Reviewed and Approved by Tamara LaFontaine, LMFT.
Addiction is a mental health condition where an individual becomes dependent on one or more substances. Commonly abused substances that require detox include alcohol, opioids, prescription medications, and benzodiazepines.
Substance use disorder is not a choice. Regardless of known and harmful side effects and health risks, those addicted to alcohol or drugs continue using. This disorder changes the way people think and act, ultimately changing the brain’s structure. When left untreated, substance use disorders can cause permanent damage.
Undergoing medically supervised detoxification is the most important step in any addiction recovery program. The purpose of it is to stop the consumption of drugs and/or alcohol in a controlled, safe environment. This is the first step in breaking free from substance dependence. It allows individuals to enter the next phases of treatment without struggling with withdrawals.
The detox and withdrawal process is not easy. Medical detox allows doctors, nurse practitioners and clinicians to help clients feel comfortable during a time of crisis. It allows these professionals to monitor life-threatening withdrawal closely. In this article, we will review the process of detoxing from drugs and alcohol and the role of medically supervised detox in the addiction treatment process.
According to Tamara LaFontaine, Clinical Director, LMFT, “Entering substance abuse treatment is crucial because it provides individuals with the comprehensive support and resources necessary to overcome addiction. In a structured treatment environment, clients receive medical supervision, peer support, individual counseling and therapy; all of which are essential for safely navigating withdrawal and building a foundation for long-term recovery. Our goal is to help clients not only detoxify their bodies but also address the underlying issues contributing to their addiction, empowering them to lead healthier, more fulfilling lives.”
Understanding Addiction
Detoxing from substances of abuse is dangerous and in some cases, deadly. Many people who attempt to quit “cold turkey” often relapse quickly, potentially resulting in overdose. This is why it is important to undergo detoxification with medical supervision and then enter a treatment program. Some of the most commonly abused substances that require detox are:
- Alcohol
- Prescription pain medications
- Heroin
- Opiates
- Fentanyl
- Benzodiazepines
Factors Contributing to Addiction
Two major factors that play into substance use disorder are the user’s environment and genetics.
If a person surrounds themselves with friends and family members that are addicted they are more likely to become addicted themselves. Peer groups with a casual attitude towards drug use makes addictive substances seem less dangerous. While some people seem to be able to use without harmful consequences, there is no such thing as a safe addiction.
The other major component contributing to addiction is one’s genetic makeup. A family history of addiction does not determine addiction within a family line. However, it increases the probability that a person can develop an addiction. Likewise, if someone has a co-occurring mental health disorder such as depression or attention deficit hyperactivity disorder (ADHD) or anxiety, they are more likely to turn to drugs and alcohol to cope.
Physical and Psychological Effects of Substance Abuse
Substance abuse often goes hand-in-hand with other health issues, both physical and psychological. People who smoke or inhale drugs often have lung and heart problems.
Methamphetamine users experience dental problems which is known as “meth mouth.” Opioids can lead to long term nervous systems complications and seizures.
Substance abuse can make pre-existing mental health conditions worse. It can also bring previously non-existent conditions to light.
Drug and alcohol abuse can manifest as physical health issues including low or high blood pressure, infection, dental loss, muscular atrophy, and more.
Psychologically, substance abuse makes people dependent on their drug of choice just to feel “normal.” In reality, it makes them anything but normal. Substance abuse often results in risky behavior, poor financial choices, sleep issues, lack of motivation, and more.
When someone is deep in substance use disorder, they may be fully aware of the harmful effects, and still choose to use.
The Detoxification Process
Detoxification is the process of removing toxic substances from the body, while managing withdrawal symptoms. The safest form of detoxification is under medical supervision. It allows doctors to prescribe medications to manage withdrawal symptoms and avoid life-threatening problems like arrhythmia, dehydration or seizures.
Withdrawal Symptoms and their Management
Alcohol Detox Symptoms
There are many alcohol detox symptoms such as anxiety, mood swings, fatigue, irritability, depression, and loss of appetite. Along with these common symptoms, when someone undergoes alcohol detox they can experience more serious symptoms such as a rapid heart rate, clammy skin, tremors, head and body aches, nausea, and vomiting.
