How Do You Know if You Need Detox?

Legacy Healing Center Blog

Have you ever heard an addict or alcoholic say they want to quit drinking and/or using drugs but they physically can’t stop? There may actually be some truth to what he/she is saying. Detox is one of the first and most important steps in early recovery. After prolonged substance abuse, the individual can become physically dependent on the substances.

Without detox, the body is unable to rid itself of the harmful toxins and it is impossible to reach a healthy state of homeostasis. In order to have a chance at maintaining long-term success in sobriety, the body and mind need time to heal.

If you or someone you love is struggling with addiction, you may ask yourself – when does someone need detox? Unfortunately, this is a simple question with a complex answer. The necessity of detox is determined on a case by case basis, based on a variety of variables. Here are a few general situations that may help you identify when detox is necessary for you or a loved one.

What is a Medically Supervised Detox?

Medically supervised detox is a clinical setting filled with professional nurses and doctors available, around the clock, to monitor an individual’s withdrawal from drugs and/or alcohol. Medical detox may sometimes include administering medication however, this is determined on an individual basis of how long and what kind of substances were abused. Detox can be a very painful, unsafe, and uncomfortable process.

Oftentimes, detox centers have access to therapies proven to lessen and mitigate the symptoms of drug/alcohol withdrawal. Under the care of a physician, each individual is monitored for distressing signs of hallucinations, crippling anxiety, cardiovascular distress, and any other possible life-threatening withdrawal symptoms. Detox centers have access to a wide variety of medications which may be used to manage symptoms like high blood pressure, seizures, nausea, vomiting, insomnia, extreme depression, or anxiety.

Withdrawal is one of the most dangerous times in a person’s recovery. In addition to the physical symptoms and disorientation, individual’s may often face an emotional element of fear, depression, anxiety, and desperation as he/she comes face to face with the physical consequences of their addiction and the dire necessity of getting sober. It is always beneficial for substance abuse treatment to start with medically supervised detox or under the care of a professional.

What Substances Require Detox?

Some substances are far more addictive than others. You may find that all substances are mentally addictive, while others may provoke a physical dependence as well. Any substance that cultivates a mental and physical dependence, will most likely require detox for the individual. Without the aid of medical health professionals or a medical detox center, the individual will have to face difficult and potentially dangerous withdrawal symptoms.  

Cocaine and Crack

The withdrawal symptoms of cocaine and crack are very similar in nature. The short-lived high from both of these substances typically lasts anywhere from 10-20 minutes before withdrawals set in. As soon as the high wears off, the user may begin experiencing withdrawal symptoms. Typically, the crack and/or cocaine abuser will binge use the substances in excess over a short period of time. Crack/cocaine withdrawal symptoms include:

  • Anxiety
  • Rapid mood swings
  • Depression
  • Intense cravings
  • Anhedonia
  • Lack of energy

It would not be uncommon for the abuser to spend $1,000 in a day or two on these specific substances. Withdrawals, from crack or cocaine, will become more intense the longer and more the individual abuses the drug. After one day, abstinent from these substances, the individual will experience extreme cravings, anhedonia, anxiety, lack of energy, and depression. Intense cravings will become the obsession of the abuser and he/she may last a week before returning to the drug. Physical withdrawal symptoms typically last a week but the mental symptoms generally linger for a month.

Prescription Opiates and Heroin

There is always an associated risk for mental and physical dependence with opiates, even if the medication is prescribed for pain management. Some of the most commonly prescribed painkillers include:

  • Percocet
  • Vicodin
  • Morphine
  • Codeine
  • Fentanyl
  • Dilaudid
  • Methadone

The withdrawals associated with opiate abuse are among the most painful to overcome. An individual abusing opiates will oftentimes have to use multiple times a day to avoid inevitable and uncomfortable withdrawal symptoms. One of the most challenging aspects of abusing opiates is the risk associated with tolerance. Over time, the abuser will develop a tolerance for opiates and will need to take more and more of the drug to achieve the desired effect and avoid withdrawals. This puts the individual at high risk for overdose.

