Tag: Opioids

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Understanding Cross-Tolerance: Effects on Medication and Substance Use

Have you ever felt like tolerance to one drug affects your response to a seemingly unrelated substance? This is cross-tolerance: building tolerance to one substance as a result of using another. And the mechanisms in our brain that cause cross-tolerance to develop show just how interconnected our body’s adaptations are.

Cross-tolerance has a host of implications for everyday life. It affects overdose risk from drug use, complicates addiction recovery, and can even influence the effectiveness of medications for pain management, psychiatry, and chronic disease treatment. 

Here, we explore what cross-tolerance is and how it develops. We’ll also take a look at what the medical community is currently doing to prevent, manage, and treat cross-tolerance for people who use substances or take medications. 

What Is Cross-Tolerance?

The American Psychological Association (APA) defines cross-tolerance1 as “a condition in which tolerance to one drug results in a lessened response (i.e., increased tolerance) to a related drug.”

Cross-tolerance develops when the use of one substance leads to a reduced response to another substance with a similar way of taking effect. This happens due to the body’s adaptation to repeated exposure to a particular type of substance, leading to brain changes that affect your sensitivity. For example, people who develop a tolerance to opioids might also be less sensitive to other substances that affect their opioid receptors, such as certain prescription pain medications.

The APA notes that “Cross-tolerance may be seen with amphetamines, benzodiazepines, hallucinogens, and opiates, among other drugs.”

Other types of substance cross-tolerance include:

  • Alcohol and marijuana 
  • Alcohol and opiates2 
  • Opioids and other opioids
  • Benzos and other sedatives or painkillers 

There’s also evidence to show that you can build cross-tolerance between different psychedelics,3 like LSD (acid) and psilocybin (mushrooms), or mescaline and LSD. This may be because both substances use similar substances to produce effects on the brain. “These two drugs cause psychic disturbances by acting on some common mechanism, or on mechanisms acting through a common final pathway,” say researchers.

Cross-Tolerance in Substance Use

If you use drugs recreationally, cross-tolerance can impact their effectiveness and the risks they carry. 

Cross-tolerance may lessen the desired effects of certain drugs. If you build a tolerance to one drug, you may find it harder to achieve the same level of euphoria or intoxication with a different drug that acts on similar receptors.

Potential for Overdose

Cross-tolerance poses a significant risk of overdose.4 People with higher tolerance may consume higher quantities of a substance, unaware that their tolerance to one substance doesn’t always extend to another. Miscalculating doses in this way increases the risk of toxicity and overdose.

Cross-Tolerance and Polydrug Use

Tolerance can also increase the risks of polydrug use (using multiple drugs at a time). People with cross-tolerance might combine different substances to compensate for reduced effects. This complicates the chemical reactions in your body, increasing the risks of adverse drug reactions, unpredictable interactions, and overdose.

Challenges in Addiction Recovery

Cross-tolerance complicates addiction treatment, as people might require higher doses of medication to achieve therapeutic effects. This can pose challenges in managing withdrawal symptoms and cravings during recovery.

Increased Relapse Risk

People with cross-tolerance can also be at an increased risk of relapse. If you’ve become less sensitive to the effects of one substance, you may be more likely to look for alternatives, which can work against your efforts to stay sober.

How Cross-Tolerance Can Impact the Effectiveness of Your Medication

Cross-tolerance increases the risks of taking certain medications, especially if you use medication regularly for conditions like pain management, a psychiatric disorder, or chronic disease treatment. 

Pain Management

Cross-tolerance complicates the prescription of opioids and other pain-relieving medications. If you’ve developed cross-tolerance through the use of opioid medications, it may reduce their analgesic effects. That means you need higher doses to achieve the same pain relief, increasing the risk of opioid addiction and other negative side effects.

Response to Psychiatric Medications

If you take medication for a psychiatric condition,5 cross-tolerance can change your response to your medication. People with a history of tolerance to one class of psychotropics may need to have their dosage adjusted, or use a different medication to achieve therapeutic effects.

Impact on Chronic Disease Management

Cross-tolerance can impact the effectiveness of medications used to manage chronic diseases such as hypertension, diabetes, or heart conditions. Reduced responsiveness can compromise the ability to control your symptoms and manage the progression of the disease.

Overmedication and Increased Side Effects

Cross-tolerance can lead to overmedication as you require higher doses to achieve the intended therapeutic effects. This increases the likelihood of adverse side effects and complications, including overdose.

Treatment Resistance

People with cross-tolerance may develop treatment resistance, where medications lose their effectiveness over time. This poses a significant challenge in managing chronic conditions, and may mean you’ll need to explore alternative treatment approaches.

Managing Cross-Tolerance and Reducing Its Effects

Strategies Used in Professional Settings

If you’re seeking rehab for substance addiction, your program should create an individualized treatment plan that takes your cross-tolerance and need for medication management into account. Your rehab will need to carefully assess your substance use history to tailor treatment effectively. Ideally, they should have a psychiatrist or other specialized medical doctor on their clinical team. 

In an addiction treatment program, or as part of your normal medical or psychiatric care, you should receive a regular medication review.6 In this review, your doctor can check for cross-tolerance and ensure your medications work together effectively without excessive side effects. 

If you’re in recovery and have a history of cross-tolerance, you should receive continuous monitoring and support by qualified professionals. A comprehensive recovery strategy includes regular assessments, adjustments to treatment plans, and ongoing therapy.

Rehab programs often include an educational component to help people understand how addiction works in the mind and body. This may include education about cross-tolerance to help you make informed decisions about your recovery.

Tips for Patients and People Who Use Substances

If you’re concerned about cross-tolerance, it’s important to get guidance from medical care professionals.

If you’re addicted to multiple substances, or want to recover from substance addiction while taking medication, seek professional help via an addiction treatment program that includes medical treatment. Be transparent with your treatment team about substance use patterns so they can tailor treatment plans effectively. Rehab admissions staff can also help you understand what the available treatment options are, and which ones may be most appropriate for you. 

If you use multiple substances and don’t plan on quitting, or don’t feel ready to quit yet, learning harm reduction techniques can help you stay safe and prevent overdose. These are reputable harm reduction resources: 

If your prescribing doctor isn’t already doing so, request regular medication reviews to maintain therapeutic benefits without relying on increased dosing.

The Science Behind Cross-Tolerance

Chemical Processes in the Body

Your brain has an amazing ability to adapt. Unfortunately, that also means it can adapt to repeated exposure to certain substances. This happens on a cellular level, influencing your neurotransmitter (brain chemical) systems, receptor (sites in your brain that receive chemicals) function, and neural plasticity (the ability of your brain to change).

Prolonged exposure to a specific substance can alter your baseline levels of certain neurotransmitters. This includes feel-good chemicals like GABA and dopamine.7 You also become less sensitive to the effects of these chemicals, meaning you need higher doses of a substance to elicit the same response. This is how tolerance is formed.

As your body strives to maintain internal stability in response to chronic substance exposure, it may activate certain mechanisms to counteract the substance. This might include releasing extra enzymes that help metabolize the substance, for example.

With cross-tolerance, these mechanisms of tolerance-building apply to multiple substances. That is, the tolerance you build to one substance affects your tolerance for another. This usually happens between substances that share common receptor systems or pathways. For example, opioids and prescription painkillers can cause cross-tolerance,8 because they work by affecting your opioid receptors.

Risk Factors for Cross-Tolerance

A number of factors can affect your likelihood of developing cross-tolerance:

  • Inherent sensitivity: Some people’s neurotransmitter systems are more sensitive than others. People with naturally high or low sensitivity to certain substances may have different levels of tolerance.
  • Substance type and similarity: Cross-tolerance is more likely to occur between substances that have similar chemical structures or act on the same receptors. 
  • Polydrug use: Using multiple substances increases the risk of cross-tolerance. That’s because exposure to different substances at the same time can lead to overlapping adaptations in neural pathways.
  • Frequency and duration of use: Regular and prolonged use of substances contributes to the development of cross-tolerance, because they influence the extent to which your body adapts to substances. If you have a pattern of bingeing on substances intermittently, this can also accelerate the development of tolerance.
  • Individual metabolism: Your metabolism affects how substances are processed and cleared from the body, and therefore affects the speed at which cross-tolerance develops.
  • Underlying conditions: People with underlying mental health conditions may be more susceptible to cross-tolerance. 
  • Age and developmental stage: Teens and young adults may be more vulnerable to the development of cross-tolerance due to ongoing neural development. Substance exposure during this critical period can have lasting effects on the maturing brain.
  • Environmental factors: Stressful environments and chronic stress can amplify the risk of cross-tolerance. Environmental factors, like exposure to trauma or adverse life events, can prompt addictive behaviors that shape neural adaptations.
  • Rapid tolerance building: Research shows that building tolerance to a substance quickly9 can be a predictor of chronic tolerance and cross-tolerance.

How Research Helps Us Understand Cross-Tolerance

Ongoing research on cross-tolerance plays a pivotal role in our understanding of the complex interactions between substances and the human body. These studies help professionals develop more effective strategies to manage and treat cross-tolerance. 

