Do I Need to Detox from Drugs Before Rehabilitation?

The short answer here is YES. You do need to go through detoxification from drugs before entering a rehabilitation or aftercare program.

Can I Go Through Detoxification from Drugs at Home?

As addiction becomes increasingly common, more and more addicts are considering going through drug detoxification on their own rather than partnering with a professional facility.

It might have to do with the shame and guilt that’s so common among substance abusers. It could be the stigma attached to addiction. Or maybe it’s even the money (though detox is more affordable than ever as we’ll see later).

No matter what the reasons, though, it’s important to truly understand both the dangers of at-home detox from drugs and the advantages that a professional detoxification facility provides.

Let’s take a closer look at what makes at-home detox such a bad idea compared to a professional program.

Medical Oversight – Perhaps the biggest benefit of a professional program is having access to medical care during your drug detoxification. Whether it’s dealing with the lethal withdrawals that are possible with some drugs or treating the serious complications that can occur, a professional program will keep you safe throughout the course of your detox. Going through withdrawals at home, then, may end up being a risk to your health.

Expertise & Proven Treatments – Protocols of a professional facility are often built off of evidence-based strategies that are proven by science. Studies have shown that they can reduce both the severity and duration of your withdrawals. If you detox at home, then, expect a much longer, more painful detoxification process.

Supplementary Therapies – Many programs for detoxing from drugs also incorporate additional therapies to teach you valuable coping strategies and help you deal with withdrawals in a healthy way. Not only will these therapies help with your detoxification, but they can also even be used later to support your long-term recovery as well.

Emotional & Motivational Support – Getting through recovery takes an enormous amount of support. And when you’re being assaulted by numerous psychological withdrawal symptoms, that support is even more essential. A professional drug detox program will help provide that vital emotional and motivational support throughout the process. So, you can always be sure someone is cheering you on towards sobriety.

Relapse Prevention – Last but not least, a professional program for detox from drugs will also protect you from your own worst enemy: yourself. Withdrawals during detoxification can often be exceedingly uncomfortable and sometimes overwhelming. And that might lead you to try and start using again just to stop feeling these symptoms. A professional detox program will help stop you from relapsing during recovery. But if you try to get through withdrawals by yourself, it’s likely willpower alone won’t be enough.

What Kinds of Drug Withdrawals Can I Expect?

Not everyone’s drug detoxification process is going to end up being the exact same. In fact, your withdrawals could end up being drastically different from someone else who abused the same drug for the exact same amount of time.

That’s because your experience detoxing from drugs of abuse is determined by a number of different factors. These include:

• Unique genetic predisposition
• Individual physiology
• Overlapping abuse and use disorders
• Culture and environment(i.e., surrounded by drug users, from a staunch anti-drug family, etc.)
• Social support system

Accurately predicting the precise physical and psychological symptoms you’ll experience during drug detox, then, is almost impossible. That being said, many substances of abuse have a list of documented withdrawals that have been observed in the past. We’ve listed those symptoms below organized by drug type.

Remember though; this list is not meant to be a 100% accurate roadmap of the symptoms you will go through during drug detoxification. Rather, think of it more as the possible side effects of detox that you might experience instead.

Prescription Opioids – Prescription opioids like OxyContin, Vicodin, and Fentanyl are some of the most widely abused and dangerous drugs being used today. According to the Centers for Disease Control and Prevention, around 46 people die every single day from overdoses involving prescription opioids. Added to that, more than 40% of all drug overdose deaths in 2016 involved prescription opioids.

As you can see, prescription opioids have a huge hand in the current drug epidemic. And part of that is due to just how difficult it can be to weather the symptoms of withdrawal during this type of drug detoxification. Most people describe the process as a being similar to the flu, but ten times worse.

According to MedlinePlus, the most common symptoms you can expect to go through during this kind of drug detox are:

• Agitation
• Anxiety
• Muscle aches
• Increased tearing
• Insomnia
• Runny nose
• Sweating
• Yawning
• Abdominal cramping
• Diarrhea
• Dilated pupils
• Goosebumps
• Nausea
• Vomiting

Cocaine – Cocaine has long been one of the most problematic and widely abused illicit drugs in the country and indeed across the world. This illegal stimulant has a strong connection with the party scene, and while abuse statistics have gone down since the early 2000s, cocaine abuse is on the rise once again.

NIDA reports that in 2011, cocaine was involved in more than 1 in 3 emergency room visits involving the misuse or abuse of a drug (505,224 of the nearly 1.3 million visits). Beyond that, overdose involving cocaine numbered well over 5,000 in 2014 alone.

Drug Detox from cocaine addiction is usually limited to psychological symptoms. However, cravings during cocaine withdrawals can be incredibly intense and often times overwhelming. Without professional help, pushing through these cravings and maintaining sobriety can be especially tough to do.

