The Importance of Supervised Drug Detox

Detoxing from a drug can be a painful process, and for this reason it can easily lead to a relapse. People going through detox experience withdrawal symptoms and intense cravings for the drug they are trying to stop using. While some people may attempt to detox alone or without help from any professionals, this is risky. Supervised detox is important for health, safety, a successful outcome and transition to the next phase of treatment.

What Does it Mean to Detox?

Detox is short for detoxification.¹ It refers to any interventions that manage intoxication and withdrawal as a person stops using a drug or alcohol. Detox occurs as the substance is cleared from the body and no more is taken in. The ultimate goal of detox is to clear the body of the drug, but the process is more complicated than simply stopping use. The withdrawal symptoms that begin as intoxication ends can be extremely uncomfortable, and in certain cases dangerous and life-threatening to the person going through it.

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Drug Detox

The process of detoxification looks different for each person, but ultimately it is a way to begin the treatment process for a substance use disorder. Detox may be medicated, medically supervised, completed with support from friends or family, or done alone. The safest way to detox is to go through the process with some degree of professional supervision.

Facts about Drug Detox

• According to the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Episode Data Set (TEDS) from 2005 to 2015², 22 percent of recorded admissions for substance use disorder treatment were for detoxification.
• Of all the people admitted for treatment, 18 percent received residential detox treatment, three percent were hospitalized for detox and one percent was treated by detox on an outpatient basis.
• More than half of people admitted for detox services were self-referred, meaning they chose to enter detox treatment.
• Rapid and ultra-rapid detox methods, which use varying degrees of sedation to speed the process, are controversial and not recommended by the American Society of Addiction Medicine.³

Detox Triggers Withdrawal and Relapse

One of the most important reasons to only undergo detox while supervised is that it triggers withdrawal. This is a collection of symptoms caused by stopping use of a drug, and they are generally more severe with longer use and more frequent, higher doses. The actual symptoms vary depending on the drug, but they are always uncomfortable, sometimes quite painful and emotionally distressing, and in some cases dangerous. Some typical symptoms of withdrawal from opioid drugs include:

• Agitation and anxiety
• Increased tear production
• Insomnia
• Yawning
• Sweating
• Muscle aches
• Runny nose
• Abdominal cramps
• Diarrhea
• Nausea
• Vomiting
• Goosebumps

Another common category of drugs of abuse, stimulants, can also cause uncomfortable withdrawal symptoms that make it difficult to avoid the urge to relapse:

• Excessive sleeping, followed by difficulty sleeping later
• Irritability and depression
• Binge eating
• Cravings
• Mood swings
• Lethargy
• In rare cases, psychosis

Relapse is not uncommon for anyone struggling to stop using drugs, but detox is a crucial phase. This is when the process of giving up substances of abuse feels most uncomfortable. Relapsing during detox is much more likely when there is access to drugs or alcohol and when a person is not supervised by someone who is supportive.

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Drug Detox

Supervised Detox for Safety

The majority of people who go through detox will not actually be in any danger, but there are some instances in which detoxing alone can be unsafe. Alcohol is the most likely substance to actually pose a risk. Long-term alcohol misuse can trigger withdrawal symptoms that can cause chest pains, fever and even a condition known as delirium tremens, which can trigger seizures and psychosis. Delirium tremens is considered a medical emergency.⁵

Withdrawal from benzodiazepine drugs can also be dangerous. People who have misused these drugs, like Xanax, for a very long period of time may develop a withdrawal syndrome that can cause panic attacks, anxiety, nausea, weight loss, muscle pain and stiffness, difficulty thinking and irritability. It can also trigger psychotic symptoms, such as delusions and hallucinations, as well as seizures.⁶

Detox does not necessarily have to be medically supervised, but for these substances that can cause actual physical harm it is strongly recommended. Even for other types of substances, medical detox can provide greater comfort for the person going through it. For instance, anti-anxiety medications can be used to help a patient relax; opioid agonists used as replacements for heroin or prescription narcotics may be used to reduce the severity of symptoms; and other medications, fluids and supplements and vitamins can be used to improve overall wellness and comfort.

Transitioning to Treatment

Detox, whether supervised or not, is only the first step in treating a substance use disorder. Without ongoing treatment after detox, most people will go back to substance abuse. One study⁷ illustrated this clearly by following up with patients with opioid use disorder. One group completed detox, while another went through supervised detox followed by six weeks of treatment.

Of those people who only completed detox, 91 percent relapsed and used opioid drugs again. Fifty-nine percent of these people relapsed within the first week after leaving detox. Those who went on to complete six weeks of treatment were able to remain sober much longer.

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Drug Detox

Someone who goes through detox without professional supervision may be tempted to avoid any kind of professional treatment. He or she may attempt to simply go it alone, trying to stay sober without any ongoing treatment. With supervised detox, addiction professionals are there to guide the person into the next phase of treatment, which is so important for overall successful recovery. Detox is only ever a first step and should not be considered as a replacement for long-term treatment. According to research, effective treatment should last three months or longer.⁸ Detox simply isn’t enough on its own.

Drug detox is an essential component and first step in recovery from substance use disorder. Every person going through this has options, but the best choices are always supervised. Whether by professionals or simply supportive loved ones, supervision can help reduce the risk of relapse. When supervised by professionals and medical caregivers, detox is safer and helps to ease the transition to ongoing treatment, which is necessary for long-term recovery and relapse prevention.

¹Substance Abuse and Mental Health Services Administration. Detoxification and Substance Abuse Treatment.
https://www.ncbi.nlm.nih.gov/books/NBK64119/

²Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set 2005 – 2015. https://www.samhsa.gov/data/sites/default/files/2015_Treatment_Episode_Data_Set_National/2015_Treatment_Episode_Data_Set_National.html#Chp2

³American Society of Addiction Medicine. Rapid and Ultra Rapid Opioid Detoxification.
https://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2011/12/15/rapid-and-ultra-rapid-opioid-detoxification

⁴Medline Plus. Opiate and Opioid Withdrawal.
https://medlineplus.gov/ency/article/000949.htm

⁵Medline Plus. Delirium Tremens.
https://medlineplus.gov/ency/article/000766.htm

⁶Addiction. The Benzodiazepine Withdrawal Syndrome.
https://www.ncbi.nlm.nih.gov/pubmed/7841856

⁷Irish Medical Journal. Lapse and Relapse Following Inpatient Treatment of Opioid Dependence.
https://www.ncbi.nlm.nih.gov/pubmed/20669601

⁸National Institute on Drug Abuse. Principles of Drug Addiction Treatment: A Research-Based Guide.
https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment