Substance Abuse Detox

Detox, also known as detoxification, is the first stage in the recovery process for most drug and alcohol addictions. The detox process purges the body of foreign chemicals, allowing patients to begin their recovery with a “clean slate.”

During detox, the patient immediately and completely stops using the substance or substances to which they’re addicted. This results in their body experiencing withdrawal, a painful, uncomfortable, and often terrifying series of symptoms ranging from cravings to hallucinations. In some cases, withdrawal symptoms such as seizures can even cause death, meaning that proper medical supervision is critical. This is especially true for alcohol and opioid detox. During withdrawal, medical intervention is often necessary to keep the patient safe and comfortable. Some of the most common interventions include medication and therapy.

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How Does the Detox Process Work?

The exact detox process will vary significantly between patients. Factors that influence detox include:

  • Which substance or substances the patient is addicted to
  • The length of time the patient has been addicted
  • The severity of the addiction
  • The presence of any underlying mental health conditions, also known as co-occurring disorders
  • The presence of any additional medical problems
  • Drug allergies
  • Local laws
  • The policies and procedures of individual treatment facilities

Despite these differences, there are some broad similarities. A typical detox process will follow these general stages.

Early stages

During the first few hours, symptoms tend to be mild. However, they quickly worsen as the amount of drugs in the body decreases. Within a day or two, they usually will reach peak levels. Medication is not generally required at this point, although it may be prescribed proactively. Initial patient assessments are often conducted at this point.

Peak Stages

The first few days of detox are generally the worst. This is when symptoms are at their peak and therefore most severe. By this point, all or most of the drugs have left the patient’s body, leaving it unable to function properly. The symptoms that occur at this point are mostly the result of the body struggling to cope with the loss of the drugs. For many, this is the stage most likely to lead to relapse as many patients find it almost impossible to cope. Medication use is generally most prevalent at this stage. Some facilities begin therapy and other forms of treatment at this stage, depending on the patient’s condition and ability.

Weakening Stages

As the body slowly becomes accustomed to the lack of drugs in its systems, withdrawal symptoms generally decrease or weaken. This generally occurs within a few days to a week after detox begins. For some addictions, especially alcohol, this is often the most dangerous part of detox, because it is when some of the most severe symptoms set in. Relapse is somewhat less common during this stage because individuals have already been through the worse and are beginning to see improvements in their condition. Medication use is typically tapered off or ceased at this point. Many facilities begin to introduce other forms of treatment such as therapy at this point.

Final Stages

For most patients, detox will end between 5 and 14 days after it begins. By this point, symptoms have usually lessened to the point where the patient is capable of leaving the detox facility and entering residential treatment (in the case of inpatient rehab). Some patients may experience post-acute-withdrawal syndrome (PAWS), whereby certain symptoms of withdrawal persist, usually in a weakened form, for up to a year. Detox medication is usually ceased at this time, and patients begin to become much more heavily involved in such treatments as therapy and 12-step groups as their mind and body begin to heal.

Doctor Drawing The Word Detox On A Screen

Why Can’t I Detox on My Own?

There are four primary reasons why unsupervised detox is extremely inadvisable. It is dangerous, uncomfortable, less likely to be successful, and it reduces the likelihood that the patient will try again.


There is real danger associated with detox. Some symptoms, such as hallucinations, will cause the patient to act in unpredictable and dangerous ways, potentially resulting in injury. Others, such as seizures associated with delirium tremens, can actually cause death themselves. Medical supervision keeps the patient safe.


Detox can be an intensely painful and unpleasant process. Medical supervision and intervention, such as the use of certain painkillers or specially designed equipment, can make these negative consequences much less severe. Most patients find that the increased comfort associated with supervised detox makes a tremendous difference, both in their ability to get through withdrawal and in their mental state once they begin other treatments.

Reduced Likelihood of Success

Patients are significantly more likely to complete supervised detox than unsupervised detox. There are a number of reasons for this, including increased comfort, better safety, having a support system, the love and connection provided by treatment professionals, and increased motivation. Once a patient gets through detox, their eventual likelihood of successfully obtaining sobriety goes up dramatically.

Reduced Likelihood the Patient Will Try Again

Those who have experienced withdrawal often state that it is one of the most difficult things they have ever endured. This is especially true of unsupervised withdrawal. Patients who have previously tried to detox themselves without medical supervision often simply cannot handle it and relapse almost immediately. However, they remember the pain that they experienced, without gaining any reward other than feelings of failure, and they are much less likely to make an attempt to get sober again out of fear.

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Detox Treatments

There are many treatments available to help patients get through detox. Some of the most common include:

  • Biofeedback therapy
  • Psychotherapy
  • Meditation
  • Spiritual and faith-based therapy
  • Benzodiazepines
  • Naltrexone
  • Acamprosate
  • Disfulfiram
  • Clonidine
  • Naloxone
  • Suboxone
  • Methadone

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Do You or a Family Member Need Detox?

Alcoholism and drug addiction can have truly devastating consequences for addicts and their loved ones. The suffering caused by withdrawal symptoms can also be quite devastating, to the point where it is a major deterrent for those who realize that they need to find sobriety. However, medically supervised detox can greatly reduce the severity of withdrawal and make it a much more endurable experience. More importantly, detox is a necessary step in your transformation from a life of addiction to a life of purpose and passion.

If you or someone you know needs detox in order to begin the journey to sobriety, contact us now to speak with a dedicated treatment expert.

Last Edited: April 2, 2018

  • About the author
    Photo of Jeffrey Juergens
    Jeffrey Juergens
    Jeffrey Juergens earned his Bachelor’s and Juris Doctor from the University of Florida. Jeffrey’s desire to help others led him to focus on economic and social development and policy making. After graduation, he decided to pursue his passion of writing and editing. Jeffrey’s mission is to educate and inform the public on addiction issues and help those in need of treatment find the best option for them. In his free time, Jeffrey chooses to spend time with family and friends, preferably outdoors.
  • Sources

    National Institute on Drug Abuse. (2017). Understanding Drug Abuse and Addiction: What Science Says: 8. Medical Detoxification. Retrieved on January 5, 2018 at


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