The most serious effect of alcohol detox to look out for is delirium tremens (DT) which appears as altered mental status and autonomic hyperactivity. This can develop into cardiovascular collapse. This condition is not very common, but when it occurs it can be deadly.
Indicators of delirium tremens include severe agitation, seizures, hallucinations, and fever. When this occurs during alcohol withdrawal, it is incredibly serious. If DT happens when alone it can become fatal. This is why medically supervised alcohol detox is vitally important.
Benzodiazepine Detox Symptoms
Benzodiazepine or “benzos” are prescription drugs, and the most frequently abused ones are Ativan, Xanax, and Valium. When used as prescribed, these medications can treat anxiety, seizures, insomnia, and other conditions. However, they are highly addictive and many users abuse them. These drugs target the nervous system, and when used in large amounts or outside of direction, they are known to lower blood pressure and reduce the heart rate.
Additionally, mixing benzodiazepines with alcohol can be deadly because both substances are depressants. Combined, they can shut down motor function and the respiratory system. This makes it hard or even impossible to breathe. Combining alcohol and benzos can be fatal.
Common benzodiazepine withdrawal symptoms include anxiety or panic, insomnia, muscle spasms or tension, nausea, vomiting, diarrhea, blurred vision, mood swings or agitation, and decreased appetite. Someone using benzos may experience one of these symptoms or all of them. More severe side effects include seizures, hallucinations, short-term memory impairment, and drug cravings. A 7 to 10 day medical detox for benzodiazepines is the safest method for benzodiazepine addiction.
Fentanyl Detox Symptoms
Fentanyl is an incredibly dangerous synthetic opioid that can be up to 100 times stronger than alternative opioids such as morphine. Its potency makes fentanyl highly addictive. It is one of the most dangerous substances that requires medical detox to navigate the withdrawal process.
Detoxing on one’s own poses far too many risks to health and wellbeing. Depending on the amount of fentanyl use, one may experience withdrawal symptoms for several days or weeks.
The most prevalent fentanyl detox side effects include nausea and vomiting, muscle aches and pains, sweating and chills, anxiety or irritability, insomnia, runny nose, diarrhea, and abdominal cramping. Some of the more serious and potentially fatal side effects include increased heart rate, high blood pressure, seizures, and depression or suicidal thoughts. If a user does not detox from fentanyl under medical supervision, withdrawals could result in heart failure.
Opioid Detox Symptoms
Opioid detox poses many risks for people suffering from substance use disorder. Withdrawal symptoms can start within hours, and can last several weeks depending on how often the opioids were used. It is possible to develop post-acute withdrawal syndrome (PAWS).
PAWS is essentially the occurrence of long-term opioid withdrawal symptoms that last beyond the initial detox window. Medical detox helps ensure that an individual does not experience PAWS while detoxing from opioids.
During withdrawal, opioid users will experience nausea, vomiting, diarrhea, tremors, flu-like symptoms, insomnia, and hot/cold flashes. These symptoms come in addition to excessive sweating, joint pain, and headaches. In more serious situations, opioid withdrawal can bring on dysphoria, fever, dehydration, and hypernatremia. Like its more potent, synthetic cousin fentanyl, opioid withdrawal is serious and is best treated with medical detox.
Importance of Medical Supervision During Detox
Medical detox is the safest form of drug detox. Detoxing without an experienced support system makes users more likely to relapse or suffer unnecessarily.
During medical detox, doctors and nurses supervise a patient’s condition and prescribe specific medications. These medications can help make them more comfortable and make withdrawal symptoms easier to get through. Some of the main side effects doctors can prescribe medication for include:
- Headaches
- Nausea and vomiting
- Fever
- Body aches
- Seizures
- Heart palpitations
- Psychosis and/or anxiety
Medical detox is best conducted in a controlled environment; either in an inpatient setting or a hospital setting to insure the highest level of patient safety. Inpatient detox treatment also means a medical team is readily available in the event of a medical emergency.
Uncommon & Dangerous Detox Approaches
Quitting cold turkey is incredibly dangerous. When one detoxes on their own without a proper addiction treatment team, they are putting their lives at serious risk.
Getting powerful substances like alcohol, heroin, or opioids out of the system lowers one’s tolerance drastically. If there is not a supportive sobriety team, individuals are at risk of relapse. This is the most dangerous stage of recovery. Tolerance becomes low and users that consume pre-detox levels of drugs and alcohol are at a higher risk of overdose.
