Addiction to drugs and alcohol takes a toll on your life in many ways. Struggling financially, damaging your relationships or career, and even developing severe health complications are just a few of the multiple ways a substance use disorder can affect your life.
If you have decided that you’re ready to take the first step and seek help through an addiction treatment program, you will need to start with medical detox. Since prolonged use of drugs and alcohol can change your body’s internal chemistry, getting you medically stabilized and ready for addiction treatment is the goal of any medical detox program.
Withdrawals are an unfortunate and uncomfortable side effect of addiction. Often, fear of withdrawal symptoms can keep you using drugs and alcohol, even when you don’t want to. By undergoing medical detox, a rigorous detox regimen will be implemented to help alleviate your withdrawal symptoms to make the process as easy and hasty as possible.
You may be wondering about the detox medications used during your medical detox program. What kind of detox medications will you encounter? What are the benefits and side effects of detox medications? Read on to learn more about these life-changing medications and what you can expect from the detox process.
Addiction, or a substance use disorder (SUD), is a harrowing condition affecting tens of millions of people in the United States alone. The National Institute on Drug Abuse estimates that nearly 22.7 million people require addiction treatment, or drug rehab/alcohol rehab. With these numbers so high, it’s no wonder that addiction has reached crisis status in recent years.
Since substance use disorders are recognized by the Diagnostic and Statistical Manual (DSM-V) as a chronic disease, no current cure is available. This means that the only way to combat addiction is through different addiction treatment methods and addiction therapies.
The issue surrounding many people facing a substance use disorder is that they are unaware of just how serious their addiction may be. People may not even recognize that they have a problem because they have had no serious implications in their lives. This is called “functioning.’ Still, others seriously struggle with their substance use disorder daily.
No matter what substance you are recovering from, the first step when looking to live a sober life is undergoing the medical detox process. Whether you go through private detox or detox hospitalization, the overall goal is to achieve medical stabilization and manage any withdrawal symptoms that you may encounter.
Detox is the process by which, through both medical and clinical intervention, you can safely stop using drugs and alcohol and rid your body of these substances. Abusing drugs and alcohol has severe implications on your body and brain.
Over time, it alters the physical chemistry of your brain and other organs. This means that whenever you stop taking drugs and alcohol, your body will need to go through an adjustment period as it attempts to regulate itself without the presence of these substances in your system.
Withdrawal refers to the group of different symptoms, both physical and psychological, that occur upon the abrupt discontinuation or decrease in the intake of drugs and alcohol. These symptoms can range from mild to severe and can last for days, weeks, months, or even years in certain cases.
Some of these symptoms can also prove to be life-threatening, with certain drug withdrawals presenting the possibility of having seizures or causing psychosis.
Because of the potentially life-threatening and genuinely uncomfortable nature of withdrawals, detox is crucial. Medical detox uses different prescription medications and therapy techniques to help patients manage their withdrawal symptoms, which may be impossible to handle on their own.
With strict medical monitoring and implementation of an individualized detox process, you can navigate the withdrawal symptoms quickly and safely.
Withdrawal can be dangerous, depending on several factors. Different drugs will cause different symptoms when you stop using them after developing a dependency. Plus, you are more likely to experience more dangerous withdrawal symptoms if you stop using the drug cold turkey, than if you taper off the drug. If you were dependent on a high dose of a drug for a long time, and you stop using the drug abruptly, you will start to experience withdrawal symptoms sooner, and you may experience more severe symptoms.
Still, the biggest determining factor in whether or not withdrawal will be harmful is the type of drug you are dependent on. Not every drug is dangerous during withdrawal, but some can be. Central nervous system depressants like alcohol, benzodiazepines, barbiturates, and other sleep aids are the most dangerous drugs during withdrawal. This causes your nervous system to become overactive, potentially causing seizures and a deadly disorder called delirium tremens.
Not everyone who goes through alcohol withdrawal will experience seizures or delirium, and all instances of those severe symptoms are deadly. However, going through withdrawal without medical treatment increases your risk of fatal consequences. Plus, depressants cause a phenomenon called kindling, which is when withdrawal symptoms get worse if you’ve experienced detox and relapse.
Other drugs that aren’t known to cause deadly withdrawal symptoms may also cause extremely uncomfortable symptoms. For instance, opioids can cause flu-like symptoms. In rare cases, symptoms can lead to dangerous complications like dehydration.
In many cases, going through withdrawal alone will result in relapse. Even drugs that don’t cause dangerous withdrawal symptoms will cause extreme discomfort and powerful cravings. Between the symptoms and the compulsion to use, it can be extremely difficult to resist using again. Relapse can be dangerous.
If you spent enough time away from the drug to lower your tolerance and then take your usual dose, you might experience an overdose. Plus, withdrawal symptoms may make you desperate and willing to engage in risky behavior, like taking drugs from an unknown source.
Medical detox is the safest way to go through withdrawal. Medications can be used to help taper you off a drug, mitigate uncomfortable symptoms, and avoid dangerous complications.
