Drug and Alcohol Detoxification

Drug and Alcohol Detoxification

The body’s reaction to the removal of a substance it has become dependent on is called withdrawal. Withdrawal causes craving for more of the substance being removed. The period of time when the body is trying to overcome its addiction is called detoxification (detox). Detox is the first step in overcoming a substance addiction such as drugs or alcohol. Detox is a pertinent step for the patient is to be successfully rehabilitated.

Opiate drugs such as heroin and methadone, and prescription medications including Hydrocodone, Oxycontin, Xanax, Vicodin and Lortab, require medical detox supervision. There are however, other illegal drugs such as marijuana, crystal methamphetamine, and cocaine that do not require medical detox. Since there is psychological dependence associated with these drugs, it would be wise to complete a period of stabilization. The process of drug detox requires the patient to be closely monitored by keeping vital signs, giving support and administering medications if needed.

There are numerous withdrawal symptoms or side effects when a patient stops or dramatically reduces drugs after heavy or prolonged use. Those side effects include:

  • Sweating
  • Shaking
  • Headaches
  • Drug cravings
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Sleeplessness
  • Confusion
  • Agitation
  • Depression
  • Anxiety
  • Behavioral changes

There are two commonly used drugs to enable the patient to feel relief from these symptoms.

  • Klonepin, which reduces physical symptoms
  • Buprenophex, which is an anticonvulsant

These drugs must also be monitored as cessation produces withdrawal symptoms. Generally, the time period for drug detox is three to seven days under medically monitored supervision.

Alcohol detox, like drug detox, is usually accomplished in an inpatient medical facility. Duncan Raistrick identifies the key to a successful, planned detoxification is preparation. Raistrick goes further to detail that the first job of therapy is to bring the patient to a point of readiness to change their drinking behavior. Second, patients need to be given accurate information about what to expect during detoxification.

There are two withdrawal categories: minor, meaning early withdrawal and major, meaning late. The severity of withdrawal depends greatly on the duration of alcohol used. Alcohol Withdrawal Syndrome (AWS) falls into three main categories: central nervous system (CNS) excitation, excessive function of the autonomic nervous system (ANS), and cognitive dysfunction.

Richard Saitz, M.D., M.P.H., states, since alcohol enhances gamma-aminobutyric acid's (GABA) inhibitory effects on signal-receiving neurons, neuronal activity is lowered. This lowering leads to an increase in excitatory glutamate receptors. Tolerance occurs as GABA receptors become less responsive to neurotransmitters, which in turn requires more alcohol to produce the same inhibitory effect. During detox, the GABA is ineffective and unable to suppress the excitatory glutamate receptors.

Detox is intended to relieve physical symptoms such as:

  • Shaking or tremors
  • Headaches
  • Vomiting
  • Sweating
  • Restlessness
  • Loss of appetite
  • Sleeplessness
  • Delirium Tremens (DT’s)
  • Hyperactivity
  • Convulsions

Alcohol detox medications are similar to drug detox medications: Buprenophex, certain benzodiazepines and anticonvulsant medications. Alcohol detox completion can take from three to fourteen days.

Norman S. Miller notes that medical management of alcohol and drug withdrawal during detoxification often is not sufficient to produce sustained abstinence from recurrent use. Therefore, further addiction treatments are needed to prevent relapse to alcohol and drug use following treatment of withdrawal.

In conclusion, drug and alcohol detoxification can effectively prepare the addicted abuser for rehabilitation and treatment.

Some physicians believe the withdrawal phase is related closely to the drug addiction - the worse the withdrawal, the more likely the continued use of the chemical to prevent withdrawal. Numerous factors are key to successful detoxification.

  • Acknowledge that there is a problem and decide to do something about it.
  • Get rid of all the drugs and paraphernalia.
  • Drop friends and associates that are tied to our drug problem.
  • Seek and accept spousal support, or support from friends, or relatives.
  • Prepare for symptoms with the support of a professional.
  • If tranquilizer drugs are needed for a few days or longer, they must be handled sensitively, as one addiction can easily replace another.



  1. http://www.addict-help.com/detox.htm
  2. Drug and Alcohol Resource Center: Nationwide Alcohol and Drug Addiction Rehab Information.
  3. Raistrick, Duncan Advances in psychiatric treatment: management of alcohol detoxification The Royal College of Psychiatrists (2000) 6: 348-355.
  4. DeSena, James. Overcoming your alcohol, drug and recovery habits: an empowering alternative to AA and 12-step treatment. Tuscan, AZ: See Sharp Press, 2003: 68.
  5. Miller NS. Treatment of the addictions: applications of outcome research for clinical management. New York: Haworth, 1995.
  6. Blondell, Richard D. Ambulatory detoxification of patients with alcohol dependence, American Family Physician, 1 February 2005.
  7. Saitz R. Introduction to alcohol withdrawal. Alcohol Health Res World 1998; 22:5-12.

Topic Discussion

  1. Addict

    I have been on propoxiphen for approx 1 yr for knee pain due to loss of meniscus. I recently underwent surgery for some bone spurs and went cold turkey on all pain meds. I am on a blood pressure pill, birth control pill and glucosamine. I occasionally experience a rapid heart rate and sweats. I've been off the pain meds for approx 1 week. Can this be a sign of drug detox from the propoxiphen? How long does it take for your body to detox from it?

  2. Addict

    I found your article very informative. I would recommend your page if I knew of anyone with a problem. Thank you.

  3. Addict

    Alcohol detox cold turkey is not only risky but extremely open ended. I have had two in hospital (not detox centers) detox experiences which produced the desired results without the pain and realization of what my body was going through. Thus, on the third try, on my own without any medical support or anyone to look after me during the process, I almost died. One of the side effects of self imposed alcohol detox was a total loss of balance after day two. I had to crawl to the bathroom on my hands and knees for two days to relieve myself. The other side effects common to detox were very intense and totally out of my control. After two weeks I began to come out of it. It took a month before my balance was restored where I felt comfortable walking without fear of falling. I fell many times during the detox period. I was very fortunate to end up with only bumps and bruises. Please remember, once you begin the process alone it is almost impossible to turn it around. You may have side effects that can kill you.

  4. Addict

    I am so happy that there are so many dedicated professionals out there to help with this sort of thing. I have no idea where we would be as a society if people felt that there was no place to turn to for help. Keep up the good fight and keep educating people about change.

  5. Addict

    Hi there, I came out of detox two months ago to come off 15 ml of Methadone and I used to smoke crack cocaine also. I was diagnosed bipolar last year but am getting a second opinion. Since I have been clean off all substances I've experienced extreme anxiety and paranoia (self-consciousness, low self-esteem?), I feel like I'm going to cry sometimes when somebody asks me a normal question. I also cannot stop thinking about bad things from my childhood and my mind has mixed up thoughts and races a lot when in alone. I was dealing with these feelings at first but now I'm getting bogged down with them and I don't want to relapse. I'm going to groups and am waiting for a counseling appointment. I'm hoping these feelings will fade (quickly), the doctors want to go the counseling route but I feel I need some valium. Has anyone else experienced this?

  6. Addict

    Are the symptoms stated there have facts or basis? Seriously I have a friends whom I've known a long time ago and has those kinds of things happening within well I don't know any of the other details but if those are correct I think now I know why his acting like that.

  7. Addict

    @Joelo If you would actually read it for a while.

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