For many people, freedom from substance addiction and abuse won’t come until they step into an alcohol or drug rehab and start the recovery process. For people who abuse drugs and alcohol, the first step toward sobriety is medical detoxification.
As the National Institute on Drug Abuse explains, medical detoxification is the process that safely manages the acute physical symptoms of withdrawal that comes when substance users stop their drug or alcohol use. A professional medical detoxification (detox for short) also:
Recovering users are advised to choose a medical detox over quitting their drug(s) of choice abruptly. Going cold turkey, which is what quitting suddenly is called, can lead to serious injury, relapse, overdose, and death. Once users are in the cycle of using and then quitting to get clean, they are likely to go through withdrawals that make them want to use again just to avoid uncomfortable, severe withdrawal symptoms. This is a cycle that puts users’ lives and health on the line. This is especially true in withdrawal situations involving opiates or opioids, benzodiazepines, and alcohol.
Withdrawal symptoms can range from mild to severe, depending on what drug was used and how often. Symptoms that send people to detox include:
Severe and dangerous symptoms, some of which commonly accompany withdrawal from alcohol or opioid medications include:
A person going through cocaine withdrawal may experience:
A person experiencing benzodiazepine withdrawal may experience:
A person need not wait until withdrawal symptoms start before they start a medical detox. The process can last anywhere from three to seven days or longer if needed. The process varies from person to person because each person is different. Some factors to take into consideration when it comes to detox include:
It is important to note upfront that effective drug or alcohol treatment does not start and end with medical detoxification. The detox process is the first stage of addiction treatment, NIDA writes, adding that detox by itself does little to change long-term substance use and rarely helps addicted users achieve long-term abstinence. Detox, however, can be a precursor to effective substance treatment, it writes.
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Most people think of only the physical part of medical part of detox, which involves the removal of toxins and drugs. But there are three steps involved, as outlined by the Substance Abuse and Mental Health Services Administration. The steps, which are based on the recommendations of a consensus panel, include evaluation, stabilization, and fostering entry into drug treatment. The process ends with the client being advised to enter a treatment program that addresses their particular needs.
Step 1 – Evaluation. Before one starts a medical detoxification, an assessment will perform an assessment to determine what level of treatment is needed for the prospective client.
Testing is done in the evaluation stage to:
During the evaluation, you can expect to be asked to provide details about:
You also may be evaluated to see if you have any nutrition issues or deficiencies. In addition to the paperwork you have to complete, prepare to show proof of insurance that can be used to cover the costs of detox.
Step 2 – Stabilization. During the stabilization stage, clients receive help throughout their acute intoxication and withdrawal. The aim is to help them become medically stable, fully supported, and attain a substance-free state. Clients at this stage may or may not receive medications. Also, in this step, clients receive information on what to expect in addiction treatment and what their role is in treatment and recovery. Friends, family, employers, and others who know the client in recovery also may be asked to become involved.
Step 3 – Fostering entry into treatment. In this last step, clients receive information and help with preparing to start a substance abuse treatment program. The importance of staying in and completing substance abuse treatment is emphasized at this stage. The National Institute on Drug Abuse cites research supporting that at least 90 days are needed for effective recovery.
These are the three steps you can expect to complete when you undergo a medical detox. Policies regarding cell phone use, computer use, urine drug testing, and visitors, among other topics, vary across programs and centers. Be sure to check the rules and ask questions about anything you don’t understand.
The detoxification process is considered successful by whether substance users enter, stay in, and complete the addiction treatment program. According to a consensus panel, any detoxification process that does not include all three steps is considered incomplete and inadequate.
A program that does not advise clients on where to get addiction treatment and aftercare services can mean clients are at risk of going back to using the drugs and alcohol they were trying to get away from. Relapse, or a return to using addictive substances, is a real risk that everyone in recovery needs to take seriously.
Medical detox can take place in a variety of settings. They include:
While there are various types of detox facilities, it is important to choose the one that meets the needs of the person in recovery.
Choosing the right facility for a medical detox can be a process because there are different types.
Detox treatment typically is divided into two categories—inpatient or outpatient. Outpatient is ideal for people who have mild addiction or addiction that’s in the early stages. They can complete detox and live off-site in a hospital or private addiction treatment center. People with more severe substance disorders or have a history of substance addiction likely will have to undergo a medical detox at an inpatient facility. This kind of center offers close monitoring of recovering clients during a critical time and makes it easier for recovering clients to make the transition from detox to the longer-term care.
If you are considering whether you should complete medical detox at a hospital or private center, consider that there are benefits and drawbacks to each that should be reviewed before making a decision.