Using different detox medications is the primary method most detoxes, whether public or private, treat patients. These various detox medications combat the multitude of uncomfortable and potentially dangerous withdrawal symptoms you may encounter as the drugs and alcohol leave your system. Typically speaking, private health insurance will cover the cost of these crucial medications as well.
Different drugs will impact the body in different ways. This means that the type of withdrawal symptoms you can expect to encounter will vary and directly depend on which type of drug you were abusing. Because of the variable nature of detox and withdrawal, the following list of detox medications is broken down by category of substances. The detox medication and the benefits and side effects of detox medications are listed below.
Opioids are a category of drugs that include illicit and prescription substances. These substances can be natural, semi-synthetic, or fully synthetic (manmade). The category includes drugs like heroin or prescription painkillers.
Opioids produce physical dependence and psychological addiction. They have a notoriously uncomfortable withdrawal process that often keeps opioid-dependent people using even when they want to stop. Undergoing a medical detox for opioids is crucial for your success in recovery, as many people find themselves relapsing on their drug of choice when faced with opioid withdrawal symptoms.
Several different detox medications are used when treating opioid addiction. The following list is comprised of each detox medication and what it’s used for:
Methadone is, in fact, an opioid, but it is used to treat opioid withdrawal/addiction. Methadone works by altering the way in which the brain reacts to pain while simultaneously also blocking the effects (high) you get from other opioids like heroin or painkillers. It also blocks the withdrawal symptoms you would encounter when stopping other opioids.
Subutex is the brand name of buprenorphine. Similar to methadone, it works by blocking the effects/high you would encounter when using other opioids and also stops any withdrawal symptoms from making the detox off opioids far more comfortable.
Suboxone/Zubsolv are other brand-name versions of buprenorphine, but also include naloxone. Much like the previous two detox medications, the drug is meant to stop any withdrawal symptoms from manifesting following your cessation of opioid use. It will help relieve any drug cravings you may have without actually getting you high. This is a favorite detox medication used in a tapering method, which means you receive smaller and smaller doses to slowly wean you off the drug altogether. This method both bypasses any withdrawal symptoms while also preventing you from developing a physical dependence on this drug.
Antidepressants are prescribed during the detox process for opioids as well. Since not all symptoms of opioid withdrawal are physical, antidepressants help ease the onset of any emotional symptoms such as depression. Antiadrenergics are a type of prescription medication that also treats the psychological symptoms of opioid withdrawal. They’re responsible for keeping blood pressure low and lowering stress levels that may be experienced during treatment.
Alcohol is a type of drug, whether people believe so or not. It acts as a central nervous system depressant, and over time changes the way that the brain itself functions. By preventing and impeding the natural production of the neurotransmitter GABA (gamma-Aminobutyric acid) within the brain, the withdrawal process associated with alcohol is intense.
As the brain attempts to return to normal GABA production and overall functioning, the withdrawal symptoms can be severe on a physical and psychological basis. Alcohol withdrawals can cause you to develop Delirium tremens and even have seizures. Since these symptoms can cause long-term damage, getting proper medical attention, and using the following detox medications, is crucial to your physical well-being.
Acamprosate is a popular “detox” medication for alcohol. It actively works to help the brain return to a balanced state in regards to its neurotransmitter production. It is also effective in helping alcoholics resist the urge to drink. Rather than directly treating or preventing alcohol withdrawal symptoms, it prevents the individual from desiring alcohol at all.
Disulfiram is much different from acamprosate. Instead of merely reducing cravings for alcohol, this detox medication will create aversion behavior in the patients who take it. This means that whenever a patient drinks alcohol with the medication in his or her system, it will create very unpleasant side effects that mimic those of a severe hangover. Rather than experiencing drunkenness, you’ll feel incredibly sick. This is intended to prevent people from drinking since they know they’ll encounter these negative effects.
Naltrexone is technically a type of opioid. However, it is incredibly helpful in treating alcohol addiction. It drastically reduces any cravings for alcohol. Naltrexone also prevents you from experiencing the effects of alcohol consumption that you normally would. By both removing the desire and the reward for/from alcohol consumption, it can help you overcome your alcohol addiction.
Benzodiazepines make up another category of drugs that people often abuse. When used as a detox medication, it can prevent those with alcohol addiction from encountering any withdrawal symptoms associated with alcohol use. Benzodiazepines, or benzos, interact with the brain in the same way as alcohol by impacting the GABA production in the body. This means that by taking benzos instead of consuming alcohol, some of the more dangerous withdrawal symptoms like seizures and delirium tremens can be bypassed. Benzos also have a calming effect on the brain as well, preventing some of the different emotional symptoms like anxiety or irritability.
Anticonvulsants are an important classification of alcohol detox medications. Since seizures are the primary concern of the attending physicians at detox facilities, these medications help to prevent you from experiencing them. They are also showing effectiveness in treating other conditions like bipolar disorder and borderline personality disorder, making them effective detox medications for dual diagnosis patients.
