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In 2018 in the UK 4,359 people died from drug poisoning. Of these deaths, 2,917 were from drug misuse. In 2018/2019, there were 7,376 hospital admissions recorded for drug-related mental and behavioural disorders and there were 18,053 hospital admissions for poisoning by drug misuse. Opiate drugs including heroin and methadone continue to account for the highest proportion of drug-related deaths.
What is a detox from drugs?
A detox from drugs is the first stage in treating drug addiction. Drug detox is the process that occurs in the body when it clears the waste products and toxins from drug use so that all traces of the drug are removed from the body. The purpose of a drug detox is to treat the physical dependency on the drug in the first instance so that other aspects of the addiction can be addressed. This may include counselling, therapy or accessing medication for any other conditions.
If your body is dependent on drugs, you may experience withdrawal symptoms which can range from mild to severe. The idea of withdrawal symptoms can make people reluctant to go through the detox process as these can be extremely unpleasant and, without the right support, can be serious, or even life-threatening. Withdrawal symptoms can become aggressive and change quickly. This means it is important to detox under the supervision of a medical professional. Severe withdrawal symptoms can be treated with medication. Withdrawal symptoms can begin within as little as two hours after you last used the substance you are withdrawing from. A medically assisted detox can help with any painful withdrawal symptoms and prevent any serious complications.
If you need treatment for drug addiction, you are entitled to be treated for this by the NHS. You can make an appointment with your GP or contact your local drug service. Your GP will carry out an assessment of your needs and can refer you for treatment. There are also various charities and drug treatment programmes that can offer you support. There are also private drug treatment programmes. These can be very expensive; however, occasionally referrals can be made through the NHS.
Why would someone have a drug detox?
Someone would usually detox from drugs if they have a drug addiction. Drug addiction is a disease that affects a person’s brain and makes them unable to control the use of a legal or illegal drug or medicine. When someone is addicted to drugs, they may continue to use the substance even though it is causing them harm. Drug addiction is also called substance use disorder and it affects a person’s brain and behaviour. Substances such as alcohol, cannabis and nicotine are also drugs.
The risk of becoming addicted to a drug will vary depending on the type of drug as some drugs carry a higher risk of addiction than other drugs. For example, opioid painkillers can cause addiction more quickly than others. People become addicted to drugs for many reasons including family history, social problems, to escape past trauma or simply because they initially enjoyed the experience of taking drugs. Drug use becomes an addiction when you are no longer in control of your drug use or decision to take drugs.
Drug addiction symptoms can include:
- Feeling like you have to use the drug regularly. This may be daily or several times a day.
- Experiencing intense urges to use the drug.
- Needing to take more of the drug to feel the same effect.
- Ensuring that you always have a supply of the drug.
- Spending a lot of money on the drug even though you may not be able to afford it.
- Your drug use impacting on your work or personal responsibilities.
- Continuing to use the drug even though it is causing you problems. This could be financially, personally or even because of health problems.
- Going to extraordinary lengths in order to get the drug, for example stealing.
- Being involved in risky activities while being under the influence of drugs.
- Spending significant amounts of time getting the drug, taking the drug or recovering from the drug.
- Attempting to stop using the drug and failing at doing so.
- Experiencing withdrawal symptoms when not using the drug.
If your body is dependent on drugs, you may experience withdrawal symptoms which can range from mild to severe.
Your withdrawal symptoms will depend on:
- Which drug you are dependent on.
- How much and how frequently you use the drug.
- How long you have been using the drug.
- The method you have been using to take the drug; for example, smoking, injecting or snorting a drug usually results in heightened withdrawal symptoms compared to if you ingest the drug.
- Whether you have been using multiple types of drugs.
- Your general physical and mental health.
- Your family history and genetic make-up.
Addictive drugs which are illegal include:
- Cocaine.
- Crack cocaine.
- Heroin.
- Methamphetamine.
- Amphetamine.
Addictive drugs which are legal include:
- Alcohol.
- Nicotine.
- Caffeine.
Addictive drugs which are prescription drugs include:
- Methadone.
- Benzodiazepines.
- Opioid painkillers.
- Stimulants.
How long does a drug detox take?
