When people abuse alcohol or drugs for an extended period of time, they become physically dependent upon the substance. If they stop taking these substances, their body will respond by going into withdrawal. Some people's withdrawal symptoms become so bad that they need to be medically supervised when they stop taking the substance.

What are the symptoms of withdrawal?

Mild symptoms:

• Depression
• Emotional instability
• Feeling shaky
• Exhaustion
• Nightmares
• Nervousness and anxiety
• Mental fogginess

Moderate symptoms:

• Trouble sleeping
• Heart palpitations
• Nausea and vomiting
• Head pain
• Decreased appetite
• Clammy, sweaty skin
• Hand tremors
• Unusual movements
• Pale skin
• Changes in pupils

Severe symptoms:

• Hallucinations
• Convulsions or Seizures
• Fever
• Confusion
• Anger

What is detox? Detox medically monitors people going through withdrawal, and helps them alleviate symptoms as their body rids itself of the drugs or alcohol. Detox usually takes place in one of the following locations:

• Hospital or other medical facility
• An inpatient treatment center that specializes in detoxification
• Outpatient facility (occasionally)

Usually, people will be admitted to the detoxification facility for a few days to a week or more. Medications used by the treating professional to help those going through physical withdrawal include:

• Anxiety medication
• Mild sedatives
• Vitamin B1 (to treat Wernicke-Korsakoff syndrome in alcoholics).
• Painkillers or strong sedatives (if convulsions or seizures are present)

Once symptoms of withdrawal have abated, the person can be discharged and begin drug and alcohol treatment.

Which drugs are likely to cause severe withdrawal? People using the following drugs often need medical intervention during withdrawal because symptoms of withdrawal can be severe:

• Opioids (codeine, heroin, OxyContin)
• Barbiturates or sedatives
• Pain medications
• Alcohol (if there is physical dependence)

Does everyone starting recovery need to begin with detox services? Other substances than the ones listed above may not necessarily require medical detoxification. It is always best though to check with a medical professional when considering whether to go through detox or not. Sometimes pre-existing medical conditions can complicate the withdrawal process and necessitate medically supervised detoxification, no matter the substance. Although someone may not require medical detoxification, they may require something called social detoxification. During social detoxification, people are supervised during the withdrawal period, but are not usually given medications to treat their symptoms. Instead, they are offered a warm, loving environment to begin their journey toward sobriety. Often social detoxification lasts a few days to a couple of weeks, and sometimes it occurs in conjunction with admission to a drug or alcohol rehabilitation program. It is important to remember that detoxification is not treatment. Detoxification does not address the emotional and behavioral aspect of addiction. It is simply the first step in recovery.

See also:

• Are you an Enabler?
• Rock Bottom: Not What You’d Imagine
• Sending them to Treatment: What’s Next?