The Complete Guide to Detox

Drug detoxification is a crucial part of drug rehabilitation. This article is the ultimate guide to detox.

What is a Detox?

Detoxification is the process of disengaging a person from addictive psychoactive substances both safely and effectively. There are various techniques and strategies available for a successful detox and choosing between one of the many options depends on a few factors.
Detox

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Define Detoxification

Detoxification is a main player in the successful treatment of substance abuse. In fact, it is often the first and most challenging step in the process. But a successful detox not only depends on the type of treatment. It is also dependent on the patient’s health, and as such, detox should be supervised under qualified supervision. A drug detox at home is not recommended.

New studies have provided profound insight into the drug detox process. Techniques and views are constantly evolving as well. Understanding every established and contemporary aspect of the detox process is essential for patients, family, friends, care providers, medical professionals, and everyone else involved in the process of caring for and treating people with substance abuse disorders.
In this article, we’ll cover it all, from the complete detox meaning to the processes. Most importantly, we’ll talk about the importance of ensuring that the patients experience a safe and effective drug detoxification from beginning to end.

Understanding Drug Abuse and the Brain

What is a Drug Detox?

Healthcare professionals who are involved in the patient’s recovery process should have the most significant and influential involvement in the type of plan, the length of the program, and any other details about the drug detox process.1

The need for drug detoxification doesn’t always imply addiction or substance abuse. There are many cases of accidental overdoses, unforeseen drug interactions, and mental health-related issues, like self-harm and suicide attempts by way of overdosing. That being said, within this article, we are focusing primarily on detox in the context of substance abuse rehabilitation.

The preferences and circumstances of the person with a substance abuse disorder should also be considered, although this comes second to urgent health risks. These may include family matters, work priorities, religious perspectives, moral viewpoints, financial needs, and logistical access to medical facilities and treatment options.1

Teen Substance Use Statistics

What is Detoxing from a Biological Perspective?

From a biological perspective, drug detoxification refers to a decrease in biological activity after metabolization. Biotransformation is a critical and essential pathway for detoxification and elimination in humans. The biotransformation of drugs leads to the termination or alteration of their biological activity. Otherwise, most drugs would have a prolonged duration of action.2
Even though every organ in the human body can metabolize drugs, the liver and the small intestine serve as the more dominant expression sites as the primary drug-metabolizing enzymes. There are such broad spectrums of enzymes in humans, and they can catalyze biotransformation reactions.
They have also been classified into Phase I and Phase II processes:
  • Phase I represents oxidation, reduction, and hydrolytic reactions
  • Phase II involves conjugation of the drug with an endogenous molecule
Ultimately, all drug metabolites are excreted primarily through the urine or via bile.

How Long Does Detox Take?

It is challenging to work out the exact timeline for the detoxification process. First of all, the biological timeframe, or the time that it takes for the substance to leave the body, differs in accordance with the drug type. Then comes the withdrawal period, which is much longer, though the length of the withdrawal period also depends on many factors.3
We will discuss withdrawal in detail a bit later on in this article. But back to the detoxification process, it can last anywhere from a few days to a few months, depending on the following factors:
  • The type of drugs used
  • The period of addiction
  • The method used in drug consumption
    • Snorting
    • Injecting
    • Swallowing
    • Smoking
  • Amount of substance taken
  • Family history of usage disorders
  • Underlying medical conditions of the patient

    • Metabolization Rates of Different Drugs

    Since drugs are metabolized at different rates and in other parts of the body, we differentiate between the time drugs remain in the urine and in the blood to determine how long they stay in the system.4

    Alcohol

    • 3-5 days in urine
    • 10-12 hours in blood

    Amphetamines

    • 1-3 days in urine
    • Around 12 hours in blood

    Barbiturates

    • 2-4 days in urine
    • 1-2 days in blood

    Benzodiazepines

    • 3-6 weeks in urine
    • 2-3 days in blood

    Cannabis

    • 7-30 days in urine
    • Up to 2 weeks in blood

    Cocaine

    • 3-4 days in urine
    • 1-2 days in blood

    Codeine

    • 1 day in urine
    • Up to 12 hours in blood

    Heroin

    • 3-4 days in urine
    • Up to 12 hours in blood

    LSD

    • 1-3 days in urine and up to 2-3 hours in blood

    MDMA or ecstasy

    • 3-4 days in urine
    • 1-2 days in blood

    Methamphetamine or crystal meth

    • 3-6 days in urine
    • 24-72 hours in blood

    Methadone

    • 3-4 days in urine
    • 24-36 hours in blood

    Morphine

    • 2-3 days in urine
    • 6-8 hours in blood

    What Does Detoxing Feel Like?

