What You Need to Know About Detoxification in Rehab

Inpatient, outpatient, at-home detox: everything you need to know about the detox process.

What is Detoxification?

Many people know that one of the first steps of treating addiction can also be one of the hardest steps—detoxification. Detox is the process of ridding a person’s body of all traces of drugs, and it can be a difficult process mentally and physically. The withdrawal symptoms that can occur alongside detox include mood changes like irritability, depression, and anxiety, as well as physical symptoms like nausea, shaking, and headaches. Cravings are also common during withdrawal.

Types of Detox

There are two types of professional detoxification programs: medically assisted (or medically supervised) detox and clinically managed (“social”) detox. Medically assisted detox happens under the care of medical and mental health professionals and includes observation from these professionals to ensure the patient is safe and comfortable throughout treatment.

Clinically managed detox is a short-term, non-medical strategy for someone looking to end their substance use. Clinically managed detox can vary; some social detox settings will only provide room for detox to take place, while others have more hands-on treatment approaches like peer encouragement and professional support.

Relying on a professional drug detox program can help people recovering from substance use disorders complete the detox process more easily. In medical detox, withdrawal symptoms are managed with medications and other therapies. Medically supervised detoxification is a safer and more effective way to rid the body of drugs or alcohol and ultimately begin the road to recovery.¹

What Does Detox Treat?

Detox can be used to treat different addictions, including alcohol use disorder (AUD) as well as substance abuse disorders (SUD). Detox can also treat people dealing with many different types of addictions, including those who use…

Opioids, like prescription pain medications and heroin
Stimulants, like cocaine and methamphetamine
Benzodiazepines, like Xanax
Alcohol

The process of detoxifying the body of alcohol is approached similarly to the process of ridding the body of drugs. In both cases, detox is “designed to manage the acute and potentially dangerous physiological effects of stopping drug use,” according to the National Institute on Drug Abuse.²

It is important to note that drug detox and alcohol detox do not involve treating the psychological or physical problems that may have led a person to become addicted to a substance in the first place. Following detox, it is often necessary for patients to receive further treatment like therapy and medication-assisted treatment (MAT).

How Long is the Detox Process?

There is no set time for how long the detoxification process takes—it varies from person to person. For some, it may take as little as a few hours, while it could take weeks for another person to completely clear their body of a substance. several factors influence the potential length of drug detox, including:

Which substance is being used
The rate, dosage, and duration of substance use
The detox setting
Previous detox attempts
The presence of multiple drugs in the system
The individual’s health condition
The goals of the individual undergoing treatment

Rapid Detox and Ultra-Rapid Detox

There are also somewhat controversial options of rapid detox and ultra-rapid detox. Rapid and ultra-rapid detox focus on completing the process as quickly as possible to shorten the amount of time the patient faces withdrawal.

During rapid detox, the patient receives medication to speed up the onset of withdrawal and is then given medications that minimize the discomfort associated with it.

As for ultra-rapid detox, doctors put the patient under general anesthesia when withdrawal symptoms hit their peak. Theoretically, when the patient recovers from the anesthetic and wakes up, most uncomfortable symptoms already happened without the patient having to feel them.

The Risks of Rapid Detox

However, these methods have risks, and most professionals agree that the risks outweigh the benefits. The risks of rapid and ultra-rapid detox include:

Higher intensity of withdrawal symptoms
Higher treatment dropout rates due to the intensity of withdrawal symptoms
Potentially unnecessary exposure to additional pharmaceutical agents, each with differing levels of safety
Potential worsening of psychological symptoms
Possibility of delirium development in the detoxing individual
Lack of positive information related to long-term benefits

Despite these variations in detox method, length, and withdrawal symptom duration, the Substance Abuse and Mental Health Services Administration states that the average length of traditional detox is fewer than eight days.³ This relatively short frame of detox time is an encouraging component of recovery, as people with substance use disorder may be worried about the difficulties of detox and withdrawal. Knowing detox is, on average, only about a week long may encourage more people to seek addiction treatment.

Can I Detox Myself?

