Drug Detox: What Is The Substance Detoxification Process?

Last Updated: November 1, 2021

Authored by Isaak Stotts, LP

Reviewed by Michael Espelin APRN

Drug addiction runs more profoundly than most people think. When a person is used to consuming a certain amount of drugs, it’s not very easy to stop cold turkey. The body’s relationship with the drugs is very complex, and everyone’s journey to recovery will also be different. In addiction treatment, each patient’s detox programs will also differ.

A medical detox plan will help ensure that the patient can work the drug out of their system without putting their physical or psychological well-being in danger. However, recovery from addiction isn’t an easy feat. The individual should go into the process knowing that the recovery process may take months of work before their brain and body return to the pre-addiction state.

What Is Drug Detoxification?

Detoxification of drugs is the first step for the treatment of addiction. Addiction or dependency is when the body has become accustomed to consistently elevated levels of a particular substance making the person feel they are functioning normally only when they are taking the drug. When that drug use is stopped, the individual who has developed an addiction will start experiencing withdrawal symptoms, which are uncomfortable and dangerous if no detox programs are applied.

In a drug detox program, the drug is slowly removed from the individual’s system. It has to be done methodologically depending on which drug or substance they have been addicted to. This method can be difficult. That is why an addiction specialist must decide the timetable of tapering off. That is what is done at a medical detox facility. If the individual tries to do the drug detox at home, they may do it too fast or not fast enough; they could put their health and life, in general, at risk.

Female patient discussing drug detox with her doctor.

The detox programs alone are not sufficient to help a person get rid of the addiction. Getting the drugs out of their system is just step one of a long and strenuous process. Addiction doesn’t just affect a person’s physical health, but also their mental health. That is the reason why just stopping the intake of drug or alcohol abuse isn’t enough. The individual would also need counseling and behavioral therapy throughout their recovery from addiction. Addressing the underlying problems why their substance abuse problem began is the key to ensuring their recovery is successful.

The complete process can last up to 7 days. There is also the rapid detox procedure, but it comes with an increased risk of medical complications and even death.

That gives us an idea of how the wrong drug detox methods can be dangerous for an individual’s health. That is why they should consult a rehab center for a professional detoxification process instead.

Drug Detox Process

Detoxification isn’t a very simple process. The process has to be customized for each person and their history of drug use to create a recovery model that fits them best. However, these are a few general steps that are followed:

Evaluation

The initial step that a person will have to undergo before initiating detoxification of drugs is an evaluation. It is a critical part of the program as it allows the professionals at a rehabilitation facility to determine the patient’s current condition and develop an appropriate treatment program for the individual.

The patient will be thoroughly assessed during the evaluation. The mental health of the patient will be considered, as well as the physical state.

Doctor evaluating a patient, measuring blood pressure.

These steps are essential to ensure existing conditions or factors are found. For example, safe detox while pregnant may require special care and a different approach compared to a person who is not pregnant.

Drug tests will be done to determine how much of the chemical remains in the person’s system. During this step, the professionals in charge of setting up a treatment program should tell the patient how long the process will take.

The evaluation phage also helps the professionals overseeing the program determine if the person would need medication-assisted detox.

Stabilization

That is the stage where the person begins their initial journey towards being drug-free. After that, they begin tapering off from the drug slowly, and with that come to a lieu of withdrawal effects. The withdrawal effects are the body’s way of stabilizing without the drug- hence the term “stabilization.” That is one of the critical stages that is different for everyone. Depending on an individual’s substance abuse habits, they may have to use a certain amount of the drug and safely come to a stop to ensure their mental health and physical health remain safe throughout the process. How long does it take to detox? It will depend on the substance used, however, in general detoxification can last for up to a week.

Preparation

The last stage in the process of detoxification is the preparation phase. At this point, the chemicals are expected to have left the person’s body. The stage includes appropriate education to help the individual understand that detoxification of drugs is not the only part of treatment. Continued treatment will be required to assure long-term success and to help the person remain drug or alcohol-free.

Types of Substance Detoxification

Clinics offer various addiction treatment strategies depending on the individual’s needs, the drug abuse, the patient’s health, and the period of addiction.

