When you’re a person going through an addiction detox it is hell on earth, there are no two ways about it. Shakes, cramps, hallucinations, fever and even death are all possible.
The experience of watching a loved one go through addiction withdrawal can be almost as painful as the detox itself. You’re absolutely helpless to do anything meaningful about it and it hurts.
Whether it is alcohol, cocaine or opioids, detoxing is challenging, painful, potentially dangerous, and confusing.
If you are a loved one watching a friend or family member detox, you might think to yourself:
“I can stop drinking at any time, for crying out loud, and sure, I may feel a bit hung-over the next day, but I’ll live.”
This is not the case for the alcoholic or addict, whose withdrawals are potentially dangerous. This isn’t just a matter of shaking off a little hangover; this is a serious medical condition and needs to be treated as one.
This is detox.
In the following article, we are going to help you completely understand detox and the various methods that are used. We’ll explain what is known to be safe, effective, and backed by data and what isn’t.
Just What is Detox Anyway?
When you’re an alcoholic or drug addict who has been using for years, your body becomes accustomed to the drugs or alcohol being a part of daily life.
This is different than for the person who occasionally “parties hard”.
To the addict, having drugs or alcohol in their body makes them feel normal. This outside chemical is as natural to the addict or alcoholic as food is to the normal person. Detoxing this foreign substance from the body is almost as painful for them as draining the blood from your own.
When an addict or alcoholic stops using for a period of time, even hours, their bodies start feeling a little squirrelly and tell them that it is time to re-up, or replenish their stores. They then drink or use in order to maintain that life giving balance that only their substance of choice provides.
This is a cycle that can end up lasting years.
For the addict, using is no longer a matter of seeking a better high. It’s a matter of maintaining the chemical equilibrium that their body is crying out for.
Throughout this process, the chemical builds up in their body and they require an ever-growing dose in order to feel normal.
If and when the time comes that an addict realizes they are powerless over their addiction and that they need help, they simply can’t quit like a recreational user. To the addict’s body this chemical they’ve been using all of this time has become the very stuff of life.
Their actual physical being has become so dependent upon this drug that their whole body recoils and violently reacts to its absence.
This is detox.
For the addict or alcoholic this isn’t just a matter of sleeping off a little alcohol or the slight buzz they caught last night.
The addict’s body has become so accustomed to that substance that it believes it may die without it.
And in the case of alcohol or benzodiazepine “benzo” withdrawals, it actually can.
As this chemical reduces in an addict’s system, they may feel a number of symptoms including:
- Digestive upset or loss of appetite
- Depression and irritability
But the above are comparatively mild side effects when compared to more serious cases of withdrawal. For example, improperly managed withdrawal from alcohol or benzos can cause seizures and even death.
Another serious potential side effect of withdrawal are delirium tremens, or DTs, as they are often called. In movies DTs are sometimes referenced as the “pink elephants” seen by a recovering alcoholic.
In reality, there is nothing funny about them. They are terrifying.
In a nutshell, delirium tremens are caused when an extended period of drinking is suddenly stopped. This leads to a biochemical regulation cascade that has specific hallucinatory and physical effects.
The DTs cause a rapid onset of confusion and the detoxing person may see or hear things that aren’t there. They may look at their arm and see insects crawling on it or chewing it or they may see bats flying around the room that aren’t there.
They make look at the room and see walls crawling with spiders.
They will see or hear things that other people don’t see, because they’re not there in the first place.
DTs can last anywhere from two or three days to a week, can occur anytime, and are most often completely unpredictable.
A similar syndrome may occur with benzo and barbiturate withdrawal and yes, it can also be fatal.
In the case of opioids, cocaine and crack, the detoxing person will often feel intense pain or cramping, usually in the joints of the knees or elbows. They can also experience extreme cramping in the stomach and may actually buckle over from the extreme pain.
Thankfully these cases are not generally considered to be fatal, but are excruciating when left untreated.
Addiction is a medical and psychological condition
This is probably the most important thing to remember about addiction-it isn’t simply a bad habit. This is medical and psychological condition.
For this reason, good addiction treatment is a two pronged approach.
It’s psychological in the sense that the addict truly believes that they need this drug in order to survive. As a result they develop certain lifestyles or traits that only compound the addiction.
They will literally schedule their whole life around the intense need for this particular drug.
The heroin addict may sneak into a bathroom during the day for just a little buzz to maintain their bodies throughout the day until they’re finally home for the big-bang dose of evening when it won’t affect their work or school.