According to Mental Health Daily, the long list of symptoms of opioid withdrawal include:

• Agitation
• Concentration problems
• Diarrhea
• Dizziness
• Goosebumps
• Heart palpitations
• Hot flashes
• Irritability
• Memory problems
• Nausea
• Paranoia
• Suicidal thoughts
• Vomiting
• Yawning
• Watery eyes
• Sweating
• Runny nose
• Panic attacks
• Muscle aches
• Itchiness
• Insomnia
• High blood pressure
• Headaches
• Fatigue
• Dilated pupils
• Depression
• Cravings
• Anxiety

Heroin – Undoubtedly one of the most infamous illicit drugs in the world today, heroin has continued to be a serious problem for decades. A combination of high risk of addiction, deadly side effects, and particularly powerful withdrawals makes heroin abuse not only especially habit-forming but also quite dangerous as well.

The American Society of Addiction Medicine reports that over half a million U.S. citizens were struggling with a heroin use disorder in 2015. In the same year, heroin was involved in almost 13,000 overdose deaths as well. And finally, almost one-quarter of all individuals who use heroin end up developing a full-blown addiction to opioids.

And when you consider the symptoms of withdrawal during drug detox from heroin, it isn’t hard to imagine why so many people have a hard time overcoming this drug dependency. According to MedlinePlus, the symptoms of withdrawal most typically experienced include:

• Agitation and restless behavior
• Depressed mood
• Fatigue
• General feeling of discomfort
• Increased appetite
• Vivid and unpleasant dreams
• Slowing of activity
• Anxiety
• Lack of pleasure (anhedonia)
• Irritability
• Sleepiness
• Paranoia
• Extreme suspicion

Benzodiazepines – Despite just how much a part of daily life these drugs are for many people, benzodiazepines like Xanax and Valium have some of the most unbearable withdrawal syndromes of any other drug. That even includes illegal heavy hitters like heroin and crystal meth.

In fact, according to the online community BlueLight, over 38% of survey respondents reported that benzodiazepine withdrawals were the worst.The next two highest responses were Methadone and heroin at 14.24%and 13.77% of respondents respectively.

According to renowned benzodiazepine researcher Professor Heather Ashton of the Institute of Neuroscience at Newcastle University, the most common withdrawal symptoms you may experience during benzodiazepine detoxification are:

• Excitability (jumpiness, restlessness)
• Headache
• Insomnia, nightmares, other sleep disturbances
• Pain/stiffness – (limbs, back, neck, teeth, jaw)
• Increased anxiety, panic attacks
• Tingling, numbness, altered sensation – (limbs, face, trunk)
• Agoraphobia, social phobia
• Weakness (“jelly-legs”)
• Perceptual distortions
• Fatigue, influenza-like symptoms
• Depersonalization, derealization
• Muscle twitches, jerks, tics, “electric shocks”
• Hallucinations, misperceptions
• Tremor
• Depression
• Dizziness, lightheadedness, poor balance
• Obsessions
• Blurred/double vision, sore or dry eyes
• Paranoid thoughts
• Tinnitus
• Rage, aggression, irritability
• Hypersensitivity - (light, sound, touch, taste, smell)
• Poor memory and concentration
• Gastrointestinal symptoms - (nausea, vomiting, diarrhea, constipation, pain, distension, difficulty swallowing)
• Intrusive memories
• Appetite/weight change
• Dry mouth, metallic taste, unusual smell
• Flushing/sweating
• Over-breathing
• Urinary difficulties/menstrual difficulties
• Skin rashes, itching

Stimulants – In most cases, withdrawals from stimulants usually have to do with psychological symptoms rather than physical ones like other drugs. And while that might sound easier to bear to some people, the truth is that the effects of withdrawal on the mind can be even more overwhelming than the physical symptoms of other substances.

In fact, the withdrawals from stimulants might be so overbearing in some cases that they can bring about a type of psychosis where recovering addicts might become violent both to others and to themselves.

According to SAMHSA, some of the most common symptoms of withdrawal experienced during this kind of detoxification are:

• Intense drug cravings
• Dysphoric mood, which may become clinical depression, suicidal thoughts
• Weight loss, gaunt appearance, anorexia
• Anxiety, irritability
• Dehydration
• Impaired memory
• Fatigue, lethargy, lack of energy
• Hunger
• Loss of interest in pleasurable activities (anhedonia)
• Psychomotor lethargy and retardation
• Withdrawal from social interactions
• Intense and vivid drug-related dreams
• Chills
• Insomnia followed by hypersomnia

Club Drugs – As the name implies, these drugs have a strong connection to the late-night partying scene. Clubs, raves, concerts, bars, and other venues are some of the most common places that they’re used and abused, though they certainly aren’t the only locations.

