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Detoxification: Frequently Asked Questions

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Detoxification is the first step in addiction treatment for many people. We’re here to help you learn more about what it entails, what it feels like, and whether or not you can detox at home.

Below, you’ll find answers to frequently asked questions around detox:

  • How Does Detox Work?
  • When is Detox Required?
  • Can I Detox From Drugs at Home?
  • How Long do I Need to Detox for?
  • Detoxing From Different Substances:
  • Alcohol
  • Benzodiazepines
  • Opioids
  • Cocaine
  • Where Can I Detox?
  • How Long do Withdrawal Symptoms Last?
  • How Much Does Detox Cost?
  • How Does Detox Work?

    Detoxing is the process of allowing substances to leave your system and managing the withdrawal symptoms that may follow. Your substance use history will affect your detox experience and determine whether or not you need medication-assisted treatment.

    A few hours after you stop using substances, your body begins to recalibrate as they leave your system. During this adjustment period, you may develop withdrawal symptoms, which occur in stages ((Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2006). 4 physical detoxification services for withdrawal from specific substances. Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK64116/ )): early, peak and late.

    Early stage: Generally 6 to 12 hours–or even up to 30 hours after you’ve stopped using–mild withdrawal symptoms like anxiety or difficulty sleeping may occur.

    Peak stage: At the peak stage, symptoms are at their worst and can include vomiting, tremors and chills. This usually occurs 72 hours after you’ve stopped using opiates or 24 to 48 hours after you’ve stopped drinking. Because of the discomfort, relapse is likely during this stage. It’s important to have a strong support system around you, along with medical supervision.

    Late stage: At this stage, your body is starting to get used to the absence of substances. Any withdrawal symptoms you may have had will start to die down.

    Why supervised detox? Remember that the purpose of a supervised detox is to minimize the severity of withdrawal symptoms and ensure you’re safely clearing your body of substances.

    When is Detox Required?

    Whether or not you need detox depends on your history of substance use, including factors such as the type of substance used as well as the duration and level of use.

    Withdrawal from certain substances, such as benzodiazepines or alcohol, can be life-threatening. That, combined with the physiological effects of frequent exposure to substances ((Physical and Psychological Effects of Substance Use. (2004). National Institute on Drug Abuse. https://ncsacw.samhsa.gov/files/TrainingPackage/MOD2/PhysicalandPsychEffectsSubstanceUse.pdf)), means it’s recommended to receive a medical evaluation from a medical professional before attempting to detox.

    You may want to consider getting an evaluation for detox if you notice the following signs of substance or alcohol abuse, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

    • cravings for substances
    • using more substances than you plan to
    • inability to cut down or stop substance use
    • taking substances for longer than intended
    • trouble maintaining relationships due to substance use
    • continuing to use substances even when it puts you in danger or negatively affects your life in other ways

    Can I Detox From Drugs at Home?

    For your safety, it’s never recommended to detox from drugs at home without supervision.

    Not all substance detoxification is lethal. However, withdrawal from certain substances, such as alcohol withdrawal, can potentially be life-threatening. ((Trevisan, L. A., Boutros, N., & Petrakis, I. L. (1998). Complications of Alcohol Withdrawal Pathophysiological Insights. Alcohol Health & Research World. https://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf)) More serious symptoms include hallucinations, seizures and delirium tremens.

    It’s always safest to detox under the supervision of specialized, experienced medical professionals.

    Keep in mind that you don’t always have to go through detox at a hospital or rehab facility. If you have a strong support system at home and your condition doesn’t require hospitalization, you may be able to opt in to outpatient detox. ((Hayashida, M. (1998). An overview of outpatient and inpatient detoxification. Alcohol Health and Research World, 22(1), 44–46.))

    How Long do I Need to Detox for?

    This depends on your substance use background and the substance you’re detoxing from. On average, detox takes 3 to 7 days.

    Expected detox time frames from commonly used substances are as follows:

    • Alcohol: 5 to 7 days
    • Benzodiazepines: One day to several months until treatment is introduced
    • Opiates: Up to 7 days (however, it’s possible to develop post-acute withdrawal symptoms ((Post-acute withdrawal syndrome (Paws) | semel institute for neuroscience and human behavior. (n.d.). https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) that last weeks, months or even years)
    • Cocaine: Up to 7 days
    • Heroin: 5 to 7 days

    Detoxing From Different Substances:

    Alcohol

    Do I need to detox from alcohol?

    This depends on how long, and how much, you’ve been drinking.

