Detox vs Rehab
Detox at a glance
When we think about treatments for addiction, detox is one of the buzzwords that crop up time and time again. But what does detox mean?
Detox literally means detoxification of the body after it has become reliant on an addictive substance such as drugs or alcohol. How long this process will take depends on a number of factors:
- Type of substance – some drugs leave the body quicker than others
- How long it has been used – the body can develop a tolerance to a substance if it is regularly consumed, making it a longer detox process as your body adjusts
- Amount consumed – just like with legally prescribed medication, the dosage of what you take will determine how quickly it leaves your system
- Underlying conditions – you may have a physical or mental condition that could affect how an addictive substance leaves your system
- Genetics – genetics can play a major part in our recovery, with certain sets of genes thought to determine how likely we are to become addicted, so it can affect detox as well
How long the Detoxification process takes varies on the substance, quantity and how long the individual has been using it. Once the toxin has been flushed from your system, your body can begin to heal from the damage caused by addictive substances. By completely flushing the drug out of your system, you should also notice your cravings are reduced.
Detox also has the added benefit of cleansing your brain. Addictive substances change your brain chemistry, which can lead to difficulty making decisions, poor judgement, limited concentration and unpredictable mood swings. Once they have left your body, your mind can begin to repair itself and lift the fog addiction creates.
Physical dependence and tolerance
When it comes to drugs and alcohol, what begins as an escape from a stressful reality can become a necessity. Eventually, your body becomes used to a regular amount of a substance. Once it knows to expect this amount, you can become physically dependent on the substance. This means that you then need to drink or take even more than usual in order to experience a high or tranquil state. This is known as having a tolerance.
For example, if you drink one bottle of red wine every night, your body will eventually learn that it regularly consumes that much alcohol. It expects to receive that amount daily, so you have to go up to two bottles if you want to feel tipsy or drunk again. If you then respond by drinking two bottles a night every night, your tolerance will increase again and so on. In a short period of time, you can increase your consumption to the point that you barely feel the desired effect anymore, but your body needs that amount of substance to function now.
Detox is about adjusting the body and mind to a new baseline. But with reducing your intake comes the possibility of withdrawal.
Withdrawal
We conflate the two, but there is a difference between detox and withdrawal. Detox is the process of purifying your body and withdrawal is the effect this can have when your tolerance for an addictive substance can no longer be met.
Withdrawal can sometimes be experienced in very small quantities when you make a change to your diet. For example, if you tend to drink full-sugar fizzy drinks regularly and decide to stop, you may find yourself craving sugar because your body is used to the amount you were previously getting from colas.
When it comes to drug or alcohol withdrawal, the symptoms can be life-threatening. This is why medical supervision throughout your detox is recommended to ensure you are safe at all times. As your body accepts the shock of no longer receiving an addictive substance, it can react violently. Some common symptoms of withdrawal include:
- shaking and tremors
- difficulty sleeping and insomnia
- sweating
- exhaustion
- aches and pains
- nausea
- hallucinations
- anxiety
- depression
- irritability
Rehab at a glance
Rehab is another common buzzword when we talk about addiction. Countless reports of celebrities and public figures attending rehab have become somewhat commonplace in society, without the concept of a rehabilitation centre being fully grasped. So what is rehab?
Rehab programmes are able to teach people about their addictions, break down the reasons that they turned to substance abuse and create coping strategies to help an addict to ingratiate themselves back into the real world. It focuses mainly on the psychological and emotional effects of addiction.
You can attend an inpatient rehab if you feel that you need a higher level of support as you adjust to recovery, or an outpatient facility if you want to stay in comfortable surroundings. Patients live at the facility in inpatient rehab, allowing them to form strong bonds with other people who are also making positive changes to their lives. Outpatients can attend daily or weekly in-person treatments and partner with support groups in their local area.
The general consensus is that the longer you spend in rehab, the more successful you will be in transferring to an outpatient programme, but this varies from person to person. Rehab can last for several months.
Understanding triggers and developing strength
The aim of rehabilitation is to assess why someone has turned to an addictive substance for comfort, what factors in their life add to their stress or can trigger substance abuse and prepare them to go back to their daily life, armed with coping strategies to make healthy choices and stay sober.