Implications for Heroin Addiction Recovery

Buprenorphine is an opioid medication that’s used to treat heroin addiction. Because heroin and other opioids are so physically addictive, quitting them cold-turkey can be dangerous. With medication-assisted treatment, patients take a prescribed opioid instead, then taper off under the guidance of their doctor. A recent study finds that for people who regularly use heroin, cross-tolerance to buprenorphine10 is associated with intravenous drug use and a faster return to opioid use.

Effects on Anesthesia 

Cross-tolerance can also affect how effective anesthesia is, which is especially important to know for performing major surgeries. Emerging research looks into how building tolerance to certain substances, like opioids, impacts the effects of anesthesia.11  

Cross-Tolerance Between ADHD Medications

As increasing numbers of people, especially teens and young adults, are taking medication for ADHD, new research explores important considerations for these drugs. One study shows that cross-tolerance and “tolerance build-up” can result from stimulants prescribed to treat ADHD12 when multiple medications are used.

Future Directions 

As the behavioral health community strives to learn more about cross-tolerance, continued research looks at mapping neural pathways, identifying genetic markers, and understanding substance-specific adaptations. Researchers are also further exploring the associations between cross-tolerance and certain mental health conditions.

The more we learn about how cross-tolerance develops, the better medical professionals will be able to prevent, treat, and manage its effects. In the future, this could look like earlier intervention, more precise treatment, and more effective treatment methods. 

Get the Medical Support You Need to Stay Safe

If you use medication regularly to manage pain, chronic disease, or a psychiatric disorder, cross-tolerance can have serious implications for how effective your medications is and what side effects it has.

And if you use multiple substances in combination, or take different substances in sequence, your tolerance to each of those substances can impact your tolerance to others. That poses significant challenges to preventing adverse reactions and managing your risk of overdose. It can also complicate the addiction recovery process and require additional medical support. 

Thankfully, our understanding of cross-tolerance is evolving as scientific research continues.   

If you take multiple medications, it’s a good idea to request regular medication reviews from your prescribing doctor or a qualified psychiatrist. And if you’re ready to get help for an addiction and cross-tolerance is a concern for you, plenty of treatment centers have medical professionals on staff who can ensure your recovery is as safe as possible. 

See our list of medical treatment rehabs to search by conditions treated, insurance accepted, and more, and start your recovery journey today.

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How to Use Naloxone: What Is Narcan and Where to Find It

If someone is overdosing, immediately call 911 or local emergency services.

Narcan, or naloxone, is used to reverse opioid overdose. Opioids, such as heroin, opium, morphine, codeine, and fentanyl, can be legal prescription medications or illegal substances. 

Overdose occurs when an opioid’s depressant effects on the central nervous system cause life-threatening reactions. Narcan reverses an overdose by binding to the same brain receptors as opioids, thereby blocking the opioids from attaching to the receptors. This helps restore normal breathing and consciousness.

Narcan is usually administered through a nasal spray, and it can also be injected.

When to Use Narcan

It’s possible for opioid users to accidentally ingest too much at once and overdose. Other substances like MDMA can be cut with opioids, such as fentanyl, to lower production costs. If someone is displaying the signs of overdose, even if they didn’t knowingly take an opioid, you can still administer narcan—narcan won’t harm someone who didn’t ingest opioids1.

Overdoses usually include respiratory failure, where breathing becomes slow, shallow, or even stops completely. Other signs of overdose1 include:

  • Unconsciousness 
  • Very small pupils
  • Vomiting
  • Inability to speak
  • Faint heartbeat
  • Limp arms and legs
  • Pale skin
  • Purple lips and fingernails

Without immediate medical intervention, an opioid overdose can be fatal. In addition to using narcan in the event of an overdose, immediately call 911 or local emergency services.

Until emergency services arrive, you can help someone who’s overdosing2 by assisting them to sit or lay down in an open space. You can administer CPR if you are qualified, and if their skin is blue, perform mouth-to-mouth resuscitation. Additionally, use Narcan.

How to Administer Narcan

The American Medical Association created instructions showing how to administer Narcan3. You can also watch in video format:

If you are using NARCAN nasal spray, follow these steps:

  1. Peel back the package and remove the device. Put your thumb on the bottom of the plunger and two fingers on the nozzle.
  2. Place and hold the tip of the nozzle in either nostril until your fingers touch the bottom of the patient’s nose.
  3. Press the plunger firmly to release the dose into the patient’s nose.

Tip: When administering a nasal spray, help the patient gently tip their chin upward. This helps open their airways so the spray can better reach the bloodstream.

If you are using EVZIO auto-injector, follow these steps:

  1. Pull the auto-injector from the outer case.
  2. Firmly pull off the red safety guard; do not touch the black base (this is where the needle comes out).
  3. Place the black end of the auto-injector against the outer thigh, through clothing if necessary.
  4. Press firmly and hold in place for 5 seconds. (There will be a distinct “hiss” and “click” sound when working properly. The needle will not be visible after use.)

If you are using yellow cap nasal spray, follow these steps:

  1. Pry off the syringe’s yellow caps (both sides).
  2. Pry off the purple cap on the naloxone capsule. 
  3. Grip the clear plastic wings on the spray nozzle.
  4. Thread the spray nozzle on the syringe.
  5. Gently screw the naloxone capsule into the barrel of the syringe.  
  6. Insert white spray nozzle into the patient’s nostril. Give a short, firm push on the end of the naloxone capsule to spray.
  7. Administer half of the capsule into each nostril.

If you are using an intramuscular syringe needle, follow these steps:

  1. Inject 1 cc of naloxone straight into a muscle, such as the thigh, outer side of the glute, and shoulder.

Administer another dose of Narcan if the patient doesn’t respond/wake up after 2-3 minutes.

Where to Find Narcan

Fortunately, Narcan is becoming more widely available. You can purchase Narcan over the counter in many pharmacies. Local health clinics and community health centers may offer naloxone training and distribution. 

You can also order it online from websites like Narcan.com4. Some states will even send it to you for free—search “free Narcan _(your state or city)_” to find an organization.

How to Care for Someone After You Give Narcan

After you administer Narcan to someone, stay with the person. Emergency services should already be dialed and on their way, but don’t leave the person’s side until medical professionals assist them.

If the person is not breathing or has a weak pulse, continue with CPR if you are trained to do so. Otherwise, ensure the person is lying comfortably on their side with their airways clear to avoid choking on vomit. Once medical professionals arrive, discuss all relevant details to the overdose and what you have done to assist the person (including the type of Narcan you administered and how many doses).

How to Become Trained to Administer Narcan

You can become a trained Narcan administrator through online courses or in-person events. Websites such as Overdose Lifeline5, The Center for Disease Control6, End Overdose7, and American Red Cross8 provide virtual training. You can typically become certified in an hour or less.

Sometimes, you can receive training in person at harm reduction events. Some states may have a map showing where you can get trained, such as Colorado’s End Overdose page9.

However, even if you are not Narcan trained, you can and should still use it to save someone’s life.

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Why Is Fentanyl So Dangerous and Hard to Spot?

Why is fentanyl so dangerous? 

This powerful opioid can be lethal even in small doses. It’s also hard to detect and is often mixed with other drugs, unbeknownst to the user. 

Let’s look at the risks involved in taking fentanyl, the challenges in reducing the harm it causes, and what you can do if you or someone you know is addicted to opioids. 

Fentanyl Is an Extremely Potent Opioid

This synthetic opioid is incredibly potent compared to other opioids. Fentanyl is up to 100 times stronger than morphine1 and 50 times stronger than heroin. This means that a very small amount can produce a powerful effect—and that a very small amount can be fatal. It’s often mixed with other drugs, such as heroin and cocaine, without the user’s knowledge. This can easily lead to accidental overdoses. According to the DEA, 

“There is significant risk that illegal drugs have been intentionally contaminated with fentanyl.  Because of its potency and low cost, drug dealers have been mixing fentanyl with other drugs2 including heroin, methamphetamine, and cocaine, increasing the likelihood of a fatal interaction.”

Fentanyl’s extreme potency makes it very dangerous and increases the risk of overdose. 

It Acts Quickly on the Body

Fentanyl is a fast-acting opioid:3 it enters the bloodstream quickly and reaches the brain within minutes. This also heightens its addictive properties. People who use fentanyl quickly develop a tolerance to it, meaning they need to take more of it to achieve the same effect. This can lead people to use more fentanyl than they can handle, increasing their likelihood of overdose.

Inconsistent Quality and Purity

Illicit fentanyl production has become increasingly common4 in the U.S., as fentanyl is cheap to produce and easy to transport. It can also be used to produce other synthetic opioids, like carfentanil,5 which is even more potent.

Counterfeit fentanyl is often produced in clandestine laboratories with little to no quality control. As such, the quality and purity of illicit fentanyl can vary widely from batch to batch. And because of its strength, even small variations can be deadly. An especially strong batch of fentanyl can lead to widespread overdoses. The Red Pheasant Cree Nation in Canada, for example, declared a state of emergency after 8 fentanyl overdoses6 in one weekend—a scenario that’s unfortunately all too common. 


Illegal fentanyl is often mixed with other drugs7 like heroin, cocaine, meth, and MDMA without the user’s knowledge. This vastly increases the risk of overdose and adverse reactions for people who don’t even intend to take fentanyl. 

