Do I need a Drug Detox: Checklist
Table of Contents
More than 20 million Americans [1] age 12 and over suffer from a substance use disorder—alcohol or drug addiction.
The first step in recovering from addiction, and reversing its damaging physical and psychological effects, is to undergo a detox process.
It is essential for people experiencing addiction to learn the details about detox and treatment. This information includes symptoms of withdrawal from drugs and alcohol and knowing whether or not detox is needed.
What Is Drug Detox?
Drug or alcohol detoxification—or “detox” for short—is the process of eliminating an addictive substance from the body after a period of prolonged use of the substance.
A person undergoing detox will almost always experience physical, mental, and emotional withdrawal symptoms. These symptoms can range from mild to extremely uncomfortable. This occurs because the body has become dependent upon these substances.
The detox process can be overwhelming and very challenging to do alone successfully. However, it’s generally safer and more effective with the support of a team of medical and mental health professionals. These doctors and counselors can help manage the most severe withdrawal symptoms.
Why Does Withdrawal Occur?
When a person regularly drinks alcohol or uses drugs, their body adjusts to this substance’s presence. Long-term alcohol use dramatically changes brain chemistry [2], and the same is true for other medications. Over time, the brain begins to crave the reward of the substance (e.g., the release of dopamine). In addition, the brain’s impulse-control mechanisms are damaged.
When this happens, the person becomes physiologically dependent on alcohol or drug. They now rely upon the substance to feel “normal” and function “effectively” in the world.
During the withdrawal process, the person’s body needs to recalibrate—to create a “new normal dramatically.” Little by little, the body regains homeostasis that doesn’t depend upon the presence of the addictive substance. This transition comes with temporary disruptions in brain chemistry. These disruptions are responsible for physical withdrawal symptoms and corresponding mental-emotional symptoms.
The Four Stages of Addition
Medical and psychiatric experts who specialize in addiction recovery have identified four stages of addiction:
Someone who has reached the fourth stage—addiction or dependency—can be diagnosed as having a Substance Use Disorder (SUD).
The Prevalence of Substance Use Disorder (SUD)
A National Survey on Drug Use and Health [3] states that over 65.6% of Americans over the age of 12 have used or abused the top ten addictive substances.
These frequently used and abused substances are:
- Alcohol
- Barbiturates
- Benzodiazepines
- Cocaine
- Heroin
- Inhalants
- Marijuana
- Nicotine
- Opioids
- Stimulants
The first step in recovering from addiction to one of these substances is to admit that there is a problem. See and understand how the substance creates physical, mental, emotional, financial, legal, and relationship issues.
The next step is to undergo detox. When a person regularly asks themselves—”Do I need a drug detox?”—chances are good that the answer is yes. But there are ways to become even more confident that detox is a good choice.
When Is Drug Detox Necessary?
If you or a loved one asks, Do I need a drug detox?—then, viewing our checklist will help to answer this question. It will help to determine whether a given individual must receive expert care for the withdrawal process [4].
This checklist will help determine whether a person has moved from occasional experimentation with a substance to high-risk use. And even more concerning, into the realm of dependency or addiction.
Do I Need a Drug Detox: Checklist
It may be tempting to try detoxing alone for those not yet ready to ask for help. Answering “yes” to any or all the questions means that professional support for detox is probably the best choice.
1. Is your tolerance for the drug, prescription medicine, or alcohol increasing?
If a person finds that they need more of the substance to feel the effects, the body has developed a tolerance. When this happens, the individual may have to use the substance just to feel normal. And as the substance begins to leave their body, they start to feel sick. This is a sign that a formal detox is needed.
2. Do you experience mood changes when you quit using the substance?
Alcohol or drug withdrawal can lead to mood changes and feelings of agitation, anxiety, or depression. Detox may be needed if someone experiences significant mood changes when they haven’t used the substance.
3. Do you experience physical withdrawal symptoms?
Physical withdrawal symptoms are a sign of physiological dependence upon the substance. When a person stops using the substance, their body reacts with symptoms such as headaches, body aches, sweating, nausea, or vomiting. In more extreme cases, a person may experience delirium tremens (aka DTs), uncontrollable trembling, confusion, hallucinations, or seizures. If a person has any of these symptoms, this is a sign that a supported detox is needed.
4. Do you have intense cravings for the substance?
A person addicted to a drug will spend a lot of time thinking about the substance. They will also spend a great deal of time planning the next way to use it. They will experience intense urges to use the substance, which they feel powerless to resist.
