Drug Withdrawal and At-Home Detox: What Are the Risks?

Detox is the process of the body ridding itself of toxins. There are many methods out there to aid this process. Detox “kits” are available online and over the counter at drugstores to help purge drugs from the body. At-home remedies are not tested, however, and they are not considered to be a safe option since drug detox can be both dangerous and unpredictable.  

Potential withdrawal symptoms from certain drugs of abuse can be life-threatening. When attempting to detox at home, individuals may be more prone to relapse, or a return to drug use. A relapse can be particularly dangerous as any amount of time without drugs can allow the brain time to reregulate itself, and tolerance levels go down. Then, if a person returns to using drugs at the amounts they used to, the body will no longer be able to handle it, and the risk for overdose is high. In 2014, more drug overdoses were recorded in the United States than ever in history, with more than 47,000 people dying from a drug overdose, the Centers for Disease Control and Prevention (CDC) reports. 

The Drug Abuse Warning Network (DAWN) measures visits to emergency departments (EDs) for the use or misuse of drugs. Between 2004 and 2011, DAWN reported almost 28 million ED visits for drug use, the Western Journal of Emergency Medicine publishes. In some instances, these ED visits were due to relapses after attempts at at-home detox. Many of these visits ended with a referral to a professional detox program.  

A formal detox program can protect individuals against potential complications during detox and help to manage withdrawal symptoms. Medical detox provides the highest level of care, offering medical and mental health care and supervision around the clock during the brunt of acute detox. Medical detox programs can help to shorten the detox timeline by providing medications and medical help during the most vital time after stopping drug use. In essence, at-home detox is not worth the potential risks, particularly when safety and comfort can be ensured in a physician-assisted medical detox program.

What Is Drug Withdrawal?

Drug withdrawal occurs when a person regularly uses a drug for long enough that the brain begins to rely on it being present. Depending on the type of drug used, this amount of time may vary. Drugs that are considered to be highly addictive, such as opioids, stimulants like cocaine, and benzodiazepine drugs, can lead to dependency rather quickly. Even when used with a prescription for licit purposes, drugs like Xanax can cause dependence in as little as a few weeks with regular use, the US Food and Drug Administration (FDA) warns.  

Drugs create a shortcut to happiness by increasing levels of some of the brain’s chemical messengers that signal pleasure. In doing so, they can also interfere with normal decision-making and thinking abilities. Willpower, motivation, and short-term memory functions may then be impaired. The parts of the brain that are responsible for regulating emotions are disrupted with drug abuse as well. With repeated use, the brain may try to account for these changes and therefore alter the way it manufactures, transmits, and reabsorbs some of its neurotransmitters. Circuitry in the brain can actually change as a result.  

When drug dependence has formed, a person may suffer from difficult withdrawal symptoms when the drug processes out of the body and is no longer active in the bloodstream. The brain may attempt to regulate itself without the drug, and emotional and physical side effects may occur.

Timeline for Drug Withdrawal

Drug withdrawal duration can depend on many things, such as the type of drug used, the method of abuse (e.g., snorting, smoking, ingesting, or injecting), the dosage regularly used, biological and genetic aspects, any co-occurring or underlying mental health or medical issues, environmental factors (including a person’s support system), polydrug abuse (abusing more than one drug at a time), and the length of time abusing drugs. In general, the more significant a person’s dependence is on a particular drug, the longer and more intense withdrawal may be.  

The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes the following general timelines for acute detox from common drugs of abuse:

  • Marijuana: 5 days 
  • Alcohol: 5-7 days 
  • Opioids (heroin, prescription painkillers): 4-10 days 
  • Stimulants (cocaine, methamphetamine, prescription ADHD medications): 1-2 weeks 
  • Benzodiazepines (prescription sedatives and tranquilizers): 1-4 weeks 

Acute withdrawal refers to the bulk of the significant symptoms. Withdrawal can begin as soon as a drug stops working in the bloodstream, which depends on how fast the drug is metabolized out of the body. Each person’s metabolism is different, and how quickly a drug leaves the body can depend on how short the particular drug’s half-life is, how much food the person had to eat that day, gender, age, biological factors, and more.  

Further Reading

Antidepressant Withdrawal: How Long Is It?