    The media often portrays people who are addicted to alcohol as living lives that are in shambles or complete disarray. But the truth is, addiction can affect anyone–many people suffer from high-functioning alcoholism. If you notice red flags, you may want to consider receiving an evaluation for detox. The DSM-5 outlines the following signs of alcohol addiction:

    • drinking more, or for a longer period of time, than intended;
    • trying to stop drinking, but being unable to;
    • spending a lot of time drinking or dealing with the aftereffects of drinking;
    • continued drinking even when it negatively interferes with work or relationships;
    • …and more.

    Alcohol detox carries a high risk for potentially life-threatening withdrawal symptoms, like delirium tremens (DT), ((Rahman, A., & Paul, M. (2021). Delirium tremens. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482134/)) which is why it is safest to detox from alcohol under medical supervision.

    If you plan to attend rehab, most residential facilities require you to be substance-free for a certain period of time before starting treatment. You can find out whether or not you’ll need to detox from alcohol during the admissions process. You have several options for detox, including on-site detox at certain luxury rehabs.

    Can I safely detox from alcohol at home?

    No. Complications from alcohol withdrawal ((Trevisan, L. A., Boutros, N., & Petrakis, I. L. (1998). Complications of Alcohol Withdrawal Pathophysiological Insights. Alcohol Health & Research World. https://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf)) can pose severe to life-threatening side effects, which is why it’s never recommended to detox from alcohol at home.

    Side effects like delirium tremens (DT) can lead to chronic memory disorders or life-threatening seizures. DT side effects often don’t show up until 2 to 3 days after you’ve last ingested alcohol.

    Even if you don’t experience life-threatening side-effects, because of the extreme discomfort of withdrawal, you’re more likely to relapse if you try to detox from alcohol at home ((Moos, R. H., & Moos, B. S. (2006). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction (Abingdon, England), 101(2), 212–222. https://doi.org/10.1111/j.1360-0443.2006.01310.x)) in comparison to detoxing under medical supervision.

    How long does it take to detox from alcohol?

    It usually takes about 5 to 7 days to detox from alcohol.

    What does alcohol detox feel like?

    Most people experience varying levels of discomfort when detoxing from alcohol. As alcohol leaves your system, you can experience mild to severe alcohol withdrawal symptoms: ((Newman, R. K., Stobart Gallagher, M. A., & Gomez, A. E. (2021). Alcohol withdrawal. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441882/))

    • sleep disturbances, like insomnia
    • nausea
    • vomiting
    • sweating
    • irritability
    • tremors
    • headaches
    • anxiety
    • visual and auditory disturbances
    • cardiovascular complications, like rapid heart rate
    • muscle pain and stiffness

    The discomfort caused from alcohol withdrawal can lead people to relapse, especially if they try to do this alone at home.

    When you detox under medical supervision, clinical staff are there to monitor your conditions, help soothe your symptoms, and offer round-the-clock support. Detoxing under medical supervision helps enhance both your safety and comfort.

    Benzodiazepines

    Can I detox from benzodiazepines at home?

    You should never try to detox from benzodiazepines, or “benzos,” alone at home.

    Unsupervised withdrawal from benzodiazepines can result in life-threatening side effects. ((Greenberg, Michael I. MD MPH Benzodiazepine Withdrawal, Emergency Medicine News: December 2001 – Volume 23 – Issue 12 – p 18
    doi: 10.1097/01.EEM.0000292622.83311.c3
    )) Because of the potential severity of these withdrawals, the U.S. Food and Drug Administration recommends: “patients taking benzodiazepines should not suddenly stop taking them ((FDA Drug Safety Communication. (2020). U.S. Food & Drug Administration . https://www.fda.gov/media/142368/download)) without first discussing a plan with your health care professional for slowly decreasing the dose and frequency.”

    It is also not recommended to quit cold-turkey following long-term use, as multiple negative and long-lasting side effects of benzo withdrawal ((News, A. B. C. (n.d.). Tranquilizer detox withdrawal can last years. ABC News. https://abcnews.go.com/Health/DepressionNews/story?id=6354685&page=1)) have been reported by a large number of users.

    How long does it take to detox from benzodiazepines?

    It takes one day to several months (until treatment is introduced) to detox from benzodiazepines. Withdrawal symptoms such as anxiety, vomiting, and nausea peak within the first 14 days after you last ingested benzodiazepines.

    What does benzodiazepines detox feel like?

