The Detoxification Process: The First Steps Toward Long-Term Sobriety

The Detoxification Process: The First Steps Toward Long-Term Sobriety

The journey of a thousand miles may begin with one step, but an adult with a 2.3-foot walking stride will put approximately 2,295,651 additional steps into that journey. Anyone with nit-picking tendencies is better off not knowing that; you can waste a lot of energy constantly checking the distance you still have to go against how “up to it” you think you are.

Some people blame that sort of how-will-I-ever-manage-to-finish obsession for “driving them to drink”—and in fact, there’s evidence that perfectionists are more likely to develop addictions and to relapse after drug detox. Small wonder that Alcoholics Anonymous emphasizes “one day [or step] at a time”—physically, you have to live life that way anyway, and you’re a lot happier when your heart stays in step with your body.

The detoxification process that launches the “journey to sobriety” has its “steps,” too. While specifics such as length of detox period vary, most recovering addicts follow a five-stage path.

1. Point of Decision

The first small step on the recovery journey is the point where denial is put aside, “getting help” becomes more than a “maybe someday” option, and (to borrow AA terminology again) someone admits that “I am powerless over my use of substances—my life has become unmanageable—I am an addict.” That point may be triggered by any number of things: the classic “hitting bottom” moment that leaves nothing to lose, a loved one’s urging the addict to get into treatment, a formal intervention, recognizing oneself in a seminar speaker’s description of addiction, or an out-of-the-blue realization of “I don’t want to live like this anymore.” However exactly it begins, this is the stage where the addict takes the first definite action steps:

  • Choosing a drug detox center
  • Setting the time period for detox
  • Explaining the decision to family (if they aren’t already involved) and others who will notice the patient’s absence
  • Making medical-leave arrangements
  • Physically entering the detox center as a patient

Once someone is officially signed in for treatment, the second stage of the detoxification process begins. 

2. Acute Withdrawal

This stage is what most people think of on hearing the words “withdrawal” or “drug detox”—it usually evokes an image of someone in the throes of violent agony. While it’s not that severe for everyone, acute withdrawal is in fact the most physically dangerous stage, best not attempted outside the supervision of a drug detox center. The majority of patients experience high physical and mental discomfort, most commonly in one or more of the following forms:

  • Severe nausea and vomiting
  • Heavy perspiration
  • Hammering heart
  • Muscle spasms or severe physical weakness
  • Mental disorientation
  • Intense anxiety or panic
  • Feelings of despair

How “acute” all this becomes varies by the drug involved, the patient’s overall physical and mental condition, the severity of the addiction, and the detox procedures used—a patient in “cold turkey” withdrawal will pass through the acute stage more rapidly, but with more intense symptoms, than one “weaned off” the addictive substance. (The “rapid” nature of cold-turkey detox should not be confused with the controversial procedure called “rapid drug detox,” which involves keeping a patient under general anesthesia while using various medications to speed up acute withdrawal.)

The acute withdrawal phase typically takes anywhere from a few days to two or three weeks.


Sara Clancy Hernandez, Ph.D.

"Wrap yourself within a healing environment. Respect your journey toward recovery with a consistent schedule so you can cultivate security and healthy habits, Surround yourself with people who care about you and your recovery, places and objects who help ground and anchor you, and ask for help if you need it. Keep your scheduled appointments. Remember that your aren't an island and honor your strength."

Sara Hernandez, Ph.D.,


3. Post-Acute Withdrawal

Patients move into post-acute withdrawal when the most obvious symptoms abate. This phase of drug detox (often called PAWS, for Post Acute Withdrawal Syndrome) lasts anywhere from a few months to as long as two years. A person in this stage is fully functional most of the time, but continues to experience periodic drug cravings and such withdrawal symptoms as mood swings, fatigue and poor sleep. Early on, these episodes are regular and intense, lasting up to three days. As the person remains abstinent from drugs, PAWS symptoms become less frequent and eventually disappear. (Not everyone experiences PAWS to the extent described; some people just have occasional episodes of moodiness and low energy, plus the occasional “I sure wish I could have a drink” struggle.)

Most patients in drug detox remain under ongoing medical care for the first few weeks of post-acute withdrawal, while professional detox experts help them plan for long-term sobriety and learn techniques for coping with additional post-acute withdrawal symptoms after discharge from the drug detox center.

4. Full Detox

There’s no clear line between post-acute withdrawal and “fully detoxed,” which is one reason 12-Step programs measure sobriety anniversaries from the first day of sobriety rather than from a day of “being cured.” When it’s been several months since you’ve had a dose or a serious temptation to relapse, you can count yourself among the post-PAWS “detoxed.”

In another sense, though, few addiction survivors are ever completely detoxed. Most drug detox programs will warn you not to plan on a future time when you can again drink “socially”—your brain will probably never forget the tolerance and dependence now programmed into it, and even years later, “just one” dose may activate irresistible “binge” cravings and end in your going through drug detox all over again.

So you begin a lifelong journey with the final stage of detoxification:

5. Long-Term Sobriety

Strictly speaking, this stage doesn’t begin after Stage 4 ends: it begins no later than the planning-for-the-future section of Stage 3. However, long-term sobriety is the “final” stage in that this is where you expect to be for the rest of your life, long after any feeling of “still detoxing” is a distant memory.

Long-term sobriety includes total abstinence, ongoing awareness of one’s vulnerable spots, and continuing participation in therapy and support groups. However, long-term sobriety means much more than not doing the wrong things. It means knowing and loving your own real self. It means keeping a sense of unique individual purpose in your life. It means standing up for your values and not being swayed by peer pressure or expediency. It means doing what you do best and learning to do it ever better. It means finding regular opportunities to contribute to the larger community.

And it means living in the moment, one successful day at a time.

When you can live that way with reasonable consistency, you’re better than detoxed, better than merely sober. You’ve become a healthy, fulfilled person in every sense of the word.

If you or a loved one need help starting the journey toward sobriety, call Inland Detox today at (888) 739-8296. We’ll provide you with advice, support and treatment.