A Practical Guide to Drug & Alcohol Detox Options

By Megan Krause

There are two kinds of people in the world: those who know the misery that comes with drug and alcohol withdrawals, and those who don’t.

If you don’t know, that’s good. Very good. Because it’s absolutely miserable. A smattering of symptoms include:

  • Muscle pain
  • Sweating
  • Nausea, vomiting and stomach cramps
  • Lethargy and restlessness
  • Loss of appetite
  • Shakiness, weakness and tremors
  • Clammy skin and feeling cold
  • Crying and depression
  • Delirium, hallucination and paranoia
  • Insomnia and nightmares
  • Seizures

Yes, “absolutely miserable” pretty much covers it.

This level of suffering not only torments the addict, it’s dangerous and potentially life-threatening. And while nothing can fully take away the discomfort of withdrawal, much of it can be reduced through a reputable detox program.

In this article, we’re examining which substances require detox and the options available.

Who should detox?

If you use certain substances for a prolonged period of time, you become physically addicted to them. When you try to stop using them, you will suffer mild to severe pain and discomfort.

The Center on Addiction defines this as physical dependence — when the brain adapts to the effects of a drug and develops tolerance, and the user will “rely on continued use of the drug to prevent painful and uncomfortable withdrawal symptoms.”

If you’ve been using any of the following substances for an extended period, you may suffer some or all of the following symptoms when trying to get off them:

  • Heroin and other opiates (such as Vicodin and Percocet): Diarrhea, nausea, vomiting, difficulty sleeping, dilated pupils/poor vision, racing heartbeat, elevated blood pressure, depression
  • Alcohol: Difficulty sleeping, nausea, tremors, depression, anxiety, headaches, seizures, delirium
  • Cocaine and methamphetamine: Exhaustion, agitation, paranoia, violent behavior, hallucination, psychosis
  • Marijuana, spice, ketamine, and bath salts: Depression, difficulty sleeping, anxiety
  • Benzodiazepines (such as Valium, Xanax, Ativan, and Klonopin): Anxiety, difficulty sleeping, panic attacks, sweating, nausea, racing heartbeat, headache, muscle pain, seizures

A variety of factors will affect how severe these symptoms will be, including:

  • How long you’ve been using
  • How much you were using at the time of detox
  • The combination of drugs you were using
  • The half-life of the drug(s) in question

When an addict can safely get through the withdrawal period without picking up their drug of choice to ease their pain, their chances of achieving sustained recovery increase. Let’s look at the detox options available today.

Medical Detox

In this type of detox, a physician prescribes medication to help ease the symptoms of withdrawal. There are two main types of medical detox:

1. Short-term/in-patient

The patient checks into an inpatient detox facility, which may be part of a hospital, connected to inpatient treatment facility, or a stand-alone facility. The process looks something like this:

  • You’ll stay anywhere from three to seven days.
  • You’ll see a doctor every day, and nurses and nursing assistants will monitor you several times a day to make sure your detox is safe.
  • You may see a social worker or case manager who will help you devise a plan for after you leave detox. Many people go straight from short-term/inpatient detox to residential or outpatient treatment.

2. Long-term/outpatient

This type of detox is for opiate addicts. It looks something like this:

  • Under a physician’s care, you’ll stop taking the opiate.
  • The doctor will write you for a synthetic opiate — usually buprenorphine (better known as Suboxone and Subutex) or methadone — to be used as a substitute.
  • Over several weeks or months, the doctor will wean you off the medication.

If you’re considering this route, there are a couple things you should know. One, it requires frequent appointments to take medication and be evaluated, so you must be able to make these appointments. And two, not all sober living facilities permit their residents to take such maintenance medications, so if that’s part of your treatment plan, check with the facility first.

Rapid detox

This is another detox option that is specifically for opiate addicts. It takes place in a hospital and goes like this:

  • You’ll be put under general anesthesia.
  • Over three to six hours, a drug such as naloxone, naltrexone or nalmephine is given through an IV.
  • The medication forces your body to go through withdrawal by flushing the opiates off the brain receptors.

While the attractive part of rapid detox is that you go through all the terrible withdrawal symptoms while unconscious, you should know that the process puts a lot of stress on your body. Patients report it taking up to three days to recover just from the process.

A word about going it alone

Then there’s the cold turkey method, in which you simply stop taking your drug of choice and resolve to “suck it up.” It is an option, but not a very good one, especially for the following scenarios:

  • You’ve been a daily drinker for a long time. Alcohol withdrawal is a potentially life-threatening condition. Seek medical attention.
  • You’re hooked on benzodiazepines. The risk of seizure is high, so do not stop abruptly. Seek medical attention.

A word about over-the-counter, “detox at home” medications:

Most professionals and laymen alike agree that these methods are ineffective. Perhaps you can achieve a small amount of relief this way, but don’t rely on them as a reputable detox method.

When in doubt: Seek medical attention

We addicts and alcoholics have already taken huge gambles with our health; don’t do so any longer. Get medical attention if you think you need it.

Detox is a great start

But it is just that, a start. Once the body is physically clean, then you can begin the work of recovery. Give yourself the best chances of success by entering treatment, attending 12-step programs, or undergoing counseling — or even better, all three. You’re worth it!