Detoxification, or detox, is the first step that an addict takes to become sober. It is a process that seems simple enough – just wait until the drugs have left your system and your bloodstream is clean. However, the withdrawal symptoms that can occur can require medical attention.
But what exactly happens during detox? You always hear that you need to have medical personnel present in case of an emergency. The first week is always said to be the worst week. So, what happens during the first week of detox that causes such a huge turning point in an addict’s life?
Detox varies because of a number of factors, such as the drug used in the addiction, the length of the addiction, and the severity of the addiction. Perhaps this is the reason that there is no definite formula to make detoxing easier.
Why is Detoxification Necessary for Rehabilitation?
While this question would seem to have an obvious answer, some people may wonder why it is necessary for an addict to completely detox from his drug of choice before beginning any further form of rehabilitation. Why can’t an addict move straight into rehabilitation and deal with withdrawal symptoms as the treatment progresses?
This is because detox is a period of extremely intense withdrawal that not only results in unpleasant physical symptoms but also manifests psychological symptoms. The pain the addict is in physically and the altered state of his reality that he is experiencing mentally both prevent the addict from being able to concentrate on beginning his recovery.
Dr. Glen Hanson, the director of the Utah Addiction Center, states, “Detox is a part of addiction treatment. You’ve got to get the drugs out of the body to figure out where you are. Not only in terms of the brain, but in terms of the rest of the body: the heart, the cardiovascular system, liver, everything is affected by these drugs.”
The best plan of action to begin the recovery process properly is to completely rid the body of drugs and overcome the hardest withdrawal symptoms before moving on the other rehabilitation methods like therapy, medication, treatment, and support.
The Most Abused Drugs in America – Ranked
There are many drugs that are abused in America, but some are abused much more than others. Many different factors contribute the how often and to what extent a drug is abused, like availability and cost.
These are the 5 most abused drugs in America:
- 1 – Alcohol – 18 million users
- 2 – Prescription Opioids – 1.8 million users
- 3 – Cocaine – 821,000 users
- 4 – Heroin – 426,000 users
- 5 – Benzodiazepines – 400,000 users
The focus of the detox timelines in this article will be on these top 5 abused drugs in the United States.
It is also important to remember that detox severity is influenced by:
- Length of addiction
- Severity of addiction
- Drug used in the addiction
- Mental health
- Family history
- Childhood trauma
A full detox from certain drugs takes much longer than 7 days. However, one thing that most detoxes have in common is that the worst symptoms are over or are lessening by the end of the first week.
A Week of Alcohol Detox
Alcohol abuse is extremely common because it is legally obtained by anyone over the age of 21 with a valid identification card. It is the 3rd leading cause of death in America, and 1 out of every 3 visits to the emergency room are related to alcohol consumption.
Stage 1 – within 8 hours
This stage begins within 8 hours of consuming alcohol. It’s rather mild compared to most other detox processes. Symptoms can include anxiety, insomnia, abdominal pain, depression, and mood swings.
Stage 2 – 1 to 3 days
The second stage of alcohol detox includes symptoms like increased blood pressure, body temperature, and respiration. It is also characterized by mental confusion, sweating, and extreme mood disturbances.
Stage 3 – up to 1 week
Most mild to moderate cases of alcoholism can be fully detoxed within 3 or 4 days, but more severe alcohol addiction can take a week or more (without medical help) to complete the detox process. At this point, the addict will experience something called delirium tremens that causes hallucinations, fever, seizures, and extreme confusion and agitation.
A Week of Prescription Opioid Detox
Prescription opioids are one drug that you do not want to stop cold turkey. Even if you become addicted to opioids as the result of a prescription that you follow religiously, stopping these drugs requires tapering, or weening, off of the medicine by slowly lowering your dosage under the guidance of your doctor.
Stage 1 – within 24 hours
The first stage of prescription opioid detox includes symptoms such as anxiety, insomnia, muscle aches and pains, and excessive sweating.
Stage 2 – 1 to 10 days
Detox symptoms typically peak at 72 hours (or 3 days) after stopping opioids and sometimes don’t stop until after the ten day mark. Symptoms during this time include nausea, vomiting, diarrhea, abdominal cramping, and rapid heart rate. The withdrawal feels like an extremely bad case of the flu.
A Week of Cocaine Detox
Cocaine detox has a bit of a different timeline than others because the initial “crash” from the drug lasts for an entire week, on average. Cocaine withdrawal symptoms include strong cocaine cravings, anger and irritability, lethargy and fatigue, psychomotive agitation, vivid nightmares, tremors, depression, hyperactivity, and erratic sleep.
The Crash – Week 1
The crash period of cocaine detox starts anywhere from 1 hour after the last dose to 40 hours after the last dose and can last up to a week, depending on usage factors. Some symptoms will appear, the most prominent ones being the intense craving for more cocaine and the heightening urge to sleep. As the cravings subside in the first week, the need for sleep increases.
Cocaine Withdrawal – Weeks 1 to 4
There is a period that can range from 1 to 5 days after the initial crash that a cocaine addict may believe they are in the clear, but, soon, more symptoms begin to set in and the strong desire for more cocaine comes back. Within these weeks, there are many triggers that can cause a person to easily relapse. This is the most crucial part of the cocaine detox process because it is the part during which most addicts will relapse if not careful.
Extinction – Weeks 5+
Once the cocaine withdrawal part of the detox phase is over, the cravings for the drug become less and less and the other symptoms begin to subside. This can take just weeks to fully dissipate, or it can take months. Some people will experience symptoms for years.
