One primary characteristic of drug or alcohol dependence (and addiction) is when the body can only function normally when that substance is present. When that chemical is removed, it sets off disturbances throughout the body, causing a substance user to experience symptoms that range from uncomfortable to life-threatening. Those effects are commonly referred to as withdrawal symptoms.
When someone enters into professional drug treatment, the first phase is usually medical detoxification, which the National Institute on Drug Abuse (NIDA) defines as a process that “safely manages the acute physical symptoms of withdrawal associated with stopping drug use.”
Professional detox is a procedure where a medical staff provides around-the-clock care and supervision as the substance and other toxins are safely removed from the body. With opiate and benzodiazepine detoxification, clients are usually administered medications to help wean them off of the addictive substance.
A professional treatment program offers the safest environment for detox. However, drug detox can be deadly when a user attempts to do it on their own, i.e., going cold turkey. People have also been known to die from engaging in a process known as rapid detox.
Can someone die during the drug detox process? Yes. However, it depends on the substance, the severity of the addiction, and the type of detox a user is undergoing.
A detox process of any type has its side effects. Those consequences are the result of the body no longer being able to rely on the presence of the addictive substance. When drugs leave the body, it alters brain chemistry and inflicts physical and psychological changes. While the effects depend on the kind of drug that was abused, common symptoms that come from this bodily imbalance include fatigue, anxiety, depression, and even suicidal thoughts.
Prescription opioids like OxyContin and Vicodin and illicit opiates like heroin profoundly impact the brain’s opioid receptors, the neurotransmitters that allow the body to manage pain.
The brain comes to rely on the presence of those opioids, so much so that any removal triggers intense side effects that can be experienced during the detox process. In fact, a recovering user undergoing these disturbances likely will feel compelled to relapse. This is why addiction specialists advise against attempting to quit opioids on your own.
Nevertheless, common detox side effects from opioids include:
Severe heroin and prescription opioid addictions tend to produce intense withdrawal symptoms that can be experienced during detox, which include:
Chronic, long-term alcohol abuse can produce life-threatening withdrawal symptoms, which is why going cold turkey is also not recommended in this scenario. Attempting to quit alcohol on your own can lead to relapse, permanent injury, and even death. Common alcohol detox side effects can include:
Benzodiazepines such as Valium or Xanax can produce withdrawal symptoms that are downright harrowing. Like alcohol, benzodiazepines depress the central nervous system. When users consume benzos, the brain stops making its own gamma-Aminobutyric acid (GABA), a neurotransmitter responsible for sedation.
When someone stops using benzos, those GABA levels decrease, which triggers anxiety and insomnia much worse than the original ailments — the kind that made users turn to the drugs in the first place.
This rebound anxiety is linked to severe panic attacks, and the rebound insomnia can keep users awake for days. Then there is also benzodiazepine withdrawal syndrome when symptoms grow stronger and become increasingly unpredictable.
This sort of syndrome can produce psychosis. Other detox side effects that come from benzodiazepine use include the following:
Stimulants like cocaine, methamphetamine, and Adderall produce euphoria where the brain is flooded with dopamine, the neurotransmitter that regulates the brain’s pleasure center. Thus, the side effects of a stimulant detox are often psychological in nature. Dopamine levels dry up when someone stops using stimulants. This causes a user to “crash” where their mood and energy levels fall.
They will experience drug cravings and severe bouts of depression that can lead to relapse and self-harm. Stimulant detox side effects can include:
There are a few critical factors as to why people have more severe withdrawal symptoms than others. The type of drug that was abused can determine the degree of withdrawal as different substances remain in the body for varying amounts of time — commonly referred to as “half-life.”
What’s more, factors such as the length of addiction, dosage, the method of administration (snorted, smoked or injected), family history and genetics, and medical or mental health history can influence the severity of withdrawal. Polysubstance abuse, whether multiple drugs were ingested at one time, can also worsen withdrawal symptoms.
Length of Opioid Withdrawal
Heroin and prescription opioid withdrawal symptoms occur between six to 30 hours after the last use. The worst of those withdrawal symptoms typically occur 72 hours after and lasts up to a week. Even then, opioid withdrawal symptoms such as tiredness, anxiety, insomnia, and depression can last for a month. They can also linger for several months.
Length of Alcohol Withdrawal
Alcohol withdrawal can begin within six hours of your last drink. The more severe symptoms of withdrawal do not begin to appear until between 24 to 72 hours after your last drink. The effects of alcohol withdrawal typically last between five and seven days.
Length of Benzodiazepine Withdrawal
Benzodiazepine withdrawal varies. The length and severity of withdrawal will depend on the kind of benzo that was abused as there are shorter and longer-acting kinds. Nevertheless, there are two phases of benzo withdrawal to consider. There is the acute phase, which can last between seven and 90 days, and the post-acute withdrawal symptoms (PAWS) phase, which can last months or even years.
For shorter-acting benzos such as Xanax, Ativan, and Halcion, withdrawal can begin within six to eight hours from the last dose. Withdrawal from longer-acting ones like Valium, Librium, and Klonopin can start within 24 to 48 hours.
Death is possible in the detox process, particularly with alcohol. The most dangerous alcohol withdrawal symptoms are seizures and delirium tremens (DTs).
According to a study published in the Oxford University Press, the death rate for patients admitted to the hospital for alcohol withdrawal syndrome was at 6.6 percent. If left untreated, the mortality rate from severe alcohol withdrawal and DT has been as high as 20 percent, according to this report.
While opiate withdrawal is not life-threatening, death, however uncommon, can occur. Fatal withdrawal from opioids can occur from diarrhea and vomiting, two notable withdrawal symptoms associated with this class of drug:
“Persistent vomiting and diarrhea may result, if untreated, in dehydration, hypernatraemia (elevated blood sodium level) and resultant heart failure,” says a report by the Society for the Study of Addiction.
Benzodiazepine withdrawal tends to produce life-threatening symptoms that are psychological in nature. Those symptoms are self-harm and suicidal thoughts. Stimulant-related detox can also produce suicidal thoughts and behavior.
A professionally administered drug detox typically lasts three to seven days or sometimes longer. This depends on the type of addiction someone has and the duration of their substance abuse. There are distinct benefits that a medically supervised detox offers. This kind of detox:
For these reasons, a professionally administered, medical detox is the safer, preferable alternative to the “cold turkey” method or even abrupt cessation.
What’s more, professional addiction treatment includes therapy and counseling designed to help you get to the root of your addiction. If you have another co-occurring substance or mental health issue, assistance is also available. That means, after detox, you can receive this kind of ongoing care in a residential, partial hospitalization, or outpatient treatment program.
In addition, you can connect with a recovery community through an alumni program to ensure your sobriety and protect against relapse.
Alcohol withdrawal: MedlinePlus Medical Encyclopedia. (n.d.). from https://medlineplus.gov/ency/article/000764.htm
Alcohol, Benzos, and Opiates-Withdrawal That Might Kill You. (n.d.). from https://www.psychologytoday.com/us/blog/all-about-addiction/201001/alcohol-benzos-and-opiates-withdrawal-might-kill-you
Coping with Opiate Withdrawal. (n.d.). from https://www.healthline.com/health/coping-opiate-withdrawal#symptoms-andtimeline
Monte, Rabu, & Mateos. (2010, January 13). Analysis of the Factors Determining Survival of Alcoholic Withdrawal Syndrome Patients in a General Hospital. from https://academic.oup.com/alcalc/article/45/2/151/134927
National Institute on Drug Abuse. (2018, June 06). Prescription Stimulants. from https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants