Common Medications Used for Drug Detox
When drug or alcohol use leads to physical dependence, a person may seek detox as the first step in recovery.1 Withdrawal from alcohol or drugs can give rise to a number of uncomfortable physical and troubling mental health symptoms, sometimes making it extremely difficult to get through on your own.2 In such cases, detoxification and pharmacological withdrawal management can help.
Learn about the different medications available for medical detox and how they can help with addiction, as well as how to obtain professional addiction treatment at Recovery First.
What Is Medical Detox?
Medical detox is a set of interventions—including medications and medical supervision—that allow a person to more safely and comfortably clear drugs and alcohol from their body.2 During detox, the body rids itself of the influence of substances, but the process can be very uncomfortable and even dangerous with certain types of substances.2 Professional help gives people a better chance of getting through this step in their recovery without potentially relapsing during the process.2 However, medical detox alone is not intended to be a solution to substance use disorders; it is focused primarily on treating acute withdrawal, while the issue of addiction may benefit from more additional, comprehensive treatment.2
How Do Detox Medications Help?
Detox medications can help a person better manage the unpleasant symptoms experienced during withdrawal from a substance.2 In general, detox medications may reduce symptoms of withdrawal including (but not limited to) body aches, sweating, increases in heart rate, anxiety, agitation, and even seizures.2 The appropriate medication for each person depends on their substance of misuse and factors specific to them.3
Medications for Opioid Withdrawal
Opioid withdrawal is not usually life-threatening but can be extremely difficult to get through without assistance.2 Withdrawal symptoms can be uncomfortable and can include anxiety, insomnia, muscle aches, racing heart, fever, chills, and gastrointestinal distress.2 Additionally, withdrawal can give rise to drug cravings, which can provide a particular challenge for patients in trying to avoid relapse during this challenging start to recovery.3 There are a few medications available to help people through detox from opioids, as well as with ongoing opioid use disorder treatment.3
Buprenorphine/Suboxone
Buprenorphine is a partial opioid agonist used to reduce cravings and withdrawal symptoms associated with opioid use disorder.3 As a partial opioid agonist, buprenorphine binds to the same receptors as many other opioids but activates them less completely.3 When started during detox, buprenorphine can reduce cravings and withdrawal symptoms by stimulating those receptors, but with less risk of a euphoric high, sedation, and even overdose (should it be misused).1,3
Suboxone is a brand name formulation that combines buprenorphine with naloxone, an opioid antagonist.1 When Suboxone is taken as prescribed as an oral medication, the naloxone has little to no effect.1 But, if a person tries to misuse Suboxone by injecting it, the naloxone becomes pharmacologically active to block the effect of any opioid drugs in the system, potentially sending someone into full opioid withdrawal.1
Certified clinicians most commonly prescribe buprenorphine as a tablet or dissolvable film that is placed either under the tongue or in the cheek, though extended-release injectable formulations may become more widespread in the future.3 Buprenorphine may be initiated during detox and continued beyond the withdrawal period for ongoing maintenance treatment for opioid use disorder, allowing patients to remain on the same medication as long as necessary.1
Methadone
Methadone is a long-acting synthetic opioid agonist that has a long history of use in opioid use disorder treatment.1 Since methadone is an opioid agonist, it works on the same receptors as illicit opioids.1 With regular therapeutic use, methadone also elicits a significant degree of cross tolerance to other opioids, essentially blocking some of the effects of illicit opioids if they are used.1
Over the years, methadone has proven successful in preventing withdrawal symptoms and diminishing cravings in people with opioid dependence.1 It can be used during withdrawal or as a maintenance medication, and has additionally been shown to increase patient participation with behavioral therapies during treatment.1,2 Prescription and distribution require a special license and patients may need to enroll in particular methadone maintenance programs to obtain it.1
Other Medications
Buprenorphine and methadone may be the most well-known and widely used medications for opioid use disorder, but other medications (both prescription and over-the-counter) can be effective in augmenting withdrawal management during detox, too.2
Clonidine and Lofexidine
Clonidine is a non-opioid medication initially approved and sold for the treatment of high blood pressure but has been used “off-label” for opioid detox since 1978.2 It helps alleviate many of the physical symptoms of opioid withdrawal, but it does not work on the same receptors or have any abuse potential.2
However, patients often do not prefer treatment with clonidine alone because it may not entirely relieve some of the most common opioid withdrawal symptoms, including insomnia, achy muscles, or opioid cravings.2
More recently, the FDA approved lofexidine (brand name Lucemyra)—a drug in the same adrenergic agonist class as clonidine—for similar use in reducing certain opioid withdrawal symptoms in people recovering from opioid use disorder.3
Medications for Sedative and Alcohol Withdrawal
Withdrawal from alcohol and sedatives after chronic misuse can lead to life-threatening withdrawal complications.2 For example, in severe alcohol or benzodiazepine withdrawal, a person could experience a life-threatening seizure or delirium.2 Other symptoms for both substance withdrawal syndromes can include:2
- Anxiety.