Fentanyl Is Hard to Dose

Fentanyl’s extreme potency makes it very hard to dose accurately. Even a small mistake can lead to overdose.

Just 2 milligrams of fentanyl can be fatal. If someone is using a scale to measure fentanyl, but the scale is slightly off, they could easily take too much. Likewise, if someone injects fentanyl using their normal dose, but the product they’re using varies in potency from the last time, they could overdose. 

People who are new to using the drug can have a hard time gauging their dosage. But even experienced drug users can easily make fatal mistakes when dosing fentanyl. 

Tips for Avoiding Fentanyl Overdose

  • Never use drugs alone.
  • With any new drug, start with a small amount and wait at least 30 minutes before using more.
  • Be aware of the signs of overdose, such as loss of consciousness, slow or shallow breathing, and blue lips or fingernails.
  • If you suspect an overdose, call 911 immediately and administer naloxone if you have it.

Using Naloxone (Narcan) for Fentanyl Overdose 

Fentanyl overdose can happen quickly,8 even after a single use. They can also be hard to reverse, even with naloxone,9 a medication that’s commonly used to reverse opioid overdoses. People who overdose on fentanyl may need multiple doses of naloxone to be revived, and likely need to be hospitalized.

What to Do if You Suspect a Fentanyl Overdose

If you suspect that someone is overdosing on fentanyl, call 911 immediately. Administer naloxone if you have it available, but don’t wait for naloxone to arrive before calling 911.

Tips for Administering Naloxone

  • If the person is unconscious, roll them onto their back and give them one dose of naloxone in the nose.
  • If they’re still unconscious after 2-3 minutes, give them a second dose of naloxone.
  • Continue to give naloxone every 2-3 minutes until they becomes responsive or help arrives.
  • Stay with them until help arrives. Monitor their breathing and keep them warm.

Nalaxone Challenges

Naloxone is an effective medication for reversing opioid overdoses, but there are some challenges in using it with fentanyl.

Fentanyl is so potent that it can take multiple doses of naloxone to reverse the overdose. And because the effects of naloxone don’t last as long as the effects of fentanyl, people who overdose on fentanyl may need repeated doses of naloxone to stay alive.

Another challenge is that, because fentanyl is often mixed with other drugs, it’s difficult to know how much fentanyl is in someone’s system and how much naloxone they need.

There can also be delays in administering naloxone if the person is overdosing alone or if it takes time for help to arrive. Any delay in administering naloxone to someone who overdoses on fentanyl can reduce their chances of survival. 

“Though naloxone can block fentanyl’s effects, there is evidence to suggest that there is less time to save someone from a fentanyl-related overdose, in comparison to other opioids,” says Associate Professor of Clinical Neurobiology Jermaine Jones, PhD. That’s because fentanyl can cause respiratory depression and death very quickly.

Fentanyl Slows Breathing

Fentanyl depresses the central nervous system10—particularly the respiratory centers—meaning it slows down breathing and can even stop it altogether. 

Fentanyl binds to opioid receptors in the brain, which regulate pain, pleasure, and mood. This is how it produces its euphoric effect. But opioid receptors also regulate breathing. Respiratory depression is the main cause of death in fentanyl overdoses.11 

Prevalence and Overdose Statistics

Fentanyl is responsible for a growing number of overdose deaths12 in the U.S.: 

  • The DEA has found counterfeit fentanyl pills containing up to 5.1 milligrams of fentanyl, which is over twice the lethal dose.
  • Fatal overdoses from synthetic opioids—mainly fentanyl—rose 55.6% from 2020 to 2021.
  • Fentanyl is the leading cause of fatal overdose in the U.S.

Fentanyl plays a significant role in the opioid epidemic, and the number of fentanyl-related deaths continues to rise. The need to address this epidemic is urgent—and it starts with recovery from opioid use. 

If you’re using fentanyl or struggling with opioid dependence, getting help is crucial. Medically supervised detox can help you safely stop opioid use. And comprehensive addiction treatment can help you address the root causes of opioid use disorder, so you can start your journey toward a better life.

By addressing fentanyl addiction, we can save lives and reduce the impact of the opioid epidemic on our families and communities.

Frequently Asked Questions About Why Fentanyl Is So Dangerous

What makes fentanyl so dangerous?

Fentanyl’s extreme potency (up to 100 times stronger than morphine) and its presence in various street drugs, significantly heightens its lethality. Often laced without users’ awareness, even small doses of fentanyl can lead to fatal overdoses.

How does fentanyl impact the body and why is it hard to dose?

Fentanyl is fast-acting, entering the bloodstream quickly and creating a rapid tolerance in users, leading to higher consumption and overdose risks. Its potency makes it challenging to dose accurately. Even small errors in dosage measurement or variations in product strength can be fatal.

What are the challenges of using naloxone to reverse fentanyl overdoses?

Naloxone is generally effective in reversing opioid overdose, but is harder to use for fentanyl overdose. Due to fentanyl’s potency and the duration of its effects, multiple doses of naloxone may be required. Delays in administering naloxone can also reduce the chances of survival.
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What Is Carfentanil?

Carfentanil is a fentanyl analog, or a synthetic opioid chemically similar to fentanyl. It’s 100 times more potent than fentanyl and 10,000 times more potent than morphine. Because of that, carfentanil is considered the strongest and most dangerous fentanyl derivative. 

People usually take carfentanil by accident. But since you need so little (about one grain of salt) to overdose, these accidental uses can quickly become life-threatening. 

What Is Carfentanil Used For?

Carfentanil has only one approved use: a large-animal tranquilizer. The veterinary field uses carfentanil on elephants and other similarly sized animals; it’s not approved for human use in any way.

But in illicit drug markets, dealers use carfentanil to increase the potency of their drugs and sell them for more money. Additives like carfentanil make drugs like heroin feel stronger, leading to faster dependency and continued profit for the dealer. 

Carfentanil easily blends into other substances, so you never truly know if you’re taking a clean or laced substance. Even fentanyl test strips often don’t pick up on carfentanil. To the naked eye, carfentanil doesn’t stand out against the substance you think you’re taking—which is why it poses such a risk.

What Does Carfentanil Look Like?

Carfentanil looks white and powdery, like powdered sugar. If it’s been dissolved into a liquid, it can look as innocent as water. It may also look grainy, like salt grains. Carfentanil has no smell or taste. 

Dealers manipulate carfentanil to create new ways of ingestion. For example, you could take carfentanil as a pill, inject it intravenously, snort it as a powder, or place a small piece of carfentanil-soaked blotter paper on your tongue for a few minutes.  

What Are The Potential Effects of Using Carfentanil?

As a synthetic opioid, carfentanil’s effects mirror those of heroin, including:

Euphoria

Carfentanil is a mu-opioid receptor agonist, which means it triggers mu-opioid receptors to send a cascade of chemical signals in your brain. This ultimately releases dopamine, and lots of it. The flood of dopamine causes both euphoria and the need to repeat the behavior. 

Pain Relief

When used as prescribed, opioids work as powerful pain relievers. Carfentanil is no different. It calms the neurons in certain areas of the brain, leading to pain relief. But because of its potency, no amount of carfentanil has been approved for pain relief. 

Sedation

Carfentanil can calm the brain and nervous system to the point of total sedation. That’s why veterinarians use carfentanil to sedate large animals. 

Overdose

Carfentanil overdoses continue to rise in the US. Just two milligrams of carfentanil could kill you. Anything below that tiny amount would likely cause a non-lethal overdose. 

What Are The Symptoms of Carfentanil Overdose?

Overdosing on carfentanil causes a host of side effects. Even accidental exposure to carfentanil, like getting some of it on your hand or having the powder blow on your face, could cause an overdose. Knowing the signs of an overdose can help save lives. 

Blue Lips And Nails

Look at the nail beds and lips for blue coloration. Carfentanil overdoses can cause low blood pressure and a dangerously slow heart rate, which can lower breathing and oxygen intake. Less oxygen in the blood makes it look blue in areas like the lips and fingertips.

Choking And Gurgling

Overdosing on carfentanil can slow your breathing and dangerously sedate you. Because of this, you may choke on your spit or be too disoriented to remember to swallow it. That can cause choking and gurgly breathing, almost like snoring.

Pin-Point Pupils

A carfentanil overdose often causes tiny pupils. Someone who’s overdosed may have strangely small pupils that don’t dilate in different lighting.

Slowed Breathing

Your breathing may slow to null if you overdose on carfentanil. This can then lead to black outs, blue fingers and lips, and death.

Losing Consciousness

Overdosing on carfentanil could cause you to black out. The reasons for losing consciousness can include sedation/sleepiness, slow breathing, slowed heart rate, and a combination of all 3. 

Hypothermia

Someone who overdosed on carfentanil may feel cold to the touch, shiver, and have a bluish tint. 

Clammy Skin

Carfentanil overdoses also cause clammy skin, or like someone’s slightly sweaty and cold at the same time. 

Heart Failure

Too much carfentanil could cause total heart failure. An overdose can depress your central nervous system enough to stop your heart. Without immediate help, this symptom often leads to death.

