Detox

Aspects of Recovery: Detox

What is Detox?

Detoxification, or detox, is the process of letting the body remove the drugs in it. The purpose of detox is to safely manage withdrawal symptoms when someone stops taking drugs or alcohol.

Everyone has a different experience with detox. The type of drug and how long it was used affect what detox will be like.  Medications used in detox help keep former users comfortable while the drugs leave their body.

It can take days or weeks to get through withdrawal symptoms for most drugs. The length of withdrawal depends on a number of factors, including:

  • Type of substance the user is addicted to

  • Duration an addiction has lasted

  • The severity of the addiction

  • Method of abuse (snorting, smoking, injecting, or swallowing)

  • The amount of a substance the user takes at one time

  • Family history

  • Genetic makeup

  • Medical condition

  • Underlying mental health conditions

The Process of Detoxification

Everyone’s detox needs are different. The drug detox process helps addicted people get personalized treatment. In most cases, the process involves three steps:

1.  Evaluation

  • The medical team screens incoming patients for physical and mental health issues. Doctors use blood tests to measure the number of drugs in the patient’s system. This helps determine the level of medications needed.

There is also a comprehensive review of drug, medical and psychiatric histories. This information sets up the basis for the patient’s long-term treatment plan.

2.  Stabilization

  • The next step is to stabilize the patient with medical and psychological therapy. The goal of stabilization is to prevent any form of harm to the patient. Doctors can prescribe addiction treatment medications to prevent complications and reduce withdrawal symptoms.

3.  Preparing Entry into Treatment

  • The final step of detox is preparation for a treatment program. Doctors familiarize their patients with the treatment process and what to expect. For some, the inpatient rehab offers the best chances of success after detox.

Side Effects of Detox

The process of drug detox can be painful and dangerous. This is why medical detox is so important.   with medical supervision allows patients to detox in a safe and comfortable environment. The extent of supervision is different in inpatient and outpatient rehab.

A medically supervised detox prevents dangerous complications of drug and alcohol withdrawal.  Although medical detox limits the symptoms of withdrawal, some are unavoidable. Some of the most common side effects may include:

  • Nervousness or anxiety

  • Insomnia

  • Nausea

  • Body discomfort

  • Mood swings

  • Poor sleep

  • Difficulty concentrating

Detox During Pregnancy

Drinking alcohol or using drugs while pregnant can harm not only the mother but also the unborn child as these substances cross the placenta to the baby. Detox, especially if done cold turkey, can cause stress on the unborn child such as preterm labor or severe fetal distress.

Detox with medical supervision is an absolute must for pregnant women, as withdrawal symptoms may be especially harmful to the fetus. The goal of detox for pregnant women is to prevent relapse and manage pain.

Detox specialists can keep babies safe and healthy by treating pregnant women in detox.

Doctors often prescribe medications to stabilize pregnant women. Alcohol and opiate detox usually pose the most risks to unborn children.

Types of Detox Facilities

Choosing to detox at home can be dangerous and should be attempted only after consulting a medical professional. Quitting “cold turkey” or without medical supervision can lead to serious issues such as seizures and severe dehydration.

There are inpatient and outpatient detox programs that help prevent dangerous complications. Inpatient detox includes 24-hour medical support and monitoring.

1. Rapid Detox and Risks

Rapid detox is a method of removing substances from a user’s system faster than regular detox. Advocates of rapid detox say it’s a faster way to get the drugs out of the body while avoiding painful withdrawal symptoms. Rapid detox can be dangerous as well as expensive.

In rapid detox, the addicted person is sedated with anesthesia and given medications that replace the drugs in the body. This method was originally developed for people addicted to opiate drugs like heroin and painkillers.

  • Rapid detox can cause
  • Heart attack
  • Paranoia
  • High body temperature
  • Infection
  • Nausea
  • Vomiting
  • Aspiration
  • Choking
  • Death

Traditional rapid detox programs take about two to three days to complete and are generally more expensive than a typical detox. It can cost up to $10,000 and isn’t generally covered by insurance.

About Rapid Detox

Rapid detox is the process of rapidly cleansing your system of opioids:  

  • Rapid detox: A patient is given medication to speed up the onset and process of detox, then administered a number of medications to help treat withdrawal symptoms that occur during detox.
  • Ultra-rapid detox: The patient is sedated with a general anesthesia. Once the anesthesia has taken effect, doctors will administer an opioid blocker. The opioid blocker forces the body to begin detox. In theory, once a patient wakes up from sedation, the majority of the uncomfortable symptoms have already passed.