Triggers are one of the biggest stumbling blocks for addicts, with certain people, memories, events or stresses pushing them towards using an addictive substance. Through a range of therapies, rehab patients can learn what their specific triggers are, how to avoid them and plan replacement behaviours that are healthier as a coping mechanism. A treatment team could use Cognitive Behavioural Therapy, bereavement or trauma therapy, holistic therapies (such as art or exercise) or the 12-step programme as a basis for finding the underlying factors that helped cause addiction and build strength in defying those impulses.
Preparing for long-term sobriety
One of the bonuses of a rehabilitation facility is that your transition back into society is managed by a treatment team. They can signpost you to local support groups, create plans for going back into employment and even mediate family issues that might be a barrier to your recovery once you leave the facility.
Remaining sober is all about having the correct professional and personal system in place so that you can get support when you need it most. These could be numbers to call when you feel like you need to use an addictive substance or a group that you can meet with regularly to help you re-centre.
What’s the difference between detox and rehabilitation
People often think that rehab and detox mean the same thing. It is important to know the difference between them, with a reported 130,490 people entering substance abuse treatment between 2020 and 2021 in the UK.
As highlighted above, they are 2 very different but vital stages in long-term sobriety. One of the best ways to understand the difference between rehab and detox is to look at detox as the act of getting sober and rehab as the process of staying sober.
The physical detox
So what does detoxing mean? Detox is concerned with the physical state of an addict. It is the period of time it takes to flush out an addictive substance from your body, giving it the clear out it needs to begin healing from any damage that has been done. Depending on the type of substance and how much you normally take, this can be an intense period of time physically and mentally as you essentially force your body to adjust quicker than it wants to.
While detox and rehab are different stages of treatment, often rehab will only work at its best once you have detoxed because addictive substances can also affect your brain chemistry.
Mental reprogramming
Rehab, on the other hand, is far less risky from a physical standpoint. Once you have detoxed, you may experience cravings, but your body will have gotten through withdrawal and the painful symptoms this can cause. Rehabilitation is more concerned with rebuilding your life and unlearning the bad habits that led you to your addiction. It can teach coping strategies that do not involve risk-taking and putting your health in danger. It wants to root out the problems that caused the addiction, in the hope that this will stop you from going back down this path.
Often rehab is just the first step in the journey of sobriety. It gives you the tools you need to change addictive behaviours and can put you in contact with outpatient facilities and support groups that you can use once you are back in the real world.
Is detox required to attend rehab?
Every rehabilitation facility is going to have its own features and entry requirements. It is important to fulfil what is required of you before you begin the process, as a sign that you take the treatment seriously and are ready to make positive changes to your life. Researching the facility extensively before paying any money for your treatment is essential to ensure you receive the right help.
Some facilities will provide detox to rehab programmes, allowing you to detox under supervision and then join the rehabilitation process. However, not all can provide this and they may still require you to detox before your arrival. In order to do this in the safest possible environment, you should find a detox facility that can provide around-the-clock medical supervision in case you go into severe withdrawal.
Firm foundations
Whether a rehab requires it or not, detoxing is the strongest foundation you can create for recovery. It marks a clear commitment to removing an addictive substance from your system. While it will be uncomfortable, your body will only be able to feel the physical benefits once you stop using the substance. Being able to physically recover as you also mentally recover helps restore balance and will encourage your progress.
Mastering your physical cravings will also give you more mental capacity to focus on your treatment and therapies. It is the best way you can prepare for the next steps you need to take.
Being emotionally ready
Even though detox is physically draining, rehab can be mentally and emotionally draining. It is hard to reexamine your life and break down negative thought processes to better understand how your addiction formed in the first place. It requires a huge amount of inner strength, which is going to be easier to access once you are no longer physically dependent on a substance.
Addictive substances will alter your brain chemistry. As you gradually increase in use, you might not have noticed the change, but often you can be quicker to anger, more irritable and unreceptive to the kind of thinking rehab requires of you.