Can You Reverse a Carfentanil Overdose?

You can save someone who’s overdosed on carfentanil by immediately using Naloxone. If you administer it fast enough, you can reverse the effects of carfentanil and save their life. Since carfentanil is so potent, you’ll likely need several strong doses of Naloxone. You can inject it intravenously or, if your kit includes a nasal spray, squirt it up their nose.

 If you’re injecting Naloxone (Narcan), be sure to fill the syringe with liquid and not air. Then poke the needle into a large muscle, like a shoulder or thigh muscle. To administer the nasal spray, stick the nozzle into their nose and push up on the plunger. You’ll likely need to spray into each nostril. Narcan takes 2-3 minutes to show effects. 

Once stabilized and physically safe, treatment begins. 

Get Treatment for Opioid Use

Treatment for synthetic drugs like carfentanil includes medical and emotional care. You’ll begin with detox, which safely removes carfentanil from your body. Once carfentanil is out of your system, you and your treatment team will address the thoughts and behaviors leading to your drug use. Then, you’ll work together to learn new coping skills and navigate difficult emotions, cravings, and triggers as they come. 

Your treatment journey may begin in a residential rehab, where you’ll have 24/7 care, 1:1 and group therapies, and a safe space to detox. After residential treatment, you can move into day treatment or an intensive outpatient program, which provides intensive but more independent care.
To start your journey, you can browse our list of rehabs for opioid use to see pricing, photos, reviews, and more.

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How Long Does It Take to Detox?

Detox usually lasts at least a couple of days, but many factors can affect how long detox lasts and your side effects. Getting proper care during this sensitive time is vital. Licensed professionals will help you understand how long the detox process is and safely guide you through it.

These days can provide an opportunity to start a healthier life, and detox can help lay the foundation for success. Residential or outpatient treatment can further equip you with necessary skills to maintain sobriety. To begin your journey towards a healthier life, explore the various detox services available.

Factors Affecting Detox Duration

Here are 4 things to consider when talking with a doctor about what your detox process will look like:

  • How long you’ve been using the substance
  • To what extent you’ve been using the substance
  • If you’ve been using just one substance vs multiple substances
  • Individual factors, such as overall health, mental health conditions, and metabolism
detox timeline

Detox Timeline for Common Substances

Every substance, and every person, is different, but this is what you can expect to encounter during detox for each substance. 

Alcohol

Alcohol detox usually lasts 2 – 10 days1. Symptoms appear within 6 – 24 hours after quitting drinking and are most severe during the 36 – 72 hour period. Symptoms include:

  • Anxiety
  • Sweating
  • Tremors
  • Dehydration
  • Increased heart rate and blood pressure
  • Insomnia
  • Nausea and vomiting

Severe withdrawal may involve complications like:

  • Seizures
  • Hallucinations
  • Delirium tremens
  • Extreme agitation

Alcohol detox can be life threatening, so doing this with medical care is vital.

Opioids/Heroin

Opioids are drugs such as heroin, opium, morphine, codeine, and methadone. Detox can last 4 – 20 days, depending on the opioid used1. Quick-acting opioids like heroin typically have a shorter duration than long-acting opioids like fentanyl. Withdrawal symptoms usually appear in 8 – 12 hours after quitting. Symptoms include:

  • Nausea and vomiting
  • Anxiety
  • Insomnia
  • Hot and cold flashes
  • Sweating
  • Muscle cramps
  • Diarrhea

Opioid withdrawal can be safely worked through as long as you are detoxing with medical supervision. 

Benzodiazepines

Benzodiazepines are psychoactive drugs that act as central nervous system depressants. Doctors prescribe them to treat anxiety and sleeping disorders. This drug is relatively easy to become addicted to, so if you are prescribed benzodiazepines, you should use them with caution.

Detox typically lasts 2 – 8 weeks, depending on the benzodiazepine. Quick acting benzodiazepines, like oxazepam, have a shorter detox period1, while clonazepam and other long acting ones have longer detox periods. Symptoms include:

  • Anxiety
  • Insomnia
  • Restlessness
  • Agitation
  • Poor concentration and memory
  • Muscle pains

Benzodiazepine withdrawal could be fatal, so it’s important to taper off these with guidance from medical professionals.

Meth/Stimulants

Stimulants are drugs such as methamphetamine, amphetamine, and cocaine. Detox usually lasts 3 – 5 days1, and symptoms begin within 24 hours of quitting. Symptoms include:

  • Agitation and irritability
  • Depression
  • Increased sleeping and appetite
  • Muscle aches

Particularly those who use methamphetamine can develop hallucinations, paranoia, or depressed thoughts during detox.

Meth and stimulant withdrawal can be safely worked through as long as you detox with medical support. 

Barbiturates

Barbiturates are depressant drugs prescribed for sleep aid, muscle spasms, anxiety relief, and seizure prevention. Detox usually lasts around 2 weeks, and symptoms appear 2 – 4 days after stopping the medication2. Symptoms include:

Barbiturate detox can be life-threatening, so it’s vital to do so under medical supervision.

Marijuana

Marijuana detox typically lasts 1 – 2 weeks1, and the symptoms are relatively mild compared to other detoxification processes. However, this can still be an uncomfortable experience. Symptoms include:

  • Anxiety 
  • Feelings of fear or dissociation
  • Restlessness
  • Irritability
  • Poor appetite
  • Disturbed sleep
  • Gastrointestinal upsets
  • Night sweats
  • Tremors

Marijuana withdrawal can be safely worked through as long as you detox with medical supervision. 

Your Unique Experience Detoxing

Taking all of this into account, detox duration and experience can vary from person to person.

The detox process can negatively affect your co-occurring disorder(s)4 or vice versa. This could apply to medical disorders or mental disorders. Agitation, depression, or hallucinations can appear during detox, so if your mental health issues include these, they may be heightened during this process.

Be sure to tell your doctor about any medical conditions you have. It’s very important that they take these into account when deciding what medication to give you, your tapering timeline, etc.

Medical Detox vs. Other Forms of Detox

Detox is a broad term, and the general definition is to rid the body of toxic things. When we hear “detox,” we may first think of using dandelion tea to cleanse our bodies, or holistically-based cellular detox. 

Medical detox, what we’ve been covering in this article, involves ridding the body of drugs or alcohol under the supervision of licensed medical professionals. Often, this involves using medication to assist the detoxification, like methadone and diazepam. 

Coming off of any substance could have negative or life threatening effects, so this process shouldn’t be taken lightly. Your detox beyond dandelion tea needs to be medically monitored for your own safety and well being.  

Detoxing Safely With Professional Guidance

Substance detox is a complicated process that requires professional guidance 24/71. Doctors can help you safely rid yourself of the substance. You could risk harming yourself if you detox without proper care. You might also relapse without the guidance of a doctor. Having professionals there helps make this uncomfortable experience as comfortable as possible. 

Post-Detox Transition and Treatment

Detox is a great start to recovery, but most of the time people will relapse if that’s the only care they receive1. The next part of your journey can include attending a residential or outpatient program to build your recovery toolkit with essential coping skills. In fact, SAMHSA emphasizes this as their 3rd pillar of detoxification5. These 3 components are 

  • Evaluation: testing how substance use has affected your body and creating a plan
  • Stabilization: medically assisted detox to get you to a stable, substance-free state
  • Fostering the patient’s entry into treatment: emphasizing the importance that you follow through with a substance abuse program to maintain your sobriety

During detox, you usually won’t participate in talk therapy because you’re in a susceptible, healing state. The real work and self growth comes after detox. During residential or outpatient care, you’ll work in individual and group therapy sessions using a variety of methods, including cognitive behavioral therapy (CBT). CBT is a highly effective treatment for addiction6. This is because it targets the thoughts, feelings, and behavior patterns that are common in substance use disorder.

You can build a support network with your therapists, peers, and family. You’ll learn to identify the early warning signs of relapse. You can even participate in relapse prevention groups. And in treatment, you’ll have more time to solidify your new coping skills. 

Addiction is more than just using substances, and recovery is more than just detoxing from those substances. It’s impacted your perspective and how you think. Treatment can guide you back to a better place by shifting how you view yourself, your surroundings, and your future. 

 A Step Forward You can try your best to plan for what your detox may look like, but the bottom line is that there are a lot of variables. Detoxing safely with medical professionals ensures that the bumps along the road during this process can be molehills instead of mountains. Explore where your new journey will take you by starting with detox.

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Can Withdrawal Kill You?

Without proper care, the withdrawal symptoms from certain substances could kill you. A symptom this extreme depends on what you’ve been taking, how much, and how long you’ve been taking it. 

Not every drug has dangerous withdrawal symptoms. Some, though extremely uncomfortable, won’t hurt you. But alcohol, benzodiazepines, and opiates have the potential to be deadly.

After discussing your situation with your doctor or care team, you might decide to detox in a licensed, medically monitored detox environment. Many rehab centers with detox offer just this. 

What Causes Withdrawal Symptoms?

Your brain and body get used to drugs or alcohol and adapt to work around them. Once you stop taking substances, your body has to adjust to life without them. So, you experience withdrawal symptoms as your body returns to homeostasis1. Though the change is arguably good, your body still has to adjust—which might not feel good at all. 

