Deciding to enter a treatment program for drug or alcohol addiction is an important first step towards lifelong recovery. For many addicts, the prospect of a treatment program can be daunting, and bring with it feelings of anxiety and dread. Much of this anxiety is associated with the withdrawal process from drugs and alcohol. Withdrawal is often uncomfortable, sometimes excruciating, and it can be dangerous in some situations. Yet, in order to pursue recovery effectively, an addict must stop taking drugs or alcohol and hence precipitate withdrawal symptoms.
In nearly every treatment program, whether it be outpatient or inpatient, recovering addicts must rid themselves of the drugs and alcohol in their system. This process is known as detox or detoxification. Detox is unanimously recognized as a necessary step for individuals entering a recovery program. For addicts considering a recovering program, detox is closely associated with withdrawal. While this association has some merit, detox occupies a central role in the recovery process and cannot be avoided. As such, it is important for individuals addicted to drugs or alcohol to understand what detox is, how long it takes, and what makes a medically managed detoxification program different from doing it yourself. The answers to these questions can help reduce anxiety associated with entering a rehab facility by illuminating the strength of detox and dispelling some of the myths associated with it.
What is Detox?
Detox, or detoxification, is the process through which an individual’s body is cleansed of drugs and alcohol. Detox is necessary because treatment can’t truly begin until the effects of drugs and alcohol have been removed and the withdrawal process has been worked through to a manageable degree. Without these two steps, recovering addicts can’t truly begin to treat their addiction.
Detox is a necessary part of the recovery process but doesn’t in itself constitute recovery. This is an important distinction for individuals entering a recovery program. Some mistakenly see detox and rehab as the same thing. Detox is an important part of any recovery program but doesn’t address the physiological, social, and behavioral factors that contribute to addiction in the way that a recovery program does. Detox simply gets a recovering addict ready for the recovery process by removing harmful drugs and alcohol from their body.
Detox vs. Withdrawal
While detox is not the same as withdrawal, the two processes are closely linked. During the detox process, the body enters a state of withdrawal through the removal of any incoming drugs or alcohol alongside efforts to eliminate any traces of those substances in the body. At the same time, detox is focused on mitigating the withdrawal process. Withdrawal is a natural process related to a recovering addict’s chemical dependency upon a substance. Once that substance is no longer being taken, the body enters withdrawal within a short time. Depending on the substance of abuse, withdrawal symptoms will differ. Withdrawal from some drugs can be more difficult and dangerous than from other drugs.
Although detox and withdrawal are often seen as synonymous, they are distinct. Individuals addicted to drugs or alcohol will incur withdrawal symptoms if they stop taking drugs or alcohol whether or not they are in a detox program. If they continue abstaining, their body will naturally purge the substance as it breaks it down and excretes it. However, a medically managed detoxification process seeks to make withdrawal manageable for the individual while also monitoring for any health complications. In this way, medically managed detox in an inpatient setting is vastly safer than simply quitting drugs or alcohol “cold turkey”.
During a detox program, individuals will undergo a medical evaluation to determine any underlying medical conditions that could lead to complications during detox. Following an evaluation, the individual will begin the detox process where the individual is monitored and withdrawal symptoms are managed and minimized to the extent possible. Lastly, the recovering addict will work with a medical professional to establish a transition to a recovery program if this hasn’t already occurred. Each of these steps is important for ensuring that individuals will have the best chances for a successful recovery.
Detoxification provides several important safeguards for individuals going through withdrawal. First, understand that while withdrawal has many uncomfortable symptoms, there are also health complications that can arise during withdrawal that can be potentially fatal. Not only can withdrawal from certain drugs or alcohol trigger health events that can be fatal, but long-term drug addiction can mask underlying health conditions that can lead to rapid deterioration during the withdrawal process. For example, individuals detoxing from alcohol can have a number of negative outcomes associated with the withdrawal itself. While some individuals may experience more mild withdrawal symptoms, certain recovering alcoholics will suffer from acute alcohol withdrawal syndrome. Roughly 5% of these will be at risk for suffering from seizures during withdrawal. Alongside seizures, recovering alcoholics may suffer from Delerium Tremens (DTs), which can result in death in roughly 5% of cases. However, the mortality associated with DTs can be reduced through medical monitoring and medical intervention.
