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Which Drugs Require Detox Before Addiction Treatment?

Medical detoxification is the first and most intensive phase of treatment in the continuum of addiction care. For a vast majority of those who enter into treatment, this is the first stop where clinicians trained in the science of addiction help clients cope with withdrawal symptoms of early drug or alcohol abstinence. The detoxification process safely manages the acute physical symptoms of withdrawal, but a medical detox is only the first stage in addiction treatment; if done by itself, it does little to change long-term drug use.

While detox alone is rarely a sufficient means to help people who abuse drugs or alcohol achieve long-term sobriety, for some, it is a powerful precursor to effective drug addiction treatment. One of the most challenging tasks for someone who uses drugs is to stop using drugs. But in many cases, it is the difference between life and death. Detox may sound like a long and painful road ahead, but it is a vital step to abstinence and sobriety.

People who attempt to go to rehab without first attending detox will not experience the same level of success as someone who medically managed their drug withdrawals. The purpose of detox is to give clients the ability to focus more on recovery and the issues that led to their addictions than trying to manage withdrawals on their own. Not addressing these issues before treatment will cause a relapse even while someone is in recovery.

The only way the advantages discussed can be obtained if someone begins their journey in detox. During their stay, they will experience a carefully monitored and controlled environment where addiction specialists can assist them in ways not possible if you begin in a standard rehab. 

Detox is a complex medical process, even when handled by professionals. But attempting this alone can be a dangerous and sometimes life-threatening situation. If someone has reached the point of wanting to abstain from drug use, it’s vital that they seek professional help to mitigate the dangers during this time.

It’s not possible to predict the severity or the length of the symptoms that will be experienced during detox, and this rings true for someone who attends detox as well. The rehab process, including detox, must be customized to meet changing needs. A high-quality facility will monitor the needs of someone as they change while the body adjusts to the flooding of chemicals that return when the drugs leave the body and will change up the process at any point to accommodate current needs. It is in your best interest to find a treatment center that is willing to address your needs in a caring and respectful  fashion. Let’s take a look at what drugs require detox before entering an addiction treatment facility.

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Detoxing from Opioids

In 2016, it was discovered that nearly 948,000 people used heroin in the past year. In that same year, 11.5 million people were nonmedical users of narcotic pain relievers. This is defined by taking narcotics that were not prescribed to them. Some narcotic pain relievers include:

  • Heroin
  • Codeine
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Methadone
  • Morphine
  • Meperidine (Demerol)
  • Oxycodone (Oxycontin or Percocet)

These drugs cause severe physical dependence, which means a person will rely on these drugs to avoid uncomfortable withdrawal syndromes. The length of time it takes for someone to become physically dependent varies from person to person, but when you stop taking the drugs, your body needs time to recover, which in turn, causes withdrawal symptoms. Withdrawal can occur at any time if someone cuts back or stops using addictive substances abruptly. Opioid withdrawal symptoms can be extremely uncomfortable. They include:

  • Agitation
  • Anxiety
  • Increased tearing
  • Muscle aches
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Symptoms that can arise later during withdrawal can include:

  • Diarrhea
  • Abdominal cramping
  • Dilated pupils
  • Nausea
  • Vomiting

While the symptoms are uncomfortable, they are not life-threatening. Due to the sheer discomfort, however, opioid detox should be done under the supervision of medical professionals. They can administer medications like methadone, Subutex, or buprenorphine to help alleviate the symptoms and ensure the process is as comfortable as possible. The severity of the addiction and method of administering the drug will dictate what kind of detox would be the most beneficial. A severe addiction will require someone to live on-site, but someone who has never been to treatment and is at a lower risk of addiction can participate in outpatient detox.

Detoxing from Stimulants

Stimulant withdrawal can be an uncomfortable task that leaves the former user unable to sleep and continue to think about using. Withdrawal symptoms from stimulants can be both physical and psychological and can range from moderate to severe, which can lead someone trying to quit into a relapse. In some cases, someone can become violent or even suicidal, and this is why they are advised to seek professional medical help with quitting. Symptoms of stimulant withdrawal can include:

  • Jittery reactions
  • Chills
  • Anxiety
  • Dehydration
  • Slow heart rate
  • Insomnia
  • Depression
  • Paranoia
  • Hallucinations
  • Drug cravings
  • Body aches

Stimulant withdrawal-related depression can be severe, and someone in detox for stimulant withdrawal is often given depression medication to help deter suicidal behavior and help recovering users cope with some of the worst symptoms. Residential detox is recommended for stimulant withdrawal because of the psychosis that can occur as a result of withdrawal.

Sad man resting on his arms

Detoxing from Benzodiazepines

Benzodiazepine withdrawal is dangerous. While stimulants and opioids may not have deadly side effects, benzos do.

Withdrawal symptoms from benzos can be physical and psychological, and the severity of the symptoms will depend on the dosage.

The length of withdrawal will be determined on how you stop and whether it was done abruptly or slowly tapered off.

Since the medication works by slowing brain activity, your brain has trouble adapting to the sudden change. Some withdrawal symptoms from benzos include:

  • Muscle weakness
  • Muscle pain
  • Shaking
  • Excessive sweating
  • Severe anxiety
  • Depression
  • Panic attacks
  • Stomach pain
  • Cramping
  • Vision problems
  • Seizures
  • Psychosis
  • Delirium Tremens

A benzodiazepine withdrawal requires immediate and extensive attention, and a medically supervised detox is highly advised. It is a dangerous medical condition that should be treated as such. Addiction specialists advise against the sudden cessation of benzos or tapering on your own.

Detoxing from Alcohol

Like benzodiazepines, alcohol is equally dangerous when attempting to stop. Alcohol detox is the first stage to treat addiction to alcohol and can involve withdrawal symptoms that range from mild to life-threatening. The longevity of an alcohol use disorder (AUD) will play a role in the withdrawal symptoms that will be experienced. Someone who has been drinking for several years is more likely to develop severe withdrawal symptoms like seizures than someone who has been drinking for a shorter time. Some signs of alcohol withdrawal include:

  • Sweating
  • Anxiety
  • Nausea
  • Headaches
  • Insomnia
  • Tremors
  • Extreme hallucinations
  • Seizures
  • Delirium tremens (DTs)

Because withdrawal symptoms have the potential to be severe, it is necessary to attend an inpatient detox facility to deal with withdrawals. Due to the extreme and sometimes unpredictable symptoms, it is better to be in the supervision of medical professionals that can change up treatment on the go.

Sources

National Institute on Drug Abuse. (n.d.). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

NIDA. (2018, January 17). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

WebMD. Alcohol Detox and Rehab Programs: What to Know. What Happens During Detox?. (July 19, 2018) from https://www.webmd.com/mental-health/addiction/alcohol-detox-programs#2

U.S. National Library of Medicine. MedlinePlus. Opiate and opioid withdrawal. (May 5, 2018) from https://medlineplus.gov/ency/article/000949.htm

Psychology Today. Stimulant-Related Disorders. (n.d.) from https://www.psychologytoday.com/us/conditions/stimulant-related-disorders

Psychology Wiki. Benzodiazepine withdrawal syndrome. Symptoms. (n.d.) from https://psychology.wikia.org/wiki/Benzodiazepine_withdrawal_syndrome

Healthline. Alcohol Withdrawal Syndrome. (April 23, 2018) Boskey, E., PhD, Legg, T. PhD, PsyD. from https://www.healthline.com/health/alcoholism/withdrawal

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