Strengths and weaknesses: detox vs rehab
Detox strengths
One of detox’s biggest strengths is that it allows your body to begin healing after prolonged substance abuse. Whether this is alcohol or drugs, this can affect your body and damage organs, alter brain chemistry and leave you feeling weak. Once you have flushed the substance entirely from your system, the body can begin to repair itself, making you feel better, stronger and ready to take the next steps forward.
Without the addictive substance in your body, your physical tolerance for it will also diminish. It is the first step in taking yourself away from dependency. Paired with the correct therapy and treatment, this can help you conquer your cravings and stop relying on substances for comfort and support in times of stress.
Detox programmes offer a variety of options for medical supervision. Some are offered in a hospital setting, and others are dedicated detox facilities with qualified staff to monitor your condition while your body adapts. This gives you more choice, as some may find a hospital daunting. Detox facilities will usually be in a residential setting, where you can feel more relaxed and are surrounded by other people going through the same experience as you.
Detox weaknesses
Detox alone is usually not enough to transition into sobriety. Even though your physical cravings reduce, you are at a high risk of using again without further help. While it is an incredibly important step to take, it will not be effective if you find yourself turning to an addictive substance when you are stressed or under pressure again. This is especially true if you have been reliant on the substance for a long time or have been consuming a large amount.
When you have developed a tolerance to a substance, detoxing is going to be a challenge. You will likely go into withdrawal, which mayhave uncomfortable symptoms. This is why you often need medical supervision, because without it your body could have an adverse reaction that could be potentially life-threatening. However, nothing good comes from the comfort zone and if you are committed enough to getting sober it will be worth it.
Rehab strengths
Rehab centres are usually inpatient and you will be able to stay in a neutral environment while you are at your most vulnerable. This helps to take away the stress and worries of daily life so that you can focus solely on recovery. The treatment programme offered will help to structure your day and ensure your time is used wisely. This will be with holistic activities such as painting or yoga and group and individual therapy sessions.
While you are at a treatment centre, you are also going to be living with other people going through a similar experience to you. Addiction can take many forms, but being surrounded by people that are focussed on recovery as well creates a support system. You may find yourself forming strong bonds as you share your stories that will carry on once you return to your normal life.
Another strength of rehab is that you will have a dedicated treatment team to help you return to your life. Stepping back into your normal routine can be difficult coming from a space without the pressures that daily life brings. Your team from rehab will help find the outpatient services that you need once you leave, come up with action plans for returning to work, social events and family and conduct counselling sessions with the people in your life that you need to improve your relationship with.
Rehab weaknesses
At a residential centre, while the stresses of normal life will melt away, you also have to adapt to a new environment. You will be away from your friends and family. They will be able to visit and attend therapy with you, if your treatment team encourages this, but you will have to get to know a new group of people. You will also be away from all your home comforts, which can be difficult when you are feeling particularly vulnerable.
If you choose to be an inpatient, you will have to take time away from work. This can be great for recovery if this is a source of pressure in your life, but it also means you will not be earning. Some people take comfort in the routine of work and find it hard to manage their free time, so this can feel intimidating, to begin with.
A combined path: detox and rehab
Whereas some facilities exclusively offer rehabilitation support/services, a combined detox and rehab facility is typically favoured and beneficial for many people. People often find the best success by combining detox and rehab, followed by outpatient treatment as they transition back into their daily life. This offers support every step of the way, helping you to navigate the trickier moments of recovery with the right teams in place. You will first cleanse your body, preparing yourself for therapy and then learn new coping mechanisms in rehab. Then you can take what you have learned from rehab into your life, with regular support groups and outpatient appointments to help you adjust.
A fresh start
Most medical professionals advocate for detox before rehab, making a combined detox/rehab facility beneficial. The idea behind this is that once you have flushed an addictive substance out of your system, you will be better prepared for a fresh start and to adopt new ways of thinking. Due to the effect addictive substances can have on your mental health, you will be more receptive to the therapies offered at the same facility.
There is also a holistic reason for detoxing first. Mentally, you are preparing yourself for a fresh start. You are taking on the commitment of detox to take away your tolerance and dependency on addictive substances. Once you come out to the other side, you will feel ready to start rehab immediately.