Rapid drug detox is an inpatient procedure that is usually done in a hospital or clinic setting. In the procedure, you are put under general anesthesia and opioids are flushed out of your system, generally with the use of the opioid antagonist naloxone.

Detox can be accomplished very quickly this way — typically in only a few days — and withdrawal symptoms may be largely avoided. However, the treatment method is highly controversial compared to other methods. It is also considered dangerous.

 

Why Choose Rapid Detox?

“Anesthesia-assisted rapid opiate detoxification appeals to patients who want a ‘magic bullet’ to treat their addiction,” explained experts with the California Society of Addiction Medicine (CSMA).  “Patients do not wish to feel the pain of withdrawal.  Rather they want to go to sleep and wake up clean.”

CSMA experts continue to explain that treatment providers play into their patient’s unrealistic expectations of the anesthesia-assisted rapid opiate detoxification process. When patients wake up from the procedure, they expect to feel normal again. However, this is rarely the case.

Rapid detox may sometimes succeed at clearing a person’s body of opioids. However, it is not a cure for addiction, which is a complicated disorder.  Detox is not treatment.  

More often than not, patients will continue to feel uncomfortable withdrawal symptoms for a long period of time after the detox process.

Dangers and Risks of Rapid Detox

While sleeping through or speeding up the detox process can sound appealing, it can come with intense complications such as:

  • Sweating
  • Muscle aches
  • Nausea
  • Rapid breathing
  • Respiratory distress
  • Acute renal failure
  • Psychosis
  • Delirium
  • Feelings to commit suicide
  • Fatality

After conducting a clinical trial, The National Council on Drug Abuse felt these methods carried serious risks. The study’s author noted: “Patients should consider the many risks associated with this approach, including fluid accumulation in the lungs, metabolic complications of diabetes, and a worsening of underlying bipolar illness, as well as other potentially serious adverse events.”

Does Rapid Detox Work?

Rapid detox may succeed at clearing a person’s body of opioids, but it is not a cure for addiction.  

Though detoxification may only take a few days, the road to recovery takes much longer. A person using rapid detox usually also needs additional services to address all of the needs of the patient.  Learning how to live a life without drugs, developing and strengthening coping skills to deal with cravings and triggers, addressing the medical complications of drug or alcohol use are just a few of these needs.  

Relapse is common in narcotic addiction, and rapid detox has an extraordinary high relapse rate.  

Further, experts agree the risks of rapid detox outweigh its benefits. The American Society of Addiction Medicine does not recommend rapid detox due to the high risk of serious side effects and death.

2. Detox Centers

Detoxification is a medical intervention process aimed at helping a substance abuser through the experience of acute withdrawal. Detox is the process of getting all addictive substances out of your body. This could mean going “cold turkey,” where you stop using altogether.

A detox center is a medically supervised facility to handle symptoms related to drug detox. The initial detox process is physically challenging and takes a significant toll on an addict’s mind and body. “Cold turkey” detoxes from certain substances, specifically benzodiazepines and alcohol, can be fatal if not done under the care of a medical professional. Other detoxes, such as from opioids, can be so physically and mentally uncomfortable that the individual is unlikely to make it through the process before resuming substance use if a detox is attempted outside a medical facility.

Withdrawal symptoms can be extremely straining on addicts. Many times, it is recommended to undergo detox within the confines of a medically supervised facility, like a detox center, to monitor and help ease the discomforts of withdrawals. Time frames for stays range from 3 days to 7 days; peer support specialists, peer mentors and substance abuse counselors are usually available to help with transitioning out, but are historically understaffed.

Opting for a detox center can help you transition to inpatient substance use treatment at a residential rehabilitation program or outpatient therapy.

3. Hospital Detox

One of the biggest differences between tradition detox facilities and hospital detox is that hospitals tend to mirror the experience of being institutionalized. Although this approach can be effective for some people, it can evoke an overwhelming sense of anxiety in others. Hospitals are staffed with physicians and mental health professionals that can help address the physical and psychological components of addiction and withdrawal.

Peer support specialists and case managers support discharge plans, as do the nursing staff, especially in the case of medication managed care.

Similar to traditional drug detox centers, hospitals also provide medically-assisted detoxing, which can make your journey toward recovery more palatable. Also, if during the course of your detox your experience a medical emergency, you can take solace in knowing you’re in a hospital environment. This is important since some patients experience severe withdrawals symptoms that require medical intervention. If you are considering a hospital detox program, it is worth noting that hospitals will restrict personal belongings; instead, patients will have to make use of amenities provide the hospital’s detox program like public phone and shared television rooms, for example, but it is worth noting that some patients do appear to thrive in these types of structured environments.

