It is undeniable — America’s addiction epidemic is worsening. The cost of substance abuse to society as a whole is substantial. Between healthcare costs, crime, and overall lost productivity, illicit drug and alcohol abuse data estimates that costs relating to crime stemming from illicit drug and alcohol abuse costs the United States an estimated $700 billion each year.
Additionally, 80% of people in our prison systems abuse drugs or alcohol, while almost 50% of that population is considered to be clinically addicted. Perhaps one of the saddest things is a report to Congress from the Department of Health and Human Services that estimated somewhere between one-third and two-thirds of all child abuse cases are affected by substance abuse issues to some degree.
Substance Abuse by the Numbers
Alcohol abuse in the US is extremely pervasive due to the social nature of drinking. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the number of adults who self-report either past or present alcohol consumption is approaching 90%. Of this nearly 90%, 71% report consuming some amount of alcohol within the previous year. Almost 57% report consuming it during the past month. As if those numbers weren’t staggering enough, consider this: About 25% of US adults report having an episode of binge drinking within the past month.
With those statistics, it should come as no surprise that 33% of all visits to the emergency room are related to alcohol consumption. There is a common misconception that alcohol isn’t a dangerous substance because it isn’t illegal. Due to its pervasive and public use, it’s important that everyone knows the major signs of alcoholism, which include:
- Drinking four or more times in one week.
- A complete lack of ability to consume alcohol in moderation
- Needing alcohol as a motivator to begin your day.
- Experiencing feelings of guilt or remorse after a night of drinking.
- Having a reputation among family and friends as someone who should probably slow down the drinking.
Concurrently, the rate of prescription opioid abuse is steadily climbing. According to data from 2013 collected by the National Institute on Drug Abuse (NIDA) 6.5 million people in the United States ages 12 or older admitted to using prescription drugs for nonmedical reasons. NIDA estimates say that the number of people who regularly abuse prescription opioids worldwide falls between 26.4 million and 36 million, and 2.1 million of those people live in the US.
Commonly abused prescription painkillers include:
- Oxycodone (OxyContin)
- Hydrocodone and acetaminophen (Vicodin)
- Hydromorphone (Dilaudid)
- Morphine sulfate
Even as the number of opioid prescriptions written is decreasing, the number of opioid-related deaths is still increasing. In 2014 alone, 28,000 people died as a result of opioid use.
Sadly, there is a rather large treatment gap in the US for people who need interventions for their addiction. In 2013, government statistics showed that 8.6% of Americans were in need of treatment for some form of substance abuse disorder. Just 1% actually received that care at a specialized treatment facility, however. Meanwhile, alcohol use disorder (AUD) affects nearly 7% of US adults and just 9% of those people receive treatment.
Substance abuse affects the lives of more than just the user, too. Beyond the physical dangers of abuse, your addiction may cause serious implications in the other important areas of your life, including your career, your relationships, your family, your finances and even homelessness. The first step is committing to detox and a life reset — and knowing the types of detox and the drug detox options available to you will likely make that decision seamless.
Why Is Detox Needed?
When people overload their bodies with certain substances for extended periods of time, namely alcohol and illicit drugs, it is common for them to develop a physical or mental dependence on that substance. To help your body heal and learn how to subsist without these substances, you first have to physically rid yourself of the substance. Detox programs can help connect you with people trained to guide you through this process.
Pursuing a natural detox, otherwise referred to as “going cold turkey,” entails the total stoppage of the substance in question. Depending on what type of drug is abused and how large the dosage is, you can expect to start experiencing withdrawal symptoms within a few hours. Generally, this method is not recommended because most successful recoveries involve a strong support network and some medical supervision during the actual withdrawal.
For its part, the American Society for Addiction Medicine (ASAM) promotes the idea that people should receive detox treatment at the lowest intensity at which they’d still benefit. For example, ASAM criteria recommend that outpatient care is best suited for people who:
- Do not need increased supervision due to comorbid medical or mental health issues. The detoxification process can be particularly difficult for people in this group.
- Have expressed a desire and motivation to go through a detox. Any degree of motivation is acceptable.
- Have access to an environment in which they will be able to remain completely abstinent during the entire detoxification process. This environment should include a support network and a relative life structure.
What Physically Happens to Your Body During Detox?
The symptoms experienced during detox largely depend on both the type and amount of the substance. You can likely expect to feel uncomfortable and both physically and mentally weak during the earlier stages of detox. Some people liken these symptoms to the flu, only much more severe.
Withdrawing From Prescription Opioids
Oftentimes the onset of withdrawal symptoms when detoxing from opioids occurs within the first 24 hours. Early symptoms can include:
- Muscle aches
- Teary eyes, otherwise known as lacrimation
- Excessive sweating
- Insomnia and general exhaustion
The later symptoms, which are often more intense and uncomfortable, generally set in within the first few days. These later symptoms can include:
- Abdominal cramping
- Nausea and vomiting
- Elevated blood pressure
- Bone pain
- Increased heart rate
- Dilated pupils, which can inhibit the ability to see
These symptoms tend to subside after 72 hours, and you can expect to begin feeling nearly back to normal after a week of detox. Unfortunately, a different set of symptoms normally present once you have detoxed. Post-acute withdrawal symptoms (PAWS) can persist for weeks or even years into your recovery.