The alcoholic may also be addicted to benzos which have a similar effect on the body as drinking. They may drink during the morning hours before work in order to catch a little buzz, but then suck pills all day to hold them off until night.
Sometimes, though, they will also quietly go off for a quick maintenance drink during the day and hope their boss doesn’t smell it.
The bottom line is, it actually takes a lot of work and planning when you’re an addict. Every event and every moment of the day must be scheduled or postponed around that using schedule.
Being an addict really soaks up a lot of time.
All of these habits and lifestyles must be broken when they enter recovery.
The newly clean person must learn how to live their lives without using. How to interact with family and friends with a clear head and they need to learn how to manage all of this time they suddenly have on their hands that used to be consumed with drinking and using.
All of this requires intense psychological treatment in order to shed all of these character traits that made up the habit part of using that became their life’s routine.
This behavior modification requires modern, 21st century proven methods like group and individual services like Cognitive Behavioral Therapy and Motivational Enhancement Therapy as well as a strong focus on Mindfulness training for emotion regulation.
Now, let’s take a look at the other side, the medical aspect.
Addiction is also a serious medical condition that ideally should also receive adequate medical attention.
The addict’s body has undergone dramatic physiological changes that need to be treated medically. The whole chemistry of the addict’s body has been altered and it takes proper medical attention in order to restore its natural, healthy balance.
The whole chemistry and wiring of the brain has gone haywire and there’s neurons firing electrons that they shouldn’t and there are foreign chemical molecules bouncing all over the place that shouldn’t even be there in the first place.
The brain is sending messages between the hemispheres that are demanding more and more of this drug.
Then there are also the serious physical effects of detox itself, including DTS, possible seizures and the intense pain.
These are all serious medical conditions.
Detox Can Be Deadly
Because addiction is a medical and psychological condition, there are as we already mentioned, deadly medical aspects that can arise during the detox process.
In other words, yes, detox can kill you.
The problem when it comes to detox related emergencies is by the time you find out that they’re happening, it’s often too late.
What happens is that these serious symptoms can come about with absolutely no warning whatsoever.
The detoxing person can be lying in bed with what seems to be minor shakes, chills and just general discomfort, but suddenly throw into a seizure without any warning. They will violently convulse and literally be thrashing around the room.
They can swallow their tongue and choke very quickly or wind up smashing their head so violently, they render themselves unconscious.
By the time you call 911 and the ambulance arrives, they’re already dead.
There are actual cases of individuals seemingly detoxing just fine one moment, but suddenly their temperature shoots up, their heart rate increases to a dangerous level and suddenly they’re no longer alive.
All of this can happen without any forewarning.
This is why detoxing at home without any medical assistance just isn’t a good idea. You’re taking a chance on something that you just don’t know enough about.
You are literally playing with fire.
The Natural Detox
Sure, there are all kinds of home based detox methods out there and we could write an entire piece just about them.
But here, let’s rather concentrate on just a couple of the more popular, commonly used home detox methods.
There’s the all-natural holistic juice fast approach.
In this method the detoxing person goes on a juice fast for a period of days or even for a couple of weeks. The idea here is that the juice is replacing nutrients that the drugs or alcohol deprived the body of and at the same time this fast is building electrolytes up in the body.
There’s another similar detox method that is diet based and consists of the addict eating nothing but raw fruit and vegetables during the detoxing period of time. The idea is to replace the drug the addict had previously been using with nutrients that will help the body heal itself.
We’re not saying there’s anything wrong with these methods and a person can go ahead with them if they want. But the problem lies with the fact that there is no real science proving that these methods actually are effective.
All of the evidence for these methods is antidotal. That simply means that while there is no scholarly research done on it and no clinical studies testing its true effectiveness, somebody out there tried it and it worked for them.
There’s probably dozens of people on the internet who have shared their success with this method, but again, there is no sound science or research behind it.
It’s a method that simply worked for some people.
The Controlled Reduction Method
On the surface the controlled consumption method of home detox makes sense. The user slowly cuts back on consumption and slowly detoxes in the process.
Generally, in this method a third party actually controls the substance and distributes it at certain intervals.
By using this method it’s believed that the addict isn’t detoxing all at once, so there shouldn’t be the negative effects or consequences of home detox.
