Detoxification, or detox as it’s most commonly referred to, is typically the first step in the treatment process for substance abuse. It’s a process that can last for several days or sometimes weeks. There are some programs which are designed to last only through the most difficult phase of the detox process, while others last much longer. Detox programs are meant to lead directly into addiction rehabilitation programs.
Detox is the start of any further treatment, as detox itself can’t actually treat the addiction. NIDA explains that brief and intensive outpatient detox programs followed by treatment with medication for the cravings were very effective in initiating abstinence among opioid addicts and also maintaining abstinence. Treatment after detox was an essential part of maintaining abstinence. This enforces the argument that while detox is not enough to treat addiction, it’s an important first step in the recovery process.
Detox typically involves symptoms of withdrawal, along with strong cravings, which can make the entire process very difficult. However, detox is essential to recovery and there are many treatment options available that can help people through detox.
SAMHSA reports that there are a few components which are key to a safe and effective detox process, such as:
- Detox on its own is not enough to treat addiction and it should be follow by additional substance abuse treatment. One of the goals of detox should be for people to enter and remain compliant with a treatment or rehabilitation program.
- The detox process should ideally involve three steps: evaluating people and identifying their needs, stabilizing their health, and encouraging them to pursue treatment for their substance abuse issues.
- Detox can take place in different settings and follow different methods. Treatment should typically depend on each person and their individual needs. Detox also needs to consider cultural diversity and personal beliefs.
For those who are physically dependent on drugs or alcohol, withdrawal is central to detoxification. NIDA defines it as the period of time in which a person’s body adjusts to the lack of whichever substance it has become dependent upon. Withdrawal can involve many uncomfortable symptoms which start after lessening or stopping substance use.
Depending on the type of drug a person is physically dependent upon, the duration and severity of the symptoms of withdrawal can vary. Detox takes about five to seven days on average for most substances, but there are some symptoms that can go on for weeks or even months. They are, however, manageable, and they improve greatly with time. Some physical symptoms like insomnia, vomiting, muscle pain, and others, may last for days or weeks, while psychological symptoms like depressions or anxiety can last up to months. Treatment is offered during the detox process to address these symptoms.
Outpatient or Inpatient Detox?
The detox process can take place in a variety of settings. Some people undergo detox at home without any medical supervision and they may try to completely quit substance use at once, but this can be very difficult and even dangerous to accomplish, as it can cause severe withdrawal.
While an inpatient setting such as a hospital may be the easiest way to detox, a lot of people safely go through the process in an outpatient setting under the supervision of either a medical professional or an addiction specialist.
People who experience milder withdrawal symptoms may actually benefit from outpatient detox. Tremors, heart palpitations, nausea, or sweating aren’t usually dangerous, and they can be managed in an outpatient setting. Most of the time this is a less expensive and less time-consuming option for detoxification. Outpatient detox can also allow people to stay in contact with their friends and family, providing a support system that can make the whole process a lot more bearable. On the flipside, outpatient programs have a higher risk of relapse as people have easier access to addictive substances.
There are many people whose withdrawal symptoms are more severe and thus they require medical supervision. They should only attempt to detox in an inpatient setting where they can be closely monitored, and they can receive constant medical care. Some advantages of inpatient detox include less access to addictive substances and, as a result, fewer chances of relapse. A lot of people who suffer from addiction can benefit from the 24-hour care received in an inpatient setting. Anyone with an increased risk of complications during detox should choose an inpatient program for greater chances of success.
While both types of programs have their advantages and disadvantages, the long-term success of maintaining sobriety is unlikely to depend on the setting in which they underwent detoxification; the rates of long-term sobriety are about the same for both groups.
The Risks of Detoxing at Home
Some people will try to simply stop taking their substance of abuse on their own, this can be very dangerous. There are some drugs which can cause severe withdrawal symptoms which require medical supervision.
People who are addicted to central nervous system depressants, such as benzodiazepines, should not go through detox on their own, as NIDA recommends that in these cases, detoxification should occur in an inpatient setting. The withdrawal symptoms in these cases can be very serious and even life-threatening, so quitting suddenly and without any medical supervision can be extremely dangerous. In these cases, it is recommended that the detox process be medically supervised so that the doses of the substance are reduced gradually.
Additionally, detoxing from alcohol should always be done in an inpatient setting since delirium tremens can occur in some people, which has the potential to be life-threatening. Medical detox is also the best way to go when dealing with opiate addiction, because of the severe withdrawal symptoms associated with opiates.
As mentioned earlier, even if someone is trying to detox from substances that don’t necessarily need medical detox, the chances of success are lower when going at it alone. When the withdrawal symptoms get too difficult, one can simply stop them by using the substance again, thus most people who attempt detoxing at home are unsuccessful.