Residential Detox –

What to Expect in Recovery

Residential Detox – What to Expect in Recovery

Residential detox offers a fresh start and begins healing from addiction and substance abuse. Most people with substance use disorder or addiction need to undergo detoxification to experience treatment with a clear mind and a body free of substances.

Let’s take a closer look at what residential detox looks like, its benefits, and the time and therapies it takes for an effective detox to take place.

What Does Residential Detox Look Like?

Why is Detox Needed

One of the goals of residential detox is to address withdrawal symptoms while the body is weaned off alcohol or drugs. It is not uncommon to try to stop withdrawal symptoms by going back to taking substances because of how painful or distressing symptoms become when detox is attempted alone. One way of preventing withdrawal symptoms is medications. A survey of treatment facilities found that medications were used in approximately 80% of detoxes.1

The First Steps in Detox

Once admitted into a residential detox program, the first step is to get comfortable and settled in the new environment. Then, a drug test occurs to see which and how much of any substances are present. Medical professionals provide monitoring to see what unpredictable withdrawal symptoms may develop and treats any expected withdrawals.

Monitoring in Detox

You are also monitored for any illnesses. Substance abuse and addiction increase the risk of a wide range of other physical and mental illnesses that are related to a lifestyle that involves substances. Also, there are the toxic effects of the substances themselves that need to be addressed during a detox.

Detox is Only the First Step

Keep in mind that a detox is not a standalone treatment. Detoxification is not enough to help with full recovery. Detox alone without continued substance use treatment generally leads to relapse.2

Why Medications are Used in Detox

When alcohol or drug use stops, many different physical and emotional symptoms can occur.

These symptoms can include:2

Restlessness

Sleeplessness

Depression

Anxiety

Various other mental health conditions

Certain detox medications can reduce these symptoms, which makes it easier to stop using them and concentrate on treatment and recovery.

Medications that Treat Withdrawal

While staying in a medical detox center, healthcare staff monitors vital signs to make sure the withdrawal from alcohol or drugs is happening safely. The body handles eliminating alcohol, opiates, and other drugs in different ways. The staff follows guidelines that address the substances taken before admission into the detox program.

Common medications used to treat opiate withdrawal include:

Methadone

Buprenorphine 

Lofexidine 

These drugs act on the same parts of the brain as heroin, morphine, and prescription opioid painkillers. Methadone and buprenorphine inhibit withdrawal symptoms and help relieve cravings.1 Lofexidine works to block neurochemicals that can contribute to opioid withdrawal symptoms.3

Alcohol Withdrawal

Severe alcohol withdrawal symptoms can include:4

Delirium
Hallucinations
Delusions
Body temperature, pulse, and blood pressure disturbances
Seizures

Medications used to treat alcohol withdrawal syndrome include:

Acamprosate: Acamprosate helps lessen symptoms connected to long-lasting withdrawal, such as sleeplessness, anxiety, restlessness, and a general sense of feeling ill or unhappy. This drug has been found to be more effective treating severe addiction.1

Other Prescribed Medications: Medications commonly used to treat withdrawal symptoms from alcohol include benzodiazepines, such as diazepam (Valium) and chlordiazepoxide (Librium) — research has shown they are effective. Benzodiazepines reduce alcohol withdrawal symptoms and help prevent alcohol withdrawal seizures, which happen in about 1% to 4% of people in withdrawal.5

Anti-seizure Drugs: Anti-seizure drugs may also be used in an alcohol detox for those people who have a history or high risk of experiencing convulsions while undergoing detoxification.5

Benzodiazepine Withdrawal

Withdrawal from benzodiazepine drugs carries the same risks and displays many of the same symptoms as alcohol withdrawal. Medical complications of benzodiazepine withdrawal include seizures, which can happen at any detox stage. Similar to alcohol withdrawal, delirium can occur. Many people who started taking benzodiazepines did so to treat anxiety. Then during benzodiazepine withdrawal, panic attacks may re-emerge. Elderly people are at risk for delirium, falls, and heart attacks. Therefore, a taper down of benzodiazepine drugs should always be done under medical supervision.

Medications used in benzodiazepine detox may include:4

Switching to another benzodiazepine 

Switching to another benzodiazepine with a long half-life, such as clonazepam or chlordiazepoxide 

Another medication called phenobarbital may be used as a substitution 

Stimulants Withdrawal

Withdrawal from stimulants such as cocaine, amphetamines, and methamphetamine is much different than withdrawal from alcohol, opioids, and sedatives. While there are no specific drugs used in stimulant detox, there are medical hazards.