The purpose of a detox is to address the physical side of an addiction before the psychological side of an addiction is addressed. The detox process aims to minimise the negative impact of withdrawal symptoms, making the experience as safe and as comfortable as possible.
The most effective form of detox is one that is medically assisted where trained professionals can support you. This can sometimes happen in a rehabilitation centre, also known as rehab. People go into rehab in order to receive rehabilitation and health treatment for an addiction. In order to help someone overcome addiction, rehab uses a range of therapies and treatments. A rehab centre can treat you as an inpatient or an outpatient.
A detox in a rehab centre will usually include a three-step process, which includes:
- A comprehensive review of alcohol use and medical history, including psychiatric history.
- Medication if this is appropriate to the individual treatment programme.
- Stabilisation which consists of medical and mental health support.
Detoxing from drugs involves clearing the body of substances and managing any withdrawal symptoms that might occur.
There are two main categories of withdrawal:
- Acute withdrawal – this consists of medical withdrawal symptoms which require medical attention.
- Post-acute withdrawal – this relates to the psychological symptoms which requires continuous treatment in order for this to be effectively managed.
The process may take a few days or several years depending upon:
- How long the drug has been used for.
- Severity of use.
- Frequency of use.
- How physically dependent you are on the substance.
- Which substance you use.
- How many substances you use.
- How you take the drug.
- Your medical history.
- Your mental health history.
- Your age.
- Your gender.
- Any other medication being used which may interfere with the detox process.
The time it takes to detox varies from person to person; however, detox programmes are typically between 3 and 10 days long. Detox is only the first stage of a drug addiction recovery. Only after a successful detox will other forms of treatment have a chance of being successful. Detox alone will not be enough to address the social and psychological problems associated with addiction.
Different substances will require different detox lengths as different substances remain in the body for differing lengths of time. On average a person can detox from substances within a week.
What happens during a drug detox?
Drug withdrawal refers to the process your body goes through when you stop using a particular drug. This may be because you decide to stop taking the drug or because you cannot take the drug, for example because you have run out and cannot get hold of any more.
When you take drugs, your body and brain change to accommodate the drugs that are in your system. After using the drug repeatedly, your body will get used to the drugs being in your system. If you were to then stop using the drug, you are likely to experience withdrawal symptoms. These can be unpleasant; they can also be dangerous or even life-threatening.
The first stage of drug withdrawal is known as a comedown. This is where your brain chemistry gradually returns to normal as the drug begins to wear off. If you don’t take any more drugs, the withdrawal symptoms will continue. Drug and alcohol withdrawal symptoms can be both mental and physical.
Drug withdrawal symptoms may include:
- Intense headaches.
- Fever.
- Chills.
- Nausea or vomiting.
- Shaking and shivering.
- Heart palpitations.
- Feeling restless.
- Irritability or agitation.
- Inability to concentrate.
- Sweating excessively.
- Paranoia.
- Anxiety.
- Extreme mood swings.
- Depression.
- Panic attacks.
- Insomnia.
- An intense craving to take the drug.
Some people also experience delirium tremens (DTs); these are severe symptoms which include vivid hallucinations and delusions. These happen when people have an extreme reaction to drug withdrawal. The condition is more likely to occur when a person is severely addicted to drugs and has experienced withdrawals previously. Delirium tremens is not common.
The symptoms of delirium tremens include:
- Emotional distress.
- Fatigue.
- Fever.
- Intense confusion.
- Hallucinations.
- Intense agitation.
- Intense irritability.
- Seizures (usually within 24 hours of last taking the drug).
If you’re dependent on drugs, it can be dangerous to stop using the drug suddenly, and in some cases even fatal. It would usually be recommended to seek medical support before beginning the detox process.
Some of the risks of detoxing alone without medical support include:
- Seziures.
- Anxiety.
- Aspiration pneumonia.
- Insomnia.
- Heart arrhythmias.
- Kidney dysfunction.
- Liver dysfunction.
- Fever.
- Intense cravings.
In order to help you cope with withdrawal symptoms, medication can be used as part of the detox process. Medication cannot prevent all the withdrawal symptoms but the medication can, for example, help with anxiety or insomnia.
