Rapid detox is tempting for many people who are struggling with opioid addiction. The idea that you could expedite the withdrawal process and get through the discomfort more quickly is undoubtedly attractive. But quick cures rarely work, and the risks associated with this form of detox are just too high.
Most often, people who go through rapid detox end up quickly relapsing. While rapid detox can technically “work,” it is not recommended by experts in the field due to its ultimate lack of success.
What Is Rapid Detox?
Rapid detox programs were developed in the mid-2010s, as researchers looked for ways to speed up detoxification and help patients move in and out of treatment quickly.
Early rapid detox programs used anesthesia to ensure patients wouldn’t remember any discomfort or pain associated with the process. When patients were asleep, medications like naltrexone were used to block the action of opioids inside the person’s body. This method has been deemed unreliable and unsafe, as some people aren’t healthy enough for anesthesia. Life-threatening side effects were tied to this program.
Current rapid detox programs don’t always use anesthesia. Instead, doctors use medications like ketamine to ease discomfort, and they place naltrexone implants in their patients to start withdrawal.
In a study of a program like this, 9.5% of patients in a rapid detox program without anesthesia had severe withdrawal symptoms, such as confusion and gastrointestinal distress. Since their medications were implanted, they couldn’t drop out of treatment. After five days, they were considered healed and ready to move to the next stage of recovery. It’s not clear if they were encouraged to enroll in follow-up programs to ensure they stayed sober.
Patients who choose rapid detox often complete the protocol in a day or two. Rapid detox is often pursued as a way to avoid lengthy withdrawal from opioids, but most treatment experts do not recommend it.
Why Do People Choose Rapid Detox?
People who are afraid of withdrawal and do not wish to experience withdrawal symptoms often consider rapid drug detox.
In traditional detox, withdrawal symptoms can last days or even weeks, depending on the severity of the addiction. Rapid detox seems like an easy way to shorten the entire process.
Withdrawal Symptoms
Common opioids of abuse, like morphine, codeine, and heroin, are highly addictive and can cause intense physical dependence. Because of this, withdrawal symptoms can be strong when use is stopped.
The same is true for opioids like oxycodone, methadone, and hydrocodone. These are powerful drugs that quickly lead to addiction with continued abuse.
Withdrawal symptoms from opioids often include the following:
- Intense sickness
- Body aches
- Nausea
- Vomiting
- Dizziness or delirium
- Hallucinations
Rapid detox promises to get people through this process quickly, while they are asleep, so they won’t experience this discomfort.
Is the Experience of Withdrawal Beneficial in Some Way?
Some medical professionals are skeptical about the intentions behind rapid detox as well as whether or not it is as effective as more traditional detox methods. Perhaps it can be argued that the discomfort from experiencing withdrawal may serve as motivation for the individual to avoid relapse.
In addition, rapid detox comes along with more than a few risks that should be considered during an individual’s treatment decision-making process.
Pros & Cons of Rapid Detox
Rapid detox does have some benefits and potential advantages during the drug detoxification process. And certainly, the idea of sidestepping the discomfort of withdrawal is appealing.
Potential pros of rapid detox include the following:
- Detox treatment with medical supervision
- Avoidance of withdrawal symptoms
- Faster detox time
Cost and rate of insurance coverage might be considered drawbacks when it comes to rapid detox. Rapid detox can often cost anywhere from $10,000 to $15,000 and treatment is generally not covered by insurance providers. The cost of treatment is much more expensive than traditional detox, and individuals are often expected to pay upfront.
Beyond risks associated with rapid detox (described below), rapid detox might also be considered a way of “cutting corners” and not experiencing the full weight of consequences associated with substance misuse.
Rapid detox might be the quickest avenue to get rid of withdrawal symptoms, but it also leaves a person more susceptible to relapse. Completing a normal length and more intensive detoxification treatment program, followed by a comprehensive addiction treatment program, is the optimum solution for recovery. With rapid detox treatment, there is often no follow-up care that is provided.
Dangers of Rapid Detox
There are certain risks and dangers that come along with rapid detox that go far beyond being considered cons. Risks associated with rapid detox include the following:
- Respiratory issues and complications
- Delirium or psychosis
- Pulmonary distress, which can result in pulmonary failure
- Thyroid hormone suppression
- Fluid buildup in the lungs
- Amplified co-occurring disorders, such as bipolar disorder
- Death
The Centers for Disease Control and Prevention reported severe adverse events and even deaths resulting from rapid detox treatment. Individuals with pre-existing medical conditions are at greater risk of experiencing an adverse event during rapid detox.
Even if an individual completes rapid detox treatment successfully, it does not mean they aren’t still susceptible to withdrawal symptoms. Individuals can still experience common withdrawal symptoms like nausea, body aches, vomiting, and other symptoms. There are no studies or evidence that support rapid detox having a 100% rate of success.
In an analysis published in the Journal of Addiction in 2016, researchers said relapse rates after any kind of opioid detox range from 72% to 88% after 12 to 36 months. Research published in the International Journal of High Risk Behaviors in Addiction, the relapse rate in patients who had rapid detox was 75% at the one-month mark. Studies like this suggest that rapid detox isn’t associated with a higher rate of long-term sobriety.