According to NIDA some of the most popular club drugs are GHB, Ketamine, LSD, DMT, and MDMA or ecstasy. Rohypnol and methamphetamine are a few others though they tend to be grouped under benzodiazepines and stimulants respectively.

The withdrawal syndrome of many club drugs is quite minor in some cases. That's because many hallucinogens aren't actually physically habit-forming. That being said, there are two factors in particular that can make it exceedingly difficult to get through this type of drug detoxification: club drug additives and psychological dependence.

Many club drugs are combined with other substances like illicit stimulants or anti-anxiety medications. As such, if you’ve become addicted to a club drug, you may experience benzodiazepine or stimulant withdrawal symptoms during detox.

What’s more, just because you aren’t physically addicted to a club drug doesn’t mean you aren’t psychologically addicted to it. When you go through detoxification then, you may experience symptoms like depression, fatigue, irritability, and more as a direct result of your psychological dependency.

Additionally, some club drugs like GHB do have physical withdrawals. According to the DEA, the most common of these withdrawals are:

• Insomnia
• Anxiety
• Tremors
• Increased heart rate and blood pressure
• Psychotic thoughts

Synthetic Drugs – While technically there are a number of other drugs that fit into this category like LSD and even fentanyl, synthetic drugs, in this case, refer to substances like synthetic marijuana, bath salts, and designer drugs like N-BOMe.

One of the biggest problems with these types of drugs is that in many cases they're legal for a brief period of time. Eventually, they do become outlawed, but manufacturers often tweak the chemical makeup enough to make it technically a new compound but still retain the same high-inducing qualities.

The DEA and FDA, then, are usually playing catch up trying to outlaw version after version of these dangerous drugs.

Since synthetic designer drugs are often so varied and have chemical compounds that change from month to month, it can be hard to nail down specific withdrawal symptoms. However, according to addiction magazine The Fix, withdrawals from one synthetic drug, Spice, may include:

• Depression
• Headache
• Loss of appetite
• Anxiety
• Suicidal thoughts
• Intense cravings
• Tremors
• Palpitations
• Nightmares
• Psychotic episodes
• Confusion
• Extreme sweating
• Paranoia
• Loss of motivation
• Restlessness
• Inability to sleep
• Apathy for consequences of behavior
• Hallucinations
• Seizures

How Does A Professional Drug Detox Program Treat Your Withdrawals?

Partnering with a professional program for detoxification from drugs is one of the best ways of ensuring your detox goes as smoothly and safely as possible. But how do these programs actually treat your withdrawals?

There are a couple of ways in particular that many detox programs use to make sure you’re both comfortable and healthy throughout detoxification.

Nutritional Planning – Addiction can wreak havoc on your body both internally and externally. And in addition to the enormous strain it can put on your body’s organs like the heart, liver, and kidneys, your nutrient-starved body may not be able to cleanse itself as quickly while it’s in such a compromised state.

With the help of a nutrient-rich and healthy dietary plan during detox, though, your body can recover from the ravages of addiction much more quickly and painlessly than before.

Exercise – Believe it or not, exercise can be incredibly beneficial when it comes to expelling the massive buildup of toxins that have accumulated in your body thanks to your addiction. Getting your blood pumping can jumpstart your hormone systems into releasing a number of feel-good endorphins as well, helping you stay positive and motivated throughout your drug detoxification.

Plus, it’s a great way to keep your mind off of the cravings.

Behavioral Therapies – There are a host of effective behavioral therapies that you might encounter during your drug detoxification.

Some of these may be evidence-based and may have been extensively studied like cognitive-behavioral therapy (CBT), and others might include practices such as art therapy and mindful meditation. In the end, all of these therapies can help you overcome your cravings and develop more control over your addicted mind.

What Kinds of Medications Are Used During Detox from Drugs?

In addition to treating your withdrawals during drug detox using nutrition, exercise, and behavioral therapies, some facilities might also use what is known as Medication-Assisted Treatment or MAT.

With MATs, addiction specialists can reduce the severity and duration of your symptoms of withdrawal during drug detox as well as help eliminate cravings along the way. The only medications currently cleared by the FDA for treating addiction are for opioids and alcohol. However, you might also be prescribed other medications.

Below are some of the medications most commonly used during drug detox.

Opioids – Addiction treatment research has recently been heavily focused on finding medications that can effectively treat opioid withdrawals in particular. That’s because opioids like OxyContin and heroin are some of the major driving factors for the rise in drug overdoses and deaths in the U.S. in the past few decades.

And while studies have been exploring the benefit of other medications for treating opioid withdrawals, three drugs specifically are considered the best options for medicated treatment: methadone, buprenorphine, and naltrexone.