There are two main types of detoxification:

Medical Detox

As the name suggests, during the medical detox for drugs, the patient receives medical treatment to prevent or help cope with the withdrawal symptoms and their complications. Medical detox or medication-assisted treatment is a crucial part of the process of drug addiction treatment. The purpose of the medications used is to decrease cravings, nausea, headaches, insomnia, depression, and many other detox side effects. Sometimes IV detox drips are also used in medical settings to restore the chemical balance in the body.

Rapid and Ultra Rapid Detoxification

Scientists disapprove of this method, and the Cochrane Database of Systematic Reviews has issued a warning regarding the safety of this method and its life-threatening risks. Despite this, there are still many drug detox facilities that perform it. During the fast drug detoxification, the patient is placed under anesthesia and given medication to start the withdrawal process. The purpose is to keep the patient under anesthesia until the withdrawal symptoms wear off.

At-Home Detoxification

Addiction can be a personal process, and for some people, embarrassing, or the idea of medical detox just “sounds expensive.” Unfortunately, that leads to many people choosing not to reach out to a professional and try out an at-home detox for drugs instead. While that may be okay for something like nicotine addiction, the situation is starkly different when it comes to more serious addictions like alcohol, heroin, or any other heavy drugs.

Going through the detox at home without any support may not be the best idea with heavier, dangerous drugs. Detoxification from drugs and alcohol needs to be calculated and monitored closely, and if there are any errors, it could result in serious health complications and even death.

Why Is Drug Detox Important?

When an addict has been using drugs or alcohol for a significant amount of time or in substantial quantities, their bodies become used to the presence of the substance and readjust everything accordingly. If the substance is suddenly removed from the body, the body may go into shock, or other major health-related issues may arise, some as severe as a coma or death. That’s why the individual must go through appropriate drug detox instead.

Even though some addictive substances such as nicotine could be detoxed at home, others are far too dangerous.

These Substances Include:

  • Stimulants. The detox side effects from stimulants, such as amphetamine and cocaine, are very uncomfortable and can last for weeks after drug cessation. The symptoms vary in intensity and get stronger towards the end of the withdrawal period. The individual might also feel severe emotional and physical discomfort and experience a crash leaving them with no energy.
  • Benzodiazepines. Benzodiazepines are other drugs with serious withdrawal side effects such as anxiety, irritability, and nausea. That is why benzodiazepines detox for drugs is based either on gradually decreasing the amount of drugs or switching to other types of benzos.
  • Heroin and Opiates. Withdrawal from opioids sets in about 12 hours after the last drug intake, and it’s at its worst in about day three. The individual may even experience symptoms as serious as the contents of the stomach making their way to the lungs, lung infections, seizures, or even death. With medical detox, the patient slowly weans off the drugs thanks to medication based on buprenorphine and methadone.
  • Alcohol. According to NIDA, detoxing from alcohol is among the most dangerous types of detoxification, posing the threat of delirium tremens and seizures. The symptoms can be life-threatening if they get severe enough. If addicts don’t have medical assistance, they could suffer life-threatening withdrawal symptoms and have no one to save them. The withdrawal process isn’t necessarily steady either, so they could start okay but begin experiencing severe symptoms later in their recovery journey.

Drug Detox Side Effects

Although drug detox aims to limit or prevent withdrawal symptoms, some of them cannot be avoided. The common symptoms will most likely happen to everyone, although the degree of severity may vary.

Some of the Typical Adverse Reactions Include:

  • Nausea
  • Anxiety
  • Insomnia
  • Difficulty concentrating
  • Mood swings
  • Body discomfort
  • Tremors and shakes
  • Racing heart
  • Depression
  • Fatigue
  • Panic attacks

Dangers of Improper Substance Detox

Depending on the type of drug used, the person’s medical history, and the chronicity of the abuse, improper detox for drugs can lead to uncomfortable and even fatal adverse effects.

Some people choose at-home drug detox, with detox kits bought on the internet. There are also detox drinks, teas and the Thomas Recipe. Some people even try detoxification pills. What they do not know is that this can result in serious complications. For example, withdrawal can cause seizures, delirium, and hallucinations, all requiring immediate medical management.