If you’ve become highly dependent, stopping becomes dangerous. In those cases, you can seek treatment in a detox center or a residential rehab with detox. Detox centers treat non-life-threatening withdrawal symptoms too. Your comfort and safety both matter. 

Withdrawals vary across the different types of drugs and substances. Some pose no threat. Others require careful supervision. 

Alcohol Withdrawal

Detoxing from alcohol2 could be dangerous. The level of danger, and general symptom intensity, depends on how much you drink and how long you’ve been drinking. 

Alcohol withdrawal symptoms2 could include 

  • Rapid heartbeat
  • Shaking
  • Delirium tremens (DT)
  • Insomnia
  • Hallucinations
  • Extreme confusion
  • Nausea or vomiting
  • Excessive, purposeless activity (getting in and out of bed, wandering around)
  • Anxiety
  • Grand mal seizures

Delirium tremens commonly affect those with a long history of drinking. DT’s symptoms3 include “profound confusion, autonomic hyperactivity, and cardiovascular collapse.” It’s rare, but needs to be caught as soon as possible to avoid danger. 

The other symptoms of alcohol detox may feel gross, but don’t tend to be life-threatening—especially under the supervision of doctors and nurses. Then, medications like Antabuse can help you stay sober4 in recovery.

Opiate Withdrawal

Opioid withdrawals can feel like a bad flu5, or the sickest you’ve felt in your entire life. Typically, though, it’s not one of the withdrawals that can kill you. The severity of symptoms depends on your dose and how long you’ve been taking opioids. 

The discomfort of opiate withdrawals can make you crave opioids even more. For many, temptations to alleviate the pain can cause a relapse5. Detoxing in a residential setting could help you avoid this in your early days of recovery.

During your opioid detox period, you might experience

  • Diarrhea
  • Dysphoria
  • Goosebumps
  • Restless legs
  • Muscle pains
  • Dizziness
  • Insomnia
  • Malaise
  • High heart rate

You can die from dehydration during opioid withdrawals6, caused by excessive vomiting and diarrhea. This catastrophic effect usually happens in jails, where prompt (and sufficient) medical care isn’t as common. 

Medications can curb the effects of opioid withdrawals7. For opioid detox, your doctor may prescribe methadone, buprenorphine, clonidine, and lofexidine. Each operates in different ways to diminish cravings and make withdrawals more comfortable. You can continue to take these medications to maintain your sobriety.

Heroin Withdrawal

As a short-acting opioid, heroin’s withdrawals typically set in 8-24 hours after your last dose7. They can last 4-10 days. 

Heroin’s withdrawal symptoms mimic a very bad flu. Turning to opioid-agonists, like methadone, can help you taper off high doses and maintain sobriety. Methadone relieves cravings and discomfort without the euphoric rush of heroin and other opioids8, making it non-addictive at the proper dose. 

And, using a maintenance medication like methadone reduces the risk of relapse by satisfying cravings8. This can also prevent HIV and infections caused by needle sharing—and, largely, relapse in general. 

Benzodiazepine Withdrawal

Depending on your dose and length of use, benzodiazepine withdrawals can be life threatening. Benzos treat anxiety and sleep disorders5 but could become addictive if used too long. Detoxing from benzos presents several dangers.

Benzo withdrawals resemble alcohol withdrawals5, which have a death risk. For that reason, you’ll likely need to detox in a medically monitored setting, like a hospital or residential rehab. Here’s what you might experience during benzodiazepine detox9:

  • Seizures
  • Muscle pains
  • Insomnia
  • Anxiety
  • Restlessness
  • Agitation
  • Difficulty concentrating
  • Hand tremors
  • Excessive sweating
  • Heart palpitations
  • Catatonia
  • Death

Withdrawal symptoms usually begin 2-10 days after your last dose and can last 2-8 weeks. You can manage the symptoms by gradually weaning off benzodiazepines5, which gives your body time to adjust to lower doses. Going cold turkey, or stopping all at once, could cause psychosis, death, seizures, and convulsions10.  

Withdrawing From Multiple Substances

There’s limited research on detoxing from multiple substances. But, the available research shows each drug needs its own attention during detox11. For example, detoxing from a stimulant and a depressant at the same time requires a more nuanced approach. So, physicians may prescribe 2 withdrawal medications to combat the effects of multiple substances. 

Withdrawing from multiple substances has its challenges, but it’s not uncommon. A study found 71% of patients in detox were withdrawing from 2 or more substances11. Your care provider will make the ultimate decision regarding any medications you’ll need during detox and how the process might look for you. 

Getting Treatment for Withdrawal Symptoms

At best, detoxing might feel uncomfortable. At worst, it could kill you. But for each end of the detoxing spectrum, you have treatment options. 

For many withdrawal symptoms, you may need the help and care of a detox center. Or, a residential rehab with a detox program. In a center like this, you can begin therapeutic residential treatment right after detoxing.
To see your options, you can browse our list of rehabs with detox that includes pricing, photos, insurance information, and more.

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What Does OxyContin Look Like?

If you’re worried about opioid addiction, it can be helpful to know what OxyContin looks like. This brand of prescription painkillers can be dangerous if you take them improperly. It’s easy to identify OxyContin tablets because they’re all imprinted with either “OC” or “OP.” However, the 7 doses of OxyContin all look a little different from each other. 

The answer to what OxyContin pills look like will depend on how strong the dose is. 

10 mg Pill

  • Color: White
  • Shape: Round
  • Imprint: OC or OP on one side; 10 on the other side

15 mg Pill

  • Color: Gray
  • Shape: Round
  • Imprint: OC or OP; 15

20 mg Pill

  • Color: Light pink
  • Shape: Round
  • Imprint: OC or OP; 20

30 mg Pill

  • Color: Brown
  • Shape: Round
  • Imprint: OC or OP; 30

40 mg Pill

  • Color: Yellow
  • Shape: Round
  • Imprint: OP or OC; 40

60 mg Pill

  • Color: Red
  • Shape: Round
  • Imprint: OC or OP; 60

80 mg Pill

  • Color: Green
  • Shape: Round
  • Imprint: OC or OP; 80

What Is OxyContin?

OxyContin is the brand name for oxycodone, a type of opioid. By definition, all opioids are narcotic painkillers.1 What sets OxyContin apart from similar drugs—like morphine, codeine, and hydrocodone—is its extended release.2 When you take OxyContin, the tablets dissolve slowly and release oxycodone at a steady rate for up to 12 hours. 

What Is OxyContin Used For?

Doctors prescribe OxyContin to treat moderate to severe pain. Because it lasts longer than other pain medications, most people take OxyContin for conditions that require consistent relief over a long period of time. This includes pain resulting from arthritis, serious injuries, cancer, and other conditions. 

Is OxyContin Addictive?

OxyContin has been a subject of concern due to its addictive potential. Initially introduced in 1996, it was marketed as an effective prescription painkiller with a low risk for misuse.3 However, within a few years, the landscape changed dramatically. By 2004, OxyContin had become one of the most widely misused drugs in the United States. 

Despite its intended purpose for chronic pain relief, when people take OxyContin for chronic pain they can quickly become dependent on the drug. Physical dependence isn’t the same as addiction4—it just means your body now relies on certain doses to find relief. Addiction, on the other hand, occurs when you’re no longer able to control behaviors that negatively affect your life. If taking increased amounts of OxyContin is the only way you can get pain relief, your risk of addiction increases. 

It’s important to recognize OxyContin’s addictive potential and use caution when taking this medication. If you have concerns about your OxyContin use or think you may be developing an addiction, consult a healthcare professional for appropriate guidance and support.

OxyContin Prescription Use vs. Misuse

OxyContin, like other prescription medications, has legitimate uses but also carries a risk of misuse. 

Prescription use of OxyContin is when patients who have a legitimate medical need for pain management take the drug under the guidance of a healthcare professional. When used as prescribed, OxyContin can provide relief and improve the quality of life for people with chronic pain.

However, misuse occurs when you use OxyContin in a way that doesn’t follow your doctor’s instructions.5 This can include taking higher doses than recommended, using the medication more frequently than prescribed, or using it without a valid medical reason. Misuse of OxyContin significantly increases the risk of adverse effects, dependency, and addiction.

The line between prescription use and misuse can sometimes become blurred. Some people may initially receive OxyContin for a legitimate medical purpose but gradually veer into misuse because of increased tolerance, desperation for pain relief, or other factors. It’s essential to use OxyContin strictly as directed by a healthcare professional and to promptly communicate any concerns or changes in pain management needs so they can adjust your prescription safely and appropriately.

What Are the Street Names for OxyContin?

OxyContin goes by a variety of street names:6

  • O.C. 
  • Hillbilly Heroin
  • Oxy
  • Oxycet
  • Oxycotton

How Is OxyContin Abused?

People with opioid addiction may want to bypass OxyContin’s extended release7 by snorting or injecting it. This is extremely unsafe, because then you can’t predict how strong the dose will be, or how quickly it will take effect. 