Detoxing at home is also risky because there is no one to monitor one’s condition, medically or clinically. Detox makes people more susceptible to experiencing mental health challenges such as depression, anxiety, and suicidal thoughts. Medical detox centers allow the treatment team to monitor and manage withdrawal and any co-occurring conditions.
Detoxing From Alcohol
Detoxing from alcohol is very risky, alcohol is one of the only substances of abuse that can result in death when quitting abruptly. When abused it causes many health problems. These conditions include liver failure, arrhythmia, high blood pressure, and mental health problems. When not medically or clinically supervised, alcohol detox can be fatal.
During alcohol detox, many experience:
- Anxiety
- Mood swings
- Fatigue
- Irritability
- Depression
- Nightmares/Night terrors
- Trouble thinking clearly
- Loss of appetite
- Enlarged pupils
- Rapid heart rate
- Clammy skin
- Tremors
- Headaches
- Nausea
- Vomiting
More serious symptoms may be a sign of delirium tremens (DTs) and include:
- Severe agitation
- Delirium (severe confusion)
- Seizures
- Hallucinations
- Agitation
- Fever
These types of symptoms can last anywhere from a few hours to a few days. If someone is experiencing prolonged withdrawal symptoms they need to notify their treatment team as soon as possible or visit an emergency room.
Steps Involved in Alcohol Detoxification
The alcohol detox timeline is different for everyone based on the severity of their tolerance and dependency. There are three key phases of alcohol detox, 6 hours after one’s last drink, 12-48 hours after, and two to three days after their last drink.
Six hours after the last drink, one will start to get mild symptoms of withdrawal. Symptoms during this phase may include nausea, insomnia, sweating, vomiting and anxiety.
12 to 48 hours following the last drink, individuals may start to notice more significant withdrawal symptoms. Heavy drinkers can experience hallucinations or seizures (most common in severe cases and within the first two days). Going through withdrawal symptoms with medical supervision is incredibly important from this phase on.
Two to three days after the last drink, there is a risk of delirium tremens (DTs). DT causes hallucinations, delusions, confusion, a racing heart, high blood pressure, and fever. In rare cases, DTs can be fatal.
Fortunately, these symptoms are rare and occur in only around 5% of those with alcohol withdrawal symptoms. Symptoms of alcohol withdrawal usually peak within 72 hours and will begin to taper off from there.
Medications Used in Alcohol Detoxification
The medical alcohol detox team will prescribe each patient different medications during alcohol detoxification. Prescribed medications depend on individual medical history and other substances of abuse if applicable.
Benzodiazepines are used for their sedative properties and to prevent seizures. Anticonvulsants may also be used to manage severe symptoms and seizures as well. Additional medications that may be prescribed during alcohol detoxification include:
- Ativan, for complications that may lead to seizure
- Disulfiram, inhibits the metabolism of alcohol in the body
- Naltrexone, can help decrease the urge to drink
- Acamprosate, helps rebalance the central nervous system
The exact type of medication prescribed depends on each situation, and the medical team may modify it as needed throughout the detox process.
Challenges and Risks of Alcohol Detox
The biggest risk of alcohol detox is delirium tremens. The greatest danger associated with DT is vomiting, dehydration and death. Like any other substance, the risk of overdose is highest right after one completes detox. This is why it is recommended that everyone enters an inpatient treatment facility immediately after completing detoxification.
Detoxing From Drugs
Some substances are stronger than others and all detox processes are different. As with alcohol, detoxing from drugs is best done under medical supervision. Detox should be followed up with inpatient treatment. The exact detox experience will differ depending on what substance(s) an individual has been using.
Different Drugs and Their Effects
All drugs eventually cause negative physical and psychological effects. But how they interact with the body depends on genetics and habits. The most commonly abused substances include benzodiazepines or “benzos,” fentanyl, heroin, opioids, and prescription medications.
Benzo Effects
Benzodiazepines (benzos) are prescription drugs like Ativan, Xanax, and Valium that are used to treat many complex medical conditions including anxiety, seizures, and even insomnia. When used with alcohol, detox is especially useful for maintaining withdrawal symptoms.