    Drug Detox Factors Statistics
    While necessary for recovery, drug detox is mostly a challenging process for people with addiction disorders. Again, the severity of the detox symptoms depends mainly on the factors we mentioned above, although there are certain feelings that most patients going through detox and withdrawal will feel.
    It is important to note that these symptoms differ in severity, and the duration differs for all patients. Still, no matter how difficult the symptoms can be, nothing can be worse than the physical, emotional, and mental effects of drug dependency on those who experience it.
    “This too shall pass” is something that all people with addiction disorders who are going through detox should remember. Those caring for them, and their loved ones, should provide as much emotional support as possible to get them through this challenging period in their lives.

    What Are the Symptoms of Detoxing?

    Some negative symptoms that may come with the detox process include the following:5
    • Nausea and vomiting
    • Insomnia and frequent awakenings from sleep
    • Irritability and mood swings
    • Depression and suicidal thoughts
    • Anxiety
    • Aches and pains all over the body
    • Hallucinations and fever
    • Body temperature fluctuations
    • Cold-like symptoms, including a runny nose and sore throat
    • Goosebumps and shivers
    • Paranoia
    • Confusion
    • Disassociation
    • Disorientation
    Patients often experience the following positive symptoms at various stages of their detox:
    • Affirmations that you’re doing the right thing
    • Emotional and spiritual support
    • Increased appetite
    • Better sleep
    • Improvements in skin condition
    • Increased physical capacity to exercise
    • Improved vision and taste and smell
    • The return of pride and self-belief
    • Improved hair growth
    • Healing of drug-related injuries like spike-marks and ulcers or sores

    Understanding Addiction

    Addiction is a treatable yet chronic medical disease involving complex interactions between brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in compulsive behaviors. Plus, they often continue to do so despite the harmful consequences that arise as a result.6

    Understanding addiction is a vital part of understanding detox. While addiction can pertain to many different things, like sex, gambling, substances, or compulsive behavior, for our purposes, we are focusing exclusively on substance addiction.
    Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug or substance use, continued use despite harmful consequences, and long-lasting changes in the brain. It is considered both a complex brain disorder and a mental illness. Substance addiction is the most severe form of a full spectrum of substance use disorders, and it is regarded as a medical illness caused by the repetitive misuse of a substance or substances.7

    What is the Impact of Substance Addiction?

    Substance addiction results in death, and it causes severe damage to people’s health. It also seriously impacts their friends, families, and communities. It also places a massive burden on local and national governments regarding treatment costs, hospital admissions, and other resources.7
    The employment sector is also severely impacted by substance addiction via absenteeism and job neglect. It directly affects everyone and is something for all of us to be concerned about and help towards.

    Definitions of Substance Abuse Topics

    • Substance Use: generally refers to the use of either legal or illegal substances
    • Substance Misuse: when legal substances are used in excess or non-prescription purposes
    • Substance Addiction: when misuse or use results in an inability to stop using

    Commonly Abused Substances

    Let’s take a brief look at the most abused substances:8
    • Alcohol
    • Prescriptions and over-the-counter medications
    • Cocaine, including powder and crack cocaine
    • GHB or gamma-hydroxybutyrate
    • Hallucinogens and dissociative drugs such as DMT, ketamine, LSD, acid, khat, peyote, PCP, psilocybin, and marijuana
    • MDMA or ecstasy
    • Methamphetamine including crystal meth and speed
    • Opioids including heroin, fentanyl, and carfentanil

    Statistics on Addiction Rates

    Below are several statistics regarding substance abuse throughout the United States.9
    • 31.9 million Americans aged 12 years and older are current illegal drug users.
    • 31.9 million Americans aged 12 years and older have used within the last 30 days.
    • 11.7% of Americans overuse illegal drugs.
    • 53 million people, or 19.4% of the population, have used illicit drugs in the past year.
    • 53 million people, or 19.4% of the population, have misused prescription drugs in the last year.
    • Alcohol and tobacco side, 165 million people, or 60.2% of Americans, currently abuse drugs.
    • 139.8 million Americans 12 and over drink alcohol.
    • 14.8 million, or 10.6% of the population, have an alcohol use disorder.
    • 31.9 million use illegal drugs.
    • 8.1 million people, or 25.4% of illicit drug users, have a drug disorder.
    • 2 million people, or 24.7% of those with drug disorders, have an opioid disorder.
    • 700,000 people have died from drug overdoses from the year 2000 to 2020.
    • The federal budget for drug control in 2020 was $35 billion.
    • 19.4% of all Americans have used illicit drugs at least once.