People who are no longer taking stimulants can fall into intense depressions. They can also develop profound negative thoughts and emotions. This can lead to suicidal ideation or suicide. Since these medical dangers can be significant, it’s recommended a supervised detox be used to treat stimulant withdrawal.

Symptoms of stimulants withdrawal can include:4

Cardiac complications 

Seizures 

Brain bleeds

Persistent headaches 

Polysubstance Withdrawal

Research shows that increasingly more people are coming into treatment that have been using more than one substance.

One study found that people in detox reported using:4

  • Alcohol and Cocaine 30% 30%
  • Alcohol, Cocaine, and Heroin Together 12% 12%
  • Alcohol and Cocaine Together 10% 10%
  • Heroin and Cocaine at the Same Time 7% 7%

Between 70% and 90% of people who said they abused cocaine also abused alcohol

Between 50% and 70% of people who were methadone patients reported alcohol dependence

Between 50% and 75% of people who were heroin-dependent also reported alcohol dependence.

In these cases of multiple substance issues, a reputable and effective detox program will prioritize detoxification treatment according to the severity of withdrawal from a particular substance. The most serious withdrawal symptoms, especially those that can be fatal, will be treated first.

Co-occurring Conditions (Dual Diagnosis) 

Other medications may be used to treat mental health conditions, such as depression, anxiety, or PTSD that can be contributing to the addiction.

What are the Benefits of Residential Detox?

One of the important benefits of residential detox is that there is monitoring in a medical setting around-the-clock. Withdrawal symptoms can quickly develop. By having experienced and trained staff on hand 24/7 to deal with symptoms right away, detox can be calmer and more successful.

In addition, residential detox offers a medically safe environment for detoxing. 24/7 care helps eliminate the distractions and temptations that the outside world can bring. Residential detox also helps protect people who experience severe withdrawal symptoms.

A residential detox also removes access to a potentially harmful environment where drugs or alcohol may be easily available. Without access to substances, it’s easier to more fully concentrate on the healing process.

Home Detox Dangers

Attempting a home detox is dangerous. Supervised inpatient detox is much safer because medications are dispensed to address withdrawal symptoms – which keeps everyone safe. A home detox carries a potential for great medical risks and can damage health. With no medical professionals on hand in case an emergency develops, highly damaging and possibly fatal results can occur.

Nutrition Benefits During Detox

Proper nutrition assists in the detox process. Vitamins and other nutritional supplements are given to help assist the detox process detox and reduce withdrawal symptoms. For people undergoing alcohol detox, thiamine, folate, and pyridoxine may be given intravenously to ease symptoms and improve health.

Medications and nutrition supplementation must be done in a medical setting so that reactions can be monitored and dosage adjustments made immediately as needed.

Hydration Benefits During Detox

Also, fluids with electrolytes are given to rehydrate and keep hydration up throughout the detox process.

How Long Does Residential Detox Take?

The length of a residential detox stay will vary from person to person and depend on a range of factors. The severity of the substance abuse, how long the person has been struggling with substance abuse, and the amounts taken all help determine the length of stay. The average residential detox stay is about 5 to 14 days.5

Once detox is completed, it’s important to enter a formal treatment program. Without treatment, it’s highly likely relapse will occur. Research shows that relapse occurs in 65% – 85% of people after detox, but if you enter treatment after detox, you are 10 times more likely to remain substance-free.6

What are Some Therapies Used in Residential Detox?

During and after a detox, a range of cognitive and behavioral therapies are given to help the medication taper and substitutions. These therapies are designed to change negative thoughts and beliefs connected to stopping drugs or alcohol. These therapies also provide education about dependence and addiction. Also, cognitive and behavioral therapies are provided that help reduce anxiety and stress as well as to enhance sleep during detox.

Do You or a Loved One Need a Detox?

If you or a loved one is suffering from alcohol or drug abuse, it’s important to have a detox scheduled as soon as possible. Research shows that symptoms of serious alcohol withdrawal can begin 6 to 24 hours after the last drink.4

If you or a loved one has an opioid abuse issue, bear in mind no matter which opioid it is, they all produce about the same withdrawal signs and symptoms. What will vary are the severity, how fast the symptoms develop, and how long they will last. These variations will depend on the drug; how often and how much was used. Opioid withdrawal generally starts 8 to 12 hours after the last dose, so it is equally important to have a detox plan in place. Symptoms last about 3 to 5 days.

If you or a loved one have a problem that involves drugs other than opioids, or there are multiple substances involved, scheduling a residential detox as soon as possible is the first step to a renewed and sober life.

Talk to your doctor, therapist, or a residential detox center about taking the first steps to a drug- or alcohol-free life. With the right help, a sober life is possible.