Treatment, self-help and other responses to addiction or dependence, changing consumption patterns, detox, residential treatment, self-help programs, pharmacotherapy, talking therapies

Formal & informal detox

NOTE: Quotes are presented word for word apart from minor editing for readability and clarity. Identifying details have been removed. Square brackets show text that has been added, e.g. ‘I want to maintain [my current level of drug use]’. Ellipses within square brackets […] show where text has been removed, e.g. ‘Counselling was good but […] I would have liked more information about other treatment options’.

Many of the people interviewed for this website talk about changing their patterns of consumption by seeking treatment or using informal strategies to create change. For some these strategies include detoxification (‘detox’). This is the process of reducing or stopping drug use to allow the body to eliminate the drug entirely. It usually involves managing physical symptoms that can be experienced when stopping or cutting down (often called ‘withdrawal’). Sometimes considered the first step in treatment, detox can be done through formal programs at an outpatient withdrawal service or a residential service. Outpatient detox services typically provide short-term individual consultations with a health professional, along with ongoing counselling and support. Detox at a residential service usually involves a short stay at a residential withdrawal unit or hospital. Detox can also be done at home as an informal strategy for changing consumption patterns. It differs from other informal strategies for creating change because it usually involves stopping abruptly and allowing the body to eliminate the drug. Often people do this by isolating themselves at home while they manage the physical symptoms that can be experienced when stopping.

People give a variety of reasons for their decisions to detox. These include concern about health and well-being, changes to work or study commitments and a desire to moderate or cut back on consumption. Some of those who had contact with the criminal justice system and lost custody of their children talk about how these experiences prompted decisions to detox.

Some of our participants completed a detox through health services, while others undertook home detox. Several have experiences of both. They say that each has its own benefits and disadvantages, and they recommend trying more than one kind if it doesn’t work or using a different strategy to create change. Those who completed a detox through a health service say it offers a range of benefits such as medical care, alternative health treatments, counselling and support. Some describe negative experiences and identify a number of drawbacks of formal detox programs. These include the structured nature of some programs, the use of 12-step abstinence-based approaches and the lack of follow-up or continuous care.

Some of those with experiences of residential detox say they found it hard having little or no contact with their loved ones for the duration of their stay. By contrast those who had completed a home detox say the advantages of detoxing at home include not being separated from family and having the support of loved ones. They also mention a number of drawbacks of detoxing at home such as the lack of medical care to manage withdrawal symptoms and the challenge of coping with everyday household tasks while detoxing. Having access to alcohol and other drugs when trying to cut down or stop is also seen as a disadvantage of home detox.

Read on to find out more about these different experiences of detox and the various reasons people give for deciding to complete a detox.

Why people decide to detox

People offer a variety of reasons for their decisions to create change by detoxing. Many point out that when their circumstances change so do how and when they take drugs. For example, Andrew (M, 41, works in education, cannabis) notes that a heavy work load in his final year of study prompted him to cut back on cannabis by completing a short residential detox: ‘I spent three days at a detox centre when I was in uni in my final year. It worked as a detox for three days. I got out and I was able to finish my assignment’. For some the decision to detox was prompted by concern that their alcohol or other drug use was affecting their loved ones (see also Relationships, confidentiality & telling others). Some of those interviewed had contact with the criminal justice system in relation to alcohol or other drugs. A few say this experience prompted them to cut down or stop altogether by completing a detox. Others had lost custody of their children and this encouraged them to detox as part of their efforts to regain custody (see also Contact with the criminal justice system).

Losing custody of her children prompted Zoe (F, 30, studying, ice) to seek advice from an alcohol and other drug service, which recommended she attend counselling and a residential detox. (Played by an actor)

I started dealing [drugs] again. Then I got busted again, and then I actually decided, no, this is it. I had my kids taken off me and I went, ‘No, I need to pull my head in, I need to get my life back on track, I want my kids back’ […So the decision to seek treatment] began with my children being taken off me. And that just absolutely tore me apart inside […] It felt like a part of me had actually been ripped away and I went, ‘What can I do, and what do I need to do to get them back?’ And I very quickly realised the first thing that needs to go is the drug use. So that’s when I actually [contacted the intake and assessment service] which is the first point of contact […] You’ve got to have an assessment through them […] and they […] put you in touch with the other services […They] put me in touch with my drug and alcohol counsellor and they also offered me the detox through [the unit] so I got my name put down on that [and then…] I went into detox.