    What is the Process for Drug Detox?

    There are generally three steps involved in the detoxing from drug process.
    Process for Drug Detox

    Evaluation

    This step can either occur in hospitalization cases after an overdose, via intervention, or as a voluntary step made by a patient who understands that they have a substance addiction disorder. Evaluation entails testing for the presence of substances of abuse in the bloodstream, measuring drug concentration levels, and screening for co-occurring mental and physical conditions.
    The evaluation also includes a complete assessment of the patient’s medical and psychological conditions, as well as their social situation, to determine the appropriate level of treatment following detoxification. Essentially, the evaluation serves as the basis for the initial substance abuse treatment plan once the patient has withdrawn successfully.10

    Stabilization

    Stabilization includes medical and psychosocial processes intended to assist the patient with acute intoxication and withdrawal. It helps them remain in a medically stable, fully supported, substance-free state, which is sometimes achieved with the assistance of medications, although not all approaches require medication. Stabilization includes familiarizing patients with what to expect in their treatment journey and their role in treatment and recovery. During this time, practitioners also seek the involvement of the patient’s family, employers, and other significant people when appropriate and with the release of confidentiality.10

    Creating a Treatment Program

    At this stage, detoxification has already occurred, but the patient must be encouraged to enter treatment for the detoxification process to continue and remain effective. This step involves many processes, including counseling, meeting with caregivers or loved ones, and assessing the individual state of the patient as well as the resources and medical insurance available.

    Drug Detox and Withdrawal Symptoms

    We briefly touched on how detox feels, including some of the symptoms involved in detox. Now, it’s time to go into depth regarding the psychological and physical symptoms of both withdrawal and detox from various substances.

    Opioid Withdrawal

    Timeline

    Short-acting opioids can have an onset of withdrawal symptoms 8 to 24 hours after last use, and the withdrawal process can last for 4 to 10 days.

    Long-acting opioids can have an onset of withdrawal symptoms after 12 to 48 hours from the last use, and the symptoms can last 10 to 20 days.

    Symptoms

    • Nausea and vomiting
    • Anxiety
    • Insomnia
    • Hot and cold flushes
    • Perspiration
    • Muscle cramps
    • Watery discharge from eyes and nose
    • Diarrhea

    A Further Look at Opioid Withdrawal

    Benzodiazepine Withdrawal

    Timeline

    Short-acting benzodiazepines include substances such as oxazepam, alprazolam, and temazepam. The withdrawal process can kick in 1 to 2 days after the last does and continue for 2 to four weeks or longer.

    Long-acting benzodiazepines include substances like diazepam and nitrazepam. The withdrawal process occurs within 2-7 days after the last dose and continues for 2-8 weeks or longer.

    Symptoms

    • Anxiety
    • Insomnia
    • Restlessness
    • Agitation and irritability
    • Poor concentration and memory
    • Muscle tension and aches

    Stimulant Withdrawal

    Timeline

    Symptoms for stimulant withdrawal begin within 24 hours of last use and can last for 3-5 days.

    Symptoms

    • Agitation and irritability
    • Depression
    • Increased sleeping and appetite
    • Muscle aches

    Alcohol Withdrawal

    Timeline

    Alcohol withdrawal symptoms can occur within 6 to 24 days after the last use. The symptoms are the most severe after 36 to 72 hours and they typically last 2 to 10 days.

    Symptoms

    • Anxiety
    • Excess perspiration
    • Tremors, particularly in hands
    • Dehydration
    • Increased heart rate and blood pressure
    • Insomnia
    • Nausea and vomiting
    • Diarrhea
    • Seizures
    • Hallucinations
    • Delirium
    • Extreme fluctuations in body temperature and blood pressure
    • Extreme agitation

    Can Withdrawal Symptoms Be Deadly?

    Withdrawal Symptoms
    Unfortunately, patients can die during the detox process. There are several reasons for this, and the cause of it depends on several factors. These include the level of addiction, the length of addiction, the type of drugs involved, and whether multiple drugs are involved.