When you snort OxyContin, it’s absorbed by the membranes of your nostrils. It goes directly into your bloodstream instead of first traveling through your digestive tract. If you inject the drug, it bypasses even your nostrils, so your body absorbs OxyContin even faster.8 This brings on a more intense euphoria. Injecting drugs also puts you at risk of diseases9 like HIV and hepatitis. 

Can You Overdose on Oxycontin?

OxyContin is a potent opioid and can cause overdose if used improperly or in excessive amounts. The specific dosage required to overdose on OxyContin can vary depending on factors such as your tolerance, body weight, and overall health. That’s why it’s crucial to adhere to the prescribed dosage and consult a healthcare professional for guidance throughout the course of OxyContin use.

Overdosing on OxyContin can have severe consequences and may even be life-threatening. Some common symptoms of an OxyContin overdose10 include:

  • Extreme drowsiness or sedation
  • Slow, shallow, or difficult breathing
  • Constricted pupils
  • Loss of consciousness
  • Cold, clammy skin
  • Weakness or limpness
  • Slurred speech
  • Bluish tint to lips or fingertips

Overdosing can cause seizures,11 brain damage, heart attack, and respiratory depression—slowed breathing that can become fatal.

If you or your loved one shows signs of an OxyContin overdose, seek medical attention immediately. Risks of overdose increase when you combine OxyContin with other substances like alcohol or other opioids.

What Are the Risks of OxyContin Use?

OxyContin is a powerful opioid. The U.S. opioid crisis12 started in the 1990s and is still a major problem. As doctors overprescribe opioids like OxyContin, more people are at risk of addiction, overdose, and turning to even more potent street drugs. 

Physical Risks

Like any opioid, OxyContin depresses your nervous system.13 In other words, it slows down communication between your brain and body. Your heart rate, breathing rate, and blood pressure all go down. This can cause you to stop breathing, go into shock, or even die. 

Abusing OxyContin also puts you at risk of injuring yourself or someone else.14 That’s because opioids can make you dizzy, confused, or poorly coordinated. Data shows an alarming rise in elderly people injuring themselves15 from falls while using prescription opioids. 

Psychological Risks

Over time, opioid use alters your brain’s reward system.16 You might begin to feel normal when OxyContin is in your system, and abnormal when it’s not. OxyContin also impacts your mental health. People who use opioids have higher rates of anxiety,17 irritability, lack of motivation, and depression. 

From Prescription to Street Drugs

If you first start taking OxyContin to manage chronic pain, it can become hard to function without it. Over time, you might need higher doses of the drug to achieve the same effect.18 This is a dangerous pattern, and it can quickly lead to addiction. 

If you can’t get a high enough dose of OxyContin from a prescription, you might look for other sources. When it’s sold illegally, OxyContin can be very expensive. But more affordable opioids, like heroin,19 are often impure and even more addictive. 

Following your doctor’s instructions, and bringing up any challenges you’re experiencing with your prescription, can avoid escalating OxyContin use. You can also ask your doctor about non-opioid-based pain management.

Find Treatment Options for OxyContin Addiction

When you’re ready to heal from OxyContin addiction, it’s important to get professional support. OxyContin withdrawal symptoms can be dangerous—and even fatal. The only safe way to detox from opioids is with proper medical care.


To start recovery from OxyContin, learn more about opioid addiction treatment programs here.

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2023 Oscar Nominated Movies That Include Addiction

Films and TV shows tend to shape how culture views a certain subject (or profession). Recently, the idea of therapists, mental health, and addiction in pop culture became more mainstream. However, some films and shows do more harm than good—overdramatizing addiction and mental health, or just poorly representing it.

Others capture the rawness, truth and importance of addiction and mental health. 

All the Beauty and the Bloodshed 

Winning an Oscar for best documentary, All the Beauty and the Bloodshed recounts photographer Nan Goldin’s experience with addiction. She depicts her addiction to prescription painkiller OxyContin, and her frustration with the Sackler family.  

America’s Opioid Crisis

All the Beauty and the Bloodshed shows that Nan’s addiction began after an injury. Doctors prescribed a common medication at the time, OxyContin – which is highly addictive if taken incorrectly1. It contains oxycodone, which causes a high similar to heroin. 

Nan, like many others, became addicted to OxyContin after a perhaps thoughtless pain management plan. Nan formed P.A.I.N.2, Prescription Addiction Intervention Now, to “speak for the 250,000 bodies that no longer can.”

The Sackler family, owners of Purdue Pharma, received backlash for pushing OxyContin prescriptions when they perhaps weren’t needed. Nan worked to get museums and other Sackler-supported institutions to publicly separate from the family. 

America’s opioid crisis may have begun with overprescription of pain meds3, but it’s since grown for new reasons, like cheap, accessible products. Fentanyl, too, plays a large role in the 1,500 opioid-related deaths per week.

Treatment Options for Opioid Addiction

Many rehabs treat opioid addiction. In a residential setting, you’ll likely go through a medically supervised detox first, then begin therapeutic treatment. 

Therapies for opioid addiction could range from talk therapies to contingency management plans, which offer rewards for each step you complete in treatment. Talk therapies like cognitive behavioral therapy (CBT) will help you work through the thoughts and emotions causing your behaviors. Then, you’ll learn new ways to process and manage what you feel.

You’ll learn coping tools for the future, relapse prevention strategies, and typically engage in an aftercare program to keep you well supported. 

All the Beauty and the Bloodshed explored prescription medication addiction. Other nominated movies this year blazed new trails, like The Whale.

The Whale Explores Grief And Binge-Eating

The Oscars nominated Brendan Fraser for Best Lead Actor. The Whale depicts Charlie’s (Fraser) journey through binge eating, grief, and depression. His coping mechanism began after the death of his partner. 

The story highlights the power of grief and the hold of eating disorders, and how they can function as a coping tool. Different characters in the film try to help Charlie, but as it often is, his grief is persistent. 

What Is Binge Eating Disorder?

Binge eating is eating without control4—it might feel impossible to stop. Sometimes, after binging, a purge happens; this is the pattern of bulimia nervosa5. You might purge through throwing up, taking laxatives, excessive exercise, or starving yourself. It’s meant to “undo” the binge. Not every binge eater purges, though. 

Binge eating might be your coping tool, especially if you’re dealing with something as powerful as grief.

Grief And Depression

Depression is a stage of grief6, as proposed by Kübler-Ross. In The Whale, Charlie mourns the loss of his partner, who died by suicide. Depression became a strong stage in his mourning. 

If you or someone you know is considering suicide or self-harm, you can call or text the number 988.

The film suggests binge eating became Charlie’s own way of committing suicide.

Getting Help for Grief And Depression

There’s help for the millions of others like Charlie. Grief and depression can weigh heavily—sometimes unbearably so. But you do have options to heal. 

Complicated grief therapy (CGT)7, for example, can help with grief and all its stages. Using loss- and restoration-focused care, “the therapist works to facilitate the progress of grief to help the client come to terms with the death.” 

Cognitive behavioral therapy (CBT) can help with depression and grief7. Using CBT, your therapist can help you modify your thoughts and change your behaviors. For grief, CBT could help you process your loss in a more productive way.

To Leslie And Blonde

Both To Leslie and Blonde highlight drug and alcohol addiction. They were also both nominated for Best Leading Actress in the 2023 Oscars. Ana de Armas played Marilyn Monroe in Blonde, and Andrea Riseborough played Leslie in To Leslie.

To Leslie depicts a mother’s struggle with addiction, spurred on by a seemingly-ideal lottery win. Leslie reaches new lows and eventually seeks help for her daughter’s sake and herself. 

Blonde retells the life story of Marilyn Monroe, who tragically and famously died after an overdose. 

Drug And Alcohol Addiction: Not Just for The Famous

Movies like Blonde make addiction seem almost ritzy—something only people with deep pockets can do. Then, To Leslie goes and proves that wrong. So which is true? 

It’s both. 

Addiction doesn’t discriminate. In each movie, despite the contrasts in leading women, their reasons for substance abuse were similar. The case remains true for many today. Stressors, mental illnesses, or trauma can start a habit you can’t stop on your own. 

Stories like Leslie’s and Monroe’s can help the larger public see this through a cleaner lens. Addiction wasn’t a moral failing of either woman. It was how they coped. 

But there’s more than one way to find that same sense of control. Treatment can help you see that.

Treatment Options for Drug And Alcohol Use

Many rehabs treat drug and alcohol addiction. Here, you’d have constant monitoring, individualized care, and a structured treatment schedule. Most residential rehabs also offer on-site detox. 

Depending on your situation, you might find an intensive outpatient program (IOP) or partial hospitalization program (PHP) more suitable. Each of these programs provides effective treatment, and you get to go home at night. IOP is less intensive, usually lasting 3-5 hours a day, while PHP could go for 5-8. 

In these treatment settings, you’ll learn relapse prevention skills and work on the thoughts behind your behaviors. Rehabs typically offer a variety of therapies to meet your needs. 

You can browse our list of rehabs to see reviews, pricing, and insurance information, and more.

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Detoxification: Frequently Asked Questions

Detoxification is the first step in addiction treatment for many people. We’re here to help you learn more about what it entails, what it feels like, and whether or not you can detox at home.

Understanding Detox

How Does Detox Work?

