Is Detox The Same As Rehab? No, And Here’s Why

Drug & alcohol detox and rehab are two parts of the substance addiction treatment process. Both are equally important steps to gaining a drug or alcohol-free life.

They serve different purposes, however.

It is important to dissect each of these forms of substance use treatment to better understand what they do and why they matter.

Drug & alcohol detox and rehab are both vital steps in recovering from drug and alcohol addiction.

What Is Detox?

Detoxification, frequently referred to as detox, tapers substances out of the body. Unlike what many people picture, detox is not an immediate action. The body slowly expels toxins created by any substance. Ceasing to use a substance can create an acute withdrawal. The mental and physical withdrawal symptoms are mildly painful at best and potentially lethal at worst. Common symptoms of withdrawal include:

• Severe anxiety
• Depression
• Headaches, including migraine
• Tremors
• Body aches
• Nausea and vomiting
• Mood swings
• Fatigue
• Insomnia
• Cramps
• Shivers
• Diarrhea
• Cravings

More serious symptoms can include: 

• Suicidal ideation
• Delirium
• Psychosis
• Seizures

For this reason, detox and withdrawal should occur under the careful watch of healthcare professionals. Detox centers offer social, mental, and medical support for patients. They restrict access to drugs or alcohol. They ensure patients stay as comfortable as possible throughout the process.

In short, professional detox makes withdrawal easier … and more likely to succeed.

Medical Intervention During Detox

Frequently, during detox, doctors provide patients with medications to stabilize their condition. Mental health meds help the psychiatric symptoms. Antipsychotics can prevent delirium and psychosis. Sleeping pills can manage chronic fatigue. NSAIDs can decrease physical aches and pains. Anticonvulsants can prevent deadly seizures. Secondarily, anticonvulsants can help treat comorbid mental disorders like bipolar disorder (BP), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). 

It is important to realize that medical professionals will only prescribe these medications temporarily. They are meant to manage withdrawal. Most of these medications will not be prescribed long-term unless protracted withdrawal syndrome (PWS) occurs.

Length of Withdrawal

There is no one exact answer to how long a detox stay will last. Factors that influence the duration include the type of substance, length of use, potency, and comorbid mental illnesses. The World Health Organization offered general guidelines in the 2009 document titled Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. 

For each substance, they lay out the following timelines:

• Short-acting opioids: 4-10 days
• Long-acting opioids: 10-20 days
• Short-acting benzodiazepines: 2-4 weeks
• Long-acting benzodiazepines: 2-8 weeks
• Stimulants: 3-5 days
• Alcohol: 2-10 days
• Inhalants: 2-14 days
• Cannabis: 7-14 days

What Is Rehabilitation?

Rehabilitation uses therapy, social support, and sometimes medications to recover from substance use disorder (SUD). This can occur in many settings. The most common and effective setting is a drug rehab or addiction center.

These break down further into:

• Residential rehab
• Inpatient rehab
• Partial hospitalization program
• Intensive outpatient program
• Outpatient rehab

These include varying degrees of intensity and time. Most rehab programs focus primarily on SUDs, but they can usually treat co-occurring mental illnesses as well. Doctors may prescribe long-term, maintenance medications that continue after rehab. 

In drug rehab programs, group therapies allow patients to feel less alone. They can heal with social support. To create long-lasting change, people learn coping skills, cognitive reframing skills, and emotional regulation skills. Individual psychotherapy allows patients to work on their unique challenges.

They may engage in modalities like cognitive behavioral therapy or dialectical behavior therapy. The patient's needs determine the approach a mental health professional will take.

Some facilities include family or couple's therapy to improve family systems. They work to educate everyone and build healthy dynamics.

These centers can also set individuals up with self-help groups like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Self-Management and Recovery Training (SMART Recovery), and other local support groups.

Length of Rehab

The length of inpatient rehabilitation varies greatly depending on the specific facility and type of program. Some places offer as few as seven-day stays. This is not considered effective, though. According to Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), published by the National Institute on Drug Abuse (NIDA), these are the common time frames for inpatient stays:

• Short-term residential rehab: 3-6 weeks 
• Long-term residential rehab: 6-12 months

It is worth noting that the manual also states that 90-day inpatient stays prove less effective than longer inpatient stays. Longer stays allow people the time they need to make significant changes. 

Outpatient rehab programs are much less structured regarding time frames. They frequently cater to individualized treatment programs. For this reason, treatment estimates can vary from one month to six-plus months. They also may range anywhere from three to nine hours a day. It all depends on the addiction severity, type of substance, treatment needs, support system, etc. Case managers of patients will often work with medical providers to determine the rehab period.

Why People Need Both Detox and Rehab

After describing the ins and outs of these two treatments, it is clear that they each serve different but associated purposes. Detox gets an individual through acute withdrawal. Rehab teaches patients how to manage life without substances.

Without detox, individuals will not be in a position to absorb the lessons from rehab. Without rehab, they do not receive the skills to maintain their sobriety. Neither option works on its own, but both set individuals up to succeed in their recovery journey.

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