Alcohol and drug detox are no walk in the park, but the proper medical care and research-backed medications can make the experience significantly better — and safer. You shouldn’t let the fear of detox prevent you from getting the help you need to get sober. Here’s why.
Myths About Drug and Alcohol Detox
Movies and television have done their part to perpetuate the misconception that detox means a cot in a small, empty room where you’re left to tough it out alone through violent physical and psychological withdrawal. Ashley Lewis, RN, MSN, NP-C, is a family nurse practitioner who has treated patients in drug and alcohol detox at COPAC addiction rehab for almost 10 years. She knows firsthand that this is far from the truth. Lewis says clients often come to detox with these fears and others. “Our patients also seem to worry about the amount of anxiety they may feel through the process,” she says. “Many are skeptical that the detox medications will control their withdrawal symptoms.”
Another misconception is that detox is a cure for alcohol and drug addiction. In reality, detox is the first critical step in recovery. The Principles of Drug Addiction Treatment: A Research-Based Guide by the National Institute on Drug Abuse notes that people with substance use disorders should receive comprehensive treatment following detox for the best chance at long-term recovery. Research has shown relapse rates as high as 60% to 80% for drugs like opiates just one month following detox if a patient doesn’t receive treatment and supportive measures like sober housing.
Not so much a myth as an unfortunate reality is that many people believe they can handle drug detox on their own. Medically monitored detox is safer and more effective than trying to stop drugs or alcohol cold turkey.
“It’s too easy to reach for one’s drug of choice when withdrawal becomes uncomfortable,” says Lewis. “It’s also unsafe to abruptly stop many of the drugs that are being abused. A patient needs to be treated medically to progress through detox safely.”
The Truth About Detox and Withdrawal
While no one is going to choose a stint in a drug detox facility over a trip to the Bahamas, it’s likely much better than what you’re envisioning. Lewis says most of her patients are surprised at how well detox works for them. “Many of our patients have suffered through withdrawal at home when they were unable to get their drug of choice, and it was miserable for them,” she says. “We don’t want them to feel like that when they are in our care.” If detox takes place in a medical facility or drug rehab, physicians and nurses can significantly ease withdrawal symptoms and provide emotional support and 24/7 monitoring throughout the process.
The type, duration and intensity of withdrawal symptoms depend on what substance(s) you’ve been abusing, how long you’ve been using them and your physical and emotional state. Some detoxes are more difficult than others. Alcohol, benzo, opiate and heroin withdrawals can be the toughest. Withdrawal symptoms can include anxiety, sweating, chills, shakes, nausea and vomiting, fatigue, elevated heart rate and blood pressure, as well as possible seizure. In a medical setting, detox specialists can immediately attend to these discomforts and risks. “We provide medication to handle the withdrawal symptoms and alleviate the discomfort our patients are experiencing,” says Lewis. “We observe them closely and provide plenty of fluids, food and rest for them.” In addition to relieving the physical pain that may accompany withdrawal, medical staff can also administer medications for any psychological withdrawal symptoms like anxiety, disorientation and paranoia.
What to Expect in Medical Detox
Typically, drug or alcohol detox begins with a thorough physical exam to check vitals, assess the level of drugs or alcohol in your system and determine your overall physical health and stage of withdrawal. A nurse or physician will also take a thorough history of drug or alcohol use, current prescription medications, pre-existing medical conditions and psychiatric issues. The medical team uses this information to determine the appropriate detox protocol and what types of medications are best suited for potential withdrawal symptoms and cravings.
Detox may last anywhere from two to seven days and greatly depends on the substance, duration and extent of abuse. Sometimes less severe symptoms like depression, anxiety, lethargy and emotional issues can linger for weeks. The acute phase of detox is shorter for opiates than it is for alcohol or benzodiazepines, sedatives and hypnotics. The post-acute withdrawal phase can be longer for opiates than the other substances.
The medical team will ensure you are comfortable and safe throughout drug or alcohol detox. You’ll either stay in a room by yourself or share a room with others depending on the detox facility. Nurses will regularly take your vital signs and ask about your level of pain. They will administer research-backed medications to ease withdrawal symptoms as clinically appropriate. Many detox centers have common areas where you can get snacks, watch television or interact with others as you are feeling better. You also may begin participating in drug rehab programming such as group or individual therapy toward the end of detox. This helps you more easily transition into treatment.
It’s understandable to be nervous. When substance use has consumed your life for a long time and it’s all you know, it can be scary to imagine life without it. “Of course, there is validity to someone’s fears about detox,” says Lewis. “Not because of the actual detox process, but it’s sometimes scary and emotional for our patients to face.” If you’re still feeling apprehensive about drug detox, Lewis recommends scheduling an appointment at a treatment center, meeting the staff and asking any questions you may have about their detox protocols and treatments used for withdrawal. “Patients need to feel supported and heard through the process of those first steps into a sober life,” says Lewis. “And the first step is always the hardest.”
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