Detoxing is the process of allowing substances to leave your system and managing withdrawal symptoms that may follow. Your substance use history will affect your detox experience and determine whether or not you need medication-assisted treatment.

A few hours after you stop using substances, your body begins to recalibrate as they leave your system. During this adjustment period, you may develop withdrawal symptoms, which occur in stages:1 early, peak, and late.

Early stage: Generally 6 to 12 hours–or even up to 30 hours after you’ve stopped using–mild withdrawal symptoms like anxiety or difficulty sleeping may occur.

Peak stage: At the peak stage, symptoms are at their worst and can include vomiting, tremors and chills. This usually occurs 72 hours after you’ve stopped using opiates or 24 to 48 hours after you’ve stopped drinking. Because of the discomfort, relapse is likely during this stage. It’s important to have a strong support system around you, along with medical supervision.

Late stage: At this stage, your body is starting to get used to the absence of substances. Any withdrawal symptoms you may have had will start to die down.

Why supervised detox? Remember that the purpose of a supervised detox is to minimize the severity of withdrawal symptoms and ensure you’re safely clearing your body of substances.

When Is Detox Required?

Whether or not you need detox depends on your history of substance use, including factors such as the type of substance used as well as the duration and level of use.

Withdrawal from certain substances, such as benzodiazepines or alcohol, can be life-threatening. That, combined with the physiological effects of frequent exposure to substances,2 means it’s recommended to receive a medical evaluation from a medical professional before attempting to detox.

You may want to consider getting an evaluation for detox if you notice the following signs of substance or alcohol abuse, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

  • Cravings for substances
  • Using more substances than you plan to
  • Inability to cut down or stop substance use
  • Taking substances for longer than intended
  • Trouble maintaining relationships due to substance use
  • Continuing to use substances, even when it negatively impacts your life

Can I Detox From Drugs at Home?

For your safety, it’s never recommended to detox from drugs at home without supervision.

Not all substance detoxification is lethal. However, withdrawal from certain substances, such as alcohol withdrawal, can potentially be life-threatening.3 More serious symptoms include hallucinations, seizures, and delirium tremens.

It’s always safest to detox under the supervision of specialized, experienced medical professionals.

You don’t always have to go through detox at a hospital or rehab facility. If you have a strong support system at home and your condition doesn’t require hospitalization, you may be able to opt for outpatient detox.4

How Long Do I Need to Detox For?

How Long Does Detox Typically Last in Rehab?

The duration of the detoxification process in rehab depends on your substance use background and the substance you’re detoxing from. On average, detox takes 3 to 7 days.

The time it takes to detox from commonly used substances varies:

  • Alcohol: 5 to 7 days
  • Benzodiazepines: One day to several months until treatment is introduced
  • Opiates: Up to 7 days (however, it’s possible to develop post-acute withdrawal symptoms5 that last weeks, months, or even years)
  • Cocaine: Up to 7 days
  • Heroin: 5 to 7 days

Detoxing From Different Substances

Alcohol

Do I Need to Detox From Alcohol?

Whether or not you need to detox from alcohol depends on how long and how much you’ve been drinking.

The media often portrays people who are addicted to alcohol as living disarrayed lives. The truth is, addiction can affect anyone—many people suffer from high-functioning alcoholism. If you notice signs of alcohol addiction, you may consider getting an evaluation for detox:

  • drinking more, or for a longer, than intended;
  • trying to stop drinking, but being unable to;
  • spending a lot of time drinking or dealing with the aftereffects of drinking;
  • continued drinking even when it negatively interferes with work or relationships;
  • and more.

Alcohol detox carries a high risk for potentially life-threatening withdrawal symptoms, like delirium tremens (DT).6 It’s safest to detox from alcohol under medical supervision.

If you plan to attend rehab, most residential facilities require you to be substance-free for a certain period of time before starting treatment. You can find out whether or not you’ll need to detox from alcohol during the admissions process. You have several options for detox, including on-site detox at certain rehabs.

Can I Safely Detox From Alcohol at Home?

No. Complications from alcohol withdrawal7 can pose severe to life-threatening side effects. It’s never recommended to detox from alcohol at home.

Side effects like delirium tremens (DT) can lead to chronic memory disorders or life-threatening seizures. DT side effects often don’t show up until 2 to 3 days after you’ve last ingested alcohol.

Even if you don’t experience life-threatening side effects, because of the extreme discomfort of withdrawal, you’re more likely to relapse if you try to detox from alcohol at home8 in comparison to detoxing under medical supervision.

How Long Does It Take To Detox From Alcohol?

It usually takes about 5 to 7 days to detox from alcohol.

What Does Alcohol Detox Feel Like?

Most people experience varying levels of discomfort when detoxing from alcohol. As alcohol leaves your system, you can experience mild to severe alcohol withdrawal symptoms:9

  • Sleep disturbances, like insomnia
  • Nausea
  • Vomiting
  • Sweating
  • Irritability
  • Tremors
  • Headaches
  • Anxiety
  • Visual and auditory disturbances
  • Cardiovascular complications, like rapid heart rate
  • Muscle pain and stiffness

The discomfort alcohol withdrawal causes can lead people to relapse, especially if they try to detox alone at home.

When you detox under medical supervision, clinical staff help monitor your condition, soothe your symptoms, and offer round-the-clock support. Detoxing under medical supervision enhances both your safety and comfort.

Benzodiazepines

Can I Detox From Benzodiazepines at Home?

You should never try to detox from benzodiazepines, or “benzos,” alone at home.

Unsupervised withdrawal from benzodiazepines can result in life-threatening side effects.10 Because of the potential severity of these withdrawals, the U.S. Food and Drug Administration recommends “patients taking benzodiazepines should not suddenly stop taking them11 without first discussing a plan with your health care professional for slowly decreasing the dose and frequency.”

It’s also not recommended to quit cold turkey following long-term use; a large number of people have reported negative and long-lasting side effects of benzo withdrawal.12

How Long Does It Take To Detox From Benzodiazepines?

It takes one day to several months (until treatment is introduced) to detox from benzodiazepines. Withdrawal symptoms such as anxiety, vomiting, and nausea peak within the first 14 days after you last ingested benzodiazepines.

What Does Benzodiazepines Detox Feel Like?

Detoxing from benzodiazepines can present a wide range of uncomfortable side effects. Because detoxing from benzos can be so uncomfortable, one of the goals of medically supervised detox is to help soothe patients’ discomfort while ensuring their safety.

Some of the most commonly prescribed benzodiazepines13 include Valium, Xanax, Halcion, Ativan, and Klonopin. They have similar withdrawal symptoms, however, Xanax may cause more severe symptoms.

When you detox from benzodiazepines after your body has become physiologically dependent on them, you may experience mild to severe withdrawal symptoms:

  • Headaches
  • Increased anxiety
  • Sweating
  • Racing heartbeat
  • Insomnia
  • Muscle spasms
  • Nausea or vomiting
  • Restlessness
  • Hand tremors
  • Aches and pains

Benzos withdrawal symptoms occur in stages and depend on your history of substance use.

Stage 1: You may first notice short-lived symptoms such as anxiety and insomnia within 1 to 4 days of benzos discontinuation.14

Stage 2: Peak withdrawal symptoms occur in the second stage, which many people describe as the most difficult phase to overcome. This usually lasts 10 to 14 days.

Stage 3: An estimated 10 to 25% of people who use benzodiazepines for an extended period of time experience post-acute withdrawal symptoms,15 or PAWS. During this stage, you’ll notice a return of anxiety and other withdrawal symptoms until you begin to address them with some form of professional addiction treatment.

Opioids

What Does It Feel Like to Detox From Opioids?

Detoxing from opioids can present highly uncomfortable psychological and physical effects16 depending on your past substance use and severity of dependence. These symptoms can arise whether you’re detoxing from medically prescribed pain relievers like oxycodone, hydrocodone, and codeine, or illicit opiates, such as heroin.

During detox, as substances leave your system, you’ll begin to experience withdrawal symptoms. The extent of these symptoms depends on your substance use history, severity of use, and whether you’re detoxing from immediate-release opioids17 (such as morphine) or extended-release opioids18 (such as methadone), as defined by the CDC.

Opioid withdrawal symptoms19 are often uncomfortable. They can include anxiety, rapid heart rate, muscle pain, runny or watery eyes, nausea and vomiting, insomnia, and more.

Opiate withdrawal can be lethal.20 It’s always recommended to detox under the guidance of an addiction-specialized healthcare professional.

With short-acting opioids, withdrawals typically begin 8 to 24 hours after your last use. With long-acting opioids, withdrawal symptoms can onset 12 to 48 hours after the last use.

How to Detox From Opioids

While usually not life-threatening, opiate withdrawal can be lethal. Therefore, you should always detox from opiates under the guidance of a qualified healthcare professional.

Whether you detox at a hospital, private detox center, or on-site at a residential rehab facility, you should have healthcare workers available to you 24 hours a day.

If you were using short-acting opioids, withdrawal symptoms will onset 8 to 24 hours after your last use. For long-acting opioids, withdrawal symptoms present themselves 12 to 48 hours after last use.

