Alcohol & Drug Detox Programs

Drugs like heroin, prescription painkillers, sedatives and tranquilizers, cocaine, meth, ADHD medications, and alcohol can all cause significant drug dependence.

This means you will likely suffer from withdrawal symptoms when they wear off. Cravings, flu-like symptoms, sleep problems, depression, anxiety, and intense mood swings can all be side effects of drug withdrawal.

If you suffer from drug dependence and withdrawal symptoms, you need medical detox to manage the process.

If you have a medical condition or another mental health disorder as well as drug addiction, you need a professional detox program that can manage the side effects of co-occurring disorders. The same is true if you use more than one drug, inject drugs, or don’t have a high level of support where you live.

Withdrawal from alcohol, opioids, and benzodiazepines (benzos) can even be life-threatening, Psychology Today warns, so supervised medical detox is the safest choice. In addition to managing withdrawal symptoms and cravings, medical detox can lay the groundwork for success in recovery.

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Drugs That Require Detox

When you use psychoactive drugs, the chemistry of your brain is changed to accommodate them.

Drug abuse can cause a flood of dopamine or serotonin, which are some of the brain’s chemical messengers that help to regulate your moods and emotions. This causes the high associated with drug abuse. When these drugs wear off, you will then experience a crash, as your brain chemistry attempts to balance itself after the drugs process out of the body.

The more often you use drugs and the higher your doses, the longer it can take for your brain to achieve that natural balance. Eventually, you will be dependent on the drugs. If you stop using them, withdrawal sets in.

Some drugs have more significant withdrawal symptoms than others.

Alcohol

Alcohol is one of the most regularly abused addictive substances. It is legal, cheap, and socially acceptable to drink.

Most people who drink alcohol do not suffer from alcohol dependence or addiction, but regularly consuming high amounts of alcohol can lead to this. If you have been regularly drinking a lot of alcohol for a long time, you will need medically managed detox.

Over half of everyone who abuses alcohol experiences withdrawal symptoms when they try to cut back or stop drinking. About 3 to 5 percent battle significant and even life-threatening alcohol withdrawal in the form of delirium tremens (DTs). Since the side effects of alcohol withdrawal can be extreme and even fatal, you should seek out a professional detox program to manage your withdrawal process.

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Typical alcohol withdrawal symptoms usually start about eight hours after the last drink, per the U.S. National Library of Medicine (NLM). Symptoms can include the following:

  • Headache
  • Nausea
  • Vomiting
  • Diarrhea
  • Sweating
  • Dilated pupils
  • Anxiety
  • Depression
  • Dizziness
  • Sleep problems
  • Irritability
  • Jumpiness and tremors
  • Rapid heart rate
  • Trouble thinking clearly
  • Mood swings
  • Loss of appetite
  • Fatigue

Serious alcohol withdrawal in the form of DTs may not appear for a few days after cessation of drinking. It can include significant side effects, such as delirium, confusion, agitation, fever, hallucinations, and seizures that can be fatal.

Opioids

This drug class includes illicit drugs like heroin and fentanyl and also prescription painkillers. These drugs are highly addictive, and drug dependence can set in even with regular medical use.

Opioid withdrawal can be significant, and cravings for the drugs can be incredibly intense. While the symptoms themselves are not usually considered life-threatening, the high level of discomfort makes relapse likely. Because of this, medical detox is usually recommended.

Opioids should not be stopped cold turkey due to the intensity of the withdrawal symptoms. Instead, people are usually tapered off the drugs, or a replacement medication like methadone or buprenorphine is used.

NLM reports that opioid withdrawal usually starts about 12 hours after the last dose of a drug. It can include the following symptoms:

  • Muscle aches
  • Teary eyes
  • Runny nose
  • Agitation
  • Nausea
  • Vomiting
  • Diarrhea
  • Cold sweats and goosebumps
  • Stomach cramps
  • Insomnia
  • Anxiety
  • Yawning
  • Dilated pupils

Opioid withdrawal is often compared to a really bad case of the flu with added emotional distress, which can be significant. Again, it is best managed through medical detox.

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Benzos

Benzos are a class of prescription drugs that include sedatives, hypnotics, and tranquilizers. These drugs are often prescribed to manage anxiety or sleep disorders.