Woman looking at a bottle of detox pills.

During home detox, the person can also exhibit unpredictable, dangerous behavior, leading to accidents and violence. Many women are brought to the emergency unit after trying methods of natural detox while pregnant.

Inpatient and Outpatient Detox

Many people want to quit drugs or alcohol but do not have the luxury of checking in to an inpatient facility for 30 days or more. Very often, recovering addicts need to keep working and taking care of their families while overcoming a substance use disorder. In such a case, an outpatient is a good option for them. On the other hand, patients for whom outpatient cleansing is inappropriate become candidates for inpatient drug detox. Inpatient detoxification settings offer the advantages of constant medical care and supervision by medical professionals and the easy availability of treatment for possible serious complications. Also, inpatient detoxification centers offer patients separation from the substance-using environment.

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While both inpatient and outpatient detoxification are equally focused on freeing the body from toxic substances, each type has unique attributes and benefits to offer. Outpatient detoxification of drugs involves part-time programs, which allow recovering users to keep going to school or work while being cleansed. On the other hand, an inpatient program is an intensive, residential treatment process designed to treat severe cases of addiction.

With patients staying in the residential treatment center, there is a higher success rate of completion. While it is not possible to maintain a regular daily routine, there will be no distractions of everyday life.

Some centers may also have amenities such as pools and spas; others offer holistic programs like yoga and art classes. This type of experience will help patients find relief and comfort from their daily pressures and focus more on getting better in a well-controlled environment.

Next Steps After Detoxification

Detoxification is only the first step in addiction treatment. Once the body is clean from drugs, the patient has to continue the rest of the rehab treatment to overcome physical and psychological dependence.

Rehabilitation

To remain sober for the months and years to come, the patient also has to address the behaviors, feelings, and thoughts that have pushed them towards substance abuse, and this is the purpose of the next step in recovery: rehabilitation.

The patient can choose among inpatient, outpatient, or partial hospitalization rehab, depending on the level of care needed after the program is complete.

Rehab therapy is an integral part of the success of the entire program. Through extensive therapy and counseling, the patient can address the issues that have led to the addiction.

There Are Various Types of Counseling and Therapy:

Aftercare

Even after the initial rehab program is completed, the recovery process is not over. Recovery will last for the rest of the patient’s life. A counselor will talk to the patient and create an aftercare plan. Many patients continue to attend therapy sessions regularly post-rehab, and some of them even accept scheduled drug testing to be kept accountable for their sobriety.

How To Choose The Right Detoxification Option

Anyone who wants to enter a detoxification program but does not know what to choose should first ask their therapist or physician for recommendations of the best addiction treatment centers. Then the person should do their research on the internet to find out more about that clinic or center. Finally, one should learn about their detox programs, if they are accredited, read some reviews of the previous patients and even get in touch with the facility and ask some specific questions regarding their program. There are also many free detox centers that are state-funded.

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Page Sources

  1. NIDA. 2020, July 10. Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
  2. Detoxification and Substance Abuse Treatment [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 45.) 1 Overview, Essential Concepts, and Definitions in Detoxification. https://www.ncbi.nlm.nih.gov/books/NBK64119/
  3. Gowing, L., Ali, R., & White, J. M. (2010). Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal. Cochrane Database of Systematic Reviews, (1). https://pubmed.ncbi.nlm.nih.gov/16625552/
  4. Darke, S., Larney, S., & Farrell, M. (2017). Yes, people can die from opiate withdrawal. Addiction (Abingdon, England), 112(2), 199–200. https://pubmed.ncbi.nlm.nih.gov/27514508/
  5. MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); Opiate and Opioid withdrawal: https://medlineplus.gov/ency/article/000949.htm
  6. NIDA. 2019, January 17. Treatment Approaches for Drug Addiction DrugFacts. Retrieved from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

Published on: December 15th, 2016

Updated on: November 1st, 2021

About Author

Isaak Stotts, LP

Isaak Stotts is an in-house medical writer in AddictionResource. Isaak learned addiction psychology at Aspen University and got a Master's Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.