Detox Medications Used for Drug & Alcohol Withdrawal
WHAT YOU NEED TO KNOW
- Quitting drugs or alcohol often starts with detox, and the right medications can make withdrawal safer and far more comfortable
- For opioid withdrawal, medications like methadone, buprenorphine, and clonidine or lofexidine ease symptoms and cravings
- For alcohol and sedative withdrawal, benzodiazepines are usually the first-line treatment to ease symptoms and help prevent seizures
- After detox, medications such as naltrexone, acamprosate, and disulfiram can support long-term recovery from alcohol or opioid use disorder
- Medications are one tool, and they work best alongside therapy. Call Laguna at any time, day or night
Quitting drugs or alcohol often starts with detox.1 In some cases, the fear of an unpleasant withdrawal may deter people from seeking treatment to begin with.
The good news is that going through detox with proper withdrawal management can be a safe and relatively uncomplicated experience. In a supervised medical detox, you get professional support that may include prescription medications to manage certain types of withdrawal.
This guide explains why medications are used, which ones are common, and how to get help for yourself or a loved one.
Why Are Medications Used During Detox?
Medications may be used during medical detox to manage withdrawal symptoms that can be unpleasant and, in some cases, harmful. Withdrawal from opioids, benzodiazepines, or alcohol can be intensely uncomfortable and sometimes dangerous1.
For certain types of dependence, medications reduce discomfort and lower the risk of life-threatening complications. All medicines are given in a safe, controlled setting by professionals who monitor you throughout the process.
Common Medications Used in Detox
Medications are commonly used to manage acute withdrawal from alcohol or opioids.2 During withdrawal management efforts, various medications may be used to relieve symptoms such as pain, nausea, and insomnia, as well as reduce the risk of seizures or other complications.2 All medicines are administered in a safe and controlled setting by professionals who can monitor you throughout the recovery process.
Medications for Opioid Withdrawal
Though opioid withdrawal is not usually life-threatening, it can be extremely uncomfortable.2 Without help, it can be hard to get through.2 Symptoms may include:2
- Anxiety.
- Insomnia.
- Bone or muscle pain.
- Increased heart rate.
- Fever.
- Sweating.
- Runny nose.
- Gastrointestinal distress.
Medications can help get through these symptoms and others, including cravings.1
Methadone
Methadone is a long-acting opioid agonist used for detox and opioid use disorder treatment for more than 40 years.1 It works on the same brain receptors as other opioids, which helps to reduce cravings and other withdrawal symptoms. When used as an opioid use disorder (OUD) treatment drug, methadone may also reduce or block the rewarding effects of other opioids, should they be used.2,3
Methadone is a closely regulated controlled substance and can only be prescribed and received from specific SAMHSA-certified opioid treatment programs.1
Buprenorphine
Buprenorphine is a partial opioid agonist used during detox to reduce withdrawal symptoms and manage cravings.2-4 It has a similar efficacy to methadone.4 Like methadone, buprenorphine can block the euphoric effects of illicit opioids.3
Clonidine and Lofexidine
Clonidine is a medication that was initially formulated to treat high blood pressure, but it has been used off-label since 1978 for opioid detox as well.2 Clonidine can relieve some symptoms of opioid withdrawal.2
Another non-opioid drug in the same class as clonidine, lofexidine (Lucemyra), was recently approved by the FDA for use in detox to help manage opioid withdrawal symptoms.4
In some instances, clonidine may also be given to help with symptom management in people withdrawing from alcohol or benzodiazepines.2
Medications for Sedative & Alcohol Withdrawal
Withdrawal syndromes from alcohol and sedative-hypnotic drugs are very similar.2 These types of withdrawal can be not only unpleasant, but can sometimes result in life-threatening symptoms and complications, such as seizures and delirium, that require medical management.2 Symptoms seen in both sedative-hypnotic and alcohol withdrawal include:2
- Elevated heart rate and blood pressure.
- Increased body temperature.
- Anxiety.
- Irritability and restlessness.
- Insomnia.
- Tremor or shakiness.
- Impaired concentration and memory.
- Hypersensitivity to light and sound.
- Hallucinations and delusions.
- Delirium.
- Seizures.
Seizures and delirium can be progressively severe and fatal if not treated, but medication during detox can reduce symptom progression and minimize health risks.2
Benzodiazepines
Benzodiazepines are frequently the first line of treatment for alcohol withdrawal syndrome.2 Benzodiazepines can reduce the severity of withdrawal symptoms and can prevent seizures and other life-threatening effects.2,5 Long-acting benzodiazepines can also be used to manage withdrawal from shorter-acting benzodiazepines.2
Phenobarbital
Phenobarbital is a sedative-hypnotic prescription drug member of the barbiturate class.2 It can be useful for alcohol and sedative-hypnotic withdrawal symptoms but is not as commonly used as benzodiazepines are for this purpose.2 Barbiturates are themselves highly addictive drugs, have a narrow therapeutic range, and may more easily result in overdose.2 Due to the risks, phenobarbital may be used for withdrawal management only in highly supervised settings.2
Anticonvulsants
Anticonvulsants are useful in the treatment of alcohol and sedative-hypnotic withdrawal.6 Generally prescribed for patients with recurrent seizures, they can be helpful for some patients who are at risk for alcohol withdrawal seizures as well.2
Other Medications Used to Manage Withdrawal
Some substance withdrawal syndromes, such as stimulant withdrawal syndrome, have no FDA-approved medications for treatment.2 However, over-the-counter medications, such as ibuprofen or acetaminophen, can relieve some symptoms.2
Post-Detox Medications
For people with alcohol use disorder and/or opioid use disorders, following detox, there are medications that can help with ongoing cravings and maintenance of sobriety.1
For managing opioid use disorders in the longer-term, both buprenorphine and methadone are commonly used as maintenance therapies.1,2
Various medications for managing alcohol use disorders include:
- Naltrexone is an opioid antagonist that works to block some of the reward associated with opioids and alcohol. Used to deter continued drinking or drug use for those in recovery from opioid and alcohol use disorders, it is available in oral formations and monthly injections.1, 7
- Acamprosate is a medication that can help to balance some of the neurochemical changes that develop with chronic alcohol use and reduce the risk of relapse by reducing cravings.1
- Disulfiram is a medication interferes with alcohol metabolism, resulting in an adverse reaction and making a person feel very sick if they drink. Thus, it can discourage a return to use.1
Are Medical Detox Medications Safe?
Detox medications are a safe and effective method for helping people get through withdrawal safely and comfortably.1-3 However, medications for detox are just one tool of addiction treatment. Medications are often used alongside evidence-based interventions, such as behavioral therapy, to help people understand the underlying causes of their addiction, identify triggers that could lead to relapse, and learn coping skills.8
Medical Detox at Laguna Treatment Center
If you or a loved one needs detox and medical withdrawal management, Laguna Treatment Center, an Orange County medical detox facility, can help.
As a licensed chemical dependency recovery hospital, Laguna provides hospital-based detox with 24/7 physician and nursing oversight, plus ongoing care across several levels of treatment so you can continue your recovery after detox. Admissions navigators can answer questions about the admissions process and ways to pay for rehab.
Insurance and Payment Options
Laguna accepts most commercial insurance plans, though it is not in-network with Medicare or Medicaid at this time. You can verify coverage with carriers such as Aetna, Anthem Blue Cross, Carelon, Cigna, Kaiser, and UnitedHealthcare or Optum.