    Detoxing from benzodiazepines can present a wide range of uncomfortable side effects. Because detoxing from benzos can be so uncomfortable, one of the goals of medically supervised detox is to help soothe patients’ discomfort while ensuring their safety.

    Some of the most commonly prescribed benzodiazepines ((Benzodiazepines. (2020). Department of Justice/Drug Enforcement Administration. https://www.dea.gov/sites/default/files/2020-06/Benzodiazepenes-2020_1.pdf)) include Valium, Xanax, Halcion, Ativan, and Klonopin. Withdrawal symptoms from these benzos are similar, however Xanax may cause more severe symptoms.

    When you detox from benzodiazepines after your body has become physiologically dependent on them, you may experience mild to severe withdrawal symptoms:

    • headaches
    • increased anxiety
    • sweating
    • racing heartbeat
    • insomnia
    • muscle spasms
    • nausea or vomiting
    • restlessness
    • hand tremors
    • aches and pains

    Benzo withdrawal symptoms occur in stages and depend on your history of substance use.

    Stage 1: You may first notice short-lived symptoms such as anxiety and insomnia within 1 to 4 days of benzos discontinuation. ((Pétursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction (Abingdon, England), 89(11), 1455–1459. https://doi.org/10.1111/j.1360-0443.1994.tb03743.x))

    Stage 2: Peak withdrawal symptoms occur in the second stage, which many people describe as the most difficult phase to overcome. This usually lasts 10 to 14 days.

    Stage 3: An estimated 10 to 25% of people who use benzodiazepines for an extended period of time experience post-acute withdrawal symptoms ((Hood, S. D., Norman, A., Hince, D. A., Melichar, J. K., & Hulse, G. K. (2014). Benzodiazepine dependence and its treatment with low dose flumazenil. British Journal of Clinical Pharmacology, 77(2), 285–294. https://doi.org/10.1111/bcp.12023)), or PAWS. During this stage, you’ll notice a return of anxiety and other withdrawal symptoms until you begin to address them with some form of professional addiction treatment.

    Opioids

    What does it feel like to detox from opioids?

    Detoxing from opioids can present highly uncomfortable psychological and physical effects ((Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2009). Withdrawal management. World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK310652/)) depending on your past substance use and severity of dependence. These symptoms can arise whether you’re detoxing from medically prescribed pain relievers like oxycodone, hydrocodone and codeine, or illicit opiates, such as heroin.

    During detox, as substances leave your system, you’ll begin to experience withdrawal symptoms. The extent of these symptoms depends on your substance use history, severity of use, and whether you’re detoxing from immediate-release opioids ((Commonly used terms | cdc’s response to the opioid overdose epidemic | cdc. (2021, October 15). https://www.cdc.gov/opioids/basics/terms.html)) (such as morphine) or extended-release opioids ((Commonly used terms | cdc’s response to the opioid overdose epidemic | cdc. (2021, October 15). https://www.cdc.gov/opioids/basics/terms.html)) (such as methadone), as defined by the CDC.

    Opioid withdrawal symptoms ((Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2009). Withdrawal management. World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK310652/)) are often cited as very uncomfortable and can include anxiety, rapid heart rate, muscle pain, runny or watery eyes, nausea and vomiting, insomnia, and more.

    It’s possible for opiate withdrawal to be lethal; ((Yes, people can die from opiate withdrawal | NDARC – National Drug and Alcohol Research Centre. (n.d.). https://ndarc.med.unsw.edu.au/blog/yes-people-can-die-opiate-withdrawal )) therefore it’s always recommended to detox under the guidance of an addiction-specialized healthcare professional.

    With short-acting opioids, withdrawals typically begin 8 to 24 hours after your last use. With long-acting opioids, withdrawal symptoms can onset 12 to 48 hours after last use.

    How to detox from opioids

    While usually not life-threatening, opiate withdrawal can be lethal. Therefore, you should always detox from opiates under the guidance of a qualified healthcare professional.

    Whether you detox at a hospital, private detox center, or on-site at a residential rehab facility, you should have healthcare workers available to you 24 hours a day.

    If you were using short-acting opioids, withdrawal symptoms will onset 8 to 24 hours after your last use. For long-acting opioids, withdrawal symptoms present themselves 12 to 48 hours after last use.

