Drug and Alcohol Detox: Everything You Need to Know

What started out as an occasional drink with friends may have turned into an everyday ritual. And those pills you would take to numb your bodily aches and pains are now all you can think about.

Drinking or using drugs does not make you happy or relaxed anymore as it once did. Instead, these substances have slowly taken over all aspects of your daily life, leaving you needing more no matter how much you consume. Drugs have negatively affected your personality, changed your appearance, and drained all of your energy. It is time to face it—you are addicted. When you decide to regain control of your life and quit using substances, detox is the first step in your recovery journey.

How Does Addiction Happen?

Addiction is a complex brain disease caused by repeated substance misuse. Drugs are chemicals; When you put these chemicals into your body, they tap into the brain’s communication system and interfere with the way nerve cells normally send, receive, and process information.

Some drugs may overstimulate the brain’s “reward circuit” system, while others imitate the brain’s natural chemical messengers. Here’s how addiction starts for the following commonly abused substances:

Opioids

Opioids also referred to as narcotics, are a type of drug that immediately binds to pain receptors in the brain, dulling any painful sensations. In addition, opioids release a rush of dopamine in the brain, making some users feel relaxed or “high.” With repeated use, your body’s natural production of dopamine, a mood-boosting chemical, slows down and you require more of the drug to feel good. The longer the drug use goes on, the more your natural balance is disrupted and the more your brain relies on the substance to keep feeling “normal.” This reliance is known as addiction.

There are prescription painkillers as well as illicit opioids like heroin, fentanyl, and carfentanil.

Alcohol

Alcohol and  excessive drinking  disrupt your brain’s natural processes and chemical balance in ways like opioids. When alcohol enters the brain, it triggers the release of dopamine. The substance also slows down neuron communication, which is why many intoxicated users feel drowsy or experience a loss of coordination. After continuous use, your brain begins to associate drinking with feelings of euphoria and relaxation. When the effects of alcohol wear off, you start to crave more and reach for another drink. Over time, this pattern becomes alcoholism, impairing not only your normal brain function but also harming many of your other vital organs as well. 

Benzodiazepines

Known for their calming effect on the brain, benzodiazepines, also referred to as “benzos,” are prescribed to treat anxiety disorders, panic attacks, and insomnia. Benzodiazepines increase the efficiency of GABA chemical messengers in the brain, which calm down nerve firings related to stress. This slows down activity in the central nervous system and induces a state of tranquility or bliss. If taken more than prescribed, users can quickly develop a tolerance which is why benzodiazepines are extremely addictive. With long-term use, benzos can cause cognitive impairment, speech issues, and increase the risk of developing Alzheimer’s disease. 

Common benzodiazepines include Ativan, Xanax, and Valium.

Stimulants

When someone uses stimulants, the drug hacks into the brain’s reward system and releases dopamine and norepinephrine. While dopamine causes a pleasurable rush in the head, the norepinephrine heightens awareness. This occurs because high amounts of norepinephrine raise blood pressure and heart rate, constrict blood vessels, and open breathing passages. These effects are usually followed by a wave of exhaustion. Recently, the popularity of prescription stimulants like Adderall has risen among adolescents because they help users become more focused and awake. After a few times, tolerance quickly builds up, prompting addiction.

Other prescription stimulants are Ritalin and Dexedrine. While illicit stimulants include cocaine and methamphetamine.

What is Detox?

Detoxification is when you stop using alcohol and drugs to allow your body to purge the harmful substances from its system. After months or years of repeated alcohol or drug abuse, your body needs to readjust to not having substances be a part of its daily functioning.  As your body and brain start to return to their normal state, you may feel a range of discomforts, including physical and psychological withdrawal symptoms as well as drug cravings. The withdrawal process can often be uncomfortable, and at times painful. Some people describe withdrawal as the worst flu they have ever had.

What withdrawal symptoms you experience and the intensity of the symptom depends on numerous factors.  The alcohol and drug withdrawal experience is different for each person. For short-acting drugs, like opioids, symptoms typically appear within a few hours after the last use. With other substances, like benzodiazepines, withdrawal symptoms can emerge 1 to 4 days after the last use.

Common Physical Withdrawal Symptoms:

• Nausea and vomiting
• Insomnia
• Deep physical pain
• Muscle spasms
• Headaches
• Restlessness

Common Psychological Withdrawal Symptoms:

• Emotional numbness
• Rapid mood changes
• Lack of motivation
• Depression
• Sleeping problems
• Violent outbursts

Can You Detox on Your Own?

In most cases, unless told it is safe to do so by a medical professional, you should not detox on your own. Detoxing alone can be dangerous, particularly if you are addicted to depressants such as alcohol and benzos or opioids like heroin and fentanyl.  

