Detoxification, or detox, generally refers to the process of removing toxins from the body. In the case of substance use, detox specifically refers to the period of time that the body is allowed to process or metabolize any drugs and alcohol in the system and, in doing so, clears their toxic influence. Formal detox programs can provide a number of interventions to assist with:
Safely and comfortably clearing the body completely of the unwanted substance.
Managing symptoms of acute withdrawal.
Encouraging ongoing substance use disorder treatment for the detoxing individual.
Detox is separated into two types:
Medically assisted (or medically supervised) detox – This type of treatment is done under the care of medical and mental health professionals. The observation is helpful to increase safety and comfort levels for people undergoing the painful symptoms and potential medical complications that may result from ending substance use. At times, medications can be administered to ease the process and reduce the strong cravings for the substance that typically are experienced at this point.
Clinically managed (“social”) detox – This style is a short-term, nonmedical strategy for someone wanting to end substance use. Some social detox settings will only provide a room for detox to take place while others will provide more hands-on treatment approaches including peer encouragement and professional support throughout the detox duration.
The best option will depend on the substance being abused, the current level of physical dependence and the desire/need of the detoxing individual to use or not use medically assisted techniques.
3 Stages of Detox
According to Substance Abuse and Mental Health Services Administration, detox is comprised of three stages:
Evaluation. This step will assess:
The presence of alcohol and drugs through urine, breath, or blood testing.
The person’s current mental health state.
Any existing medical issues.
The most appropriate detox strategy.
Stabilization. This will consume the majority of treatment. It will begin with acclimating the person to the detox process as well as providing medical and/or psychological services to treat symptoms, if required.
Build willingness for further treatment. Detox alone does not constitute thorough addiction treatment. As withdrawal symptoms resolve throughout the detoxification period, staff will typically begin promoting further treatment to increase the chances of sustained recovery following detox.
Who should go to detox?
Detox is a recommended initial step of treatment for a wide range of addicted individuals. Some form of detox is appropriate for anyone who has developed a substance dependency.
Dependency means that the body has adapted to persistently elevated levels of a substance in such as way that the individual begins to feel like they must take the drug in order to simply feel as if they are functioning normally. When the drug is withdrawn, dependent individuals will often experience a host of mental and physical health symptoms that are uncomfortable and potentially dangerous.
People that have had negative experiences with previous withdrawal, significant mental or physical health issues, and limited support at home will likely benefit from medically supervised detox.
Medically-assisted detox is most appropriate for people with substance dependencies involving:
Hypnotic/sedative drugs like barbiturates and benzodiazepines.
Opioids like heroin, morphine, and prescription pain medication.
Ceasing use of these substances can lead to adverse effects that range from significantly uncomfortable to fatal, depending on the type of drug being abused, the chronicity of such abuse, and the individual’s medical history.
For other drugs associated with a less dangerous or difficult withdrawal syndrome, detox might not require close medical management. For these substances, detox might be adequately conducted in the social detox setting or foregone completely as the individual enrolls in some other form of substance abuse treatment.
How long does detox take?
There is no set time frame for detox to be completed. For some, the process will only take hours or days. For others, it may take weeks to completely clear the body of the drug. Factors that dictate the length of detox include:
The drug of abuse.
The rate, dose, and duration of use.
The presence of any poly-substance abuse.
The detox setting.
The goals of the patient.
Previous detox attempts.
The individual’s health condition.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that the average length of detox is fewer than eight days. However, certain substances like methadone and buprenorphine may take longer to clear because the drugs are relatively long acting. In these instances, patients often undergo a slow tapering of the abused substance, which can necessitate longer detox durations.