Methadone – Long considered to be the go-to choice for reducing the severity of opioid withdrawals, methadone is typically administered via a single liquid dose once a day at specialized clinics.

Doses of this compound help to stimulate certain opioid receptors in the body over a long period of time, though to only a small degree. Consequently, withdrawal symptoms are muted or eliminated entirely for someone going through opioid drug detox.

However, methadone is a full opioid agonist, meaning it binds to and activates receptors just like other opioids like heroin. As a result, methadone itself can, in fact, become addictive. If used improperly then, it is possible to become addicted to it during your recovery.

Buprenorphine – Similar to methadone, buprenorphine (marketed as Suboxone) also activates the same opioid receptors that certain substances of abuse bind to. However, unlike methadone, buprenorphine is only a partial opioid agonist rather than a full agonist. That means that while it does activate those receptors, it only can do so up to a certain point. After that, the intensity of activation doesn't change no matter how much buprenorphine you have in your system.  

This quality of buprenorphine makes it even less risky in terms of developing a dependency disorder since patients simply can’t keep taking the drug until they get high.

In fact, buprenorphine doesn’t even need to be dispensed at specialized and highly regulated clinics like methadone. You can get it right from your physician in some cases.

That being said, buprenorphine like methadone can, in fact, be abused and even may become addictive. And that means this drug should only be handled with the utmost care.

Naltrexone – In contrast to both methadone and buprenorphine, naltrexone doesn't activate the brain and body's opioid receptors at all. Instead, this drug latches to these receptors and blocks them so other molecules can’t stimulate them at all.

As a result, a recovering opioid addict may end up relapsing on heroin only to find that if they’re on naltrexone, shooting up will not produce any high at all. Essentially, then, naltrexone removes the appeal of returning to drug abuse almost entirely.

What’s more, this drug can be administered via a once-a-month shot under the brand Vivitrol, making it incredibly easy to use. Plus, studies have compared the effectiveness of Vivitrol and Suboxone and have found that they are surprisingly similar.  

However, Vivitrol can only be taken once the symptoms of withdrawal have subsided so this drug is suited more for rehabilitation than detox from heroin or hydrocodone.

Benzodiazepines – In addition to medications used to reduce symptoms like anxiety and depression during this particular drug detox, the main medications used are longer-acting benzodiazepines.

Longer-Acting Benzodiazepines – When benzodiazepines are used as a substance of abuse, oftentimes it’s the short-acting versions like Xanax that are most commonly used. Longer-acting benzodiazepines like Clonidine, however, may prove useful in treating the withdrawals by stimulating the same receptors thought to a much lesser degree and over a longer period of time. This can help reduce the intensity of the often-unbearable withdrawal symptoms.

Simulants – According to SAMHSA, medications used in the treatment of stimulant drug detoxifications are a bit hard to come by. Antidepressants have shown some effectiveness, but for the most part, behavioral therapies are largely considered to be far more effective.

However, there are a few drugs that have shown some promise over the years. They include:

Naltrexone – The same drug that's used in the treatment of opioid dependence, naltrexone's receptor-blocking effects might also be useful when it comes to stimulant detox too. One study showed that the ability this drug has on reducing cravings is especially powerful for recovering amphetamine addicts.

Modafinil – Developed as an insomnia treatment originally, some studies have shown that Modafinil may be helpful in preventing relapse for methamphetamine and other stimulant abusers. What’s more, it may even be helpful in reducing the cognitive deficits of long-term methamphetamine abuse.

Disulfiram – Also known as Antabuse, Disulfiram is most commonly used in treating alcohol addiction. However, this drug also intensifies anxiety when taken in conjunction with cocaine. Studies have shown that it can reduce the risk of cocaine relapse as a result.  

How Much Does A Drug Detox Program Cost?

One of the most common concerns among addicts looking for treatment is how much a drug detoxification program costs.

In fact, according to the 2016 National Survey on Drug Use and Health from SAMHSA, almost one-third of addicts who didn’t receive the treatment they knew they needed due to not being able to afford the costs.

And it’s true – detoxification may seem to be expensive for some. Usually, services range from around $250 to $500 per day.

But your overall costs will depend on a number of different factors. The extent of your addiction, the types of treatments required, the amenities used and requested, and the duration of your stay all play a role here.

Added to that, many drug detoxification programs have a number of services that can help make your treatments even more affordable.

For instance, many centers for detoxing from drugs offer financing options that let you pay back the costs of your treatment over time at an added interest rate.

Most drug detox facilities will also offer month-to-month payment plans to ease the financial burden a bit more.

And finally, some programs will even base your final costs on a sliding scale that adjusts based on your personal or household income.

In the end, the majority of drug detox programs are more than willing to work with you directly in order to get you the help you so desperately need. All you have to do is reach out and ask.