For certain substances, like alcohol, if you attempt to quit “cold turkey”, you may suffer from serious side effects like delirium tremens. Although rare, this condition causes periods of confusion, tremors, and seizures. This is why detoxing under the care of medical professionals will help manage dangerous systems and keep you safe.

If you are addicted to opioids, these drugs numb your pain, so if you were to suddenly quit, then you would experience the opposite effect—unbearable pain. After quitting, many people resort back to substances to avoid feeling pain. Detox provides a healing environment to help minimize the risk of relapse and increase your recovery success rate.  

What Happens During Medical Detox?

Medical detox provides support during the most physically challenging part of recovery when the body is still dependent on drugs or alcohol. By detoxing under medical supervision, you will have a professional team who can help you effectively alleviate severe symptoms and monitor your progress around the clock. They will be there to provide comfort and support in a restorative environment. And if needed, they will help you safely wean off the substance(s) with medications.

Evaluation

At the beginning of your detox program, the treatment team will go through a series of evaluations and medical exams to determine your current condition. Then, staff members will perform a physical exam, and you will have urine and blood tests done to check not only for residual drugs in your system but for any  diseases that your active use  may have led to. They may also identify any co-occurring disorders you may have. 

By utilizing biopsychosocial assessments, the treatment team can get a better understanding of how your social environment, biological factors, and psychological needs overlap. Characteristics of one’s life such as familial dynamics, financial resources, interpersonal relationships, diet, and neurochemistry can all contribute to substance abuse, and these particulars can help staff learn how addiction has impacted your overall health. 

It is important that you be completely honest about your past substance use, so you receive the best possible care. After examining your background, the treatment team will develop an individualized treatment program to best fit your needs. 

Stabilization

During your stay in detox, a medical team will regularly check your vitals and ensure your physical health is in top condition. Their top priority is keeping you comfortable and safe as you go through the withdrawal process. In addition, you will receive proper nutrition and hydration and also work on maintaining a healthy sleep schedule. All of this is done in an effort to begin restoring your body back to normal.  

Medication-Assisted Detox

Medication-Assisted Detox (MAD) is when medication is used to relieve the unpleasant physical symptoms of withdrawal—everything from headaches to psychosis to tremors. Over time, your mind and body have become reliant on drugs, and suddenly quitting can send your biological and psychological systems into chaos. If you have been heavily reliant on drugs or alcohol, tapering will lessen the intensity of withdrawal side effects in a monitored environment. 

Commonly Administered Detox Medications

In certain cases, you will receive medication that mirrors the effects of your abused substance. Then, the medical staff will give you lower doses of the medication to help your body and brain gradually readjust to life without substances. They decide the amount of each dosage based on your drug use history, overall health, and other factors. As you progress, the medical team may alter the dosage based on your needs. 

Some medications used in MAD have the potential to become addictive, so that is why it’s important to use them as prescribed by medical professionals. Doctors and nurses are cautious when prescribing benzos, for example, because users can quickly develop a tolerance so they should only be used in the short term.  

Benzodiazepines (Ativan, Librium, Valium) – Medications that are used to control alcohol withdrawal symptoms by reducing nerve impulses throughout the body. Some of these symptoms include nausea, anxiety, and more

Methadone – Long-acting opioid that eases opioid withdrawal symptoms due to its pain-relieving, sedative, and respiratory depressive properties

Buprenorphine (Suboxone) – Partial opioid agonist that produces mild opioid effects, but loses effectiveness at higher doses. Buprenorphine is intended to reduce or eliminate symptoms of opioid withdrawal and ease drug cravings

Aftercare Planning

Before leaving medical detox, the treatment facility staff will recommend you the next steps in your recovery. Depending on your physical and mental health, professional and familial commitments, and financial resources, your aftercare plan will consist of treatment programs and services that best suit your needs. Ideally, you should look into an inpatient or outpatient treatment program that can further equip you with the tools needed to prevent relapse and sustain recovery. 

How Long Does Detox Last?

Whether you are medically detoxing or detoxing alone, the length of detox depends on multiple factors. These factors normally include:

• Type of substance used
• Potency of the substance
• If you mixed drugs
• How long you used the drug
• Medical history

For example, if you frequently combined powerful substances, like alcohol and benzodiazepines, you will need more time for your body to fully heal from the damage that was inflicted. Typically, medical detox lasts from 3-10 days.

What Happens After Detox?

Successfully completing detox is a huge accomplishment. It is a challenging process, and you should be proud of yourself for getting to this point.  

Studies have shown that the longer an individual undergoes addiction treatment, the higher their chances of maintaining long-term sobriety. Detoxification only scratches the surface of recovery and the period after detox can be raw and unsettling. While detox focuses on restoring physical health, your psychological issues also need to be addressed.  

By attending a drug rehabilitation program, you will work to uncover the root of your addiction. Through rehab, you will identify any troubling behaviors and learn to replace them with positive habits to prevent relapse and thrive in recovery.