The alcoholic who normally drinks an eighteen pack a day is given just enough alcohol in the morning to take the edge off. Then a little later when the detox symptoms reoccur, they’re given another small dose and they continue to do this throughout the day.
The idea is to slowly detoxify the body by gradually cutting back the consumption.
This sounds reasonable, doesn’t it?
Well, there’s a problem here.
Chemical addiction simply doesn’t work that way.
Chemical addiction is the only medical condition where the patient has to exercise total abstinence in order to recover. The addict who continues to use in whatever capacity will invariably just eventually go back to using full-time.
They are addicted to the substance and as long as they are receiving it they’re going to remain an active user. There is just no way around this.
A person can try to cut back as much as they want, but ultimately all they’re really doing is prolonging the detox process. Besides, it will not be successful, because they still have the active addiction. So as long as they are receiving this substance they will remain an active user.
The History of Inpatient Detox and Addiction Treatment
Let’s back up a moment here to talk about the actual history of addiction treatment and medically assisted detox and treatment.
Prior to 1934 if you were an addict you basically were stuck as an active addict until the day you died. There was absolutely no medical or psychological treatment for it and once an active addict, always an active addict and there was just no two ways about it.
Sure, once in a great while the town drunk would find God or some such thing and miraculously and fully recovered.
But these cases were few and far between.
In reality, the addict before the nineteen thirties had a roughly a one in 5 million chances of ever recovering from their addiction.
Not good odds at all.
But the twentieth century saw some advancement in addiction treatment, because there were some doctors who began to see addiction as it really is- a medical condition and not just a bad habit.
Slowly science began to see the value of impatient detox.
At first, most of this this sprung from the fact that detoxing at home was so disturbing to the family that society basically just wanted to get them off the streets for a while.
Sanatoriums as they were known began to grow in popularity as a method of detox.
But science at this time had absolutely no clue as to how detox works nor the risks involved with it. All they knew is that when the addict was locked away for a while, they either died or the substance finally left their bodies and a few of them recovered.
Inpatient detox was really something you didn’t really want to do in the early days, either. They basically strapped or handcuffed you to a bed and let the addict suffer until their bodies had fully detoxed or they died-whatever came first.
Then they were thrown back onto the streets and everyone hoped for the best.
Normally, the addict would last a week or two and land right back in the sanatorium.
At this time there also grew a popularity of various organizations, usually religious based self-help groups that developed some methods that seemed to help some alcoholics and addicts recover.
But in 1934 the real breakthrough occurred when two alcoholics, Bill Wilson and Dr. Bob Smith helped develop 12-steps for living that was successful at helping alcoholics recover.
AA had been born and in the early days it was highly successful at helping alcoholics, in large part because the intensity and personal attention of “sponsorship.”
In the early days of AA when you took another alcoholic under your wing through sponsorship, you didn’t just see them at meetings, they moved in with you.
The newly recovering alcoholic had 24/7 supervision and guidance and frankly, the program was fairly successful as a result of this.
For years, this remained the only known path to possible recovery; the rigorous living and behavior modification of the 12-steps.
That’s the way it remained for the next thirty or so years.
First, the alcoholic or addict suffered it out at the sanatorium and then attended AA meetings as the only means of recovery.
But then the nineteen sixties came along and there began a whole new epidemic of heroin and illegal drug use. Overdoses began to skyrocket and deaths were common place and it was then that science began to take a more serious look at medical solutions to addiction.
They began to consider and research modern medicine for methods of easing detox and helping the addict and alcoholic through sound medical practices and medications.
Medications like Librium were developed during this period that assisted with detox. Methadone was also introduced which helped ease the withdrawal and recovery of heroin addicts.
The sanatoriums eventually fell to the wayside and by the nineteen seventies; medical detox based upon sound science was just beginning to be introduced, instead of the harsh methods of the past.
Addiction treatment centers began to emerge and they used the only method known to them at the time- the 12-steps of AA.
But science was also working on something else during these years, as well and funded by the federal government pharmaceutical companies began to develop medication that were actually able to stop the cravings for drugs themselves.
This was a huge medical advancement and by the nineteen eighties the medication naltrexone was introduced that actually helped deaden the receptors in the brain that derived pleasure from opioids and other drugs.
By the turn of the century, Russia had taken naltrexone to a new level and developed the once a month shot, Vivitrol that eased the effects and cravings of alcohol addiction.
Also during this time, many studies were conducted in order to understand the exact behavior modification programs worked to assist the addict as well.