Mild opioid withdrawal management:
If you have mild withdrawal symptoms, treatment providers will ensure you consume 2 to 3 liters of water a day, along with vitamin B and C supplements to replenish lost fluids. They will also observe and monitor your symptoms 3 to 4 times a day using a Short Opioids Withdrawal Scale (SOWS).21

Moderate to severe opioid withdrawal management:
Clinicians will follow the same management techniques as with mild withdrawal cases. However, they may also use medication to minimize the severity of symptoms.

It should be noted that while detox is the first step in addiction treatment, it should be followed up with an addiction treatment program to create lasting changes to addictive behaviors.

How Long Does Opioid Detox Take?

It may take up to 7 days for opioids to fully leave your body. However, withdrawal symptoms may last longer than that.

For immediate-release opioids, withdrawal symptoms can last 4 to 10 days. For extended-release opioids, withdrawal symptoms can last 10 to 20 days

Depending on your opioid use background, it’s possible to develop post-acute withdrawal symptoms (PAWS).22 These can last weeks, months, or even years after you’ve last taken opiates. Some of these symptoms include memory issues, irritability, and depressed moods.

There is treatment for PAWS, which can be administered over the period of time you’re experiencing symptoms. Aftercare is critical to addiction treatment. If you’ve completed a treatment program, your aftercare counselor or therapist can help you identify PAWS symptoms and recommend a treatment plan. Or, you can search for rehabs that offer detox programs and speak to an intake specialist about PAWS treatment.

Cocaine

How long does it take to detox from cocaine?

It takes up to 7 days to detox from cocaine. Cocaine withdrawal symptoms are generally more psychological than physical and can include agitation, depression, anxiety, and other effects on your mood.

Where can I Detox?

You can detox at several different types of facilities. While it should be noted that not all at-home detox is lethal, detoxing from certain substances can pose life-threatening risks. It’s always recommended to detox under the guidance of a healthcare professional.

You can undergo substance abuse detox at several types of facilities:

  • Hospitals
  • Residential rehabs (not all inpatient rehabs offer on-site detox)
  • Private detox centers

How Long Do Withdrawal Symptoms Last?

On average, it takes 3 to 7 days for substances to leave your system. However, withdrawal symptoms can persist even after you’re substance-free.

Alcohol withdrawal timeline: Withdrawal symptoms from alcohol typically begin about 6 hours after you’ve last ingested a drink. They can last up to 72 hours after your last drink. In more severe yet rare cases, moderate withdrawal symptoms, such as alcohol hallucinosis, can last for up to a month.23

Benzodiazepines withdrawal timeline: Withdrawal symptoms from benzodiazepines usually last 10 to 14 days. However, some people can develop post-acute withdrawal symptoms (PAWS), which is a return of withdrawal symptoms several months after last use.

Opioid withdrawal timeline: For immediate-release opioids, withdrawal symptoms can last 4 to 10 days. For extended-release opioids, withdrawal symptoms can last 10 to 20 days. Depending on your substance use history, it’s also possible to develop PAWS from opioids. These symptoms may last weeks, months, or even years after you’ve last taken opioids.

Cocaine withdrawal timeline: Withdrawal usually begins 90 minutes following the last dose. Cocaine withdrawal symptoms,24 such as irritability and cravings, can last up to 10 weeks depending on your level of dependency.

Detox Costs

How Much Does Detox Cost?

The cost of detox This depends on the substance you’re detoxing from, the level of care, the length of treatment, and the detox facility.

In the U.S., the cost of detox at a private rehab can range from less than $10,000 to over $75,000 per month. Since the Affordable Care Act (ACA), most of these private rehab centers accept insurance.

To learn more about your options for detox treatment, browse through our list of detox centers.

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Addicted Attorneys: How to Identify Your Addiction and Get the Help You Need

A 2016 study held by the Hazelden Betty Ford Foundation and the American Bar Association found that out of the participating 12,825 licensed attorneys, 21 percent of lawyers qualify as problem drinkers,1 while 28 percent struggle with mild or more serious depression and 19 percent struggle with anxiety.

What’s worse, only 3,419 lawyers responded to the question about drug use. As explained by the study’s lead author, Patrick Krill, in the New York Times:

“It’s left to speculation what motivated 75 percent of attorneys to skip over the section on drug use as if it wasn’t there.”

Substance use disorder among lawyers isn’t just prevalent in the United States. In fact, much of the Western world’s legal profession is built on drink and drugs. But the true problem does not lie in the substance use itself, it lies within the culture surrounding it.

In this blog post, we shed light on some of the common factors of addiction for those in the legal profession, why lawyers need to be vigilant in recognizing them, and how you can seek the help you or a colleague might need to get sober and stay sober.

Death by Drugs: The Story of Peter

In July 2017, the New York Times published an article about the life of Peter, a high-level Silicon Valley attorney who overdosed on drugs.2

According to the article, it was a problem that his ex-wife, children, colleagues and close friends didn’t see coming. Further, it was a problem Peter felt he could fight on his own, but he failed to make the necessary priority adjustments to make time for doing so. His work always came first.

The article is eye-opening for any lawyer experiencing similar issues, and we urge you to read it. In the article, the writer depicts a scene prior to Peter’s death. The line reads:

“Of all the heartbreaking details of [Peter’s] story, the one that continues to haunt me is this: The history on his cell phone shows the last call he ever made was for work. Peter, vomiting, unable to sit up, slipping in and out of consciousness, had managed, somehow, to dial into a conference call.”

In any scenario, it’s difficult to understand why humans put their work before their own lives.

Perhaps it’s because we don’t want to let others down. Perhaps it’s because self-punishment is an all too common illness we’ve yet to talk about. Whatever it is, work is work and will remain so for the rest of time. Your health is precious; and it requires intentional effort to keep it stable.

A Few Addiction Factors to Watch Out For

There are many reasons people turn to drugs to deal with the realities of life. Failed careers, a lack of income, the death of a family member, stress … each person becomes addicted for their own reasons.

In the legal profession, however, there are some specific warning signs to watch out for. For example:

1. Overworking

attorney overworked

We can only work so hard.

We need sleep, food, water and rest to ensure we can sustain a peak level of performance in anything we do. But due to the nature of the legal profession, lawyers tend to work more than most other people.

Sure, they might bill 40 or 50 hours of work in a week, but in truth, lawyers likely work 60 or 70 hours3 just to keep up.

Balancing this level of work with a social life often means staying awake and “on” to get the job done, and some people may turn to artificial substitutes. According to the same study, 5.6 percent of respondents used cocaine, crack and other stimulants, 5.6 percent used opioids, and nearly 16 percent used sedatives to turn themselves off after a long day.

Be sure to recognize the signs of overworking and proactively deal with these problems by speaking up. There’s no shame in admitting you need help.

2. A Lack of Time With Family

In Peter’s story, it was expressed that he didn’t have enough time to spend with his family and that he’d often go out in the evening and not return.

Isolation is an all too common addiction factor, and it makes it difficult for people to identify personality changes. If you begin to notice that you’d rather be alone and taking drugs instead of around the people you love, it’s time to speak up and seek expert help.

3. Stress

Often people use smoking, alcohol and drugs as ways of trying to evade the reality of a situation and “calm down” when life gets overwhelming. In 2015, Bloomberg estimated that workplace stress contributes $190 billion in healthcare expenses4 and more than 120,000 deaths each year.

Given the nature of hard work, stress can be classified as an epidemic in the legal profession.5 Last year, legal website Above The Law wrote an article titled Stressed-Out Lawyers in First 10 Years of Practice More Likely to Have Mental-Health and Wellness Issues and they’re accurate in their statement.

As explained in the article:

“If you know 10 lawyers, three of them are likely depressed, and two of them are suffering from a drinking problem or anxiety.”

Get the Help You Need With Rehab

The stigma behind going to rehab is slowly diminishing, and the acceptance of seeking help is becoming more prevalent.

In the medical profession, which is also a high pressure, high-stress career path, doctors can enter rehab, get the treatment they need, and still continue practicing medicine once they’re sober.

The legal profession is similar. No longer should you or your colleagues fear losing your legal license and getting fired; you’re human. However, continuing down a path of substance use and overworking can be detrimental to any career.

We finish this article by addressing you personally:

If you notice that you’re becoming reliant on drugs, it’s difficult to balance work and life, or if you’re failing to treat yourself with the respect you deserve, help is available.

The United States has several lawyer assistance programs and we urge you to pick up the phone and call them.

If you feel that rehabilitation is your ticket to recovery, we urge you to find a rehab center that fits your needs.

Remember: You are not alone.

Frequently Asked Questions About Addiction Among Lawyers

Are lawyers more prone to addiction?

Certain factors increase the likelihood of addiction among lawyers. These include the normalization of drinking and drug use, overwork, and chronic stress.

How prevalent is drug use among lawyers?

Self-reported figures show 22.6% of lawyers engaged in problematic drug use or drinking at one point in their lives. Actual numbers may be higher. (75% of respondents in the same study skipped over questions about drug use.)

Can lawyers continue practicing after rehab?

If you were disbarred due to drinking or drug use, you can practice again under 3 conditions: 

1. You received appropriate rehabilitation.
2. You’ve abstained from drinking and drug use for one year minimum. 
3. You’ll likely continue to abstain.