Benzodiazepines are highly addictive. They are generally only prescribed for short-term use due to how quickly drug tolerance and dependence can form.

These drugs work as central nervous system depressants. When the drugs are stopped suddenly after chronic use, it can cause a dangerous rebound in brain chemistry and central nervous system activity.

Similar to alcohol withdrawal, benzo withdrawal can trigger life-threatening withdrawal symptoms, such as seizures. Medical detox is required for benzo withdrawal to manage these potential symptoms and ensure safety.

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The U.S. Food and Drug Administration (FDA) medication label for Xanax (alprazolam), a commonly prescribed benzo, lists the following possible withdrawal symptoms:

  • Blurred vision
  • Muscle cramps
  • Twitches
  • Heightened senses
  • Insomnia
  • Anxiety
  • Diarrhea
  • Decreased appetite and weight loss
  • Trouble concentrating
  • Prickling or tingling sensation on the skin
  • Mood swings

Stimulants

Stimulant drugs, like cocaine, methamphetamine, ecstasy (MDMA), and prescription ADHD medications, speed up functions of the central nervous system. They raise heart rate, blood pressure, and body temperature.

They are also highly addictive drugs. They cause an intense burst of euphoria when abused and also a significant crash when they process out of the body.

While withdrawal from stimulant drugs is not usually life-threatening, it can still be very emotionally intense. The cravings can be so significant that it is usually ideal to participate in a medical detox program.

The National Institute on Drug Abuse (NIDA) publishes that withdrawal from a stimulant drug, such as methamphetamine (meth), can include the following symptoms:

  • Insomnia
  • Anxiety
  • Fatigue
  • Depression
  • Problems feeling pleasure
  • Severe cravings for the drug

Other Drugs of Abuse

Any drugs that have mind-altering effects can impact brain chemistry. Often, your brain will need time to recover and reset after a period of sustained substance abuse.

Barbiturates predated benzodiazepines, and they can also lead to dangerous withdrawal symptoms. They are not widely abused, but barbiturate withdrawal can be fatal without assistance.

The following drugs can also lead to uncomfortable withdrawal symptoms:

  • Mood stabilizers and antidepressants
  • Barbiturates
  • Sleep aids
  • Marijuana

Anticipating the Significance of Withdrawal Symptoms

There are several things that can impact the intensity of your withdrawal symptoms.

The primary factor is obviously the type of drug you have been taking regularly. Certain drugs of abuse are associated with more severe withdrawal symptoms.

Your level of dependence will also influence the severity of withdrawal. This can be influenced by:
  • How long you’ve been taking the drug.
  • The size of the doses you regularly take.
  • The way you take the drug — by injecting, snorting, swallowing, or smoking it.
  • Biological and genetic factors, such as metabolism and a family or personal history of drug dependence and/or addiction.
  • Whether you also struggle with a co-occurring mental illness or a medical condition.
  • Abuse of several different types of drugs.

If you have been taking a lot of drugs for a long time, the odds are that your level of dependence is high and therefore drug withdrawal will be significant.

Medical and mental health disorders can complicate and exacerbate drug withdrawal symptoms, as can polydrug abuse or mixing drugs with alcohol.

Snorting, smoking, and injecting drugs increase the rate of drug dependence more so than swallowing them. This higher dependence level will mean stronger withdrawal symptoms.

Detoxification Process

Detox typically lasts three to seven days, depending on the drug used, the level of dependence, and the significance of withdrawal symptoms.

As a general rule, withdrawal symptoms can kick in as soon as the drug stops being active in the bloodstream, which is usually between a few hours and a day after taking it. Symptoms will usually peak in the first two or three days. After that, withdrawal symptoms start to wane as the brain works to achieve chemical stability.

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The first few days after stopping a drug is a crucial time. A professional detox program can help to manage and regulate brain chemistry during this vulnerable period. During detox, trained professionals may use the following to stabilize you:
  • Medications
  • Supportive measures
  • Therapies
  • Holistic methods
  • Medical interventions

The goal of detox is to help your brain and body become physically stable. Treatment professionals will ensure you stay safe and healthy while helping to control cravings and manage withdrawal symptoms.

