Detoxification, or detox for short, is the process of removing drugs or alcohol from the body, and it is often the first step in recovery from substance abuse and dependency.
There are many methods out there for accomplishing detox, ranging from just stopping abuse to at-home herbal kits to residential medical detox at a rehab facility. Your instinct may be to just stop abusing substances cold turkey, or suddenly, on your own at home without any medical assistance. Unfortunately, many drugs can have dangerous and even potentially life-threatening side effects when they are stopped immediately.
Drug and alcohol abuse changes the chemical circuitry in the brain, and chronic abuse over time can create physical and psychological dependence to the substance abused. Without the substance of abuse, the brain will scramble to regain its natural balance, which can lead to the onset of difficult withdrawal symptoms that may include nausea, vomiting, diarrhea, shakes, chills, sweating, muscle aches, irregular heart rate, insomnia, restlessness, irritability, agitation, anxiety, depression, hallucinations, fever, seizures, drug cravings and even death in some cases. The severity and duration of these symptoms may vary depending on the drug abused, dosage, length of time abused, method of abuse, physiological factors and level of dependency.
Attempting to detox from drugs or alcohol at home can have a host of complications, such as:
- Medical side effects
- Mental health problems
Stopping many drugs or alcohol suddenly may shock the system. Instead, many professionals advocate a slow and controlled weaning, or tapering process, to slowly reduce dosage levels over time. Detox should be monitored by medical professionals to avoid any potential negative medical or health problems that may arise. Often, medications are used to manage the more intense withdrawal symptoms and reduce drug cravings in order to prevent a return to drug abuse, or relapse.
Detox is thought to be most successfully and safely performed in a licensed detox facility that offers 24-hour medical support and supervision.
Hazardous Withdrawal from Alcohol
Some substances, such as alcohol, opioids and benzodiazepines, should never be stopped suddenly after a dependency and addiction have been established. Alcohol is perhaps the most dangerous substance to withdraw from, and seven percent of American adults aged 18 and older were classified with an alcohol use disorder in 2013, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol withdrawal can cause an irregular heart rate, headaches, nausea, trouble sleeping, irritability, trouble concentrating, body aches, anxiety and depression. Five to 24 percent of those withdrawing from alcohol will suffer from the most severe and potentially life-threatening form of withdrawal called delirium tremens, as published by the Annuls of General Psychiatry. Delirium tremens is indicated by seizures, hallucinations, fever, and severe confusion, and without treatment, it can be fatal.
Alcohol withdrawal may start within eight hours of your last drink and can last for weeks. Around-the-clock medical supervision is the best way to ensure that blood pressure, heart rate, and body temperature remain stable. Medical detox, which often includes the use of medications, in a specialized facility is the safest way to detox from alcohol.
Benzodiazepines and other pharmaceuticals may be used to calm the central nervous system and function as anticonvulsants during alcohol detox, thus managing the more extreme side effects of withdrawal.
Vitamins, minerals and supplements may also be recommended by a doctor during detox to help the body heal. Alcohol can also dehydrate patients, so at times, intravenous fluids may be need to be introduced during detox.
Heroin and opioid narcotics are in another class of substances that should be purged from the body in a specialized facility under the watchful eye of trained medical and mental health professionals. Physical withdrawal symptoms are similar to a bad case of the flu, and the psychological side effects can be crippling.
Opioids bind to opioid receptors in the brain, disrupting the way you feel pleasure.
When you are addicted to an opioid, you may not be able to feel pleasure without the drugs. Withdrawal symptoms may start within 12 hours for short-acting opioids like heroin and Vicodin, and within 30 hours of stopping longer-acting opioids, such as methadone. Physical withdrawal symptoms are usually the first to occur. Emotional withdrawal symptoms follow within a few days and often last for a period of weeks or even months.
Medications, such as buprenorphine products like Suboxone, Subutex and Zubsolv, or longer-acting opioids, like methadone, may be used during detox to stave off drug cravings and manage withdrawal. These medications should be administered and monitored by a medical professional as a part of a medical detox program. These drugs are still opioids and act on the same receptors as full opioid agonists do; however, buprenorphine is only a partial agonist and users do not get high when taking it. Suboxone and Zubsolv also contain naloxone, which is an opioid antagonist that takes effect if users attempt to alter and inject the medication. When abused, the naloxone component of these opioid dependency treatment medications precipitates withdrawal and blocks further opioids from activating the receptor sites.
The National Institute on Drug Abuse (NIDA) estimates that in 2012, over two million Americans were dependent on prescription opioids while another 467,000 were considered to be addicted to the illicit street drug heroin.
Benzodiazepine medications like Xanax, Ativan, Klonopin and Valium are sedative/tranquilizers used to quell panic and anxiety while promoting sleep. If you are dependent on a benzo, your brain may experience a kind of rebound effect when these drugs are removed. Side effects are largely emotional and can be very intense.There are no specific drugs for the treatment of benzodiazepine dependency; however, medical professionals may switch you from a short-acting benzodiazepine like Xanax or Ativan to a longer-acting one such as Valium or Librax during medical detox.
Stimulant drugs include methamphetamine, cocaine, and prescription medications used for the treatment of attention deficit hyperactivity disorder (ADHD) and serve to increase energy levels and focus as well as keep you awake. When these drugs are removed from the bloodstream, you may experience the opposite effects of the drug: drowsiness, depression and anxiety. Heart rate can also be affected, and medical supervision is recommended during detox.
Anxiety and depression as well as trouble sleeping may lead users to seek ways to make withdrawal symptoms stop, and without medical intervention, the result may be a relapse. Relapse after or during a period of detox is particularly dangerous, as it can result in a potentially life-threatening overdose. Since the body may not be used to the same dosage amount that you took prior to detox, relapse can lead to a buildup of toxins that your body cannot successful break down. The Centers for Disease Control and Prevention (CDC) reports that drug overdose is the leading cause of injury death in America, killing 43,982 people in the United States in 2013. Many overdose fatalities involved the use of more than one drug, often an opioid and a benzodiazepine.
Mental Health Complications
In addition to the potential for a relapse and drug overdose, withdrawal from drugs or alcohol may also lead to suicidal thoughts and other self-destructive behaviors, and it should therefore be monitored in a detox facility. Medications such as antidepressants can be used to help stabilize moods during medical detox.
Mental health disorders can be exacerbated by substance abuse, and substance abuse can interfere with treatment of a mental health issue. Drug abusers also suffer from a mental illness about half of the time while one-third of alcohol abusers also do, the National Alliance on Mental Illness (NAMI) reports. Detoxing at home is further complicated when a mental illness is also present, as mental health symptoms are heightened and may even result in psychosis if not treated properly. Detox in a facility that specializes in dual diagnosis treatment –treating both mental illness and substance abuse in tandem – can ensure that both disorders are managed properly.
Detox is often the first step in a comprehensive substance abuse treatment program that should encompass psychotherapies and possibly pharmacology to ensure sustained abstinence and a long-term recovery.
While detoxing at home without the help of a professional is not recommended, there are several things you can do on your own during detox to make recovery smoother.
Be sure to eat balanced and nutritious meals low in sugar and fats and high in protein, complex carbohydrates, and fiber. Exercise regularly, and consider holistic or mind-centering approaches, such as yoga or meditation. Keep your mind busy by taking up a hobby or finding an artistic outlet. Choose a detox facility that meets your needs.
For help finding a treatment model and care plan that can set you up for a healthy lifestyle and sustained recovery, call us today.