Drug Detox FAQ
Drug detoxification can be the first step toward a healthier, more positive future. But the prospect of going through detox and withdrawal is frightening to many drug users. How will withdrawal feel? Will detox be uncomfortable, painful, or embarrassing? How will you handle the stress and emotional pain of life without drugs? If you have questions about drug detox, our frequently asked questions may offer the answers you’re looking for.
Psychological addiction is characterized by the need to continue using drugs in order to feel happy, mentally focused, or emotionally stable. But according to Psychology Today, it is difficult to separate psychological addiction from physical addiction. The same withdrawal process that causes discomfort and pain in the body also causes psychological symptoms like anxiety, restlessness, and depression if the user tries to quit too suddenly. Very few addicts experience physical withdrawal without any psychological side effects, and vice versa.
- Watery eyes
- A runny nose
- Cold sweats
- Frequent yawning
- Muscle cramps
- Difficulty sleeping
As the hours pass, withdrawal symptoms can become more uncomfortable and more severe. The late effects of withdrawing from drugs include:
- Diarrhea or constipation
- Stomach cramps
- Bone pain
Unlike alcohol withdrawal, which can include life-threatening fevers, high blood pressure, delirium, and convulsion, withdrawing from drugs is usually not fatal. However, withdrawal from prescription medications in the benzodiazepine family (Ativan, Xanax, Valium, Klonopin, and other widely prescribed sedatives and muscle relaxants) can cause abnormal neurological activity, including seizures. Safe withdrawal from these drugs requires a gradual reduction of the dose to taper the user off the medication.
Even certain psychotherapeutic drugs that are generally considered to be non-addictive, like antidepressants, can cause withdrawal symptoms if medication usage is stopped too abruptly. These medications affect the brain’s natural levels of neurotransmitters that affect mood and energy levels.
Not all illicit drugs cause obvious physical withdrawal symptoms; however, the user may still experience intense cravings, fatigue, and an emotional crash during the withdrawal period. MedlinePlus notes that many heavy cocaine users do not experience severe physical side effects when withdrawing from the drug. Side effects like paranoia, agitation, exhaustion, and insomnia are more common with cocaine addiction.
Withdrawing from opiate drugs — heroin, morphine, codeine, oxycodone, hydrocodone, and other natural or synthetic drugs derived from opium-based compounds — is notoriously unpleasant. According to the University of Maryland Medical Center, these symptoms are rarely fatal; the most common complication is relapse. The discomfort of withdrawal drives many drug users back to their old habits, even if they desperately want to quit.
- The University of Washington’s Alcohol & Drug Abuse Institute states that marijuana withdrawal symptoms usually begin within the first 24 hours after stopping the drug. Symptoms are at their most severe within two to three days. After one week, many users are no longer experiencing withdrawal symptoms, although some continue to have difficulty sleeping.
- The first signs of opiate withdrawal begin within six to 12 hours after stopping the drug, states the Western Journal of Medicine. These early symptoms — runny nose, teary eyes, yawning, goose bumps, and sweating — can feel like a bad cold or a case of the flu. Within two to three days, the user will feel the effects of withdrawal on the central nervous system, with symptoms like agitation, restlessness, anxiety, high blood pressure, a rapid heart rate, and muscle spasms. Within five to 10 days, most symptoms have resolved.
- For heavy cocaine users, the crash that follows cessation of the drug is almost immediate. Depression is quickly followed by anxiety, restlessness, feelings of fatigue, and an overwhelming urge to seek and use cocaine again in order to feel “normal.” Although the initial feelings of exhaustion and agitation may resolve in a matter of days, depression may continue for months after stopping the drug. Along with depression, the user may experience anhedonia, or an absence of pleasure in sober activities.
- Like many other drugs, meth withdrawal takes place in stages. Many users experience the most severe symptoms within the first day after they stop using the drug. These symptoms include paranoia, anxiety, insomnia, fatigue, and delusional thinking. Over the next 14 days or so, the user will continue to experience these symptoms, but they may become less severe. Failure to eat or sleep during meth binges can lead to intense food cravings and long periods of sleep.
- Prescription tranquilizers and sedatives. Along with opiate painkillers, prescription tranquilizers and sedatives have become some of the most widely prescribed — and widely abused — drugs in the US. Withdrawal from benzodiazepines, a class of sedatives and muscle relaxants that includes popular drugs like Xanax and Ativan, requires a medically supervised drug taper to prevent dangerous side effects, like seizures. The American Academy of Family Physicians advises that long-term users of benzodiazepines should be reduced over two or three months, or even longer in some cases.
Professional detox support can make withdrawal faster and more comfortable. In a medically monitored detox program, you can receive medications and other comfort measures to reduce withdrawal symptoms and help clear the drugs from your system more quickly.