Benzos alone have an incredibly high rate of abuse and are highly addictive. Benzos affect the nervous system, lower blood pressure, and even reduce the heart rate. Chronic benzo abuse can make withdrawal symptoms quite severe, making medically supervised benzodiazepine detox vital.
Fentanyl Effects
Fentanyl is a powerful and dangerous synthetic opioid. Becoming addicted to this intense substance after just a few uses is highly likely.
Due to the potency of fentanyl, detox can be a risky process that requires careful medical supervision due to the dangerous withdrawal symptoms. Fentanyl allows users to experience relaxation and euphoric feelings. It can also make users drowsy and cause nausea and other uncomfortable feelings.
Heroin Effects
Heroin is incredibly dangerous and can be consumed by snorting, smoking, or injecting. Each method of consumption comes with its own unique set of risks and consequences.
The substance reaches the brain quickly and the impact is almost instantaneous. Heroin is an opioid, triggering opioid receptors across the entire body. Heroin gives users a sense of euphoria and ecstasy.
Opioid Effects
Opioids are commonly used for pain management, but when abused they can be astonishingly addictive. Common opioid effects are drowsiness and a sense of relaxation. When taken chronically, they inflict constipation, nausea, vomiting, and slowed breathing. These side effects can become quite dangerous and could indicate overdose.
Prescription Medication Effects
Many commonly abused prescription medications include opioids, muscle relaxers, and narcotics. They will all have different effects, depending on the exact substance being abused.
However, in general the substances will cause nausea, vomiting, dizziness, drowsiness, and similar symptoms. The more an individual abuses prescription medication, the more one will have to use to get the desired effect. This makes them more sick.
Medications Used in Drug Detox
As noted, medical detox is the safest and most effective form of detox available. Being under medical supervision allows clinicians to monitor conditions and ensure that vital signs stay stable. Verifying that one doesn’t experience any severe complications. Every substance has specific medications that are FDA approved for detox.
For inpatient alcohol detox, common medications used include:
- Ativan
- Acamprosate
- Disulfiram
- Naltrexone
Approved medications for opioid addiction include:
- Buprenorphine
- Naltrexone
As for fentanyl, approved medications are:
- Buprenorphine
- Naltrexone
- Clonidine
Like other opioids, heroin detox medications typically involve:
- Buprenorphine
- Naltrexone
Benzodiazepine detox medications are often:
- Anticonvulsants
- GABA receptor agonists
- Low-dose alternative benzodiazepines
For prescription medication detox, it ultimately depends on what substance(s) one has been using, but treatment often includes:
- Benzodiazepines
- Antidepressants
- Anticonvulsants
The medical team will monitor each client’s status closely. Adapting their medication plan and dosages as needed. It is important for recovering addicts to take their detox medications exactly as directed.
Unique Challenges in Detoxification
Detox comes with unique challenges for each patient. While physical withdrawals are challenging, the emotional component is a major challenge that many don’t anticipate. When detoxing from drugs and alcohol, many people experience depression, anxiety, and suicidal thoughts. These symptoms can occur in people who have never experienced mental health conditions in the past.
Holistic Approaches to Detox
Holistic detox methods are often used in tandem with medical detox. The approach allows participants to learn how to sustain recovery and cope beyond detox. Common components of holistic detox include balanced nutrition, consistent exercise and activity, and alternative therapies like acupuncture, meditation, and yoga.
These different methods help recovering addicts gain balance and discipline. These approaches are focused on overall health and wellness during recovery. Throughout the course of substance abuse, many people experience malnutrition and poor fitness.
Holistic therapies are a great supplemental program used in conjunction with medical detox. However, holistic approaches on their own do not provide participants with any support or care when it comes to withdrawal symptoms and risks.
Illnesses cannot be cured with exercise, art, horticulture, and music alone. These activities should only be used as a component of otherwise medically supervised detoxification and rehabilitation.
Nutrition and Hydration During Detox
The detoxification process is very hard on the body. As such, a successful recovery program must focus on nourishing the mind, body and soul. During detox, hydration and electrolytes are vital, especially if the patient is vomiting or has diarrhea. Consuming nutrient dense foods, including whole grains, proteins, and fruits and vegetables is very important during this phase.