Helen (F, 53, not working due to injury, heroin) recently completed a residential detox as a ‘preventative measure’ to ensure her drug use didn’t increase while a friend was visiting from out of town. (Played by an actor)

I’ve tried to [detox] with a partner. I’ve tried to do it by […] travelling overseas or [going] somewhere else […] My last detox was just last week actually at [a facility]. I’d done a rehab at the end of last year and I hadn’t been using every day, so I thought it was more of a preventative measure [because] a friend of mine who uses a lot was in town and I could just see things getting out of control so I went into [the detox centre]. But after two or three days, I was just really, really sick [withdrawing] so I decided to go back on buprenorphine maintenance […] to help get through that first week without really feeling like [I was] hanging out.

Sydalicious (F, 44, works in the health sector, cannabis) completed a residential detox because she was concerned that her drug use was affecting her child.

Part 1

When my son was about two-and-a-half, I was right into party drugs and I was going out [taking ecstasy…] I’d be like [at] 7 o’clock in the morning in the lounge room with doof doof [music] going. And it wasn’t actually until I turned around to my absolutely gorgeous boy, who was leaning over the back of the couch, smiling going like this. And I just turned around and went, ‘Rah rah rah’, and I just was my dad. I was my dad. And I looked in his eyes and I saw the fear, and I felt the fear that I felt as a child, and that’s when I rang up the detox.

Part 2

The decision was just easy […] Looking into my son’s eyes and making him feel that scared, seeing that in his eyes.

Formal detox

Several people say formal detox through health services offers a number of benefits including medical care, alternative health treatments, professional advice on how to manage ‘cravings’, counselling and support. Others describe the features of residential detox services they see as most helpful. Unrestricted visiting hours, a fairly unstructured daily program, a wide range of recreational activities and caring staff are all mentioned as important. Along with these features, George (M, 58, not working due to ill health, alcohol) says a good residential detox service should have a ‘homely’ setting and ‘open-minded’ staff.

Drawing on her long experience of treatment services, Kate (F, 36, works in the health sector, prescription drugs and ice) describes what makes a good residential detox service. (Played by an actor)

The most recent [detox] that I did [… they had] NA [Narcotics Anonymous] come in once a week, and we’d sit and listen to some old timers’ stories, but that was about it. They left you to your own devices. And the […] youth detox was very good […] We got to pick what meal we had, we did art classes, they had acupuncture, aromatherapy, four hourly medication. You could bring stuff in, like books and things […] You could have visits whenever. So it was very, very good and supportive.

In an effort to stop drinking, Opal (M, 45, primary carer for his children, alcohol and prescription painkillers) decided to complete a residential detox.

So I started to go to AA [Alcoholics Anonymous] and stuff, which partially helped […] While you were in the meeting it was sort of good and strengthening to stay sober. But all the talk of it seemed to encourage people to then want to go and have a drink. That’s what I found it was doing to me. It more or less encouraged me to want to go and drink, so that didn’t work very well for me. So I only had one option which was, with the doctor’s advice, to do a medical detox. I signed myself into a facility, which was a really, really fantastic place. It’s now closed, I’ve heard, which is a shame because it was a fantastic place. Everyone there helped. They did quite a lot to support you and give you all the knowledge you needed to understand what was going on. And you know, that was all really successful.

[…]

I did the detox and then I went from the detox facility into a live-in rehab place. And yeah, that was a bit ridiculous. Their whole mindset was totally wrong [in terms of] what they were trying to do. I’d gone from a place where it was really good, to another place where they had this structure that was taken from the prison system in America for people who would go into prison with addictions, and such. And it was just radical. It was just draconian what they expected you to do and how to do it. And behind it all, I think their belief was essentially to break everybody down and then re-educate them in the way that they felt you should have been.

Some people describe negative or mixed experiences of formal detox programs, and comment on the limitations of some programs. These include their structured nature, the use of 12-step abstinence-based approaches and the lack of follow-up care. Some of those with experiences of residential detox say they found it hard having little or no contact with their loved ones for the duration of their stay.

Peter (M, 41, unemployed, heroin) has completed three residential detoxes and says there is a need for better aftercare and support.

Peter: I’ve done two detoxes, sorry, three detoxes. I did agree with them both, but what I should’ve done too was follow up with a rehab maybe afterwards. Because after seven or eight days at detox they basically say, ‘Okay, everything’s good now, see you later’. They ship you off onto the street. And they’ve pumped you up full of all sorts of things throughout the week to help you get off the stuff, then all of a sudden you have nothing. It’s, ‘Goodbye, good luck, see you later. Here’s an NA pamphlet if you’re curious’, and that’s it.

Interviewer: So no continuous care.

Peter: Yeah […] at least a support worker [would be helpful], if [I] could drop in once a week or once a fortnight to see them or something similar.

