The question of whether or not to go to medical detox before rehab or an intensive outpatient program is one everyone has when they’re deciding how best to go about their recovery. Alcohol detox and drug detox can make the entire process much easier, and can even save lives in the case of severe symptoms of withdrawal.
But as helpful as detox is for some, it isn’t necessary for everyone who goes into rehab or IOP. Detox tends to be associated closely with severe addiction symptoms and withdrawals. There are even cases in which people become addicted to certain detox drugs (like Suboxone) in place of their drug of choice. That’s not a situation you want to find yourself in if you’re about to start an intensive outpatient program (IOP) for rehab, where you won’t be supervised 24/7.
As a result, detox has pros and cons. There’s no one right answer about whether or not it’s necessary for you. For some, detox is a matter of literal life and death. For others, it could actually make the problem worse. Whether it’s right for you or not is something you have to decide for yourself (and of course get medical guidance for safety), and we’re going to give you the information you need to make that decision and make it an informed one.
So what’s the line dividing those who need detox and those who don’t? There isn’t one. It’s not that simple. Addiction affects people differently, so even if your drug use or alcohol use is exactly the same as someone else’s, it’s entirely possible that one of you may need detox and the other doesn’t. That’s just how biology and genes work.
But before we go too deep in, let’s first break down what detox is, why it’s important, and what you can expect from your treatment at the best drug detox clinics available. From there, it will be easier to determine whether the services offered by detox clinics are services you will need in your recovery.
What is Detox and Why is it Important in Overcoming Addiction?
Simply put, detoxification, or detox for short, is a period at the beginning of your addiction recovery during which you can get help dealing with the harshest negative effects of rehab with detox medications administered by an experienced physician.
In medical terms, you can think of addiction rehab similar to physical rehab (from an injury or surgery, for instance). It’s a long-term place to build up your strength and get your life back to normal over the course of weeks or months.
In this analogy, think of detox like a trip to the emergency room. You’re not going to spend a very long time, but when you need it, it’s crucially important for getting through the most difficult, and potentially dangerous, part of your recovery.
But why is it necessary to get medical treatment? Can’t you just gut it out and deal with the symptoms?
Some people can, sometimes. But overcoming addiction isn’t a matter of willpower and strength. Addiction is a disease that chemically alters your body and brain. It’s not just as simple as “getting over it,” and if it was, addiction wouldn’t be such a huge problem for so many people.
When addiction takes hold of you, it changes your brain chemistry in such a way that it is fooled into believing the substance you’re addicted to is necessary for survival. It does this because your body has adapted to the presence of these substances and started building up a tolerance. But those changes that allow you to tolerate and process those drugs can start to wreak havoc on you the moment the drugs are removed from your system.
The results can be devastating. Different drugs have different withdrawal symptoms, running the gamut in severity from mildly uncomfortable and irritating to life-threatening and excruciating. Which substance you’re trying to recover from may have a huge effect on whether or not detox is the right option for you.
What are the Symptoms of Withdrawal for Drugs and Alcohol?
There aren’t any withdrawal symptoms that are good. Drug withdrawal symptoms, alcohol withdrawal symptoms, they’re all going to be unpleasant, and all in various ways.
However, there are most certainly some substances that hit harder than others. Additionally, some withdrawals are more mental and emotional, while others are more physical.
Nearly all drugs have some sort of emotional withdrawal symptom associated with them. People undergoing drug withdrawals almost always feel some combination of:
- Insomnia and restlessness
- Inability to concentrate
These are common withdrawal symptoms, and while they may be extremely uncomfortable, they are neither dangerous nor life-threatening.
What Substances Have the Worst Withdrawal Symptoms?
Substances like alcohol and opiates tend to come with physical withdrawal symptoms, in addition to the ones listed above. These symptoms can include:
- Heart palpitations
- Shortness of breath
- Uncontrollable shaking/tremors
- Nausea leading to vomiting or diarrhea
Of course, when it comes to alcohol, these are mild symptoms. The most serious set of all common substance withdrawal symptoms are alcohol withdrawal symptoms. About half of alcoholics who try to quit their addictions will run into withdrawals of some kind. Of those, a small percentage will find themselves facing delirium tremens (DTs).
DTs are extremely dangerous and often involve grand mal seizures and hallucinations. These can, and often do, lead to fatal heart attacks and strokes. They usually appear in heavy drinkers who have gone more than 48 hours without a drink but can appear as much as a week later.
Alcohol detoxification is equipped to prevent DTs during the withdrawal period, making the initial recovery period much more comfortable and much safer.
However, regardless of whether you choose to go to a detox clinic as part of your recovery, DTs are a medical emergency and should always be treated by a doctor at the very first sign of symptoms. That is very possibly a life-and-death situation.
