How Safe Is Self-Detoxing?

The American Society of Addiction Medicine (ASAM), the leading national organization of addiction treatment professionals, clearly differentiates between what many sources refer to as “detox” and what they refer to as “withdrawal management.” Detox or detoxification is a natural bodily function that occurs as the body rids itself of waste materials and toxins. This function is primarily performed by the liver. Even a person who is actively using drugs will be undergoing detoxification, as it is an ongoing process. ASAM and international organizations such as the World Health Organization (WHO) prefer to use the term withdrawal management to refer to a direct form of intervention designed to assist an individual in withdrawal from drugs or alcohol. Many treatment facilities use the terms withdrawal management and medical detox interchangeably.

There is still some misconception between the notions of the development of physical dependence and addiction or a substance use disorder. Many people still consider these terms to be synonymous with one another; however, these are two different situations. Physical dependence consists of the development of both:  

The development of physical dependence occurs over time as an individual regularly uses a drug or medication. It is generally accepted that the person will first develop tolerance and then withdrawal symptoms. People who chronically abuse certain types of drugs or alcohol may develop substance use disorders. By formal definition, a substance use disorder or addiction represents the nonmedicinal use of a substance that results in a number of negative ramifications for the person’s functioning, distress, issues with self-control, and other potentially dangerous or hazardous consequences.

Very often, individuals with substance use disorders have developed physical dependence as a result of their chronic substance use, and in many cases, they have not developed physical dependence on their drug of abuse.

Being diagnosed with the syndrome of physical dependence is neither necessary nor sufficient for an individual to be diagnosed with a substance use disorder, according to the diagnostic criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5).
 

Medical Detox

Why Is Self-Detox Unsafe?

The vast majority of people with substance use disorders should not attempt to “self-detox.” This involves attempting to withdraw from substances of abuse without any medical supervision. Self-detox is also sometimes referred to as at-home detox. 

This “cold-turkey approach” is fraught with a number of potential dangers. According to sources, such as The American Psychiatric Publishing Textbook of Substance Abuse Treatment,there are a number of situations where it can be potentially dangerous to engage in the practice of self-detoxing or a cold-turkey approach.  

Natural Detox

So-called “natural detox”approaches are often touted on the Internet as safe approaches to withdrawal management. Many of these remedies are supported by anecdotal reports that are not reliable and often based on pseudoscience. The actual empirical evidence for many of these procedures is lacking.  

While some approaches can be useful, such as eating healthy or taking vitamins when combined with a formal physician-assisted detox program, these approaches are not recommended as standalone detox approaches. The majority of these approaches use untested methods, such as herbs, green tea, smoothies, and even Epson salt baths. The empirical evidence regarding the utility of these approaches and detox is lacking and, in some cases, indicates that they are not useful at all (e.g., Epson salt baths).