It is possible to detox at home, but there are many dangers of at-home detox. Intense cravings may arise, making it difficult for the patient to maintain sobriety. Depending on the level of severity of the addiction, serious health complications could arise during withdrawal.

Additionally, stopping a substance cold turkey is not always a safe option. Some people may think it is the best route because it is a clean break from the substance, but it can be risky. The nervous system adapts to drug use. When the substance use is stopped suddenly, it can cause a shock to the system, leading to a variety of health issues like seizures and heart problems.⁴

Quitting Cold Turkey

When quitting alcohol cold turkey, a dangerous withdrawal symptom called delirium tremens (DTs) is associated with detox for alcohol use. This condition is the most severe form of alcohol withdrawal, causing serious symptoms like chest pain, seizures, fever, involuntary movements, increased heart rate, and tremors. It can also cause serious psychological symptoms like hallucinations and delirium. Without medical treatment, up to 35% of DT cases are fatal.⁵

Dangers of At Home Detox

To reiterate, there are several dangers of at-home detox. It increases the risk for relapse, as many people find withdrawal symptoms extremely uncomfortable and unmanageable and will go back to their substance to find relief from withdrawal. It can also be mentally draining to try to detox at home; even with the support of friends or family, the detoxification process is difficult to get through. It can come with a host of medical complications that only medical professionals could diagnose and treat properly, and it can also cause mental health issues that can be hard to deal with outside of a medical setting.

Some things that could happen with at-home detox include:

Insomnia or hypersomnia
Agitation
Pain
Vomiting, diarrhea, or other gastrointestinal issues
Depression
Strong drug cravings
Disorientation
Seizure
Coma

Another danger of at-home detox for substance abuse is that it can increase the risk of overdose. After taking a break away from a substance, a person’s tolerance decreases. If this person chooses to use again (in hopes of relieving withdrawal symptoms), they may overestimate their tolerance and take a dose like what they were taking before detox, leading to a potential overdose.

Process of Detoxification at Rehab

Where self-detox can be complicated and unsafe, medically assisted treatment in the form of inpatient rehab (or in some cases, outpatient rehab) can be a much smoother process. Treatment will typically begin with a medical evaluation in which doctors get an understanding of the patient’s level of drug use and their overall health. Medical professionals will then make a treatment plan that suits the patient, including a detox plan with or without medication-assisted treatment.

Treatments for Recovery

Once the patient is in stable health and most withdrawal symptoms have passed, medical professionals will implement other treatments to keep the patient in the best mental and physical health possible. Some of these treatments may include:

Healthy eating: Eating nutritious foods can not only help the body recover from drug or alcohol abuse, but it can also help to keep patients in a positive state of mind and help them to learn to nurture their bodies.
Therapy or counseling: Patients who talk to a therapist or counselor can discuss the root of their substance use disorder and make a treatment plan to maintain sobriety.
Group therapy: Group therapy allows patients to talk with others who have faced similar issues, providing a chance for connection through healing.
Sleep: Though it may seem obvious, getting enough sleep is essential for maintaining physical and mental wellbeing. In the vulnerable time post-detox, patients will be encouraged to focus on getting quality sleep.

Preparing for Treatment

When a person decides to seek recovery, it is certainly a cause for celebration. However, it is also important to prepare oneself for the difficult journey of sobriety. Whether someone chooses inpatient or outpatient detox, there are many treatment options to suit different needs. According to the Substance Abuse and Mental Health Services Administration, there are five levels of detox to choose from:

Level I – In this situation, detox progresses with visits to a doctor’s office or by visits from a home health agency checking in on the patient at scheduled times. This is typically better for mild cases of addiction.
Level II – In this situation, detox happens as part of a day program with increased opportunities for treatment interventions and observation.
Level III – This social detox situation focuses on the need for peer and social support. It is suited for those whose withdrawal syndrome is severe enough to require some social support, but not severe enough to need strict medical supervision.
Level IV – In this situation, treatment happens in a detox center, and this level provides constant medical services and supervision.
Level V – This level takes place in an inpatient medical or psychiatric center and provides intensive twenty-four-hour care for the riskiest patients who need the most medical supervision.