They will think obsessively about the places, people, activities, or rituals involved with substance use; and find comfort in these habits. If a person experiences this type of intense craving, this is a sign that detox is needed.
5. Have you tried to reduce your substance use—or quit using—many times but haven't been successful?
When people attempt to quit or reduce their substance use, they find out how difficult it is. Without a reliable support system, intense withdrawal symptoms can feel too much to deal with.
The intensity of withdrawal can lead them to resume substance use. Some people experience cycles of trying to quit and returning to using. These patterns may signify that a professionally supported detox is needed.
6. Do you have other medical issues complicating substance use?
When a person has health conditions such as diabetes, hypertension, or heart problems, this can complicate the detox process. And detoxing during pregnancy also requires extra care. If an individual has serious medical (or psychiatric) issues—or is pregnant, this is a sign that a medically supervised detox is needed.
7. Have you reduced or eliminated participation in activities you enjoyed?
People with a drug or alcohol addiction will often stop doing things they used to enjoy. They will likely start spending more time using the substance. If an individual notices that activities or events they previously found satisfaction in have been replaced, they may need detox.
Do I Need a Drug Detox: Checklist
Drug or alcohol withdrawal symptoms can range from mild to severe and differ from one person to the next. The specific symptoms that a person experiences, and the risk that they pose, will depend upon the following:
- The type and quantity of the substance that was used.
- How long the substance was used.
- The method by which the substance was used (e.g., snorting, smoking, injecting, swallowing).
- Whether multiple types of drugs were used simultaneously.
- The person's age and weight.
- The person's physical and psychological condition.
- A person's family history and genetic makeup.
- The specific withdrawal process that is used.
Stages of Withdrawal Symptoms
Withdrawal symptoms are generally described in terms of three stages:
1. An acute withdrawal period.
Which lasts from a couple of days to a week. This is when the withdrawal symptoms begin and are most intense.
2. A protracted withdrawal period.
This is when symptoms are the most difficult and then begin to fade.
3. A prolonged withdrawal period.
This is after the physical symptoms have subsided, but longer-term psychological symptoms remain, such as cravings and depression.
Withdrawal Effects Common to All Substances
Specific patterns and effects can be seen during withdrawal from a wide range of substances. These similarities include the following:
* Rebound effects
symptoms that the drug was designed to reduce/control appear in full force when the person stops taking the drug. For instance: during opioid withdrawal, a person might feel significant pain. And during withdrawal from benzodiazepine, they may feel anxiety. Meanwhile, during withdrawal from a stimulant, they might experience lethargy.
* Decreased tolerance
occurs rapidly during withdrawal from the substance. It can be dangerous if the person relapses; they could easily overdose because of the reduced tolerance.
* Depression
people in detox/recovery whose brains have been coerced into producing too much dopamine (a feel-good chemical) may experience an extreme lack of motivation or inability to experience pleasure during the withdrawal phase.
* Autonomic nervous system changes
symptoms such as irregular heartbeat, irregular breathing, and changes in blood pressure are common during withdrawal.
Physical & Psychological Withdrawal Symptoms
Common drug and alcohol withdrawal symptoms can be categorized into physical and psychological symptoms.
Physical symptoms of drug withdrawal include:
- Nausea and vomiting
- Diarrhea
- Muscle aches and bone pain
- Fever or chills
- Fatigue and exhaustion
- Restlessness
- Vivid, unpleasant dreams
- Flu-like symptoms
- Vomiting
- Headaches
- Heart palpitations
- Irregular breathing
- Changes in blood pressure
- Excessive sweating
- Shaking and shivering
- Trembling and tremors
- Hunger or loss of appetite
- Dilated pupils
Psychological symptoms of drug withdrawal include:
- Depression
- Anxiety
- Paranoia
- Insomnia
- Panic attacks
- Confusion
- Irritability and agitation
- Difficulty focusing or concentrating
- Intense cravings for the drug
- Short-term memory loss
- Anhedonia: the inability to feel happiness
Delirium Tremens
The most severe drug addiction withdrawal symptoms, known as delirium tremens (DTs), include:
- Rapid heart rate
- High fever
- Extreme confusion
- Uncontrollable shaking/shivering
- Visual or auditory hallucinations
- Seizures/convulsions
Drug Withdrawal Timelines
The timeline for drug withdrawal varies on several factors. The process depends upon the specific substance being detoxed and the physical and psychological condition of the person undergoing detox.