- Insomnia.
- Agitation.
- Restlessness.
- Irritability.
- Sensitivity to light and sound.
- Hallucinations.
- Loss of appetite.
- Poor concentration.
- Tremors.
- Elevated blood pressure and heart rate.
Benzodiazepines
When a patient requires it, benzodiazepines are the first line of treatment in managing acute alcohol withdrawal symptoms.2 Additionally, benzodiazepines can themselves be successfully used in patients to manage benzodiazepine and other sedative withdrawal as well.2
Benzodiazepines work to manage alcohol and other types of sedative withdrawal because all of these substances interact with GABA receptors to influence the inhibitory signaling of the GABA neurotransmitter.4 In alcohol withdrawal, they may be prescribed as a taper or as needed, allowing the body to slowly adjust to lower doses.2 In sedative withdrawal, patients may first be switched to relatively long acting benzodiazepines—such as chlordiazepoxide (known by the brand name Librium)—prior to it being gradually decreased in dose as withdrawal symptoms resolve.2
Phenobarbital
Phenobarbital is a barbiturate that may also be used in alcohol or sedative withdrawal.2 Use of this medication to manage alcohol or sedative withdrawal is less common than benzodiazepines because of its relatively lower safety profile.2 If a person accumulates too much in their blood, overdose and death may occur, therefore phenobarbital is only administered by experienced clinicians in supervised settings to ensure therapeutic effect without threat of this outcome.2
Are There Approved Medications for Other Drug Withdrawal Syndromes?
Most other drug withdrawal syndromes do not have specific FDA-approved medications as treatment.1,2 However, other medications may be used to treat individual symptoms as they arise in any withdrawal syndrome.2 Undergoing detox in a treatment center can provide professional guidance for symptom management and the psychosocial support needed to get through withdrawal.
Post-Detox Treatment Medications
As successful withdrawal management efforts alone are insufficient for kickstarting long-term recovery, continued involvement in a substance use disorder treatment program is highly recommended after detox.1 As part of a more comprehensive, longer-term substance use disorder treatment plan, medications are a cornerstone of recovery for many people.
For those struggling with either an alcohol use disorder or an opioid use disorder, the following are available for treatment past the detox stage:
- Acamprosate is a medication used to help treat alcohol use disorder by reducing symptoms of protracted withdrawal.1 It may be more effective in patients with severe dependence on alcohol.1
- Disulfiram is a medication used in alcohol use disorder that interferes with the body’s ability to completely break down alcohol.1 As a result, alcohol is only able to be partially broken down, therefore consuming it while taking disulfiram can cause an unpleasant reaction that can include flushing, nausea, and heart palpitations.1
- Naltrexone is an opioid receptor antagonist that can be used to manage both opioid and alcohol use disorders.1 It works by blocking some of the rewarding effects associated with substance use, which can discourage continued use and lower relapse risks.1 Vivitrol, a brand of naltrexone that is injected once monthly, reduces the burden of taking the medication multiple times per week and has increased its efficacy in substance use disorders.1
- Methadone is available as maintenance therapy to reduce cravings in opioid use disorder.1 In combination with behavioral therapy, it can be exceptionally effective.1
- Buprenorphine/Suboxone can also be used as an ongoing treatment in opioid use disorder.1 As a partial opioid agonist, buprenorphine can reduce cravings and is available in multiple formulations.1
Safely Detox from Drug and Alcohol at Recovery First
If you or someone you love are thinking about detox, Recovery First can help. Recovery First is an inpatient rehab near Miami that offers medical detox and ongoing inpatient and outpatient treatment to facilitate your path to recovery. Admissions navigators are available 24/7 to answer any questions you may have about the drug rehab admissions process, insurance plans that cover treatment, levels of addiction treatment, or handling the cost of rehab.
Begin your journey to recovery today by having your insurance verified with us. Simply fill out our secure online and get results within minutes.