A balanced diet ensures the body gets the vitamins and minerals required to reach homeostasis quickly. In a reputable detox, the treatment team will work with their clients to create a diet plan that meets their nutritional needs and meets their dietary restrictions.
Post-Detox Support and Treatment
After inpatient drug detox, the next phase of addiction treatment begins. Typically, this is an inpatient rehab program, but could also be an intensive outpatient treatment or a partial hospitalization program. An inpatient program is ideal for anyone who has not previously participated in addiction treatment. Allowing them to get the hands-on support they need at any time.
Importance of Ongoing Support in Recovery
Having a support system throughout addiction recovery is important for staying motivated and encouraged. People suffering from addiction should never have to fight alone. Examples of support systems include doctors, therapists, clinicians, as well as friends and family. Ongoing support keeps people accountable, and helps them understand they are not alone.
Types of Treatment Programs
The three main types of treatment programs include inpatient or residential treatment, partial hospitalization programs, and intensive outpatient treatment. They all work differently to support recovery and help clients reach their sobriety goals.
- Inpatient/Residential Treatment: This is best for first-time treatment clients as well as for those who have recently relapsed. These programs last anywhere from several weeks to 90 days. During inpatient programs, there’s access to medical and clinical teams around the clock. This ensures people get the support they need when they need it – because crises can happen at any time. Clients reside at inpatient treatment centers 24/7 during the program.
- Partial Hospitalization Program: This is a day treatment program that takes place in a medical setting. Clients attend partial hospitalization programs during the day most weekdays, but are able to return home or to a sober living house each night. These programs are structured and integrate therapeutic activities and help clients learn further coping mechanisms moving forward in sobriety.
- Intensive Outpatient Treatment: These programs are slightly less of a commitment than partial hospitalization programs. Intensive outpatient treatment helps people recovering from addiction that cannot commit to more time consuming treatment. Clients attend treatment that includes therapy and structured programming that helps them learn successful coping mechanisms and build a sober community. After treatment each day, clients typically return home or to a sober living environment.
Effective treatment teams create individualized plans for detox and throughout the recovery process. Most people spend a portion of their time in inpatient treatment. It’s incredibly important to enter some form of rehab after detoxing to prevent relapse or overdose.
Taking a “detox only” approach is dangerous, because once an individual has dangerous substances out of their system, their tolerance lowers significantly. This is the most dangerous time in recovery. Without support, most people are likely to relapse and use at their original dosage. This is the most common path towards overdose after detoxing.
Relapse Prevention Strategies
Post-recovery support is important for sustainable sobriety. Relapse prevention begins from the moment detox is complete. Relapse prevention integrates strategies and techniques to recognize and manage triggers, cravings, and risky behaviors that may result in relapse.
Patients learn coping skills throughout their treatment, including through holistic therapies, group work, and individual reflection. Relapse prevention planning is the most important part of rehabilitation.
Common relapse prevention activities include:
- Healthy coping mechanisms such as journaling, hobbies, or creative outlets.
- A strong support network of friends, family, and mentors for support.
- Being aware of triggers and avoiding high-risk situations.
- Maintaining a balanced lifestyle with proper sleep, nutrition, and self-care.
- Recognizing and treating underlying issues or co-occurring disorders through therapy or counseling.
- Engaging in self-assessment to stay in touch with thoughts, emotions, and behaviors related to substance use.
Newly sober individuals should be constantly in tune with themselves and their behaviors. Reaching out for help when they recognize they need it. Being open and honest prevents relapse crises before they happen.
The Role of Therapy and Counseling in Long-Term Recovery
As people transition into routine life, it’s important to maintain healthy habits. Ongoing therapy and counseling are important to maintain long term sobriety. Group therapy, family therapy, individual therapy, or a more specialized type of treatment help people stay on the straight and narrow.
It’s beneficial to have a neutral, experienced party involved to mediate feelings and emotions. This puts things in perspective during recovery.
Success Stories and Testimonials
Medical detox followed by drug & alcohol rehab is the most effective way to get sober and stay sober. We’d like to share real success stories from real people who have sought out treatment and become sober.
Lauren’s Story
Lauren was having a hard time managing anxiety and depression, two mental health conditions that are becoming increasingly more common in the United States. She turned to Xanax, benzos, and opioids to cope with the pressure she was feeling.