A complete detox—eliminating all withdrawal symptoms—can take days, weeks, or months to complete. This overview of commonly abused substances and their typical withdrawal timeline can help people know what to expect.
Alcohol
The first alcohol withdrawal symptoms can appear several hours after the last drink. These symptoms will likely peak during the first 24-72 hours. Delirium tremens typically develop 48-72 hours after heavy drinking has ceased. And they usually last for 3-4 days though they can continue for up to 8 days.
Short-Acting Opioids (such as heroin and certain prescription painkillers)
Short-acting opioid withdrawal symptoms can be expected to begin 8-24 hours after the last use. The symptoms continue for an average of 4-10 days.
Longer-acting opioids (such as methadone)
When detoxing from methadone and other longer-acting opioids, it may take 2-4 days before withdrawal symptoms begin to emerge. The symptoms typically fade within ten days.
Benzodiazepines (such as Xanax and Valium)
Withdrawal symptoms when detoxing from benzos generally begin within 1-4 days after the last use. The symptoms usually peak in severity within the first two weeks. Without treatment, protracted withdrawal symptoms can continue to appear for months or even years.
Cocaine
When a person abruptly stops using cocaine, they may experience a severe, adverse change in their mood. The user may experience cocaine withdrawal symptoms within the first day of their last use. Withdrawal symptoms from cocaine may last for weeks.
Methamphetamine
The onset of meth withdrawal symptoms is generally within 24 hours after the last use. These symptoms can continue anywhere between a couple of days and 2-3 weeks.
Marijuana
Withdrawal symptoms during marijuana detox typically begin within a week after discontinuation. The symptoms peak within ten days after an individual has discontinued marijuana use. And then they start a steady decline in severity over 10-20 days.
Nicotine
Cravings begin within 4 hours of the last nicotine intake, and other initial withdrawal symptoms appear in the first 24 hours. After three days, most of the nicotine withdrawal symptoms will be at their peak. After one week, the most uncomfortable effects will disappear, though more minor symptoms may appear for up to a month.
What Is Medical Detox?
To rid the body of the abused substance, a person must go through a detoxification process. When the person stops using drugs or alcohol, their body naturally gets rid of those substances. But this doesn’t mean that it’s safe to detox on their own. Detoxing without supervision can be life-threatening in some cases.
In many cases, detoxing in a medical facility is the safest option. A physician-supervised medical detox program won’t speed up the detox process. It does, however, help make the process as safe and comfortable as possible. This includes expertly addressing withdrawal symptoms in ways that minimize the risk of relapse.
Medical detox is considered necessary in most cases of alcohol or benzodiazepine addiction. And it’s highly recommended for other types of addiction. This maximizes the chance of a full recovery and creates a healthy, sober life.
Support for Drug Detox & Addiction Recovery
Overcoming addiction can be challenging, and relapse rates for all types of addiction are high. That’s why it’s essential to begin the process in a safe and secure environment. A detox facility with medical experts and skilled mental health professionals can provide a secure environment.
Experts agree [5] that detox and recovery from addiction are most effective when supported by psychiatric experts who agree with certain principles, protocols, and therapies.
These methods include:
is understood as only the first stage of addiction treatment since it does little to change long-term drug abuse by itself.
including individual, family, or group counseling- supports addiction recovery.
is an essential element of treatment for many clients, especially when combined with counseling and other behavioral therapies.
are assessed continually and modified as necessary to ensure that they meet the client’s changing needs.
While substance detox is a vitally important first step toward recovery, it’s not a complete treatment. At addiction treatment centers such as Everlast Recovery, detox support is followed up with extensive therapy and aftercare to help prevent relapse.
In substance abuse treatment, clients address the issues that led to their substance abuse and learn practical ways to deal with them. With the support of skilled therapists, they develop a long-term plan for avoiding alcohol or drugs. They work toward rebuilding intelligent and joyfully sober lives.
At Everlast Recovery, our expert drug addiction specialists are committed to supporting each client through their drug withdrawal and recovery process. We ensure that this process is safe, comprehensive, and managed as smoothly and comfortably as possible. Our trained professionals focus on each client’s unique circumstances during their stay at our addiction center.
Questions or comments? Please feel free to contact us.
References & Resources
- Drug Use Estimates: Prevalence and Trends
- Neurotransmitters in alcoholism: A review of neurobiological and genetic studies – PMC
- Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Healt
- Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings – NCBI Bookshelf
- Principles of Effective Treatment | National Institute on Drug Abuse (NIDA)
- Drug Withdrawal Symptoms, Timelines, and Treatment