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Alcohol use disorder (AUD), what most people think of as alcoholism, affects about 14.5 million Americans. Binge drinkers accounted for an estimated 66 million people, while heavy drinkers include about 16.7 million. Furthermore, 7 million children live in a household where at least one parent abuses alcohol or is dependent on it. And some 88,000 people die each year from alcohol-related car crashes. Clearly, alcohol abuse is both widespread and of continuing concern. Yet those who desire to quit drinking and/or drug use may face months or longer in their goal to become fully abstinent. So, how long does it take to get clean?
WHAT DOES IT MEAN TO GET CLEAN?
By most accounts, getting clean means ridding your body of toxic substances, whether that’s alcohol, drugs, or a combination of both. Getting clean also refers to changing behavioral practices and erroneous beliefs so that once the body is detoxed from alcohol or drugs, the individual is better prepared to live a substance-free life. It is one thing to initially get clean, and another to remain clean and sober. The former is a process that is often required for entering formal treatment, while the latter is always greatly enhanced and facilitate with appropriate and personalized treatment.
Detox can take place at a medically-supervised detox facility, either in a hospital or treatment setting. Formal treatment can be on an inpatient or outpatient basis at credentialed alcohol and drug rehab centers and facilities.
WHAT IS ALCOHOL WITHDRAWAL?
WebMD has a simple explanation of alcohol withdrawal. This is a process that occurs after you’ve been drinking alcohol heavily for a long time and suddenly stop or drastically cut back on drinking. Alcohol withdrawal involves a number of physical and mental symptoms, which can run the gamut from mild to serious to potentially life-threatening.
Common and More Serious Alcohol Withdrawal Symptoms
Within a few hours of quitting drinking, alcohol withdrawal symptoms may start to appear. These initial symptoms may be mild and include anxiety, headache, insomnia, nausea, shaky hands, sweating, and vomiting.
More serious possible alcohol withdrawal symptoms include hallucinations that can start anywhere from 12-24 hours after the last drink, to seizures that may occur in the first couple of days post-drinking. Very serious alcohol withdrawal symptoms involve delirium tremens (DTs), occurring only in about 5 percent of those undergoing alcohol withdrawal. Starting between 48-72 hours after the last drink, the DTs are characterized by delusions and hallucinations, as well as confusion, fever, high blood pressure, profuse sweating, and racing heart.
HOW LONG BEFORE YOU’RE CLEAN FROM ALCOHOL?
Alcohol detox (getting clean from alcohol) typically takes about 7-10 days, although the timing for fully detoxing can be longer if other drugs are also involved (polydrug abuse). Other factors affecting how long it takes to get clean include how long you’ve been drinking, what other drug use you’ve been involved in, dosage of medications abused, physical and mental health, and numerous other factors.
Just because alcohol is completely removed from the body, however, doesn’t mean that the damage caused by chronic alcohol abuse is erased. It may take quite some time to heal from the negative effects of such long-term excessive drinking.
HOW LONG DOES ALCOHOL DAMAGE REMAIN?
Contrary to popular thought that brain damage caused by excessive alcoholic consumption starts to reverse itself immediately after quitting drinking, research using magnetic resonance imaging (MRI) now shows that the damage continues. A joint work by German researchers at the Institute of Neuroscience CSIC-UMH and the Central Institute of Mental Health of Mannheim found that alcohol-induced white matter brain damage continues during the first few weeks of abstinence, despite the fact that there is no further alcohol consumption. The research was published in JAMA Psychiatry. Study participants were all participants in hospital detox program, guaranteeing abstinence. Imaging showed the damage mainly affected the brain’s right hemisphere and frontal area. The nucleus accumbens is part of the reward system, while the prefrontal cortex is key in decision making. Thus, during the early abstinence phase in those with an AUD, particular attention may be required in tailoring MAT and behavioral therapies to compensate for the lingering brain damage caused by long-term alcohol abuse.
ALCOHOL AFFECTS WOMEN AND MEN DIFFERENTLY
While it is well known that alcohol is metabolized differently in women than men, not a great deal is commonly understood as to why this happens. Since women tend to weigh less than their male counterparts, and their bodies have less water and more fatty tissue then men, this affects how women’s bodies process alcohol. Fat retains alcohol, while water dilutes it, with the result that alcohol stays in women’s bodies longer than men – and their organs sustain greater alcohol exposure.
Also, since women’s bodies have lower levels of specific enzymes that work to break down alcohol in the stomach and liver, they tend to absorb more alcohol into the bloodstream. The result is that blood alcohol concentration (BAC) is higher in a women than their male counterpart.
HOW LONG DOES IT TAKE BEFORE YOU’RE CLEAN FROM DRUGS?
Here, again, the length of time it takes before drugs are completely out of the body depends on the type of drug abused, dosage, frequency, length of time abused, and whether other drugs and/or alcohol are also present (having been abused). Just as with alcohol detox, drug detox involves a number of symptoms during the drug withdrawal phase, and these can range from mild to moderate to severe to life-threatening.
Clearing drugs from the body to get clean also depends on the type of drug used. Some take longer than others to be removed from the body, preferably during medically-supervised drug detox at an accredited drug rehab facility. Here is a look at four specific drug types, with an emphasis on how long it takes to get clean from each.
