Medical detoxification is an essential part of early recovery, in which the symptoms associated with drug use are minimized to the point where the addict becomes stable enough to enter treatment. Detox is an important piece of recovery, but the discomfort that can be associated with the process may cause apprehension. While pre-existing health issues, mental conditions, and use of other drugs can lengthen the detox process, there are general timelines in which people can expect to be in detox. The following are timelines broken down by drug type, as well as what to expect during detox.
Alcohol detoxification needs to take place in a medically-supervised inpatient setting, due to the rapid onset of withdrawal symptoms. And, the overall detox process can last about a week. Withdrawal symptoms usually start 6 to 24 hours after the last drink; patients can experience tremors, restlessness, nausea, and impaired judgment. The more severe of these symptoms usually occur within the first 48 hours, so medical monitoring is highly recommended. Continued medical supervision may be needed for a few days afterward, due to the possibility of hallucinations and seizures, which can be deadly.
Drugs such as Dilantin and Clonidine can be used to relieve withdrawal symptoms, especially if the patient has seizures or experiences delirium. Depending on the overall health of the patient, those with even moderate withdrawal symptoms may benefit from medications in the detox process. Other drugs that may be used include Diazepam, Ativan, and Tegretol.
While opiate withdrawal does not pose significant medical dangers, it can be intensely uncomfortable and unpleasant in which medical monitoring is recommended. Opiate detoxification can last 5 to 10 days, in which patients are closely monitored and throughout the detox process and given the appropriate medication to prevent severe withdrawal symptoms such as diarrhea, vomiting, and agitation. While detoxing from opiates, there is a tapering (a decrease of dosage) of a substance that is related to the original drug of abuse that is now substituted to prevent withdrawal.
Methadone is a commonly-used drug in the detox process, but it also has a high potential for abuse, and needs to be carefully monitored by medical personnel. Other drugs, such as Suboxone and Naltrexone, are being used more frequently in the detox process due to the lower risk for addiction. However, both of these drugs still need to be administered under close medical supervision.
Like opiate detox, “benzo” detox generally lasts between 5 and 10 days. Medical detox is crucial, due to the severity of withdrawal symptoms and especially the psychological symptoms. Those who are withdrawing from benzos can experience psychological symptoms that can mimic schizophrenia and other forms of psychosis. Additionally, benzodiazepines, such as Xanax, are commonly used with other drugs, like alcohol. Therefore, it is crucial those with benzodiazepine addiction undergo detoxification immediately.
Currently, there are no drugs that are FDA-approved in the management of benzo withdrawal symptoms. However, drugs such as Flumazezil and Catapres are commonly used to minimize both the physical and psychological withdrawal symptoms. Along with medical detoxification, it is common those who are withdrawing from benzodiazepines can also utilize IV therapy.
Is Detox Needed for Drugs with No Physical Withdrawal Symptoms?
There are some drugs that have little to no physical withdrawal symptoms. Even though the physical symptoms aren’t present, the psychological withdrawals may warrant inpatient drug detoxification. For example, cocaine shows little to no physical symptoms of withdrawal but the psychological cravings and dependence for the drug create intense discomfort. In these cases, cocaine detox in recommended, and can last for a few days but not longer than a week.
Marijuana is another example of a drug with little or no physical withdrawal symptoms, but have pronounced psychological symptoms such as depression and anxiety. For those withdrawing from marijuana, the detox process can last several weeks since THC, the active compound in marijuana, is stored in the body’s fat cells. However, the extent of detox would be the monitoring of psychological symptoms and any co-occurring mental disorders.