These may include:
- Depression and anxiety
- Feelings of remorse about your time as an addict
- Loneliness after having to purge your circle of friends or even losing family members during your time as an addict
- Persistent insomnia
- Short-term memory problems
Withdrawing From Alcohol
Withdrawing from alcohol and withdrawing from opioids or heroin have certain similarities. Both experiences begin with physical symptoms followed by emotional withdrawal symptoms. Withdrawing from alcohol generally follows a certain symptom timeline. All symptoms normally decrease in intensity around five to seven days following the last drink, but in the interim:
Part 1: Eight hours after the last drink, people withdrawing from an alcohol addiction can expect to experience nausea, sleeplessness, anxiety, and abdominal pain.
Part 2: The onset of part 2 alcohol withdrawal symptoms normally occurs between 24 and 72 hours after the last drink. These symptoms can include heightened blood pressure, fever, rapid heart rate, and feelings of delirium or confusion.
Part 3: Beginning normally more than 72 hours following the last drink, part 3 alcohol withdrawal symptoms can include hallucinations, seizures, fever, and agitation.
After physical symptoms have subsided, there are a host of PAWS that can persist for up to two years following the last drink. You may experience any combination of the following PAWS:
- Inability to concentrate or brain fog
- Coordination issues
- Problems with memory
- Inability to develop and maintain healthy sleeping habits
- Repetitive thinking
- Emotions that feel out of control
- Stress management difficulties
- Feelings of depression or anxiety
- Absence of motivation or initiative
- Persistent exhaustion
- Difficulty experiencing pleasure (anhedonia)
- Problems getting along with others
- Obsessive-compulsive disorder
- Feelings of guilt or remorse
One very important distinction from opioids is that you can actually die from alcohol withdrawal. The most serious form of withdrawal, called delirium tremens (DT), often presents itself after two or three days without alcohol. Alcohol is a depressant, and if it is completely removed without warning, the brain and central nervous system can rebound. This rebound can lead to cardiovascular failure and ultimately prove fatal if left untreated. The lifetime risk of DT among chronic alcoholics falls between 5% and 10%.
Withdrawing From Stimulants
The detox timeline for stimulants such as cocaine and amphetamines spans from about a week to several months. Physical symptoms peak about a weak after stoppage, while psychological symptoms can persist for months. Withdrawal from stimulants is characterized by feelings of unhappiness in tandem with some combination of the following symptoms:
- Slow or slurred speech
- Hallucinations or paranoia
- Noticeable weight loss and a gaunt physical appearance
- Extreme fatigue
- Increased appetite
- Impaired memory
- Slowed heart rate
- Slowed movement
Although these physical symptoms tend to subside after the first seven days, drug cravings may actually become more intense near day 10. After day 18 the worst is usually over.
Types of Detox
There are a few different types of detox, and the best one for you will depend on your level and length of addiction. Additionally, it will depend on the substances you’re addicted to.
Detoxification in the intensive care unit of a hospital is generally reserved for the most severe cases. Individuals who get an accelerated detox are placed under general anesthesia and given intravenous opiate-blocking drugs — such as naloxone or naltrexone. They are also given injections of other medications intended to reduce the severity of certain withdrawal symptoms, such as anti-nausea agents and muscle relaxants. This process leads to rapid withdrawal from the physical components of addiction. All in all, total physical detoxification is reached within four to eight hours, and you can leave within 48 hours of admission.
People who may benefit most from such a detox strategy could include those who have been unsuccessful in previous detox endeavors. Severe withdrawal symptoms are a major reason why so many people relapse. It is important to know, however, that this type of detox is expensive and associated with all the same risks that accompany anesthesia. For example, many people vomit during withdrawal. Vomiting while under general anesthesia can be deadly.
A medicated detox is typically supervised by medical staff and counselors alike. The process is conducted within an inpatient treatment facility. For many people, a medicated detox is the ideal method of detox because the medication helps to dull the otherwise very uncomfortable withdrawal symptoms typically associated with the detoxification process. If your symptoms are mild, then aspirin or a nonsteroidal anti-inflammatory drug like Tylenol may suffice. Medications like Imodium (loperamide) can be employed to ease diarrhea, while hydroxyzine (Vistaril or Atarax) can be taken for nausea.
More severe withdrawal symptoms, however, may call for stronger drugs. Suboxone (naloxone and buprenorphine) can be used because although it is an opioid, there is a significantly smaller addictive potential. Suboxone, when injected, prompts immediate withdrawal. When taken orally, it can shorten the length and intensity of the withdrawal process.