Tranquilizer drugs belong to the drug classification of benzodiazepines. Detox from benzos typically takes 6-8 days, followed by treatment to help get at the root of why you may have started using or became dependent or addicted to them to begin with. In many cases, taking medications such as Xanax may have been prescribed to deal with anxiety or insomnia or another legitimate medical condition for which the benzodiazepine treats. Learning how to find healthier ways to cope with anxiety and insomnia other than taking Xanax is part of the goal of treatment to help you get and stay clean long-term.
With its relatively short half-life, heroin starts to clear from the body fairly quickly. Medically-supervised heroin detox typically takes 5-7 days. Heroin can be detected in blood and saliva between 5-6 hours to 2 days after last use, while it’s 2-7 days in urine tests, and up to 3 months in hair follicle testing. As for getting clean and remaining clean, that may take up to a year or longer. Formal drug treatment (including counseling, behavioral therapies, 12-step or self-help group participation, and other therapies) is often the only way to change to a mindset and lifestyle that results in long-term sobriety (staying clean and sober).
Opiates, including heroin, generally are fast-acting and quickly leave the body. These include opiate painkillers such as hydrocodone, oxycodone, morphine, and codeine. Most can be eliminated from the body in 1-4 days. Yet, the longer-lasting physical and mental effects of long-term opiate use can linger for months. There are natural opiates (morphine and codeine), synthetic opiates (including tramadol, methadone, and fentanyl) and semi-synthetic opiates (such as Vicodin, Percocet and heroin). Long-term chronic pain can be debilitating, yet there are non-opiate medications and therapies that can help. After detox from opiates, treatment can help you find effective ways to deal with pain and provide support for long-term sobriety.
Getting clean from methamphetamine (including crystal meth) is a process that involves phases. Physical and mental withdrawal symptoms usually peak about 5 days, while cravings (phase two) can continue for 2-3 weeks. In those with long-term meth use, however, depression can last months. And in those with post-acute withdrawal syndrome (PAWS), withdrawal can go on for years. Phase three (extinction) is when those who’ve detoxed and after are most vulnerable to relapse (resorting to meth use), and this can last three months or longer. However, meth addiction treatment and rehab can restore normal functioning and put the former user firmly on the path of staying clean.
DRUG ADDICTION IN WOMEN
According to research, women and men have differences with respect to progression from first use to dependence on certain drugs. Women, in general, make the transition from initial use of cocaine, heroin or marijuana to dependence quicker than men. In addition, once they’ve developed a dependence on the substance, their problems tend to be more severe and they have more consequences, health wise.
With cocaine, as research published Nature Communications reveals, the hormonal fluctuations that women undergo make them especially sensitive (in comparison to men) to the illicit drug’s addictive properties. Researchers at the Icahn School of Medicine at Mount Sinai found that estrogen in women’s bodies intensifies the brain’s dopamine reward pathway, and that cocaine’s effects are most potent during the estrous/menstrual cycle. While men’s rates of addiction are higher, once women try cocaine (and other drugs), their addiction progresses faster than men. They also tend to start using coke at an earlier age than men, take it in larger quantities, and have a more difficult time remaining clean than men. Women also report a greater “high” from doing cocaine during their menstrual cycles, which is when estrogen levels are elevated. Researchers suggested adjusting the woman’s hormonal cycle with birth control pills or another comparable strategy as a potential intervention during addiction treatment.
THE VALUE OF TREATMENT TO GET CLEAN – AND STAY CLEAN
Just eliminating substances from the body will get the body clean, but it does nothing to deal with underlying false beliefs, inability to cope with powerful emotions, counter triggers to use again, improve self-esteem, or incorporate healthier behaviors to help you stay clean. Treatment, however, in an accredited alcohol and drug rehab center, can help you navigate the often-difficult path to effective recovery.
Besides access to evidence-based behavioral therapies and personalized counseling, drug rehab helps you regain the self-confidence and acquire necessary skills to live a clean life in sobriety. It is more than just stopping alcohol and drug use for a time. Living clean and sober means you embark on a lifelong journey to be the best version of yourself you can be, encouraged and supported by your network of family and self-help group members, friends in aftercare and alumni programs through your treatment center, and continuing counseling as needed.
For more about drug and alcohol addiction, withdrawal and recovery, check out these articles:
- American Journal of Psychiatry. “Current Status of Co-Occurring Mood and Substance Use Disorders: A New Therapeutic Target.” Retrieved from https://ajp.psychiatryonline.org/doi/pdfplus/10.1176/appi.ajp.2012.12010112
- JAMA Psychiatry. “Microstructural White Matter Alterations in Men With Alcohol Use Disorder and Rats With Excessive Alcohol Consumption During Early Abstinence.” Retrieved from https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2729425
- Mount Sinai. “Researchers Reveal Connection Between Female Estrogen Cycle an Addictive Potential of Cocaine.” Retrieved from https://www.mountsinai.org/about/newsroom/2017/researchers-reveal-connection-between-female-estrogen-cycle-and-addictive-potential-of-cocaine
- National Council on Alcoholism and Drug Dependence, Inc. “Facts About Alcohol.” Retrieved from https://www.ncadd.org/index.php/about-addiction/alcohol/facts-about-alcohol
- National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
- National Institute on Drug Abuse. “Drugs, Brains, and Behavior: The Science of Addiction.” “Treatment and Recovery.” Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
- Substance Abuse and Mental Health Services. “2017 National Survey on Drug Use and Health.” Retrieved from https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report
- WebMD. “What Is Alcohol Withdrawal?” Retrieved from https://www.webmd.com/mental-health/addiction/alcohol-withdrawal-symptoms-treatments#1