Detox hospitalization takes place in a hospital setting while private detox takes place at a center that is independently operated and privately-owned. This kind of center typically offers its own treatment services in-house.
A hospital medical detox often is necessary for people who are experiencing serious substance withdrawal symptoms. It can provide the intensive level of medical attention that someone in that situation would need. However, it may feel “institutionalized,” or impersonal, and not offer amenities or the comforts that are offered at private facilities. That’s because funding for hospitals is typically more limited than that of a private addiction treatment center.
Keep in mind, too, that hospitals do not specialize in addiction recovery treatment like private centers do. Detox may be just one section of the hospital facility. This means the hospital doesn’t specialize in individual care. However, one can more easily find that at a private treatment center.
Many centers that are privately run aim to hire the best staff of medical and clinical staff who are knowledgeable about substance abuse and addiction, offer comfortable facilities and provide access to quality addiction therapy techniques. They also aim to make the detox process as comfortable as possible for people who are in recovery from substance abuse. Comfort and safety are key goals of private facilities, and they specialize in offering an individualized approach to addiction treatment.
Private detox can offer recovering clients more amenities that appeal to their needs and preferences, such as private or semi-private rooms. Private treatment centers also specialize in addiction treatment and can provide medical staff and addiction specialists that can help recovering clients find the healing they need. These centers use different treatment methods and options that a hospital detox facility likely cannot provide.
Many private detox facilities receive their money from private sources. They operate to make a profit from providing their services, and the prices they charge for services are associated with the costs of treatment and therapy.
More variety of services often means more money, and that is the case with private detox.
Private detox is usually more expensive than hospital detoxification services. Insurance may cover some of these expenses. If not, other payment arrangements can be made to meet the costs.
Here are some things to look for in a facility that offers medical detox services:
Location. Is the facility close to home? Or would you prefer an out-of-state facility that can offer space from the setting in which drugs were used? Putting some distance there can help you avoid triggers that cause you to use and offer some privacy as you address your addiction.
Specialty medications. Entering a program that specifically treats the drug you have been using can help ensure you get the specialized care you need. The clinical staff and addiction care specialists on staff are likely knowledgeable about your specific needs, concerns, and symptoms of your withdrawal.
Specific groups. If you think you would be more comfortable completing detox in a center that treats a specific group or community, such as seniors, veterans, women, or LGBTQ+, among others, research the clients who are served at the facility. Some facilities also may fall more in line with your personal beliefs or faith, which also can make receiving treatment easier for you.
Access to treatment programs. Review the facility to see if its detox program is part of a comprehensive addiction treatment recovery. If it is, it will be easier to access a treatment program that can help you address the root of your addiction.
Cost. Expect to pay more if you choose a center that offers amenities such as massage, acupuncture, gourmet meals or scenic views. Consider if you can afford to pay for these or if your insurance will cover the costs of the programs.
Reviews. Before you commit to a treatment center, check out any reviews and research their rates of success in treating clients. Other people’s experiences and perspectives can help you decide if you have found the right center for you.
Costs can deter some people from getting a professionally administered medical detox, whether it’s in a hospital or at a private facility. Some will then decide to attempt at detox at home. This is not a good idea. Trying to quit chronic drug or alcohol use without professional help can be difficult. It also can be risky and complicate the recovery process.
Trying to detox at home or without health care professionals assisting in the treatment procedure makes withdrawing from drugs much riskier than it needs to be. It makes chronic substance users more vulnerable to dangerous withdrawal symptoms, including heart palpitations or delirium tremens. Even mild symptoms, such as anxiety or depression, can be risky for substance users.
It is strongly advised that you seek medical detox in a facility instead of pursuing an at-home detox. In many cases, such attempts are not fruitful as the symptoms of alcohol or drug withdrawals tend to be too much for people to handle alone. Doing it on your own also increases the chances that relapse will occur before detox is finished.
The chances of an accidental overdose happening during mid-detox also increase when one does it solo at home or outside of an addiction care center. This happens when someone relapses partly through their detox and takes a great deal more of the addictive substance than they normally would so they can relieve drug cravings or withdrawal symptoms.
A medical detoxification that takes place in a hospital or addiction treatment center minimizes risks, ensures recovering substances users are kept safe, and increases chances of getting them into an effective program that can help them rebuild their lives after substance abuse.
Center for Substance Abuse Treatment. (2006). “Detoxification and Substance Abuse Treatment.” Substance Abuse and Mental Health Services Administration. Retrieved on April 17, 2018 from https://www.ncbi.nlm.nih.gov/books/NBK64119/
NIDA. (January 2018). “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse. Retrieved on April 17, 2018 at from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment