Detox Withdrawal: How It Works

Drug addiction is a problem that can affect anyone no matter their socioeconomic background. The American Society of Addiction Medicine (ASAM) defines addiction as a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. It is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by the inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Addiction shares characteristics with other chronic diseases in that it involves cycles of relapse and cannot be cured. Those who place themselves in the proper care channels will have the highest rates of success.

An American dies every 19 minutes from opioid, or heroin overdoses a recent reports highlights, and the economic impact of drug and alcohol misuse and addiction amounts to a staggering $442 billion each year, which tops diabetes costing $245 billion. “At a time when we are resource-constrained already, we cannot afford for humanitarian reasons or financial reasons, to not address addiction in America.” There has been a push around the country for a paradigm shift on addiction that removes the stigma and viewing it as a disease.

The same article goes on to say, “we have to recognize addiction isn’t evidence of a character flaw or a moral failing. It is a chronic disease of the brain that deserves the same compassion that any other chronic illness does, such as diabetes or heart disease. Genetics account for about half of a person’s likelihood of becoming addicted. “Our whole approach to substance abuse disorders is they’re illegal, and you go to jail; it’s the only illness for which you send people to jail, for long periods of time.”

Roughly 21 million American’s struggle with substance addictions and that is more than the number of people who have all cancers combined. Only one in 10 people with substance use disorders will receive treatment. Addiction can affect all aspects of a person’s life, and entering into treatment is the only way they can have a fighting chance at success in life. The first step in the continuum of care, however, is known as medical detoxification. Detox is designed to help an individual safely transition through withdrawals before they enter into a less intensive stage of care. Below we will learn a little bit more about how detox and withdrawal work.

Drug Dependence And Withdrawal

Once you’ve become dependent on a substance, withdrawal symptoms will start when the body rids itself of the toxins in the drugs. Different drugs and substances will have various withdrawal symptoms and timelines. Depending on how they interact with the brain and body, drugs that are absorbed remain active in the body for varying amounts of time. It is often referred to as the drug’s “half-life,” which relates to the different withdrawal timelines for each substance.

The severity and duration of withdrawal will be influenced by the level of dependency on the substance, and other factors that include:

  • Type of substance abused
  • Length of time abusing the substance
  • Amount taken each time
  • Method of administration (e.g., smoking, snorting, injecting, swallowing)
  • Family history and genetic makeup
  • Medical and mental health factors

Someone that has regularly injected massive doses of heroin for several years, with a family history of addiction and underlying mental health problems is going to experience a more extended withdrawal period than someone using small doses for a shorter period.

General Drug Withdrawal Timeline


Withdrawal begins within 12 hours of the last dose, and peaks within 24 to 48 hours, and can last up to a week. In some cases, withdrawals can last months or years, which is known as post-acute withdrawal syndrome (PAWS).

Prescription opioids

Withdrawal can begin in eight to 12 hours for most prescription opioid drugs; it will peak within 12 to 48 hours and persist from five to 10 days.


Withdrawal can start in as little as one to four days, and will peak in the first two weeks. In some cases where treatment is not sought out, withdrawal can last months or even years. Benzo withdrawal can be dangerous, and medical detox is highly recommended.


Alcohol withdrawal is extremely dangerous and often starts eight hours after your last drink. It typically lasts for a few days, and peaks within 24 to 72 hours.

When Detox Is Necessary

As we described above, addiction is a disease that comes with unique symptoms that affect everyone differently. Withdrawal from any substance of abuse after a dependency has formed should always be done in a treatment center that offers medical detox.

Medical detox means that medical professionals are available and will monitor your vital signs as well as emotional state.

The primary objective of detox is to achieve a safe and comfortable level of physical stability so the other issues of addiction can be addressed. Someone who is addicted to opioids, alcohol, or benzodiazepines must always undergo medical detox to manage their withdrawal safely.

Due to the deadly nature of some drugs, it’s not worth risking your life if you are ready to get sober. Most substances must be weaned out of the body under the supervision of addiction specialists.

Use Of Medications In Medical Detox

The use of medication in medical detox is common and is meant to ease the effects of withdrawal. Buprenorphine products and methadone are supported by the National Institute on Drug Abuse (NIDA) as an effective treatment for opioid detox and dependency. Both of these drugs are opioid agonists, which activates opioid receptors in the brain. Buprenorphine is a partial agonist and only partially activates the receptors, which lowers the potential for abuse.

Someone addicted to benzodiazepines may require a longer-acting benzodiazepine to control withdrawal and taper off the drugs slowly. Other medications such as antidepressants or mood stabilizers may be used during detox from many addictive substances to treat psychological symptoms like depression.

Benzodiazepines can also be used to treat alcohol withdrawal and help prevent seizures by calming the overactive nerves and neurons. Depending on the level of dependency and care needed, detox from illicit drugs can take place in either an inpatient or outpatient format. An assessment of physical and emotional symptoms will first take place to determine which level of care will yield the best results.

Each drug is going to present different withdrawal timelines and symptoms, and treatment must be tailored to the specific drug and its unique effects. Mental health and medical issues can complicate withdrawal, and these must be considered during a thorough assessment by addiction specialists. If you or someone you know wants to stop using drugs, but are afraid of the consequences of withdrawal, it’s time to get help today.

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