the unpleasant withdrawal symptoms associated with opioids. The FDA-approved drugs are buprenorphine and methadone. These two medications – which are partial and full opioid agonists, respectively – are administered to stabilize the patient. Then they’re gradually tapered off so as not to experience withdrawal symptoms.
The duration of withdrawal symptoms strongly depends on whether the opioid is long acting or short acting. Heroin is relatively short acting. Withdrawal symptoms will appear within hours after the last dose and may dissipate within a few days, while longer-acting opioid painkillers may not elicit withdrawal symptoms until a few days after the last dose, possibly lasting for weeks.
Alcohol Detox. Cessation of heavy alcohol abuse can lead to distressing and potentially life-threatening withdrawal symptoms. Some non-fatal withdrawal symptoms include:
– Slow movements and thoughts
– Nausea or vomiting
Delirium tremens is a severe form of alcohol withdrawal that’s most commonly associated with heavy and prolonged use. It’s a medical emergency and can result in death if it goes untreated, though it occurs in no more than 10% of those experiencing alcohol withdrawal symptoms. Some symptoms of this condition include:
– Confusion or disorientation (delirium)
– Changes in mental function
– Deep sleep that lasts for one or more days
This severe alcohol withdrawal syndrome requires medical attention immediately. It’s always recommended that someone who has a severe addiction to alcohol receive medically supervised detoxification in order to safely remove the substance from the body.
Benzodiazepines – which are used to treat anxiety, insomnia, and seizures – are often given to the patient in a clinical setting to alleviate their withdrawal symptoms.
Psychological Withdrawal and Detox
Some drugs have few significant physical withdrawal symptoms but cause intense psychological withdrawal symptoms. Detox from stimulant drugs like methamphetamines and cocaine, for example, can result in serious depression and suicidal thoughts. Inpatient detox is recommended in these cases to ensure the safety of the patient. This is because outpatient detox allows patients the opportunity to use the drug outside the detox clinic or to otherwise hurt themselves.
Individuals receiving outpatient detox are also more likely to cancel appointments and fail to complete detoxification. Conversely, inpatient detox facilities provide around-the-clock medical care and supervision to ensure that the patient isn’t in danger. This can prevent depressed patients from committing suicide.
Patients should discuss the specifics of their situation with their medical and therapeutic team in order to choose the best type of detox for their needs. People suffering from an addiction to drugs or alcohol can call (602) 535-8200 to speak to a treatment support specialist about inpatient detox programs near them.
Methods of Drug Detox
Depending upon the drug, people might have different options in drug detox methods. No one method is right for everyone. Rather, the drug of choice, the dose taken at the time the patient starts detox, how long the person has been using that drug, and whether the patient is using other drugs will determine the most appropriate type of detox. Different detox approaches include:
Short-term medicated detox
Long-term medicated detox
A “cold turkey” detox means stopping use of all drugs and substances with nothing more than medical supervision to aid you in case of an emergency. There’s no pharmacological assistance, and patients experience the full brunt of the withdrawal symptoms for as long they last. For some drugs, these can be quite intense and last for a couple of weeks or longer. For other drugs, cold turkey detox isn’t as physically difficult.
Patients who opt for medical detox stop taking all substances, including alcohol. But as they experience withdrawal symptoms, a short-term medication plan for this detox stage might have them take certain medications for a limited period of time to ease discomfort.
For example, someone who has a hard time sleeping might be prescribed a non-addictive sleep medication. Someone who experiences bone aches or muscle pains may be offered a pain reliever. Medical personnel who give patients these medications are standing by to make sure that they have what they need to get through the discomfort of detox as quickly as possible.
Those detoxing from alcohol are commonly given benzodiazepines on a regular schedule or as symptoms arise. These drugs can treat or prevent seizures and delirium and aren’t dangerous to take. These medications aren’t to be taken long-term, but due to their cross-tolerance with alcohol, they can help the patient to safely detox from alcohol.
To treat use of opioid drugs such as heroin and prescription painkillers, patients might have the option to take longer-term medications. For example, the patient and their provider might decide on using methadone or the drug combination buprenorphine and naloxone (Suboxone) to stop the person in detox from experiencing the brunt of the withdrawal symptoms. Over time, they’ll often get to lower the dose of the medication until they’re drug-free.
No matter what type of drug detox the patient chooses, it’s important that it’s done under the supervision of a medical professional and that there’s follow up with psychotherapeutic substance abuse treatment. Contact us at (602) 535-8200 today to find a drug rehab that can provide whatever is necessary to leave addiction behind.
Duration of Drug Detox
A given period of drug detoxification will last as long as the withdrawal symptoms persist, and for as long as it takes for the patient to stabilize physically and mentally, according to the NIDA. In addition to stopping the abuse of addictive substances safely and supporting the patient through withdrawal symptoms, another goal of detox is to help prepare the patient physically and mentally for the work that lies ahead in therapy and counseling.
In some cases, antidepressant medications or antipsychotics might be necessary if there are co-occurring issues of depression or a mental health disorder. Depression is commonly seen in people who are addicted to stimulants such as cocaine or methamphetamines and opioids such as heroin or prescription painkillers. People suffering from psychiatric issues could benefit from antidepressants or antipsychotics in order to stabilize. Finding a stable dosage of these medications will help to prepare the patient to begin the process of working through other issues that might be driving or worsening their addiction issues.
It’s important to note that not every patient will successfully complete detox on the first try. In some cases, multiple attempts will be made before sobriety takes hold. Addiction is defined by relapse and is chronic by nature. There’s always hope even when relapse seems constant. The only way to create lasting change is to keep trying.