Modern psychological methods were developed to compliment the medications and modern addiction treatment was born.
Science finally realized that addiction is a medical and psychological condition and that the 12-step spiritual methods of AA simply weren’t enough and were now outdated.
Addiction treatment entered the 21st century by recognizing that addiction detox and treatment requires the most modern integrated treatment available.
To answer the question of just why you should seek medically managed detox instead of trying it on your own, is sort of like asking why you would take your car to a mechanic instead of doing that rebuild yourself.
Good detox methods require some expertise.
The bottom line is when addiction has been ongoing for perhaps years and a person’s tolerance for the drug has grown to an overwhelming extent, detox is a life-threatening condition.
Quite simply put, detox is a medical condition that needs to be treated by medical professionals using the most modern methods available.
When a person undergoes medical managed detox they are surrounded by the people with the knowhow and tools to properly manage and ease detox. The addict is in an environment where nurses and doctors are able to monitor the detox progress and vitals and prescribe the medications to help you get off on the right foot towards your new life in recovery.
When you think about it, there honestly isn’t any other potentially fatal medical condition that you’re going to try to treat yourself, so why would a person take the chance on something as serious like addiction detox?
When an addict or alcoholic undertakes medical assisted and managed detox they have the advantage of the expertise and medication for a safe, effective detox.
The days of strapping the addict to a bed are long gone and today’s medical detox uses the latest, most up to date tools at their disposal.
In a nutshell, it’s based upon sound science, techniques and medicine.
The medications commonly used to assist addicts vary with the condition and the substance the patient is detoxing from.
- Opiate Addiction – Methadone or buprenorphine, which really helps reduce cravings
- Cocaine Addiction – Desipramine, phentermine, and fenfluramine, anti-depressants or bromocriptine, these reduce cravings and diminishes the physical effects of detox.
- Benzodiazepine Addiction – Clonazepam, a similar less-powerful version of the drug
- Alcohol Addiction – Naltrexone, acamprosate, and disulfiram, which reduces cravings and eases withdrawal symptoms
While the addict is going through the detox process they also have access to psychologists and addiction experts that can also guide them and their families toward the addiction treatment that is going to be the most effective for them.
When you seek medical managed detox you’re getting around the clock monitoring and care by professionals with years of experience who take the guesswork and risk out of it.
Inpatient or outpatient?
After a person has gone through the detox process they are faced with a whole new decision. They are probably not ever going to want to go through this again and are going to seek some sort of additional long-term treatment.
On this, honestly there isn’t just one silver bullet to help you decide. When it comes to addiction treatment there isn’t a one-size-fits-all.
Experience says that the average addict probably isn’t too thrilled about the prospect of inpatient treatment. After all, who wants to be away from their families and loved ones for a month or more.
But there are advantages here that are not found in outpatient treatment.
Obviously, there is the advantage of being denied any access to the drug or alcohol. This is actually a biggie to consider. Many addicts leave detox unprepared for the stress and challenges of everyday living and many times never even make it to the first appointment without using.
They also haven’t developed the skills to stay away from the influences and situations that are bound to trigger a relapse.
When you think about it seriously, though, a person didn’t get to be an addict overnight and they’re not going to recover overnight.
Good impatient addiction treatment sets the newly recovering person off on the right foot from the start.
You’re going to receive group and individual services that are based on proven, modern evidence based modalities such as Cognitive Behavioral Therapy and Motivational Enhancement Therapy as well as a strong focus on Mindfulness training for emotion regulation.
You’re going to be to work with highly trained psychologists to overcome any trauma or challenges you may be experiencing.
You’re going to develop the skills required to face life on life’s terms and gain the tools to help with everything from personal relationships to work.
Inpatient treatment will teach you how to make the sound decisions to avoid triggers or situations where you may drink or use again.
More importantly, impatient addiction treatment provides the opportunity to concentrate and work on yourself, before you face the outside world. The staff and counselors can tailor an addiction treatment plan that is unique to your needs, your situation and family conditions.
After a person completes impatient treatment they will come away better prepared to conquer their addiction.
At this point, the addict can confidently move forward with life and is more likely to follow through on any recommended outpatient care.
What it all comes down to seeking and gaining treatment that truly and understands and cares about your addiction.
In the end, it all comes down to knowing that as an addict you can do this. Like millions of other people who were once in your same position you too can move on to live a wonderful new life as a recovering person.
All it takes is that first big step.