While opiates carry a number of the same physical discomforts as alcohol in the withdrawal stage, opiate detox professionals do not have to worry about DTs, and opiate withdrawal symptoms are not fatal. Opioids themselves are extremely deadly, but usually, fatalities are a result of an opioid overdose, not withdrawal.
That said, opioids are among the most addictive substances available, and while the withdrawal symptoms aren’t deadly, they are extremely difficult to handle without treatment.
What Should I Expect from Medical Detox Treatment?
The majority of detox treatment is medical, and for obvious reasons. Very often, medical attention is absolutely necessary to prevent complications during drug detoxification or alcoholism detox.
Detox drugs are often used to help addicts “step down” from their addictive substances, or in extreme cases, sedatives may be used to prevent DTs during detoxification from alcohol.
Suboxone is a mix of the opiate detox drug buprenorphine and naloxone and is a popular detox drug for opiate detox. It effectively activates the same portions of the brain that someone addicted to heroin or Oxycontin would get from a dose of opioid use, but it doesn’t provide the rush or “high” that the drugs bring.
It basically fools the brain into thinking it is still getting its fix of a drug but eliminates the health risks associated with the drugs themselves. This allows opioid addicts to step down their dose slowly, easing the shock of quitting “cold turkey,” while getting them off the drug in question and on the path to recovery.
Of course, Suboxone itself has some dangers and withdrawal symptoms if its users just rely on the medicine. That’s just another form of addiction, so Suboxone isn’t the ultimate solution for opioid abuse. The same goes for any other form of substance addiction. You can’t beat drugs with other drugs alone.
That’s why detox clinics are taking an increasingly holistic approach to detox, focusing on nutrition, hydration, and physical activity to make the body stronger overall and thus better able to heal itself without the use of detox drugs.
Many people who fall deep into substance abuse tend to neglect these everyday aspects of personal health, and getting a kick start to basic health can do wonders in lessening withdrawal symptoms and improving long-term recovery.
How Can I Tell if Detox is the Right Choice Before IOP Treatment?
While it varies from person to person, there are some pretty good signs that trying detox is a good choice.
If you have tried to get clean in the past and relapsed, detox might be the right way to start another attempt. This is especially true if you tried to go through withdrawal symptoms without treatment and found themselves just too difficult to cope with.
If you use substances with especially painful symptoms like opioids, or potentially dangerous withdrawal symptoms like alcohol, detox may not only be a good decision, but a potentially life-saving one.
But in these cases, and really any other case, it depends on you. The length and depth of your addiction should be major factors in your decision. The longer you’ve been addicted, and the more you use at a time, the more attractive detox might be for you.
And if you’re thinking about IOP treatment like Evergreen, maybe you’ve already determined some of those factors for yourself.
The idea behind IOP treatment is to treat people who are still enough in control to have a relatively stable home life and career to go back to during treatment. Inpatient rehab takes people away from their lives for weeks at a time, and that just isn’t feasible for many people.
True, not everybody in an IOP fits that bill, but it’s a fairly safe generalization. If addiction has gotten so bad that it has already torn your life apart, as it is known to do, leaving home for a few weeks might not be so bad.
Why is that relevant? It’s relevant because generally speaking, people considering IOP treatment may not suffer from the heavier addictions that come with major withdrawal symptoms. If you’re confident you can stay sober with regular treatment sessions during the week, you may not need to take the time to detox first.
It’s important to remember that the difference between inpatient and outpatient addiction treatment is that inpatient treatment creates an environment of forced sobriety. You cannot drink or use drugs in inpatient treatment, because you don’t have access to them.
Detox is also a forced sobriety environment. IOP is not – you attend treatment sessions multiple times a week, and you might connect with a support group as well, but you are still exposed to temptation for most of your day.
That can be difficult, and is another thing to consider, not just about whether detox is the right choice for you, but whether an IOP is. If you don’t think you can trust yourself (or your support network) to stay clean after detox, you may need more time in detox, or an inpatient treatment method.
Of course, even if you choose inpatient treatment, eventually, you’ll be faced with that temptation, and you will have to overcome it at some point. Intensive Outpatient Programs for Addiction may be a bit more difficult in asking you to face that temptation earlier in your recovery, but it’s a big hurdle. Once you’re over it, things get much easier.
Now, chances are you’re still not sure what the right choice is. That’s okay. You don’t need to make this decision alone, and you don’t need to suffer alone. We’re happy to discuss treatment options with anyone who needs help or that knows someone who does. Simply contact us and we’ll help the best we can.
We also encourage you to share your story. If you’re struggling with addiction, know someone who is, or have struggled with it in the past, please leave a comment below. Did you detox before treatment? What was your experience like? Your story may make it easier for someone else to make this important decision.