Alcohol and Drug Detox

Published: 08/17/2012 | Author:

Chronic alcohol and drug misuse can lead to many harmful effects, such as tolerance, physiological dependence, addiction, and a host of physical and psychological consequences. Drug dependence means that your body has become accustomed to the presence of the drug and you will experience withdrawal symptoms when you abruptly stop or reduce your use. Drug and alcohol withdrawal symptoms can range from mildly uncomfortable to severe and potentially life-threatening. However, alcohol and drug detox can help keep you safe and comfortable while going through withdrawal.

Drug and Alcohol Withdrawal Symptoms

If you are dependent on drugs or alcohol, suddenly quitting will cause withdrawal symptoms to emerge. Withdrawal symptoms vary from substance to substance, but they tend to be very unpleasant and distressing, and in the event of certain substances like alcohol and benzodiazepines, they can be potentially fatal.

Alcohol and Benzo Withdrawal Syndrome

Alcohol and benzo withdrawal is extremely similar, and both could have life-threatening effects without medical care. Benzo and alcohol withdrawal symptoms may include:<sup1

  • Rapid pulse
  • Excessive sweating
  • Tremors
  • Anxiety
  • Nausea and vomiting
  • Repetitive, purposeless movements
  • Insomnia
  • Hallucinations
  • Seizures

Because alcohol and benzodiazepines have similar mechanisms of action, benzodiazepines are often used to relieve alcohol withdrawal symptoms and cravings. Meanwhile, benzodiazepine withdrawal is often treated symptomatically or if the benzo of use was short-acting, the treatment team may replace it with a long-acting one.

Drug Withdrawal Symptoms

Different drugs produce different withdrawal symptoms. For example, opioid withdrawal symptoms include:1

  • Nausea or vomiting
  • Muscle and bone pain
  • Depression
  • Runny nose or teary eyes
  • Dilated pupils
  • Goose bumps
  • Profound sweating
  • Insomnia
  • Fever
  • Yawning
  • Diarrhea

Withdrawal from stimulants like cocaine and methamphetamine may include symptoms like:1

  • Slowed heart rate
  • Intense fatigue
  • Nightmares
  • Excessive sleep or inability to sleep
  • Increased appetite
  • Rapid, purposeless movements or slowed movement and thought
  • Anhedonia
  • Drug cravings

Although it is a common misconception that marijuana is not addictive, long-term use can lead to dependence and addiction. Marijuana withdrawal symptoms may include:1

  • Stomach pain
  • Tremors
  • Fever or chills
  • Headache
  • Sweating
  • Depression
  • Restlessness
  • Weight loss or decreased appetite
  • Sleep disturbances
  • Anxiety
  • Anger or aggression
  • Irritability

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Alcohol and Drug Detox Services

Because drug and alcohol withdrawal symptoms can be painful, distressing, and sometimes life-threatening, it’s important to seek out professional detox services to help manage your withdrawal. Oftentimes, symptoms may be so severe that people return to substance use in order to alleviate the unwanted symptoms. This can create a compulsive cycle of misuse that can be difficult to end. Detox can help keep you safe and comfortable and once you achieve a substance-free, medically stable state, the treatment team can refer you to addiction treatment services.

Alcohol and drug detox can occur in several settings, including:2

  • Medically managed intensive inpatient detox: The most intensive detox setting, this type of program occurs in a hospital or psychiatric hospital in which you receive 24/7 medical care. This option is best if you are addicted to alcohol, benzos, or opioids, or if you have a polysubstance addiction.
  • Medically monitored inpatient detox: Also an inpatient setting, this type of detox program offers around-the-clock care in a free-standing detox facility.
  • Clinically managed residential detox: Also known as social detox, this type of care involves living at the facility and benefiting from mutual peer support, though you won’t have access to medical care. This is not recommended for someone addicted to opioids, benzos, or alcohol, and may be best for someone with more mild symptoms.
  • Ambulatory detox with extended onsite monitoring: An outpatient detox option, this setting involves attending detox services during the day at a hospital. You receive medical care from a nursing team.
  • Ambulatory detox without extended onsite monitoring: The least intensive alcohol and drug detox setting, you receive services at a home health care agency or doctor’s office. This is often a good option for someone who has become dependent on their prescription medication, like an opioid painkiller or benzodiazepine, and will adhere to a gradual tapering schedule determined by their doctor.

Detox Medications

If you choose to attend a medical inpatient detox program, you may receive withdrawal medications that can relieve your distressing symptoms and alleviate drug cravings. Certain substance withdrawal syndromes can be treated with medications approved by the Food and Drug Administration (FDA), while others don’t yet have approved medications.

Generally, alcohol withdrawal is managed with benzodiazepines, which help relieve symptoms and keep patients safe. They may administer diazepam (Valium) or chlordiazepoxide (Klonopin). Over time, the treatment staff will gradually taper the benzo dose until they reach a substance-free state. Additionally, sometimes antipsychotics and anticonvulsants may be used to control seizures, agitation, and hallucinations. And if you are addicted to a barbiturate, your detox team will likely use a benzodiazepine to manage your withdrawal symptoms, then tapering your doses gradually.2

Opioid withdrawal may be treated with methadone or buprenorphine, both of which are opioid medications, allowing them to relieve symptoms and cravings. Although they are opioids, they are safer than opioids of misuse, like heroin or prescription painkillers. Clonidine may also be used off-label to treat symptoms like rapid heart rate and sweating, although it isn’t used alone.2

There is no FDA-approved medication for stimulant withdrawal or marijuana withdrawal. Some research has indicated that Modafinil could aid cocaine detoxification. Another study found that mirtazapine can reduce amphetamine withdrawal symptoms. Ultimately, more research is needed to determine an effective and safe psychotherapeutic protocol for stimulant withdrawal, as well as cannabis withdrawal.2

Who is Medical Detox Best For?

According to the Substance Abuse and Mental Health Services Administration, medical detox is best for people who have a history of:2

  • Severe withdrawal
  • Several withdrawal experiences
  • Delirium tremens (severe alcohol withdrawal)
  • Seizures

Additionally, because of safety concerns, medical detox is the preferred setting for people addicted to alcohol, sedative-hypnotics, and opioids like heroin and fentanyl.2 Additionally, if you are struggling with a polysubstance addiction or dual diagnosis, a medical detox facility may be beneficial for you.

Find an Alcohol and Drug Detox Program

If you are thinking of quitting drugs or alcohol, know that help is available. An alcohol and drug detox program can provide you with the care you need to stay safe and comfortable throughout this trying process. Whether you are looking for an intensive medical detox program, a social detox program, or an outpatient setting, we can help. Call our confidential helpline at 800-483-2193(Who Answers?) to speak to a knowledgeable rehab support specialist about detox options. Whether you want to attend detox near you or want to travel for it, we can help you find the right facility for you.

Resources

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
2. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.

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