The effects of heroin are short-acting and fade quickly. Typically, after 3-6 hours, the user will begin to feel “sick” and will instantly experience painful withdrawal symptoms. Once the individual is physically dependent, withdrawal symptoms may cause him/her to wake up in the middle of the night obsessing over mitigating the painful symptoms. The withdrawals from heroin mimic the symptoms of opiate withdrawals and are almost always described as “flu-like”. Opiate/Heroin withdrawal symptoms include:

  • Muscle aches
  • Joint pain
  • Restlessness
  • Vomiting
  • Diarrhea
  • Cold sweats
  • Runny nose
  • Mood swings
  • Restless legs
  • Insomnia
  • Irritability
  • Depression/Anxiety

Generally, physical withdrawal symptoms of opiate abuse last 5-10 days. However, if an individual has been abusing opiates or heroin for a substantial amount of time, the residual physical symptoms may last for a significant amount of time. Oftentimes, it takes weeks or months for the individual’s appetite and sleep patterns to return to normal.


Benzodiazepines, commonly called benzos, are one of the most commonly prescribed medications in the country. This specific drug is used to treat anxiety, panic disorders, PTSD, and seizures. Some of the most commonly prescribed benzodiazepines are:

  • Xanax
  • Ativan
  • Klonopin
  • Valium

When used appropriately and on an as needed basis, these drugs can be very helpful. However, when abused, this class of drugs can be especially dangerous. The duration of symptoms varies on whether the specific drug is short-acting or long-acting. Withdrawal from short-acting benzos can begin within a few hours of last dose and last 7-10 days, whereas fast-acting benzodiazepine withdrawal can be felt after a day of the last dose and symptoms can last for two weeks or longer. Withdrawal symptoms of benzodiazepines are very similar to the symptoms of opiate withdrawal. However, unlike opiate withdrawal, there are fatal risks associated with benzodiazepine withdrawal. Fatal symptoms of benzodiazepine withdrawal may include:

  • Grand-mal seizures
  • Nervous system instability
  • Changes in heart function
  • Intense hallucinations
  • Changes in brain chemistry/body temperature


If someone is physically dependent on alcohol, it is vital he/she enters a medically assisted detox center. Alcohol dependence is typically categorized into three stages, classified by professionals based on levels of severity of withdrawal symptoms:

Stage 1 – This stage typically takes place 1-2 days after the cessation. Anyone heavily abusing alcohol may also experience hallucinations. Hallucinations may be auditory, visual, or even touch-related. Delusional thinking, paranoia, and confusion are also common symptoms during this stage of withdrawal. Symptoms of stage one alcohol withdrawal include:

  • Headaches
  • Vomiting
  • Nausea
  • Numbness/tingling in fingers/toes
  • Tremors

Stage 2Stage two alcohol withdrawal symptoms can start within one to three days after the last drink was consumed. This stage will not be felt by everyone struggling, but it is common for around 70% of problem drinkers. Like benzos, alcohol withdrawals come with a risk of a seizure. Stage two alcohol withdrawal also includes:

  • Confusion
  • High blood pressure
  • Uncontrollable sweating
  • Insomnia
  • Restless legs

Stage 3 – About 33% of individuals experiencing stage two alcohol withdrawal symptoms will also experience stage three as well. This stage of alcohol withdrawal is the most dangerous and potentially fatal in nature. This stage has been noted, by medical professionals, by Delerium Tremens (DT’s). The common symptoms of Delerium Tremens include:

  • Intense auditory, visual, and touch hallucinations
  • Delirium
  • Extreme fear/paranoia
  • Grand-mal seizures
  • Nervous system instability
  • Total confusion
  • Changes in heart/body functions
  • Intense tremors

For many individuals, it is difficult to decide if your circumstances are negative enough to get into a drug & alcohol detoxification program. For most individuals, their addiction starts to affect financials, relationships, physical/mental health, and morals. According to SAMHSA’s 2012 National Survey on Drug Use and Health, only 10 percent of those struggling with substance dependence or abuse received treatment. Don’t wait until you hit rock-bottom to get help with your addiction. If you instinctually believe you may need help, you most likely do. Contact Legacy Healing Detox today for help.