Medication can help ease the difficult aspects of the detox process and help you remain drug free. Certain medications can mimic the effects of addictive drugs and therefore reduce withdrawal symptoms and cravings. Coping with withdrawal symptoms is often the most challenging part of the recovery process.
If you are dependent on heroin or another opioid, you can be offered a substitute drug on prescription. The most common one is methadone. Methadone is a man-made opioid and is used to reduce withdrawal symptoms when stopping using heroin.
It can reduce shaking, shivering and other flu-like symptoms and also helps to stop cravings. Methadone is only available on prescription from your GP or drug treatment service.
The side effects of taking methadone can be:
- Feeling sick.
- Constipation.
- Feeling cold and sweaty.
Using alcohol while taking methadone can have very severe side effects. Methadone can be very addictive just like other opioids. You will need to gradually reduce your intake of methadone before stopping completely.
Other medication used as part of a detox from drugs can include:
- Benzodiazepines – these are the most commonly used medication to treat withdrawal symptoms during the detox process. They work by calming the central nervous system and can be used to treat insomnia. They can also treat muscle spasms and anxiety.
- Anti-depressants – a person who is addicted to drugs cannot produce enough happiness-inducing chemicals in their brain because they have relied on drugs for so long. The brain chemicals can remain imbalanced for some time after someone has stopped using drugs. After being reliant on drugs for so long, detoxing and remaining drug free can be an extremely difficult process both physically and mentally. Anti-depressants may be prescribed in order to help the transition.
- Clonidine – this is used to treat alcohol and opiate withdrawals. Clonidine reduces cramps, sweating, anxiety and muscle pain. Clonidine can also prevent seizures and tremors.
- Acamprosate – long term, excessive alcohol use can change the way the brain looks and functions. Acamprosate, otherwise known as Campral, can help your brain begin to function normally again. It can also help to reduce the craving for alcohol.
- Disulfiram – if alcohol is used while being medicated with disulfiram, there will be a severe reaction. This can include nausea, sickness, headaches, facial flushing, low blood pressure and muscle weakness.
- Naltrexone – this medication helps to reduce the craving for drugs during the detox process. Naltrexone also inhibits the high feeling that drug use gives, therefore if there is a relapse, the drug use will not have the desired effect. Naltrexone will not usually be given until 7–10 days have passed as the medication can stimulate withdrawal symptoms.
Detoxing from alcohol and benzodiazepines like Valium or Xanax can be life-threatening if not done properly. Detoxing from other drugs is not usually as serious but can still present complications. Medical help can ensure safety and success in detoxing.
Narcotics Anonymous can help you get and stay clean from drugs. The service is run by ex-drug users who have been successful in getting clean from drugs.
If you or someone else needs urgent help after taking drugs or drinking, call 999 for an ambulance. Someone will need an ambulance if they are unconscious or having difficulty breathing.
You should also:
- Place them in the recovery position.
- Stay with them until the ambulance arrives.
- If you know which drug they have taken, tell the ambulance crew as it may help when they are treating them.
You may receive your treatment while living at home or as an inpatient at a hospital rehab facility.
Benefits of a drug detox
As drugs can be detrimental to your health, there are many benefits to detoxing from drugs completely.
These benefits include:
- Improved mental health.
- Healthier weight.
- Improved sleep.
- Improved brain function.
- Improved memory and mental focus.
- A healthier immune system.
- A healthier heart.
- A healthier liver.
- A healthier digestive system.
- Decreased risk of cancer.
When you access support for your drug use, you will have an initial appointment where they will ask you about your drug use. They will also ask you about your personal circumstances, including work, family and housing situation.
The professional assessing you will talk you through the various treatment options and advise you on what might suit you best. They will also be able to tell you about local support groups for you or your family and friends who may be supporting you. You should also be given a key worker who can be a consistent person for you to contact and who can support you in your treatment programme. Your drug treatment programme will be determined by the level of your drug use and which drugs you are addicted to.
Government statistics show that 275,896 were in contact with drug and alcohol treatment services between March 2020 and April 2021, with 130,490 people entering treatment for their drug or alcohol use between 2020 and 2021.
If you want to find out how you can access support for your drug addiction, you can visit the FRANK website or call 0300 1236600 where they will support you to find local treatment services near you.
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