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photo of different types of addictive drugs and needles

Which Drug Addictions Require Medical Detox?

With any significant and continuous use of mood-altering substances, profound changes in the physiology and structure of the brain occur. Many of the changes that occur are reversible, however, depending upon the amount and duration of the drug addiction, some of the changes that occur may be irreversible. Therefore, it is important for those addicted to drugs to seek rehab treatment as soon as possible.

With some drugs of abuse, and depending upon the amount and duration of use, the treatment process often first begins with an inpatient medical detox.

Because each drug affects the body differently, the cessation of use of some addictive drugs requires a medical detox and others do not.

It is important to remember that just because an inpatient medical detox may not be required, the brain and body are still undergoing profound changes with the cessation of any drug usage in an attempt to return to their baseline physiologic state.

Two Basic Protocols for Medical Detox from Opiates

The first does not utilize mood-altering drugs in the withdrawal protocol. Instead, medications to treat the symptoms of opiate withdrawal are used, including medications for nausea, vomiting, diarrhea, insomnia, muscle-cramping, and any other physiologic signs and symptoms that the patient is experiencing.

The second main type of opiate medical detox is one that actually uses opiates for the withdrawal. The U.S. Drug Enforcement Agency (DEA) has approved three narcotic medications that can be prescribed for this purpose: methadone, buprenorphine (Suboxone and Subutex), and levomethadyl acetate (LAAM).

Withdrawal from benzodiazepines, barbiturates, and other sedatives causes the most potential for significant, severe life-threatening complications and almost always must be treated medically.

Medical detox from drugs in these classes can last anywhere from three to fourteen days and is essential for those with chronic, long-term drug addiction. The detox is carried out by slowly tapering a benzodiazepine such as Ativan, Klonopin, or Valium, for example, or a barbiturate, such as phenobarbital.

The signs and symptoms of withdrawal will include tremors, nausea, vomiting, headache, muscle cramping, high blood pressure, fever, confusion, anxiety, panic attacks, insomnia, poor concentration, and other impairments in cognitive functioning. Seizures, stroke, and heart attack can also occur. Of course, as with all other substances, cravings are likely to occur. Being treated at a medical detox can prevent relapse back into drug addiction with any addiction and it can prevent relapse, suffering, medical complications, and death.

If medical detox is not required, it is important that the addicted person seek treatment at a drug and alcohol rehab to regain manageability in their life and to stop the addiction from progressing and resulting in additional and more severe consequences.

Classes of Common Drugs of Abuse

  • Opiates – Heroin and Prescription Pain Relievers
  • Benzodiazepines, Barbiturates, and Other Sedatives
  • Stimulants
  • Synthetic Drugs
  • Marijuana and Hallucinogens

Mood-altering and addictive drugs from the classes of stimulants, synthetic drugs, and marijuana/hallucinogens typically do not require an inpatient medical detox. However, the body will still exhibit signs and symptoms of withdrawal and the patient will likely experience mood, sleep and appetite changes at a minimum.

More often than not, patients who are only addicted to drugs from the stimulant, synthetic drug, and marijuana/hallucinogen classes will directly enter drug treatment directly at the rehab level, rather than first undergoing a medical drug detox. Addiction to drugs from the opiate and benzodiazepine/sedative classes almost always requires a medical detox.

The initial treatment of opiate dependence, although the withdrawal is typically not life-threatening, usually requires inpatient detox due to the severe symptoms that are experienced by the patient. Symptoms include nausea, vomiting, diarrhea, low appetite, muscle cramping, headache, sweating and significant mood swings. Withdrawal from opiates can create severe discomfort for the patient. There are times, however, that the withdrawal can be so severe, or in cases where the patient has significant underlying medical problems, that it can be life-threatening.

photo of intoxicated man with his head down and holding a glass of liquor and the open bottle

Why do Alcoholics Require Inpatient Medical Detox?

Medical detox services for alcoholism are provided for several different reasons. The most important reason is that medical alcohol detox is a life-saving process. Those who are considering the prospect of entering recovery to better their lives should highly consider treatment as an option.

It is typical that alcoholics no longer enjoy drinking, but do so to avoid withdrawal symptoms and to treat cravings. Once alcoholism has reached the point that the body physiologically requires its presence to function, treatment is likely the only option.

Withdrawal from alcohol without medical intervention can produce severe short and long-term consequences, caused by events such as seizures, stroke, heart attack, and death.

Alcohol binds to and causes changes in a neuroreceptor (a protein binding site for molecules) called the GABA (gamma-amino butyric acid) receptor. The physiologic reason for the receptors presence is to inhibit the excitation of neurons when they bind to the naturally-occurring substance, GABA in the brain. When one continuously and heavily uses alcohol, it causes sedation and inhibition. When one stops drinking alcohol, the receptors are no longer inhibited, and the neurons in the brain become overactive.

Symptoms of Alcohol Withdrawal

  • Cravings
  • Anxiety
  • Insomnia
  • Tremors
  • Increased heart rate and blood pressure
  • Sweating
  • Nausea
  • Vomiting
  • Loss of appetite
  • Diarrhea
  • Cognitive changes such as poor concentration, poor memory, etc.
  • Seizures
  • Stroke
  • Heart Attack

In an inpatient medical detox for alcohol, an experienced and licensed physician will assess the patient and prescribe life-saving medications, as well as medications to relieve uncomfortable symptoms. Along with the medical treatment, supportive services such as therapy and assistance with mood swings and cravings will be provided. This will all be carried out in a non-threatening, safe and nurturing environment.

The most commonly prescribed medications for alcohol withdrawal are sedatives, such as benzodiazepines (Ativan, Librium, Klonopin, Valium) and barbiturates (phenobarbital). Also prescribed are other medications to relieve symptoms, such as sleep aids, antidiarrheal medications, anti-nausea medications, and medications to control blood pressure and heart rate.

By receiving treatment in an inpatient medical detox for alcohol, the patient protects him/herself from exposure to environmental triggers and access to alcohol. With time cravings and the urge to drink will decrease. It is extremely important that the alcoholic be completely honest with the staff upon admission to an inpatient medical detox so that the best treatment regime can be prescribed. After inpatient detox is no longer necessary, a transfer to alcohol rehab will likely be recommend. In alcohol rehab patients are treated for the underlying issues that could trigger a relapse, such as cravings, relationships, emotional instability, and other environmental stressors.

Once one truly learns new ways of thinking, positive communication skills, and is able to cope with everyday life stressors, they will be put to use in the real environment in preventing a relapse and in bringing peace, happiness, and stability to one’s life.


Behavioral Wellness & Recovery is a Joint Commission accredited program. The Joint Commission recognizes excellence in health care organizations and programs.


Behavioral Wellness & Recovery is a Joint Commission accredited program. The Joint Commission recognizes excellence in health care organizations and programs.

Your decision to regain your life helps and heals your entire family. Do it for them. Do it for you.


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