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What Is Detox?
Detox is the first step in treatment for a substance use disorder (SUD). The detox process can take more than a week and can be physically and psychologically painful. Many people relapse due to the multifaceted challenges this presents.
Detoxing under medical supervision often includes the use of medication assisted therapy (MAT) to help ease the physical and emotional symptoms of withdrawal, making it easier to stay in treatment and focus on learning recovery skills. While each person’s detox protocol differs, they can expect to experience a reduction in obsessive thoughts about drugs or alcohol, digestive issues, flu-like symptoms, muscle pain, and other common withdrawal symptoms.
The detox process begins with an initial phone call or meeting with a substance use treatment professional. They will perform a lengthy assessment to determine where a person should begin a detox, which may depend on factors like previous detox attempts, the primary substance causing withdrawals, physical health, and psychological needs.
Upon entering a detox program, a doctor will perform a physical examination to determine if medications should be a part of the detox and, if so, which ones. The medical assessment helps a treatment team develop a detox plan.
Management of withdrawal symptoms begins to ease the negative symptoms. The clinical treatment team will determine which medications are necessary, at which dose, and how often to administer doses. A monitoring plan will also begin.
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What Impacts The Detox Timeline?
Multiple factors influence how long it takes a person to detox from drugs or alcohol, including physical, psychological, chemical, and behavioral.
Physical conditions may impact the detox timeline. Doctors will assess a person’s past and current medical history. Some people may have major medical conditions that began before substance use, and others may have physical ailments caused by substance use. Medical problems that affect a detox timeline include:
- Infectious diseases acquired through sharing needle
- Narrowing of blood vessels
- Tissue death
- Heart attack and stroke
- Gastrointestinal bleeding
- Kidney disease
- Bowel infarctions
Every system within the body, including the central nervous system, can be affected during detox.
Many people with an addiction also struggle with a mental illness, like depression and anxiety, that has gone untreated, except by self-medicating with drugs or alcohol. The detox process timeline may change depending on the severity of the mental illness.
Treating mental health and SUDs simultaneously is essential for the best outcomes. When both conditions are stable, it is easier for someone to avoid relapse and stay focused on their recovery.
Chemical factors refer to the substances a person is detoxing from and their body’s reactions. Someone detoxing from certain Hallucinogens, like LSD, may be able to detox and, within days, be able to enter rehab. Conversely, someone detoxing from alcohol may risk seizures and delirium tremens due to drinking large amounts for many years.
Many people have a polysubstance use disorder, meaning they must detox from multiple drugs and alcohol. For those in detox receiving MAT, it may take clinical staff a few days to determine the correct dosage to ease withdrawal symptoms.
Detox is not an easy task and, for a person with a SUD, going without drugs or alcohol can feel like losing something important. It can be scary, causing some people to change their minds after the detox process begins. Leaving detox early does happen, though. Some leave because they feel they can complete the process on their own, and some go to satisfy the urge to use, leading to a relapse.
Other behavioral impacts include:
- Problems with the treatment staff, such as a lack of connection
- Violating program rules
- Privacy issues
- Not getting along with peers in the program
- Lack of dual diagnosis services
Types Of Detox Programs
- Medically managed, intensive, inpatient detox hospital program – The typical stay includes 24-hour detox monitoring for 3 to 14 days or until physically and mentally stable. MAT may continue as a person starts their transition into inpatient rehab.
- Medically monitored, inpatient detox program and rehab – Someone beginning detox in a rehab setting needs medical monitoring but not on a 24-hour basis. They can check in with medical staff daily to receive MAT. People usually stay in inpatient rehab for one to three months.
- Clinically managed residential detox program – In residential treatment, detox monitoring is available according to the person’s needs but is less often required since people are stable and capable of managing detox symptoms without much monitoring. Participants may stay in residential treatment for 30 to 90 days, sometimes longer.
- Ambulatory detox program with extended onsite monitoring, partial and intensive outpatient programs – Detoxing on an intensive outpatient basis can take 12 to 16 weeks or longer. Outpatient treatment may delay weaning off MAT, but a person is able to live at home and maintain employment during this time. Some continue medication for withdrawals after discharge from an outpatient program.
- Ambulatory detox program without extended onsite monitoring, outpatient program – If MAT is needed, it will likely be through occasional visits to the doctor for monitoring and checkups in the doctor’s office. The length of treatment time depends on personal circumstances and needs.
To find detox and treatment centers in your area, start by exploring our rehab directory.
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How Long Is The Detox Process?
Once detox starts, the process can take days or weeks (and even longer for some). Many think detox ends when alcohol and drugs are no longer detected in their blood. However, that is just one part of detox. A psychological component exists that causes some to crave substances obsessively. Some people develop anxiety or depression during detox, requiring immediate treatment.
