The term detoxification, more commonly known as detox, refers to a metabolic progression of events that occurs in one’s body as toxic substances are reduced to substances that the body can safely excrete. Toxic substances are harmful or poisonous substances. In terms of addiction treatment and recovery, we can define the detox process as the period when an individual overcomes the physical dependence on drugs or alcohol.
Certain classes of drugs, if used over lengthy periods of time and in sufficient amounts, will result in the development of physical dependence. Physical dependence occurs when the person’s body (including the brain) changes in response to the presence of the drug in its tissues and blood.
The entire physical system of the person learns to rely on the presence of the drug in order to assist it to function in a routine manner. The body becomes so accustomed to the presence of the drug in the system that if certain levels of the drug in the tissues are reduced, the person will experience ill effects (a withdrawal syndrome).
Withdrawal occurs as a result of a natural detoxification process that results from a person either stopping the drug or significantly lowering the amount taken. As the levels of the drug in the individual’s system fall, there is a series of physical, psychological, and emotional repercussions. These effects are typically dependent on the type of drug that the person has been using but will typically present as:
- Flulike symptoms
- Nervousness or feeling jittery
- Muscle aches or cramps
- Depression or panic attacks
- Changes in mental status
- Severe cravings for the drug
Withdrawal symptoms for some drugs can produce hallucinations (e.g., alcohol or benzodiazepine withdrawal), potentially fatal seizures (e.g., alcohol withdrawal), and even thoughts of suicide (e.g., withdrawal from opioid drugs). Not all drugs of abuse will lead to serious withdrawal symptoms; however, those addicted to most drugs will experience some level of physical and emotional change when they stop using the drug.
The length of the withdrawal process will vary, depending on:
- The type of drug a person was taking
- The amount of the drug the person was taking
- The length of time the person was taking the drug
- The person’s specific physical and emotional makeup
For most drugs of abuse, the process of withdrawal will be most severe within the first 24-72 hours. Typically, after a week, withdrawal symptoms will begin to subside; however, the exact length of time the symptoms persist depends on the above factors.
Natural Detox and Home Detox
The term natural detox is a bit of a misnomer in that any time a person discontinues a drug after developing a physical dependence, the person will go a natural process of detoxification. Nonetheless, there are a number of programs that advertise as using “natural” or “herbal” detox methods, and some sites offer cleanses and programs that people can use on their own at home. Many also claim that these are somehow more effective in reducing the effects of withdrawal than engaging the help of a professional and/or medical program. These methods include such things as:
- Special diets
- Epsom salt baths
- Meditation and/or exercise
While there is no evidence that using any of these techniques in conjunction with a supervised medical detox program is harmful, there is also no evidence to indicate that using home remedies alone is advantageous or beneficial to recovery. Furthermore, most professional sources report that using home or natural detox programs alone (without a formal professional recovery program) results in a higher potential for relapse.
In addition, attempting to go through withdrawal from some substances can be potentially fatal, and medical supervision is absolutely required (e.g., alcohol withdrawal, benzodiazepine withdrawal). Some of the emotional and psychological effects of detoxing from other drugs can also lead to potentially dangerous situations.
Some sources on the Internet have suggested using absurd methods or remedies to assist in home detox, such as drinking beer in small amounts to slowly detox from alcohol. Of course, a person drinking beer without supervision to assist in alcohol withdrawal is simply running the risk of maintaining the addiction by continuing to drink or worse situations, such as severe withdrawal from alcohol leading to potentially fatal complications. Many people who are not supervised in the detox process or who have little experience with recovery can be easily fooled into thinking that such approaches make sense.
It is important to have the presence of a professional addiction specialist supervising the detox process to:
- Recognize warning signs that may signify potential complications
- Treat new issues as they arise
- Slowly taper the substance, when appropriate, so there as little discomfort as possible
- Offer support for issues that will inevitably arise
- Assist in managing any potentially harmful complications of detox
- Provide structure to the process
Finally, simply completing only the detox process is not sufficient to recover from addiction. An individual must engage in some form of recovery program following any detox process. Thus, the use of home remedies is not recommended for recovery from most drugs of abuse and may be potentially dangerous.
Medical detox procedures can be undertaken in either inpatient or outpatient programs, depending on the needs of the individual.
Because there are a great many myths associated with addiction recovery, there will always be those trying to trick people into buying into miracle cures” or remedies that claim to forgo the typical process of recovery from addiction. The search for the “magic bullet” cure that applies in every case and for every person continues. Unfortunately, there is no miracle or magic solution to recovery.
One form of detox that has received attention is an anesthesia-assisted rapid opioid detox procedure or, as it is most often referred to, rapid detox (sometimes it is also referred to as ultra-rapid detox). In this procedure:
- The person is admitted to an intensive care unit.
- The person is put to sleep under general anesthesia.
- The patient is then administered injections of opioid blockers that stop the withdrawal effects of narcotics.
- The person is also administered other medications, including drugs for nausea and muscle relaxants.
- Detox is believed to occur in a very short period of time (as little as 4-8 hours) compared to the weeks that detoxification from opioid drugs normally takes.
- If there are no complications, the person can be discharged within 48 hours.
The drugs often used in these procedures are naloxone or naltrexone, which lock on to the receptors in the brain associated with opioid drugs (e.g., heroin, Vicodin, oxycodone, and many others) and help to control withdrawal. Some procedures use different methods of anesthesia and claim quicker results. Many programs that use these procedures claim high success and recovery rates; however, the actual research regarding rapid detox shows it can be incredibly dangerous.
There is little evidence to support the technique’s effectiveness or any advantages over other supervised medical detox programs that do not use anesthesia. The drawbacks to the rapid detox procedure include:
- The rapid detox program does not address cravings that will inevitably occur later for the individual.
- This technique alone cannot prepare one for long-term recovery from addiction.
- Most of the available research on the technique does not support claims that it is advantageous to longer detox methods.
- A recent review by the Centers for Disease Control indicated that there are serious potential complications and even a higher number of fatalities associated with using this technique.
- Because it is performed in an intensive care unit, it is far too expensive for many people who need to go through medical detox.
- There is no evidence to suggest that using this technique results in better long-term outcomes and recovery, and most professional sources advise against its use.
Thus, the bottom line regarding rapid detox is that it can be dangerous and ineffective. It does not appear to be any more effective than supervised detox that occurs over a longer process; there appears to be a greater risk for adverse effects from the procedure; and the procedure is significantly more expensive than traditional detox.
Why Are There So Many Claims That These Procedures Are Better?
Of course, there are always going to be a number of different for-profit sources that claim to have found a much better, easier, and miraculous solution to any specific problem. Most of the claims for the effectiveness of rapid detox programs come from private clinics attempting to market the program and not from unbiased sources that look at the general effectiveness of treatment protocols.
Many of these shortcut solutions are fostered by individuals who attempt to take advantage of people in need. People who are desperate and looking for a quick fix are vulnerable to such influences and claims. However, using a medically supervised detox program will allow the individual to go through the process with little discomfort while at the same time minimizing risks and promoting better long-term recovery rates.