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Which Substance Abuse Issues May Require Medically Assisted Detox?

By WebMD Connect to Care Staff
Detoxing from certain substances under the supervision of medical professionals can help you navigate withdrawal safely.

Withdrawal symptoms from substance abuse can be uncomfortable and even life-threatening in some cases. Medically-assisted detox seeks to soothe the physical symptoms of stopping the use and abuse of drugs.

Since it addresses the very real physical symptoms of withdrawal, medically-assisted detox is recommended for some substances more than others. 

Prescription opioids & heroin

The U.S. Drug Enforcement Agency (DEA) classifies opioids as Schedule I or II controlled substances, meaning they are highly addictive with a higher than usual potential for abuse and dependency. Opioids bind to the opioid receptors in the brain, blocking feelings of pain and producing a sense of calm. This class includes prescription narcotics, such as Percocet, Vicodin and OxyContin as well as the street drug heroin.

Symptoms of opioid withdrawal include:

  • Muscle aches & muscle spasms
  • Insomnia
  • Runny nose
  • Nausea & vomiting
  • Abdominal cramps & diarrhea
  • Anxiety
  • Depression
  • Irritability
  • Rapid heart rate

Withdrawal symptoms from opioids are not necessarily life-threatening, though they can be difficult to manage on your own without the help of medication, says Keith Heinzerling, MD, internist and addiction medicine specialist at Providence Saint John’s Health Center.  Medications are usually required for successful detoxification from opioids as it is so uncomfortable that many patients will go back to drugs to self-medicate the symptoms before the detoxification is complete,” Heinzerling says.


Alcohol triggers the release of endorphins or chemicals in the brain that signal pleasure. Alcohol also depresses the central nervous system, which can impair speech, cognition, and muscle coordination. If you drink heavily over the course of months or years, your central nervous system gets used to the presence of alcohol and you can experience withdrawal symptoms if you suddenly stop consuming it.

Symptoms of alcohol withdrawal include:

  • Poor concentration
  • Restlessness, irritability and anxiety
  • A high fever
  • Difficulty sleeping
  • Increased sensitivity to light and sound

In more severe cases, alcohol withdrawal can be life-threatening and possibly lead to seizures or hallucinations.

“Medical treatment and supervision is usually required for detoxification from alcohol and sedatives, like benzodiazepines as the withdrawal symptoms when severe may be serious or even life-threatening, including high blood pressure, heart arrhythmias, confusion, seizures, and death,” Heinzerling says. “Abrupt cessation of high doses of alcohol or sedatives is dangerous and should be done under a doctor’s supervision.”


Benzodiazepines act as central nervous system depressants, helping to calm anxiety and panic. Some of the most common drugs in this category include Xanax, Valium, Klonopin and Ativan.

These medications increase the effect of a chemical in the brain known as gamma amino butyric acid (GABA), which produces feelings of pleasure. As with alcohol, your body can develop a tolerance and dependency on these drugs over time and you can experience withdrawal symptoms when you stop.

Benzodiazepine withdrawal symptoms include:

  • Headaches
  • Rapid heart rate
  • Anxiety
  • Muscle spasms
  • Restlessness
  • Irritability

Detoxing from these substances under the supervision of a medical professional in a specialized facility can help you navigate withdrawal symptoms and stay safe.


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