Detoxification, or detox, is the first step in the drug recovery treatment process. Withdrawal is the term used to describe the body’s reaction to the removal of any substance on which it has become dependent. Detox is the first step because, until every trace of a drug has been removed from a person's body, withdrawal can cause severe cravings for more of the addictive substance.
Additionally, while in a drug or alcohol induced state, a person is not fully prepared to participate in the educational and therapeutic process of rehabilitation and treatment. Until the detox process is complete, someone is simply not ready for rehabilitation and recovery.
The Drug Withdrawal Process
Withdrawal is caused by stopping or dramatically reducing drug use after heavy and prolonged use. The body’s reaction to an abrupt cessation of any drug abuse can involve a host of symptoms, including:
- sweating
- shaking
- headache
- drug craving
- nausea
- vomiting
- abdominal cramping
- diarrhea
- inability to sleep
- confusion
- agitation
- depression
- anxiety
- other behavioral changes
Certain types of drugs require a period of medical detox (usually in a hospital or clinic setting); others do not. Opiates, such as heroin and methadone, do require medical detox. Prescription medications of all classifications require medically supervised detox. Other illegal drugs, such as marijuana, crystal meth and cocaine (or crack) do not typically require medical detox, unless there are special circumstances. Heroin detox is accompanied by significant symptoms and discomfort, and is considered one of the most difficult drugs from which to detox.
What Is Heroin?
Heroin is a highly addictive and rapidly acting opiate drug that is processed from morphine. It usually appears as a white or brown powder that is often mixed with sugars, starch, powdered milk, and other powdery substances. Very pure heroin is often snorted or smoked. Heroin that has been crudely processed is less pure, and may appear hard and black like coal or sticky and black like tar. The less pure forms of heroin are usually diluted or dissolved in liquid, and then injected.
The short-term effects of heroin include a surge of euphoria followed by alternately wakeful and drowsy states, and cloudy thinking. Long-term heroin users may develop health problems that include:
- collapsed veins
- liver disease
- lung complications
Heroin Withdrawal and Detox
Because heroin is a form of morphine, safe withdrawal from it usually requires medically monitored detox. Heroin use causes a strong physical dependence and therefore withdrawal can result in serious complications. Heroin detox and withdrawal symptoms can typically include:
- seizures
- heart irregularities
- vomiting
- insomnia
- the sweats
- drug craving
- restlessness
- muscle and bone pain
- diarrhea
- cold flashes, goose bumps
- restless legs (kicking movements)
- various other physical symptoms
These symptoms are not limited to complete cessation of heroin—they may also occur with a gradual reduction in the dosage or frequency of drug use. Once the body has adapted to the presence of heroin, withdrawal symptoms are likely to occur if heroin use is reduced.
Withdrawal symptoms, in regular abusers, may occur as early as a few hours after the last administration. Most heroin detox and withdrawal symptoms peak around 48 to 72 hours after the last dose. Stopping cold turkey—or sudden heroin detox and withdrawal—can be particularly dangerous for heavy users, even fatal. Several different schools of thought exist as to the best method for heroin detox, and medical heroin detox programs may employ several methods.
Medical Heroin Detox
Medical heroin detox, under the supervision of a doctor and healthcare personnel, is done in a variety of ways including:
- use of methadone to taper the patient off heroin gradually
- methadone maintenance
- administration of various drugs to prevent or minimize physical side effects of withdrawal
Medical heroin detox always includes close monitoring of the person’s vital signs (blood pressure, heart rate) for complications. Heroin detoxification generally takes four to seven days to complete.