Paving the way to rehab
Once your body and mind are cleared from a detox, you are ready to enter the rehabilitation phase of your recovery. By combining both detox and rehab, you are paving the way to rehab and enabling yourself to make the most of the treatment you are about to receive.
How should I choose a detox programme?
If you have concerns about the detoxification process, it is best to research the different facilities available to you. This will help give you a clear idea of what to expect and provide reassurance about the support that will be available to you. But what is a detox centre?
Detox facilities
Detox facilities can be found in different settings. Some will take place in a hospital, while others will be able to offer a residential centre to stay at while you go through detox. Wherever you choose to go, it is important to ensure that there are qualified medical professionals there to supervise the process.
While it might be tempting to save some money and try to do this at home, you will not get the benefit of around-the-clock medical care. You will also be in a setting where you can easily access addictive substances, which you may give into once the discomfort of withdrawal sets in. If you were to do this at home, you would be reliant on friends and family for support. Withdrawal and detox can be intense experiences, and being in a neutral environment will give you dignity. You may not want to share that side of yourself with your loved ones, whereas medical professionals will not have an emotional stake in your behaviour. This allows them to think clearly and rationally when you are not able to for yourself.
The right programme for you
Detox is always going to be safer with medical supervision. Withdrawal symptoms can be life-threatening and you may end up in the hospital or severely ill without someone there that has the expertise to keep you healthy.
Some detox programmes will offer to wean you off the substance with replacement medication this can help prevent withdrawal.
Detox vs rehab: a summary
Now that you have a better understanding of how detox and rehab differ, and how they can be used to complement each other, you are able to make an informed decision about treatment and recovery.
Detox recap
Detox is often the first step in conquering your addiction. It is physically demanding and the risk of withdrawal and its more severe symptoms can be daunting. However, it is also a commitment to recovery that can help motivate you to keep going and to make the best of your rehabilitation experience. It can help you to find inner strength after you have demonstrated the physical strength of coming off an addictive substance.
Rehab recap
Rehab allows you to live in a neutral setting without the stress of daily life impeding your progress. You will be exposed to new ways of thinking and different ideas about how to replace negative addictive behaviours. Your treatment team will guide you every step of the way with lifestyle changes that will benefit you, such as finding the right kind of therapy for you and managing your transition back into your routine.
After detox and rehab
There is no quick fix when you are battling with addiction. Detox and rehab are important steps in the right direction and can provide you with the tools you need to stay sober. However, you are going to need a support system in place for when you leave these programmes.
This will start with your personal relationships. You need to surround yourself with people that encourage your sobriety and help you to make the best decisions for yourself. Most people in recovery attend a support group, where they can meet other people dealing with the same struggles. This can help you to build up a network of supportive friends that keep you on the right track. You may also want to consider outpatient appointments with therapists or addiction specialists to offer ongoing support over a longer period of time.
FAQs
How long does it take to detox from alcohol addiction?
The amount of time you need to detox is going to vary from person to person. Alcohol can be one of the hardest substances to detox from and withdrawal can come with extreme symptoms. It will depend on how long you have been abusing alcohol, how much you drink and also your genetic make up. Detox can take approx7 days for the alcohol to completely leave your system.
How long does it take to detox from drug addiction?
As with alcohol addiction, the length of detox is going to vary. It will depend on what type of drug you are dependent on, how much of it you take and how long you have been using it.
What services are available on the NHS?
The NHS can provide some support, but often you will be playing a postcode lottery with the types of treatment they can offer. While some areas may have rehabilitation facilities, others will not. Research what is available in your local area and also consider paying privately to have more choice over your treatment pathway.
What happens if I relapse?
Relapse can happen. It is not the end of the world and you can recover from this again. You will usually need to go through the detox process again to remove the addictive substance from your system. You may find you would like time in a rehabilitation facility again to help remind you of coping strategies and to understand why you relapsed.
Can I detox at a rehab facility?
Some rehab facilities will help you to detox as well. However, if they do not have the right tools in place, they may still require you to detox before you start rehabilitation. Often it is best to find a dedicated detox facility for this.
What is a detox facility?
A detox facility is staffed with medical professionals that can supervise you as harmful substances leave your system. They will monitor your condition closely to ensure you are safe at all times.