    Mild opioid withdrawal management:
    If you have mild withdrawal symptoms, treatment providers will ensure you consume 2 to 3 liters of water a day, along with vitamin B and C supplements to replenish lost fluids. They will also observe and monitor your symptoms 3 to 4 times a day using a Short Opioids Withdrawal Scale (SOWS). ((Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2009). Withdrawal management. World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK310652/))

    Moderate to severe opioid withdrawal management:
    Clinicians will follow the same management techniques as with mild withdrawal cases. However, they may also use medication to minimize the severity of symptoms.

    It should be noted that while detox is the first step in addiction treatment, it should be followed up with an addiction treatment program to create lasting changes to addictive behaviors.

    How long does opioid detox take?

    It may take up to 7 days for opioids to fully leave your body. However, withdrawal symptoms may last longer than that.

    For immediate-release opioids, withdrawal symptoms can last 4 to 10 days. For extended-release opioids, withdrawal symptoms can last 10 to 20 days

    Depending on your opioid use background, it’s possible to develop post-acute withdrawal symptoms (PAWS). ((Post-acute withdrawal syndrome (Paws) | semel institute for neuroscience and human behavior. (n.d.). https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) These are withdrawal symptoms that can last weeks, months, or even years after you’ve last taken opiates. Some of these symptoms include memory issues, irritability, and depressed moods.

    There is treatment for PAWS, which can be administered over the period of time you’re experiencing symptoms. Aftercare is critical to addiction treatment. If you’ve completed a treatment program, your aftercare counselor or therapist can help you identify PAWS symptoms and recommend a treatment plan. Or, you can search for rehabs that offer detox programs and speak to an intake specialist about PAWS treatment.

    Cocaine

    How long does it take to detox from cocaine?

    The time frame for cocaine detox is up to 7 days. Cocaine withdrawal symptoms are generally more psychological than physical and can include agitation, depression, anxiety, and other effects on your mood.

    Where can I Detox?

    You can detox at several different types of facilities. While it should be noted that not all at-home detox is lethal, detoxing from certain substances can pose life-threatening risks. Therefore, it’s always recommended to detox under the guidance of a healthcare professional.

    You can undergo substance abuse detox at several types of facilities:

    • hospitals
    • residential rehabs (not all inpatient rehabs offer on-site detox)
    • private detox centers

    How Long do Withdrawal Symptoms Last?

    On average, it takes 3 to 7 days for substances to leave your system. However, withdrawal symptoms can persist even after you’re substance-free.

    Alcohol withdrawal timeline: Withdrawal symptoms from alcohol typically begin about 6 hours after you’ve last ingested a drink. They can last up to 72 hours after your last drink. In more severe yet rare cases, moderate withdrawal symptoms, such as alcohol hallucinosis, can last for up to a month. ((Kattimani, S., & Bharadwaj, B. (2013). Clinical management of alcohol withdrawal: A systematic review. Industrial Psychiatry Journal, 22(2), 100–108. https://doi.org/10.4103/0972-6748.132914))

    Benzodiazepines withdrawal timeline: Withdrawal symptoms from benzodiazepines usually last 10 to 14 days. However, some people can develop post-acute withdrawal symptoms (PAWS), which is a return of withdrawal symptoms several months after last use.

    Opioid withdrawal timeline: For immediate-release opioids, withdrawal symptoms can last 4 to 10 days. For extended-release opioids, withdrawal symptoms can last 10 to 20 days. Depending on your substance use history, it’s also possible to develop PAWS from opioids. These symptoms may last weeks, months, or even years after you’ve last taken opioids.

    Cocaine withdrawal timeline: Withdrawal usually begins 90 minutes following the last dose. Cocaine withdrawal symptoms ((Department of Health | The cocaine withdrawal syndrome. (n.d.). https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-modpsy-toc~drugtreat-pubs-modpsy-3~drugtreat-pubs-modpsy-3-7~drugtreat-pubs-modpsy-3-7-cws)), such as irritability and cravings, can last up to 10 weeks depending on your level of dependency.

    How Much Does Detox Cost?

    This depends on the substance you’re detoxing from, level of care, length of treatment, and detox facility.

    In the U.S., the cost of detox at a private luxury rehab can range from less than $10,000 to over $75,000 per month. Since the Affordable Care Act (ACA) was passed, most of these private rehab centers accept insurance.

    The cost of detox at a private detox center varies as well. For example, at Gallus Detox Center Colorado, a luxury private detox center in Littleton, Colorado, treatment costs $1,850 per day with stays averaging 3 to 10 days.

    To learn more about your options for detox treatment, browse through our list of luxury detox centers.

    Reviewed by Rajnandini Rathod

     

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