While Emma (F, 42, works in retail, alcohol) enjoyed her stay at a residential detox centre, she says it didn’t prepare her to cope with her everyday responsibilities when she returned home.

Part 1

I think [my family] organised for me to go into detox and I was refusing. I was kicking and screaming saying, ‘I’m not going, I’m not going’. But I finally went […] And that was a seven-day detox and it was the best thing that ever happened. The people [at the service] were just incredible. Like, I just never knew that there was such caring people out there. I think, looking back on it, I enjoyed it too much. It was a way for me to escape the anxiety I had at home of being a mum, which I wasn’t coping with at all. Being a wife and earning money […] I wasn’t coping with any of that. So being away from all of that and […] having my own room, and having meals, and having friends around, you know, friends, people to talk to. I didn’t care about drinking. I didn’t crave it once. So that was when I went, ‘Ah, I think I know what I’m running away from’.

Part 2

So when I came home I remember being in the kitchen with my sister and my mum, and them just hugging. All of us [were] crying and hugging because we thought, finally, you know, after seven days I was cured. But then I remember sitting outside and just going, ‘Oh my God, it didn’t work’. And that was, you know, just after I had been giving my mum and sister a hug, I’d realised straight away that, no I want to drink now. So, you know, looking back, I wish I had recognised that and then said, ‘Hang on, wait, help’, you know, but I didn’t.

Informal or home detox

Some of the people interviewed for this website had experiences of detox through health services and experiences of home detox. Several say that each comes with its own benefits and disadvantages, and the effectiveness of a detox depends on individual circumstances. Those with experiences of home detox say its advantages include not being separated from family and having the support of loved ones. For example Zoe (F, 30, studying, ice) says she was able to stop taking ice for a few months by detoxing at home with the support of her family: ‘I had a three-month stint where I was able to get off ice with the help of my family. And I did that alone, cold turkey at home’. A number of disadvantages are also mentioned such as the lack of medical care to manage withdrawal symptoms and the difficulty of coping with everyday tasks while detoxing at home. Having access to alcohol and other drugs when trying to cut down or stop is also seen as a drawback. As Kate (F, 36, works in the health sector, prescription sedatives and ice) puts it, ‘Home detox is challenging in that you know you can still go out and get drugs if you want to’.

Amy (F, 52, studying, heroin) completed several home detoxes, some of which involved taking a break from heroin but still smoking cannabis and drinking. (Note: strong language)

Well I think, you know, with home detoxes, nearly every time I did something I thought that was it, ‘Great I’m giving up’. I never, ever thought I was just going to keep fucking up, you know. But the early ones, I still smoked and drank and didn’t even realise how problematic that was in my life, you know, I just thought, ‘What’s a half a bottle of wine? You know, everybody does that don’t they? What’s a little spliff?’ But it was a problem, it was absolutely a problem. And, like, now that those things have gone out of my life, drinking and smoking, but heroin is still there. Home detoxes when I eventually did them were just straight cold turkeys. And then as I got older, things got harder […] None of it has ever lasted. I always relapse.

Eva (F, 20, works in the entertainment industry, ice) detoxed from ice at home but found it hard to cope with the withdrawal symptoms. Very distressed, she overdosed on Valium^® and was admitted to hospital for emergency medical care. (Note: strong language)

I’ve quit a lot of drugs, like drug habits. And like crystal meth is the only one that I’ve had where every time you quit, it’s fucking harder to do. Like, yeah, it’s so much harder […] There’s something about it. It does something to your brain. Like, I don’t know what it is, but every time I quit it was harder. Like, the last time, I tried to kill myself because my brain was that out of whack. Like, that’s when I got taken to hospital and was begging them to send me to rehab, because I was trying to get off the drugs […] I was getting off the drugs, I was detoxing at home, like trying to go through withdrawals. And I just, like, lost it and took all my Valium and […] went to the hospital […] because I overdosed with Valium.

Sean (M, 48, works in education, OTC painkillers) found it hard to detox from Nurofen Plus^® at home because he still had to manage his everyday responsibilities. (Played by an actor)

I was back on the Nurofen [Plus] (ibuprofen and codeine) then […] and I was still seeing the GP, but I think she was at a bit of a loss as to what to do because I refused to go into an inpatient detox […Then] towards the end of that year […] it was just kind of hellish, you know, because I would just try to detox myself and that was […] really impossible. If I had sort of a week or two with no responsibilities, no child care, whatever, [being] looked after, I could’ve managed it, but not on top of everything else […so] I ended up going and seeing this psychiatrist who was fantastic [and] really lovely. And I still see him occasionally. I probably see him once every six months, and he suggested that I go on buprenorphine [to cut down and eventually stop taking Nurofen Plus].