Lauren felt that she had to self-medicate just to get through the day. Her family connected with Solution Based Treatment and determined that Lauren would travel to California. Allowing her to get the help she needed to break free from her substances of choice and get sober.
Lauren’s family decided to hold an intervention to highlight their concerns. During this, they placed down boundaries that could not be crossed if she did not get help. She remembers her sister being eight months pregnant and firm on the decision that Lauren could not be around her future niece unless she became sober. This was the wakeup call that Lauren needed to agree to seek treatment.
Lauren has completed a detox and rehab program, making an excellent recovery. When asked what advice she should give to someone in her shoes, she said “Trust the process and it’s terrifying, but you need to get comfortable with being uncomfortable. It won’t alway be easy, but it will always be worth it.”
Learn more about Lauren’s journey and her recovery here.
Neil’s Story
Neil had turned to alcohol to cope with the stress and pressures of daily life, until he ended up in the hospital with a bleeding ulcer caused by excessive drinking. This was a massive wakeup call for Neil. He attempted to get sober on his own on and off previously, convinced he didn’t need a program to get sober.
Neil would keep his struggles with alcohol a secret, and would only disclose his relapses occasionally. He noted, if he relapsed 10 times, he kept 8 of those times a secret. His hospitalization was one component of his wakeup call, but was not the only one.
Neil continued drinking, and was eventually pulled over and arrested for a DUI at noon on a Monday afternoon. He hauls this event as the most awful moment of his life but a necessary experience to get the motivation to seek professional help.
Neil would like others struggling with substance abuse to know “There is absolutely hope, it is not in any way a sign of weakness to ask for help. In fact, it’s quite the contrary, it’s more a sign of strength. And it’s the best thing you can do for yourself, because there is hope and you can get better. But you cannot do it alone.”
Flash forward to today, Neil has completed his treatment program with the support of his wife and family. He took a leap of faith, and Solution Based Treatment was there to catch him with open arms. Neil is now excited to continue to be the best father, husband, son, and family member he can be.
Learn more about Neil’s sobriety journey here.
Jacob’s Story
Jacob previously participated in an alternative drug treatment center for his heroin use. However four months after leaving the program he relapsed. He used the alternative substance to self medicate for about three years. Jacob was stuck in a cycle of addiction.
Three days into his relapse, Jacob unfortunately suffered an overdose. It was the reality check he needed to accept help.
Jacob noted that getting out of his hometown was crucial to his recovery. It took him away from toxic connections and allowed him to relax. Faced with life or death, he knew that he wanted to live.
When asked what advice he would give to people entering treatment, he emphasized the importance of being able to self reflect and recognize the behaviors that brought him to use heroin in the first place. From there he found the value in being able to actively work against those triggers and cope in a sober, healthy way.
Jacob has now graduated from detox and rehab, and is looking forward to meeting his true potential. He is filled with excitement at the new opportunities sobriety has unlocked for him.
Learn more about Jacob’s recovery here.
Treatment is the First Step Towards a New Life
Detox can be intimidating because it represents the first and most difficult step towards a sober life. Different substances have different effects and therefore require different treatment styles. This is why it is so important to choose an experienced and highly qualified detox program
Detoxing from drugs and alcohol should not be attempted alone or at home. It’s not only dangerous, it can have lethal consequences. Supervision from qualified medical and clinical staff gives people the best chance of detoxing safely.
If you or someone you know is currently struggling with substance use disorder, it’s never too late to reach out for help. The Solution Based Treatment team is available around the clock to lend a helping hand to those suffering from substance use disorder.
“Taking the first step toward rehab is an act of courage and hope. Every journey to recovery begins with a single brave decision. Believe in your strength and the possibility of a brighter, healthier future.” – Tamara LaFontaine, Clinical Director, LMFT.
About Solution Based Treatment
Solution Based Treatment is a national leader in detox and rehab programs. We offer inpatient medical detox, substance rehab, intensive outpatient programs, partial hospitalization programs, and sober living options. We maintain a 2:1 client to staff ratio to offer the best support possible to our patients within upscale living environments. For more information visit our website at solutionbasedtreatment.com or give us a call at (833) 999-1941.