Meanwhile, methadone is a powerful opiate that can be reduced down to a dosage unlikely to cause the intense withdrawal symptoms. It is used during the first 36 to 48 hours of withdrawal. The drug helps to reduce cravings and chances of relapse. In certain cases, people can receive a regimen of methadone for several years or even longer during recovery.
Although a medical detox definitely helps in managing the physical symptoms and side effects of withdrawal, it is critical to understand that this is only the first stage of addiction treatment. Treatment facilities are the key factor in managing the second stage of detoxification, which involves developing recovery skills and relapse prevention strategies.
Perhaps the least conventional of drug detox options may be a social detox. Social detox facilities are short-term and offer room, board, and interpersonal support systems to people who are going through withdrawal or are even still intoxicated. Treatment services are non-medical, although normally the staff is at least surveying vital signs.
This detox treatment is appropriate for people who are addicting to the actual act of consuming a substance but are not physically dependent on that substance. Detox drugs are not used, but rather positive energy and healthy environment are provided to help people break their habits.
Outpatient detox is generally most appropriate for people who are further along in their recovery. Many of these people are on a long-term methadone maintenance detox regimen or suboxone. If you decide to pursue outpatient treatment, it is recommended that you live at home or in a sober living facility. This may help you avoid the temptations that might be present from people you used to hang out with during your addiction period.
How often you attend and the intensity of outpatient detox services and relapse prevention can be customized from person to person. Overall there are several distinct benefits of outpatient programs:
- Treatment is flexible and accessible, which generally means that you can maintain your life routine and healthy work and family balance.
- Outpatient programs are much less expensive than residential inpatient care.
- After attending outpatient detox and therapy, you have the opportunity to apply skills in the real world.
- You can develop social interaction skills during group therapy sessions.
Although you are not living in a treatment facility, you should continue to see a counselor or mentor to make sure you have enough support to stay on your road to recovery. Checking in with a health professional is almost important to make sure you have the correct dosages for your need medications — especially as you start to taper off down the road.
Generally speaking, pursuing self-detox is both dangerous and ineffective. Despite the many self-detox products that inundate the market, you should never, in no uncertain terms, try to detox alone.
Purging your body of unwanted toxins from food is a completely different process than ridding your body of alcohol or illicit substances. As previously mentioned, detoxing from alcohol can cause hallucinations, convulsions or heart failure that can lead to death. Detoxing from benzodiazepines, a class of central nervous system depressants like Valium, Xanax, and Klonopin can similarly cause death due to seizures.
Self-detox may also come with a set of mental health risks. Withdrawing from cocaine or meth can lead to paranoia, depressive breakdown, and suicidal ideation. You should always pursue a supervised detox to best avoid these dangers and complications.
Finally, choosing to detox alone leaves you susceptible to the environment in which you live — which for most people is not conducive to sobriety. Your friends and connections can be negative influences on you during the hardest portions of your detox, which can leave you very vulnerable to relapse.
Detox: Just One Part of Your Treatment Plan
For many people, withdrawal is the hardest hurdle to recovery. A licensed professional detox facility can help ensure your journey to recovery begins safely and effectively. If you or a loved one is ready to commit to a life of recovery, the first step has to be detox. Generally speaking, your best bet for sustained recovery is to begin your detox journey at some form of an inpatient facility. Afterward, you should complement your inpatient program by taking advantage of a residential recovery program.
Medically assisted detox services at JourneyPure Emerald Coast can help to alleviate the symptoms of withdrawal while concurrently evaluating your mental state to determine whether or not there are any comorbid mental conditions that may have exacerbated your addiction. Findings from the latest National Survey on Drug Use and Health found that almost eight million people in the United States suffer from co-occurring disorders. However, just 55% of those people end up receiving care for their condition. Common mental disorders implicated in a dual-diagnosis include:
- Anxiety disorder
- Bipolar disorder
- Obsessive-compulsive disorder
The experienced staff is trained and equipped to handle the unique challenges that come with the different stages of detox from different substances, including emergent, acute and post-detox issues. Overall treatment plans are designed for each individual and are intended to address the mind, body, and spirit. While we promote traditional therapy methods, which usually include some combination of individual, group and family sessions, our treatment facility also employs newer, evidence-based healing approaches. These approaches can include experiential therapy and an adapted version of the signature 12-step program approach from Alcoholics Anonymous.
JourneyPure Emerald Coast’s multi-faceted treatment strategy has been shown to increase a user’s chances of success in overcoming their addiction to opiates. Experiential therapy services we offer include songwriting, art therapy, equine therapy, adventure therapy, and music therapy. Exploring these activities alongside a licensed therapist allows you to experience your recovery and develop necessary skills through movement. People who have participated in this type of therapy have reported a changed outlook, feelings of empowerment and an enhanced sense of emotional well-being.
At JourneyPure Emerald Coast, we are committed to providing support for you both during and after your detox and withdrawal. Comprehensive aftercare services are intended to help you pinpoint the causes of your addiction and to help you develop the tools and coping mechanisms needed to avoid future relapse. We are here to assist you in exploring your drug detox options and preparing for a life of recovery and fulfillment.