Certain factors can prolong the detox process, including a person’s age and physical health. Younger, healthier people tend to have less severe withdrawal symptoms than older adults struggling with a medical condition. Also, as a person ages, the body’s metabolism slows, adding to the elimination time.
Some substances produce stronger withdrawal symptoms than others, especially with severe alcohol or drug use. For example, long-term binge drinking can produce harsher withdrawal symptoms. Also, someone with an addiction to multiple substances may experience different symptoms for each substance. During detox, unexpected factors may arise, like suicidal thoughts, aggression, co-occurring disorders, or cognitive issues.
The type of substance is a key factor in the detox process. Below are detox process details on the most commonly misused substances.
Heroin, Morphine, Oxycontin, Methadone, Fentanyl, and Codeine are examples of Opioids, which are narcotic pain relievers. Anyone taking Opioids for an extended period risks developing a dependence on the substance.
When a person tries to stop taking Opioids, painful withdrawal symptoms occur. Withdrawal symptoms may include sweating, runny nose, chills, fever, nausea, vomiting, muscle spasms or twitching, headaches, and strong cravings. Someone may also have trouble sleeping and experience dreams about using drugs. Opioid withdrawal makes it impossible to focus on anything other than their symptoms. They can be so severe that relapsing becomes an easy choice to make them feel better.
Opioid withdrawal may produce high blood pressure, fast heart rate, hyperthermia, anxiety, and abnormally heightened reflexes. Pain for which a person began using Opioids may return.
A person may start experiencing withdrawal symptoms within a few hours after their last dose. The most severe symptoms typically peak within 48 hours, but milder symptoms can linger much longer. Entering a detox program helps the detox process, which can take one to two weeks.
MAT is effective for dealing with withdrawal symptoms. The type of medications prescribed may impact the detox process, usually shortening the time. MAT prescriptions include a combination of medicines, behavioral therapies, and peer support groups for the best outcomes. Common medications are Buprenorphine, Methadone, and Naltrexone.
Detoxing from alcohol should always include medical supervision since some withdrawal symptoms can be life-threatening. Withdrawal symptoms occur in stages, with the first beginning as soon as six hours after the last drink. Withdrawal symptoms may include restlessness, lack of appetite, nausea, vomiting, shakiness, increased heart and breath rate, and insomnia. Some may experience hallucinations, delusions, and seizures. Someone with a severe alcohol use disorder may cough up or notice blood in their vomit, which can signal a stomach ulcer caused by heavy alcohol use.
Withdrawal symptoms will increase in intensity over the next two to three days. For example, the risk for seizures is highest in the first 48 hours, but delirium tremens risks are high for 72 hours.
Medications can help during alcohol detox and after when lingering symptoms persist. Acamprosate, Disulfiram, and Naltrexone are the MAT drugs that treat alcohol use disorders. The purpose of these drugs is to prevent cravings for or effects of alcohol by changing how the brain chemicals respond. Topiramate and Gabapentin may also benefit some people during detox.
Like MAT for Opioid use disorders, it is a trial-and-error process to find the correct dose and combination. Occasionally, Benzodiazepines are helpful temporarily in curbing the symptoms of alcohol withdrawal. Attending Alcoholics Anonymous and counseling alongside MAT can also be beneficial.
When detoxing from stimulants, like Methamphetamine and Cocaine, most people begin feeling withdrawal symptoms within the first few hours after last use. A “crash” occurs within the first few days of detox. New symptoms may appear around day four and over the next two weeks.
Stimulant withdrawal symptoms include anxiety, depression, and overall negative feelings. Amphetamines tend to produce more severe mental health symptoms than other stimulants, lasting longer. A person may experience an inability to concentrate, strong cravings, paranoia, fatigue, insomnia, irritability, aggression, and a slowing down of thoughts and physical actions.
The physical withdrawal symptoms are not as bad as those with Opioids and alcohol. Under medical care, clinicians treat symptoms with non-narcotic medicines. Although withdrawal may not seem as bad, symptoms can recur for weeks and months. Currently, there are no approved MATs for stimulants, but doctors may choose to treat symptoms directly.
What Happens After Detox?
Detox is the process of eliminating substances from the body, but much more is needed to stay sober and avoid relapse. Transitioning to a rehab program is recommended when discharging from a detox program. Rehab is where a person learns specific skills they can apply to their life when they return home, including early recovery and relapse prevention.
People tend to have successful outcomes after detox if they participate in:
- Behavioral counseling to learn sober skills
- Peer support groups which includes others in recovery
- Family therapy and education
- Extended medication-assisted treatment if needed
- Comprehensive aftercare plans to establish support services before returning home
Start Detox Today
It’s important to remember that addiction is a disease, and, like any disease, it requires treatment. Detox is the first step in the treatment that can start you on your journey toward a life free from addiction.
If you are ready to start the detox process and want to learn more about how long it takes or how it works, contact a treatment provider today.