4. Inpatient/Residential Detox Facilities

Inpatient and residential facilities are similar, with exception that the detox must be completed prior to ‘moving’ to the residential portion of the facility. These facilities usually have a hospital unit on site, where the patient remains while they are completing detox. It is the hope and expectation that the patient will transition into the residential portion when detox is completed. These are usually affiliated with a local hospital for any emergencies. Dietitians are normally are part of their services, but check with the facility for information.

The detox units are staffed with medical professionals, although not all facilities maintain full time physicians, and are often managed through NP’s, RN’s and LPN’s. Psychiatrists and mental health professionals may be on call and may not be a part of their daily staff.

Ask for a tour of the facility, meet the staff and obtain a clear definition of the costs and services, including discharge and referral services.

‘Mom and Pop’ facilities have popped up throughout the states, and are regulated and monitored. They are frequently in previous residential homes that have been converted. They may not be physically connected to a residential facility. Dietitians are usually not employed at these facilities and meals may be prepared ‘family’ style with patients contributing to the clean up. Mental health services are usually not employed at this level. Caution and research should be used when evaluating if this is the facility you wish to use; ask for a tour and meet the staff; and as always, check the reviews of services. Have them provide you with a clear definition of costs and services prior to engaging, and ask what their discharge services include.

 

Substance Abuse Issues That May Require Medically Assisted Detox

Detoxing from certain substances under the supervision of medical professionals can help you navigate withdrawal safely.  Withdrawal symptoms from substance abuse can be uncomfortable and even life-threatening in some cases. Medically-assisted detox seeks to soothe the physical symptoms of stopping the use and abuse of drugs and alcohol.

Since it addresses the very real physical symptoms of withdrawal, medically-assisted detox is recommended for some substances more than others. 

Prescription Opioids & Heroin

The U.S. Drug Enforcement Agency (DEA) classifies heroin as a Schedule I drug, which means it has no medical use. The DEA classifies many other opioids as Schedule II controlled substances. Schedule I and Schedule II controlled substances are highly addictive with a higher than usual potential for abuse and dependency. Opioids bind to the opioid receptors in the brain, blocking feelings of pain and producing a sense of calm. This class includes prescription narcotics, such as Percocet, Vicodin and OxyContin.

Symptoms of opioid withdrawal include:

  • Muscle aches & muscle spasms

  • Insomnia

  • Runny nose

  • Nausea & vomiting

  • Abdominal cramps & diarrhea

  • Anxiety

  • Depression

  • Irritability

  • Rapid heart rate

  • Chills and sweating

Withdrawal symptoms from opioids are not necessarily life-threatening, though they can be difficult to manage on your own without the help of medication, Medications are usually required for successful detoxification from opioids as it is so uncomfortable that many patients will go back to drugs to self-medicate the symptoms before the detoxification is complete. 

Alcohol

Alcohol triggers the release of endorphins or chemicals in the brain that signal pleasure. Alcohol also depresses the central nervous system, which can impair speech, cognition, and muscle coordination. If you drink heavily over the course of months or years, your central nervous system gets used to the presence of alcohol and you can experience withdrawal symptoms if you suddenly stop consuming it.

Symptoms of alcohol withdrawal include:

  • Poor concentration

  • Restlessness, irritability and anxiety

  • A high fever

  • Difficulty sleeping

  • Nausea and vomiting

In more severe cases, alcohol withdrawal can be life-threatening and possibly lead to seizures, delirium, and/or hallucinations.  Medical treatment and supervision is usually required for detoxification from alcohol and sedatives, like benzodiazepines as the withdrawal symptoms when severe may be serious or even life-threatening, including high blood pressure, heart arrhythmia’s, confusion, seizures, and death.  Abrupt cessation of high doses of alcohol or sedatives is dangerous and should be done under a doctor’s supervision.

Benzodiazepines

Benzodiazepines, a Schedule IV drug, act as central nervous system depressants, helping to calm anxiety and panic. Some of the most common drugs in this category include Xanax, Valium, Klonopin and Ativan.

These medications increase the effect of a chemical in the brain known as gamma-aminobutyric acid (GABA), which produces feelings of calmness and relaxation. As with opioide’s and alcohol, your body can develop a tolerance and dependency on these drugs over time and you can experience withdrawal symptoms when you stop.

Benzodiazepine withdrawal symptoms include:

  • Headaches

  • Anxiety

  • Muscle spasms and tremors

  • Restlessness

  • Irritability

  • Nausea and vomiting

  • Sweating or chills

  • Seizures

Benzodiazepine detoxes can be lengthy, and following acute care, are frequently monitored on an out patient basis.  Detoxing from these substances under the supervision of a medical professional in a specialized facility can help you navigate withdrawal symptoms and stay safe and healthy.  