Rapid Detox & Your Mental Health
Researchers often use relapse rates when discussing opioid detoxification methods. If the patients stayed sober, the therapy worked. If they relapsed, it didn’t. The truth can be somewhere in the middle.
Detoxing from opioids, no matter what method you use, can be painful and scary. When you emerge from these programs, you may not be using hard drugs like heroin or fentanyl. However, you haven’t built a life that can support your sobriety. When you return home, you’ll be surrounded by all of the temptations and triggers that once led you to drug abuse.
In a traditional opioid detox program, you graduate from detox to treatment. You work with therapists and build new habits and a healthy lifestyle. Gradually, you rebuild your life.
A rapid detox program might be held in a hospital or clinic, and it may have no ties to a wider treatment community. A program like this might help you stay sober, but without follow-up care, you’re unlikely to stay that way.
Rapid Detox Alternatives
Since rapid detox has so many risks and downsides, it’s important to consider all of your treatment options.
At the end of the day, rapid detox only represents the initial step in treatment and recovery. Even if you undergo rapid detox treatment, rehabilitation and psychiatric treatment are still needed for anyone struggling with an addiction.
Going the more traditional treatment route will not only increase the chances of successful recovery, but it will also help you avoid any of the pitfalls and risks associated with rapid detox. The disadvantages of rapid detox greatly outweigh any positives associated with getting through detox quickly and with less discomfort.
This chart can help you understand the differences between rapid detox and more traditional addiction treatment programs.
| Rapid Detox | Traditional Detox | |
| Medications used | Naltrexone (an opioid antagonist), sedatives or medications like ketamine | Buprenorphine or methadone (opioid agonists), medications like clonidine for discomfort |
| Time frame | Days | Weeks |
| Discomfort | Moderate to severe (if not sedated) | Mild |
| Covered by insurance? | No (companies like Aetna consider it experimental) | Yes |
| Completion rate | As high as 100% | One in six patients leaves without completing treatment |
| Relapse rates | 72%-88% | 75% |
Inpatient Detox Treatment
When going through the detoxification process, being in a medically assisted environment is tremendously beneficial and will help you avoid any complications. Inpatient detox programs provide round-the-clock supervision.
Constant monitoring ensures withdrawal symptoms can be addressed in real time. Generally, withdrawal symptoms tend to subside at the five-day mark.
In a supervised environment, you’ll also have psychological and emotional support as you go through the detox process. This greatly increases your chances of success.
Outpatient Detox Treatment
Outpatient detox programs offer a little more flexibility than inpatient programs. Generally, outpatient detox treatment centers allow individuals to receive the care they need from a facility during the day while heading home in the evening time.
Essentially, those who seek outpatient treatment can still work and keep up responsibilities. Outpatient detox is a cheaper option and alternative when compared to inpatient detox treatment.
Treatment With Medication
Medication-assisted treatment (MAT) is also available for the detox process. This is most common in instances of opioid use disorder and alcohol use disorder.
There are a variety of medications prescribed for reducing cravings and withdrawal symptoms. Common medications for detox include the following:
- Methadone
- Buprenorphine
- Naltrexone
- Acamprosate
What Happens After Detoxification?
Again, detox only represents the first stage of the recovery process. Detox will not in and of itself treat an addiction. It is highly likely that people who have gone through detox will relapse if they don’t seek further addiction treatment, such as traditional therapy.
After detoxification, it is recommended that individuals with addiction issues attend a rehabilitation program that can last anywhere from 30 to 90 days. Traditional talk therapy will be the backbone of treatment along with support group attendance and alternative therapies.
Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More
- Six-Month Follow-Up Study of Ultrarapid Opiate Detoxification With Naltrexone. (June 2014). International Journal of High Risk Behaviors and Addiction.
- Strategies for Transfer From Methadone to Buprenorphine for Treatment of Opioid Use Disorders and Associated Outcomes: A Systematic Review. (March 2022). Journal of Addiction Medicine.
- Deaths and Severe Adverse Events Associated With Anesthesia-Assisted Rapid Opioid Detoxification. (September 2013). Centers for Disease Control and Prevention.
- Long-Term Relapse of Ultra-Rapid Opioid Detoxification. (January 2014). Journal of Addictive Diseases.
- Outcomes From the Medication Assisted Treatment Pilot Program for Adults With Opioid Use Disorders in Rural Colorado. (January 2022). Substance Abuse Treatment, Prevention, and Policy.
- Predictors of Relapse after Inpatient Opioid Detoxification During 1-Year Follow Up. (September 2016). Journal of Addiction.
- Six Month Follow-Up Study of Ultrarapid Opiate Detoxification with Naltrexone. (December 2014). International Journal of High-Risk Behaviors in Addiction.
- Rate and Predictors of Severe Withdrawal Symptoms in an Accelerated Opioid Detoxification Program. (February 2020). Psychiatry and Clinical Psychopharmacology.
- Ultra Rapid Detoxification. (April 2023). Aetna.
- One in Six Patients with Opioid Use Disorder Leaving the Hospital Before Completing Treatment. (December 2023). Penn Medicine News.