- Trying to go through withdrawal without the support of a medical detox program
- Dropping out of detox or rehab before completing the program
- Having a co-occurring mental illness, such as anxiety or depression, which isn’t addressed in treatment
- Lack of a strong support system in the community
- A return to your old lifestyle without the right skills for coping with emotional or situational triggers
Today, most addiction treatment specialists focus on preventing relapse and reducing the severity of a slip after treatment. If a relapse does occur, you should have resources at your disposal to help you get back on track, such as access to a counselor, sponsor, support group, or alumni organization.
Detox programs are offered in a variety of settings, including hospitals, dedicated rehab centers, outpatient clinics, community health centers, and correctional facilities. Publicly funded detox programs are offered at little or no charge, while private detox centers may accept private payment or health insurance.
- Quitting cold turkey. The only advantage to quitting drugs cold turkey is that you can save money on the cost of a detox program; however, this is probably the most dangerous and least effective way to break free from addiction. Without medical supervision, you could be at risk of changes in blood pressure, seizure activity, convulsions, hallucinations, confusion, and other serious side effects of withdrawal. For many people who try to detox alone, the cravings, agitation, depression, and anxiety cause a relapse before they’ve completed the withdrawal process.
- Home detox kits. Home detox kits, available at drugstores, health food stores, and online, contain a combination of herbs, vitamins, and minerals that supposedly help you flush drugs from your system. Many users purchase these kits in the hope of clearing drugs like marijuana from their system before a urinalysis. But according to Columbia University, home kits are rarely effective. For the user who’s serious about leading a drug-free life, a home detox kit can’t cause the behavioral changes or psychological transformation that are necessary for long-term sobriety.
- Outpatient detox programs. Outpatient detox programs are conducted at clinics, private doctors’ offices, rehab facilities, mental health centers, and other locations within the community. These programs allow patients to receive medical monitoring by doctors or nurses during business hours, and to take detox medications under supervision while living at home or in a transitional housing situation. Outpatient detox is appropriate for patients who are motivated to keep their appointments and adhere to the requirements of the program without extensive supervision or structure.
- Inpatient detox. Inpatient detox programs provide intensive monitoring, pharmacotherapy, and 24-hour supervision for drug users who are at risk of serious side effects or relapse. In an inpatient program, patients stay on site while they undergo treatment. In order to provide continuity of care, an inpatient detox program may transition to a full rehab program within the same residential treatment facility.
- Holistic detox programs. Holistic detox programs draw from a variety of alternative or complementary therapies, as well as traditional medical approaches, to detoxify the mind and spirit as well as the body. A holistic detox program may include nutritional counseling and spiritual support, as well as complementary detox therapies like massage, acupuncture, or yoga. Herbal remedies may be combined with conventional Western medicine to provide the best outcome.
- Sub-acute detox. Sub-acute detox programs may be offered through an inpatient treatment facility, such as a hospital or rehab center, or at an outpatient clinic. Sub-acute detox is recommended for patients who are generally in good physical and mental health, and who are currently medically stable. This level of treatment is appropriate for patients who don’t require 24-hour supervision and who are committed to a recovery program. Medication and counseling may be provided as part of the program.
- Medical detox. This level of detox is often conducted on an inpatient basis; however, intensive outpatient programs may offer medical detox, as well. A medical detox program is appropriate for patients who need pharmaceutical therapy as well as other clinical services, such as medical monitoring, IV fluid replacement, or nutritional support. According to the S. Department of Health and Human Services, the primary purpose of medical detox is to ensure that the patient remains safe and stable during withdrawal, avoiding seizures, delirium, and other life-threatening side effects.
- Anti-anxiety medications. Sedatives in the benzodiazepine family may be prescribed on a short-term basis to help reduce the anxiety, restlessness, and muscle spasms associated with drug withdrawal. Because these drugs have the potential to be addictive, their use should be limited and carefully monitored.
- Medications for alcoholism. There are several medications used in the treatment of alcohol addiction. The oldest of these drugs, disulfiram, discourages alcohol abuse by causing unpleasant side effects when the user is exposed to any product containing alcohol. Newer medications, including acamprosate and naltrexone, work by blocking the pleasurable effects of drinking rather than by causing an aversion to alcohol.
- Drugs for opiate abuse. For centuries, pharmacists have worked to develop drugs that could resolve the problem of opiate abuse. Ironically, heroin was proposed as a cure for morphine addiction in the late 1890s. Since the 1960s, the most popular detox medication for opiate addiction has been methadone, a synthetic opiate that helps the user manage cravings and avoid relapse. Two other drugs, buprenorphine and naltrexone, have also been used to help opiate addicts get through the detox process and stay on track with their recovery program.
- Drugs to alleviate secondary withdrawal symptoms. A number of prescription drugs and over-the-counter medications can be prescribed to relieve physical withdrawal symptoms, such as nausea, diarrhea, headaches, or muscle pain. These drugs make it easier to cope with the side effects of withdrawal, so you can move into the next phase of recovery.