In addition to symptoms associated with acute alcohol withdrawal syndrome, individuals can also experience health complications associated with damage caused by long-term alcohol abuse. In particular, cardiovascular damage has been shown to be associated with long-term alcohol use. Withdrawal places immense stress on the body, particularly if it isn’t managed medically. Associated with this stress is a strain on the heart, which can lead to abnormal cardiac rhythms. In a detox setting, the risks associated with underlying health conditions like the cardiovascular damage associated with alcoholism can be reduced through medical supervision and intervention when it is needed. Speak with a treatment specialist today.
How Long Does Detox Last?
Now that we understand the important differences between detox and withdrawal, and the ways that detox helps manage with the withdrawal process, let’s go over how long a detoxification program lasts. Typically, detox programs average between 3-5 days in length. After this point, many people in an inpatient setting will transition to their treatment program. Not all detox programs last the same amount of time. There are important differences in detox length associated with each individual’s addiction. Long-term substance abuse can result in unique health complications that may be associated with a longer detox period.
The substance of abuse of choice for the addict can also have an impact on how long detox lasts. The goal of detox is to minimize and manage the withdrawal symptoms, while safely cleansing the body of any residual drugs or alcohol. The presence of dangerous complications associated with withdrawal may result in longer detox periods. For example, detoxing from alcohol results in a number of effects, including hypertension, sweating, nausea, and anxiety. These symptoms are at their most intense between 10-30 hours after the last drink, and then generally subside by 50 hours. If individuals are likely to have a seizure as a result of their withdrawal it will usually occur within 48 hours, whereas DTs usually occur up to 72 hours after an individual has stopped drinking. So, this roughly equates with a 3-4 day period during which the most intense symptoms of alcohol withdrawal are occurring and during which an individual should be monitored. If the individual were experiencing hallucinations, which can occur up to six days after a person has stopped drinking, the period of time they are being medically monitored may be longer.
Detoxing for opiates can be even more complex than for alcohol or other drugs. As with alcohol, detoxing under medical supervision is essential for opiate addicts to ensure they can navigate withdrawal in the safest way, and with the best chances for a successful recovery. Opiate detox is often done through a pharmacological approach, where the recovering addict is given opiate substitute medication such as methadone or buprenorphine. Unlike quitting opiates “cold turkey”, which results in a number of concurrent and unpleasant effects, opiate substitute medications are used to slowly taper an opiate addict off of opiates. Detox treatment protocols using opiate substitutes have been demonstrated to reduce or eliminate withdrawal effects associated with opiates. The length of time that an individual is tapering off of opiate substitutes is directly related to the length of detox. Although an individual may move on to other portions of their recovery given the absence of withdrawal symptoms, their body is still detoxing until they have fully tapered off of opiate substitutes. This tapering process can take anywhere from two weeks to six months.
Understanding the role that a detox program plays in preparing an individual for recovery is necessary to see how essential detox is. Detoxing exists as a foundational step towards sobriety through the process of purging the body of alcohol or drugs. This process generally takes 3-5 days, during which an individual is closely monitored by medical professionals to ensure they are safe. It is understandable that detox is so closely associated with withdrawal in the minds of many addicts. Withdrawal can bring a sense of foreboding for anyone who has suffered from it. However, keep in mind that the goal of detox is to help a recovering addict experience withdrawal as minimally and safely as possible.
Detoxing is a necessary step towards your goal of lifelong recovery. Although there are risks associated with navigating the withdrawal process on your own, many of these risks are substantially reduced or eliminated entirely through medical supervision and intervention. A detox program also reduces the risk of relapse that is ever-present when an individual quits on their own. The staff at Above It All understand that the idea of detox can bring about feelings of anxiety. That is why we approach detox with compassion and understanding. Although detox can be challenging, it is an important first step towards lifelong sobriety.Find hope. Find recovery. Begin a commitment to lifelong recovery today – for yourself, your friend, or for your loved one.
 Mignon, Sylvia I. Substance Abuse Treatment : Options, Challenges, and Effectiveness. New York, NY: Springer Publishing Company, 2015. 73.