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What is Withdrawal Management?

The first priority for treating any illness is to stabilize the patient. In cases of substance use disorder (SUD), this will often involve a withdrawal management program. A withdrawal management program (often inaccurately referred to as a medical detox) is necessary before the patient could proceed with psychotherapy and other necessary palliative care.

If you’re in Massachusetts and need to learn more about withdrawal management and other SUD treatments, don’t hesitate to reach out to our team at Boston Drug Treatment Centers.

Why is withdrawal management necessary?

Detoxification or removing drug traces from the body is just one part of what’s involved in withdrawal management. In many SUD cases, it may not even possible to have the patient quit cold turkey without serious or even fatal withdrawal symptoms.

Rather, the emphasis of most withdrawal management programs is to reduce the harm and discomfort caused by withdrawal symptoms, with the goal of making the patient stable enough to receive further treatment.

Because of the way SUD affects individuals, harm reduction involves far more than just isolating the patient from their drugs of choice and waiting for them to naturally excrete traces of harmful substances. Doing this without any further intervention can not only be harmful, but it can also put the patient in extreme discomfort, making them less receptive to further treatment.

What happens to patients in withdrawal management programs?

Different kinds of medical interventions are given in withdrawal management programs, depending on the severity of the SUD, the types of drugs involved, and the patient’s circumstances.

Here are a few things individuals undergoing withdrawal management could expect:

1.) Medically-assisted therapy (MAT)Though not all programs use MAT, many more do, particularly for more serious SUD cases. For people hooked on substances with potentially lethal withdrawal symptoms (such as opioids, alcohol, benzodiazepines, etc.), drug substitution therapy will likely be implemented. Other patients may be given sedatives to alleviate any mental distress or sleep disorders that also often come with withdrawal.

2.) Around-the-clock monitoring

Most withdrawal management programs are done at an inpatient facility, with the patients closely monitored by staff, 24/7.

This is done for two reasons. First, it’s so the patients’ progress could be checked more closely and medical attention can be given as needed. The second reason is to prevent patients from finding and consuming more drugs, which would be far easier if they were free to go where they pleased.

Note that some withdrawal management programs are done on an outpatient basis. However, these programs are not likely to be recommended for serious SUD cases.

3.) Regular medical check-ups

While not true for everyone, it’s not uncommon for people with SUD to neglect their health more and more as drugs become their life’s main priority. People that have been using drugs and alcohol heavily for a long time also tend to have poor diet and exercise habits and are likely to have developed other psychiatric issues.

Treatment specialists will conduct periodic check-ups of patients and attempt to address any immediate health issues. While they might not treat all other less-pressing co-occurring problems immediately, they may note them so that other clinicians can follow up on them when the patient completes the program.

4.) Mild to moderate discomfort

Even though clinicians will do their best to ensure that individuals can recover from withdrawal somewhat comfortably, that doesn’t mean it’s going to be a walk in the park either. Withdrawal is almost certainly going to be an unpleasant process, no matter how well managed it is. Regardless, it is still a necessary part of recovering from SUD.

SUD patients undergoing withdrawal can expect the following physical symptoms:

  • Confusion
  • Vomiting
  • Diarrhea
  • Nausea
  • Body temperature fluctuations
  • Muscle spasms
  • Joint and bone pain
  • Delirium
  • Vivid dreams
  • Intense headaches
  • Auditory hallucinations
  • Cold sweats
  • Seizures

Psychological withdrawal symptoms may include but are not limited to the following:

  • Depression
  • Anxiety
  • Extreme mood swings
  • Paranoia
  • Sleep disorders
  • Violent tendencies
  • Agitation
  • Stronger drug cravings
  • Confusion

5.) Months or years in recovery

Completing a “detox” doesn’t mean that a patient is cured of their SUD. It doesn’t even mean that the drug traces are gone from their body. Rather, it only means that they are stable enough to receive psychotherapy and counseling. Strong cravings will remain and will continue to be a problem if the patient does not receive these interventions.

Individuals that have completed withdrawal management will likely have to enter a rehab program to fully recover. They may also have to continue drug replacement therapy for months or years, depending on the type of drug they got hooked on. Most will need at least a few years of therapy and aftercare to recover to the point that their cravings no longer have any influence on their life.


Contrary to popular belief, a “detox” doesn’t cure SUD. It is merely the first step in what is probably going to be a long road to a full recovery.

In any case, going through withdrawal management in a medically supervised setting is a better choice compared to so-called “self-detoxes”. These programs prevent potentially fatal outcomes and also help improve long-term recovery success.

Detox is only the beginning. However, it does get easier from there. Good luck, and be well!

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