Do I Need Detox? Some Important Considerations

Getting started on the path to recovery from a substance use disorder frequently involves the need for detoxification. Perhaps you’ve wondered if detox is something you may need to get your life back in order. The following overview will provide important considerations to help guide your decision-making process.

Distinguishing Substance Abuse, Dependence, and Addiction

Research shows how the use of drugs or alcohol affects the brain’s response and reaction, which can lead to a progression of abuse, dependence, and addiction. This progression is often seen as a scale measuring the time and degree of substance use. Understanding where you may be on this scale is an important indicator of the potential need for detox.

Abuse. All use of illegal drugs is considered substance abuse, but using any drug or alcohol in a way not prescribed or recommended is also considered substance abuse. Abuse is like the early stage of dependence, and as it becomes more frequent, the likelihood of developing a dependence disorder becomes greater.

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Dependence. Dependence occurs when repeated drug or alcohol exposure causes the brain’s neurons to adapt and only function normally in the presence of the substance. When the substance is withdrawn, several physiological reactions occur. These reactions can be very serious, leading to further substance abuse to avoid withdrawal symptoms. This is why dependence often leads to addiction.

Addiction. The hallmark of addiction is compulsive behavior tied to a loss of ability to abstain from the substance. When a person is addicted to a substance, the use of that substance targets certain cells in the brain, triggering feelings of reward or satisfaction, perpetuating the condition.

Although addiction involves dependency, the reverse is not necessarily true. It is possible to be dependent on a substance without being addicted. For example, this situation can occur with people being treated for chronic medical conditions. Such individuals may become dependent upon a certain drug, and if it were stopped, they would suffer withdrawal symptoms. However, they are not compulsive users of the drug, and they are not addicted.

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When is a Professional Detox Necessary

Detoxification refers to the process of completely ridding the body of a drug while safely managing the symptoms of withdrawal. There are numerous considerations, including social, medical, and psychological factors, regarding whether someone needs detox from drugs and/or alcohol.

Trained and licensed medical personnel are most qualified to perform a proper assessment, but there are general indicators that can be evaluated:

• Medical indicators. People experiencing fevers, abdominal pains or a change in responsiveness of pupils are in need of a detox. Other medical concerns that would raise the need for detox include changes in blood pressure and heart rate, as well as insomnia, hallucinations, and seizures.
• Mental health indicators. If there are suicidal inclinations, anger or aggression issues, detox is strongly advised. In these cases, frequent monitoring and contact with the patient by staff will be an important part of the detox process.
• Social indicators. Certain populations may have a greater need for detox. For example, adolescents are more likely to consume larger quantities of alcohol and/or drugs and are more likely to consume several different drugs. Other demographics can also indicate higher need for detox, such as victims of domestic violence and parents with dependent children.

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Side Effects of Detox and Withdrawal

Some substances affect the body in more severe ways, which can create particular risks during the detoxification process. Some of the symptoms of withdrawal from various drugs or alcohol are similar, but there are unique concerns associated with different substances, such as:

• Alcohol. When heavy drinker suddenly stops or significantly reduces their alcohol intake, they may experience a combination of physical and emotional symptoms, from mild anxiety and fatigue to nausea. Delirium tremens (DTs) is an intense form of alcohol withdrawal that involves sudden and severe mental or nervous system changes.
• Opiates/Opioids. There are numerous symptoms of withdrawal from painkiller medications, including anxiety, increased respiratory rate, sweating, tearing or crying, runny nose, restlessness, anorexia, and irritability. In more severe cases, symptoms of advanced withdrawal include insomnia, nausea and vomiting, diarrhea, weakness, abdominal cramps, rapid heartbeat, high blood pressure, and muscle/bone pain.
• Cocaine. Withdrawal from cocaine is rarely serious, but it produces a number of very unpleasant side effects, which can last for a week or two. Side effects may include, aggression, depression, anxiety, chills, body aches, tremors and shakiness, pain, inability to feel pleasure, exhaustion, challenges in concentration, and intense craving for the drug.
• Heroin. Symptoms of withdrawal from heroin typically peak in severity within 48 and 72 hours after the last dose. Many people who go through heroin withdrawal report physical symptoms similar to a terrible case of the flu but can also involve things like insomnia, diarrhea, cold flashes, nausea and vomiting, bone pain, and involuntary kicking movements.

These are just a few examples involving some of the more commonly abused substances. All of this highlights the importance of medically supervised, inpatient detoxification. When a medical detox protocol is followed, these and other withdrawal symptoms are minimized or even eliminated. This approach to detox allows the patient to be closely and safely monitored, prevents further use of the substance, and can increase the speed and success of the detox process.