Methamphetamine

Detoxing from methamphetamine, can mean experiencing some pretty tough withdrawal symptoms, but the benefits of overcoming meth addiction far outweigh the negative side effects of detox.

Symptoms of meth detox can include:

  • intense cravings

  • fatigue

  • depression

  • nausea

  • dehydration

  • headaches

  • anxiety 

  • hallucinations

Symptoms begin around 24 hours after the last dose. Fatigue may set in first, followed by overwhelming feelings of depression.  Methamphetamine use suppresses both appetite and sleep.   During initial withdrawal, people may spend most of their time catching up on food and sleep.

Methamphetamine detox can take about 50 hours.  Withdrawal symptoms can persist for two weeks or even months for more experienced users.  

While there are no drugs that have been proven effective in removing meth from the body, drugs targeting withdrawal symptoms could help with getting through detox and maintaining long term sobriety.

Treating meth withdrawal symptoms might include medications like Modafinil, a narcolepsy drug that helps regulate sleep.  In fact, Modafinil ‘s moderate stimulant effects may aid with the cravings and erratic sleep cycles associated with methamphetamine withdrawal.  

Modafinil has also shown promise in alleviating the cognitive effects of meth use, such as memory loss and difficulty processing ideas. 

Bupropion, commonly referred to by the brand name Wellbutrin, is an antidepressant that has also helped people quit smoking.  Long-term meth use can cause a dopamine deficiency, and Bupropion may help with meth withdrawal by regulating dopamine, the brain chemical messenger that stimulates pleasure and focus. 

Fluoxetine, most commonly known as Prozac, is an antidepressant that is also prescribed for anxiety. The drug has shown promise with meth withdrawal in trials with mice, and it might help some people.   Fluoxetine can benefit people suffering by helping them resolve heart problems and relieve all other depressive symptoms.

Undergoing detox in a treatment facility not only provides medical supervision but also a safer environment away from drugs. Being in a detox facility also provides a level of support and an opportunity to be out of the environment where use was happening,

Kratom

Kratom is often seen by people as an alternative to opioids because it acts on the brain the same way when taken in higher doses. Unfortunately, this also means that Kratom has a somewhat similar addiction potential.

As with other substances with opioid-like effects, Kratom can cause tolerance, cravings, and dependence. Eventually, this can lead to physical and psychological withdrawal symptoms when people stop using it.

Kratom withdrawal produces many of the same symptoms as opioids and opioids withdrawal though they aren’t always as severe.

Physical symptoms include:

https://www.webmd.com/

Psychological symptoms include:

How fast withdrawal symptoms kick in and how long they last is dependent on how much you were using and for how long.  The size of the last dose will also impact when the effects wear off and when withdrawal symptoms set in.  Symptoms can come on fast — within just a few hours of your last dose. This is typically within 12 to 24 hours.

Symptoms can last around 3 to 10 days.  

Not everyone who regularly uses Kratom becomes dependent on it or experiences withdrawal symptoms when they stop using it.  The risk for dependence and potential withdrawal tends to increase when you take it in higher doses — usually 5 grams or more taken more than 3 times per day. This isn’t a hard and fast rule, though, and everyone is different.  People who self-medicate with Kratom for pain or take Kratom to try to mitigate the withdrawal effects of other substance may be more likely to experience dependence and withdrawal.                                     https://www.healthline.com/

Cocaine 

When undergoing a cocaine detox, the effects can be mild to severe based on the amount taken and the duration of abuse. Cocaine withdrawal symptoms can bring about a range of different physiological and mental health side effects due to cocaine being such a potent and fast-acting drug. 

Cocaine high appears immediately and disappears within a few minutes to an hour. When the high is gone you are left wanting more which is why there are many psychological symptoms associated with the withdrawal and detox process. These include anxiety and depression.

Cocaine withdrawal symptoms can start within 90 minutes from the last use of the drug and continue up to 10 days or even longer. The cocaine detox period can be affected by how long you have been using and the amount you have used. 

Cocaine withdrawal symptoms are not as physically intense as a withdrawal from other drugs.  Cocaine detox involves psychological withdrawal symptoms which include: 

  • Difficulty concentrating

  • Slowed activity or slowed thinking

  • Hostility

  • Depression

  • Anxiety

  • Vivid dreams or nightmares

  • Paranoia 

  • Suicidal thoughts or actions

  • Increased cocaine craving

Cocaine detox is often done on an outpatient basis to manage withdrawal symptoms but there are some instances where an inpatient treatment program may be recommended. 

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