Options for Detox

There are three main options when it comes to detox: inpatient detox, outpatient detox, or at-home detox.

Inpatient

Inpatient medical detox can provide the highest level of care and supervision, ensuring that both medical and mental health issues are addressed. If you struggle with significant drug dependence, battle co-occurring disorders, or use more than one drug, you should probably attend an inpatient detox program.With inpatient detox, your vital signs and mental health can be monitored and supported around the clock. Medications can be provided as needed to lessen cravings and withdrawal symptoms.

Outpatient

You may be given medications and therapeutic treatment during the day, but you will go home at night. This type of detox can be helpful if you suffer from a mild to moderate form of drug dependence and don’t require as high a level of care or around-the-clock support.

At-Home

There are many home remedies and at-home detox methods out there, but most are not considered safe or effective.Addiction is a chronic disease with relapse rates as high as 40 to 60 percent, says NIDA. Therefore, a structured detox program is optimal to ensure you get through this tough process and progress to comprehensive addiction treatment.

Prescription Detox Medications

Medications that are used during detox balance brain chemistry. These can include over-the-counter medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs), gastrointestinal medications, and antihistamines. They also include prescription medications.

Certain drugs, like opioids, alcohol, and benzodiazepines, can be dangerous when stopped cold turkey. They may be weaned off slowly over time through a controlled taper in medical detox. They may also be replaced with other medications that can help to stabilize the brain and central nervous system.

The following prescription medications are commonly used during detox from these substances of abuse:

Alcohol
  • Acamprosate (Campral)
  • Benzodiazepines
  • Clonidine (Catapres)
  • Anticonvulsants
  • Beta blockers
Opioids
  • Methadone
  • Buprenorphine
  • Lofexidine (Lucemyra)
  • Clonidine (Catapres)
Benzodiazepines
  • Longer-acting benzos
  • Anticonvulsants
  • Beta blockers
  • Clonidine (Catapres)
  • Mood stabilizers
  • Sleep aids

There are no specific medications that are FDA-approved for the treatment of stimulant dependence. During stimulant detox, medications that treat specific symptoms of withdrawal, such as sleep aids for insomnia and mood stabilizers for anxiety and depression, can be helpful.

Medications may be used during other forms of withdrawal, like marijuana withdrawal, to address specific symptoms.

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Using Insurance to Cover the Cost of Detox

Detox is a form of addiction treatment that can usually be covered by your insurance. Under the Affordable Care Act (ACA), substance abuse treatment is covered as one of the 10 essential health benefits.

Typically, detox will need to be classified as “medically necessary” to be covered under insurance. You will need to check with your insurance provider directly to find out what your individual plan covers and how to use that coverage.

You may have a deductible to reach first or associated copays. In some instances, you may need to pay for your detox services up front and then get reimbursed by your insurance company later.

You may also need to get prior authorization for detox services, obtain a referral from your primary care provider (PCP), or use an in-network provider for detox, depending on your specific plan and coverage.

Insurance coverage varies from state to state and between different providers. Since the specifics vary so much based on your personal plan, it can be tricky to ascertain your exact level of coverage. Detox providers and your insurance company can help you determine what your exact out-of-pocket costs will be.

Just One Step in Recovery

Detox helps you to recover a safe level of physical balance after stopping drug use, but it is only one of the steps to recovery and not the entire solution. Detox manages the physical symptoms of drug withdrawal and helps you to get a handle on cravings. It doesn’t address the root causes of addiction.

You will need to continue into a drug addiction treatment program in order to address physiological and behavioral aspects of addiction.

As a disease, addiction is complex. You will need to learn how to make positive lifestyle changes and take the time to instill healthy habits for a sustained recovery.

Addiction treatment should last at least 90 days, NIDA reports. It should include therapy, relapse prevention approaches, life skills trainings, and supportive care along with medical and mental health support. Medications, nutrition planning, exercise programs, and adjunctive holistic measures, like massage therapy, yoga, chiropractic care, and acupuncture, can also aid in the healing process.

Addiction treatment should be comprehensive. While it isn’t enough on its own, detox is often the first step in allowing your brain and body to heal.

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