Anti-nausea medications are helpful detox medications for alcohol withdrawal patients since another one of the commonly reported symptoms of alcohol withdrawal is nausea and vomiting. These medications help make the detox process far more comfortable for you by preventing these nasty side effects of alcohol withdrawal.
Antidepressants are effective as a detox medication for alcoholism since, once again, not all symptoms are physical. Many people report experiencing severe depression, even suicidal ideations as a result of stopping their alcohol consumption. By combating the psychological symptoms of depression, it can help you overcome the more difficult emotional aspect of alcohol withdrawal.
Benzodiazepines are typically prescription medications and can include medications such as Xanax, Klonopin, and Valium. Much like alcohol, benzos affect the brain’s natural GABA production. As a result, whenever you stop taking benzos, the withdrawal symptoms can be serious.
Apart from the typical insomnia and aches and pains expected to manifest whenever going through benzodiazepine withdrawal, other symptoms like seizures and tremors may also present dangers to your physical well-being.
Benzodiazepines and alcohol are the only two substances that can present potentially fatal withdrawal processes. Therefore, getting proper detox medications is necessary to cut down on the discomfort and severity associated with the symptoms.
Similarly to how Suboxone works for opioid withdrawal, substitute benzodiazepines are effective detox medications. When used in a tapering method, it can lower or even eliminate the benzo withdrawal symptoms you can encounter following your final dose.
As mentioned earlier, adrenergic medications are effective when used in the detox process as well. By controlling blood pressure, which can become irregular as a result of benzo withdrawal, and lowering stress levels, it can provide further safety and comfort for you during your medical detox.
Flumazenil is a prescription detox medication that is a selective benzodiazepine receptor antagonist. It helps combat benzodiazepine related overdoses and when used in lower doses, is effective in treating benzo withdrawal and addiction. It can be used as a tapering medication as well as suppression of benzo withdrawal symptoms.
Stimulants are a type of drug that impacts the brain and body by speeding up the natural processes that occur within the body. This causes the user to have increased blood pressure, feel more energized, and more focused. This class of drug is different than the previously mentioned drugs because it does not exactly pose the problem of causing physical dependence.
This means that whenever an individual stops abusing stimulants, which includes the likes of cocaine, methamphetamine, and ADHD medications, the individual does not experience physical withdrawal symptoms. Instead, you will usually encounter psychological or emotional withdrawal symptoms. Because of this, the typical detox medications for stimulants deal more so with combating the emotional aspect of withdrawal.
Modafinil is a medication that acts as a central nervous system stimulant. However, unlike Ritalin or Adderall, it poses a low potential for addiction. It is a useful stimulant detox medication because it acts similarly to the way methadone or Suboxone behaves for people who are addicted to opioids. It reduces the cravings that you may experience when attempting to stop using stimulants.
Antidepressants are extremely important as a detox medication for stimulants. Since one of the major side effects for stimulant withdrawal is severe depression and suicidal ideations due to the body’s severe lack of dopamine (stimulant use drains the body’s feel-good chemical), it’s important to address this aspect of withdrawal. Antidepressants increase the body’s dopamine and serotonin levels, which will help counteract the body’s severe decrease in these neurotransmitters from continued stimulant use.
In many cases, psychosis is one of the withdrawal symptoms associated with stimulant use. Cocaine psychosis can occur in people who have habitually abused large amounts of cocaine or crack cocaine. Antipsychotics combat these symptoms as well help people manage bipolar disorder, making these detox medications useful for certain dual diagnosis patients.
Benzos are helpful for those experiencing a “comedown” or “crash” after stopping stimulant use. Since benzos help relieve anxiety and produce calming effects on the brain and body, using them when faced with the intense anxiety and irritability that comes with a stimulant crash helps to keep your mood stabilized and prevent you from experiencing these intense symptoms.
If you are worried that you might have a substance use disorder that may need treatment, how do you know if detox is necessary for you? Medical assistance through withdrawal is always the safest option.
However, not everyone will need the highest level of care in addiction treatment. If you have been using alcohol, benzodiazepines, barbiturates, or other sleep aids, you should definitely ask a professional about medical detox. But if you’ve taken opioids or stimulants, detox can still alleviate some of the symptoms of withdrawal.
Detox can also help if you have other medical conditions or complications that might require medical management or monitoring. For instance, if you have a heart condition, withdrawal symptoms may be more dangerous and warrant more close medical monitoring.
When in doubt, speak to a medical professional or an addiction treatment specialist and ask about safe detox.
Becker, H. C., Ph.D. (1998). Kindling in Alcohol Withdrawal. Retrieved from https://pubs.niaaa.nih.gov/publications/arh22-1/25-34.pdf
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
National Institute on Drug Abuse. (n.d.). Nationwide Trends. Retrieved April, 2018, from https://www.drugabuse.gov/publications/drugfacts/nationwide-trends
Medline Plus, (April, 2018).Delirium tremens. Medline Plus. Retrieved April, 2018 from https://medlineplus.gov/ency/article/000766.htm
Comedown (drugs). (2018, March 04). Retrieved April, 2018, from https://en.wikipedia.org/wiki/Comedown_(drugs)