A Week of Heroin Detox
Heroin begins working almost immediately after it is introduced into the body, but once it has run its course, withdrawal symptoms set in very quickly. You can even go through heroin withdrawal while you are still doing heroin – detox can begin as soon as you stop ingesting the amount your body has become dependent on.
Stage 1 – 6 to 12 hours after use
Very soon after the last dose of heroin, detox sets in, causing symptoms like chills, nausea, sweating, yawning, and body aches. The drug leaves the bloodstream quickly, and the body begins to mimic the flu.
Stage 2 – 1 to 3 days after use
This is the time that withdrawal symptoms will peak for heroin detox. Flu-like symptoms will intensify. You will experience symptoms like vomiting, restlessness, tremors, uncontrollable goosebumps, agitation, fatigue, and diarrhea. For more severe addictions, symptoms like anxiety, depression, insomnia, hallucinations, impaired breathing, high blood pressure, high heart rate, muscle spasms, and extreme heroin cravings will begin at this time.
Stage 3 – 7 to 10 days after use
Usually, the physical symptoms of heroin detox begin to fade around the week mark; however, mental symptoms – mood swings, insomnia, heroin cravings, anxiety, and depression – can persist for much longer.
A Week of Benzodiazepine Detox
Benzodiazepine, or benzo, detox is, quite possibly, the riskiest detox of all. Quitting these prescription drugs without medical help and without tapering can result in fatal grand mal seizures. You can successfully taper off of benzos at home, but it is necessary to be guided by your doctor. Symptoms of benzo detox include psychosis, memory loss, anxiety, depression, slurred speech, vertigo, heart palpitations, tremors, seizures, and muscle pains.
Stage1 – 1 to 3 days after quitting
Withdrawal symptoms can begin as soon as six hours after quitting benzos. In this first stage of detox, the addict can experience insomnia, nausea, and vomiting.
Stage 2 – 4 to 7 days after quitting
Typically, the physical symptoms of benzo detox have subsided by this time. Most likely, the user will feel extremely exhausted and crave sleep. However, cravings for the drug usually persist through this time.
Days 8 to 28 after quitting
During the weeks following, the addict will continue to experience the psychological symptoms of withdrawal with intermittent physical symptoms. By day 28, the user’s bloodstream is normally rid of all traces of benzos.
Common Drug Types, Risks, and Effects
While the five drugs previously discussed are the most commonly abused, there are 6 different types of drugs, and each type has its own set of risks and effects – along with its own detox timeline and withdrawal symptoms.
#1 – Stimulants
Stimulants are sometimes called uppers or speed. They create a feeling of “speeding up” in the body by affecting the central nervous system. Stimulants range from being legal and readily available to the public, being legal when prescribed by your doctor, and being outright illegal.
Examples of stimulants are Adderall, cocaine, methamphetamine, caffeine, and ecstasy. Abuse of stimulants can cause anxiety, paranoia, psychosis, depression, stroke, and seizures.
#2 – Depressants
Sometimes called downers, depressants effect the body’s central nervous system as well, but they slow the body down instead of speed it up. Depressants, like their opposing sibling stimulants, are also available legally and to the public, legally when prescribed by a doctor, and illegally, especially in the case of prescription drug abuse.
Examples of depressants are benzodiazepines, alcohol, tobacco, Rohypnol, and barbiturates. Abuse of depressants can result in delirium, sluggish brain function, low blood pressure, hallucinations, and impaired memory.
#3 – Hallucinogens
Hallucinogens are characterized by their ability to make the user see things that aren’t there. They can be smoked, eaten, taken as pills or on dissolving paper, and mixed into drinks. Hallucinogens work by disrupting normal brain communication to result in a “psychedelic” experience.
Examples of hallucinogens are LSD, psilocybin, and peyote. Even a single use of hallucinogens can cause effects that last an entire lifetime like flashbacks, fear, paranoia, psychosis, nausea, and anxiety.
#4 – Dissociatives
Dissociative drugs are characterized by their ability to make the user feel as if they are outside of their own bodies, also known as dissociation. They interfere with the brain’s absorption of glutamate – the chemical that controls our cognition and perception. The drugs can be taken as liquids, solids, gases, and powders.
Examples of dissociative drugs are ketamine, DXM (dextromethorphan), and PCP (phencyclidine). Not only are the immediate effects of dissociative drugs extremely dangerous, but they can also cause detachment from reality, social withdrawal, suicidal thoughts, memory loss, depression, and anxiety.
#5 – Opioids
Opioids are drugs that have been derived from opium, and they can be found illegally and be obtained by a prescription from a doctor. These drugs get rid of pain and introduce euphoria in their users. The risk of addiction is extremely high with opioids because dependency on them can be formed within three days.
Examples of opioids are heroin, morphine, Hydrocodone, codeine, and Vicodin. Abuse of opioids can result in liver damage, brain impairment, euphoria, sedation, drowsiness, and cardiac arrest.
#6 – Inhalants
Inhalants are particularly dangerous, even for children, because they are mostly household items that can cause brief euphoria when inhaled. The fumes from these products produce a “high,” and it’s so incredibly brief that users will inhale over and over in small amounts of time.
Examples of inhalants are paint fumes, gasoline fumes, glue fumes, nitrous oxide, and aerosol sprays. Abuse of inhalants can cause brain damage, nosebleeds, weakness, increased heart rate, slurred speech, loss of smell, and loss of consciousness.
The detox experience can never truly be predicted. Every single addiction is just as unique as the body that it is ravaging. Because of this, there is no control to test variables against to find a detailed detox timeline.