    The number one factor that can influence detox death more than any other, however, is whether or not the patient is detoxing under qualified supervision. Drug and alcohol detox and withdrawal are severe and potentially deadly processes, and drug detox treatment centers and detox rehab facilities are essential to save the patient’s life potentially. These are great places to go if you are searching the internet for drug detox near me.

    Severe withdrawal symptoms that can lead to severe injury or death include the following:
    • Heart palpitations
    • Seizures
    • Hallucinations
    • Delirium tremens

    The Dangers of At-Home Detox

    Informal detox at home is not recommended at all, and common risks include the following:
    • Death
    • Dehydration
    • Malnourishment
    • Organ failure
    • Heart attacks
    • Mental breakdown
    • Psychosis

    Drug Detox Benefits

    As we know, detox is necessary, and despite the difficulty experienced, it’s ultimately worth it. Patients will experience the following during and after detox:
    • A return to their ideal weight
    • The removal of waste via blood and urine
    • A regenerated immune system
    • Mental strength
    • Physical vitality
    • Weight Loss

    Drug Detox Programs

    When it comes to substance use disorders and addiction, detox treatment is vital. Ideally, this should take place in a credible detox treatment center. Here, patients will undergo detox programs for drug addiction, and very importantly, they’ll also receive drug detox symptoms treatment, because as we’ve seen, the symptoms can be deadly. The type of drug detox and rehab program largely depends on the individual circumstances. Drug detox and rehab facilities are qualified to assess and determine what is needed on a case-by-case basis.

    Professional Detox Process

    According to The National Center for Biotechnology Information (NCBI), the guiding principles of professional detox includes the following:11
    • Detoxification does not constitute substance abuse treatment but is part of a continuum of care for substance-related disorders.
    • The detoxification process consists of three sequential and essential components: Evaluation, Stabilization, Fostering patient readiness for and entry into treatment.
    • Detoxification can occur in various settings and at several intensity levels within these settings. Therefore, placement should be appropriate to the patient’s needs.
    • Persons seeking detoxification should all have access to the components of the detoxification process described above.
    • All persons requiring treatment for substance use disorders should receive treatment of the same quality and appropriate thoroughness and should be put into contact with a substance abuse treatment program after detoxification.
    • Ultimately, insurance coverage for the full range of detoxification services is cost-effective. If reimbursement systems do not provide payment for the complete detoxification process, patients may be released prematurely, leading to medically or socially unattended withdrawal.
    • Patients seeking detoxification services have diverse cultural and ethnic backgrounds and unique health needs and life situations. Therefore, organizations that provide detoxification services need to ensure standard practices to address cultural diversity.
    • A successful detoxification process can be measured, in part, by whether an individual who is substance dependent enters, remains in, and is compliant with the treatment protocol of a substance abuse treatment/rehabilitation program after detoxification.12

    Continuing Care Program

    Once detox is complete and the patient has received treatment for their addiction, there is always a concern that relapses might occur for various reasons. Therefore, patients, their families, friends, and loved ones are encouraged to seek continuing care programs to mitigate the risk.

    These programs can take many forms, from group sessions to one-on-one sessions with therapists or counselors, but they are often vital to maintaining progress and staying drug-free. Continuing care also means that patients need love, support, compassion, and camaraderie during this arduous process, which often makes all the difference.
    Detox is a vital component of the fight against substance use disorders, and as such, should ideally be undertaken by qualified professionals. We hope you’ve learned a lot more about detox. Thank you for taking the time out to find out more, and we wish you all the very best.

    Resources

    1. https://www.researchgate.net/publication/340704755_Detoxification_of_Drug_and_Substance_Abuse
    2. https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4131.pdf
    3. http://www.drugs.ie/NDRICdocs/protocolsassessment.pdf
    4. https://www.drugs.ie/drugs_info/about_drugs/how_long_do_drugs_stay_in_your_system/
    5. https://www.healthdirect.gov.au/addiction-withdrawal-symptoms
    6. https://www.asam.org/quality-care/definition-of-addiction
    7. https://archives.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics
    8. https://www.dea.gov/sites/default/files/drug_of_abuse.pdf
    9. https://drugabusestatistics.org/
    10. https://www.ncbi.nlm.nih.gov/books/NBK64119/
    11. https://www.ncbi.nlm.nih.gov/home/about/
    12. https://www.ncbi.nlm.nih.gov/books/NBK64119/box/fig1.2/?report=objectonly