Alcohol Withdrawal Timeline

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New Orleans Drug Treatment Guide

Cocaine, for example, has a short half-life, taking effect quickly but also wearing off fast. The National Highway Traffic Safety Administration (NHTSA) reports that cocaine’s effects generally only last an hour or two, meaning that the “crash” following the high can start within a few hours of the last dose of the drug. The National Library of Medicine (NLM) publishes that opioid withdrawal typically begins within about 12 hours after the last dose of a typical opioid drug (within 30 hours for a longer-acting opioid like methadone), and benzodiazepine withdrawal usually starts within a day or two after the last dose. Marijuana withdrawal syndrome typically begins within the first day or so of stopping use of the drug, Psych Central publishes.

Withdrawal SymptomsWhy Choose Medical Detox over At-Home Detox?

In general, withdrawal symptoms tend to start out with sleep problems, anxiety, depression, irritability, agitation, and restlessness as well as headaches, tremors, sweating, chills, and muscle aches. Symptoms progress into abdominal pain and cramping, chills, dysphoria, derealization, difficulty thinking clearly, trouble concentrating or making decisions, suicidal thoughts, irregular heart rate and blood pressure, nausea and/or vomiting, diarrhea, appetite changes, and drug cravings.

In the case of opioid drugs, withdrawal often mimics the flu physically, accompanied by significant emotional lows. Stimulant drugs produce such intense pleasure when abused that the crash following the high can be significant emotionally, and suicidal ideations may be common. Energy levels drop drastically, and fatigue can set in.

Benzodiazepine and alcohol withdrawal can actually be life-threatening, as these substances suppress functions of the central nervous system and increase levels of the natural sedative GABA (gamma-aminobutyric acid) in the brain. When these drugs are suddenly removed, the central nervous system and brain can become hyperactive and experience a rebound effect. Seizures, intense anxiety, fever, delusions, and psychotic symptoms may occur. It is not recommended to stop taking any drugs “cold turkey,” as the brain may quickly try to regulate itself, leading to difficult and even dangerous withdrawal symptoms.

Typically, withdrawal symptoms build up over a few days, starting out after the drug leaves the body and peaking in the first few days after stopping use. Most withdrawal symptoms will begin to taper off after the first several days and continue to lessen over time, with the majority of them dissipating after the first week or two. Withdrawal symptoms, including cravings, sleep difficulties, and emotional disturbances, may continue for longer than the projected general timelines, however.

Protracted withdrawal, which may be more common with significant benzodiazepine dependence, can continue for months or even years in some cases, ABC News reports. Medical detox and comprehensive follow-up treatment can help to ease these symptoms.

Medical detox is performed in the safety of a secure and specialized treatment facility staffed by highly trained professionals. Vital signs, such as heart rate, blood pressure, respiration rates, and body temperature, can be monitored, and fluids can be administered when needed.

Medications are often an integral part of medical detox as they can aid in managing cravings and the more difficult emotional and physical symptoms of withdrawal. Pharmaceutical tools can be beneficial in helping to shorten the overall detox timeline as well as in helping individuals to achieve abstinence initially. Drugs like cocaine, for example, can be difficult to stop using, and new methods and medications are being explored for use during treatment, according to information published in the journal Psychiatry.

Nutritional supplements and other considerations can be useful during detox in helping to regulate and restore balance to the body as a whole. Many drugs, like benzodiazepines and opioids, may be tapered off slowly during medical detox in order to lessen and avoid some of the more difficult withdrawal symptoms that can occur when these drugs are stopped suddenly. Doctors can set up a tapering schedule that allows the drug dosage to be slowly lowered over a safe period of time until it is completely out of the system. Mental health personnel are on-hand to provide supportive care and encouragement during medical detox to sustain abstinence and build a strong foundation for recovery. These benefits are simply not available with at-home detox attempts.

Medical detox programs last 5-7 days on average. After medical detox, individuals are physically stable and equipped to enter into a comprehensive treatment program that will aid in a long and healthy recovery.

At-Home Detox: Not Worth the Risk

The risks of at-home detox are substantial. While the specific risks depend on the particular drug of abuse, general risks include a high likelihood of relapse, extreme discomfort, and psychological effects, like depression. In some cases, depression can even lead to suicidal ideation and actual suicide attempts. Medical detox can protect against all these issues and ensure a greater likelihood of successfully completing the withdrawal process.

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Brooke Abner,

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