The Most Difficult Drugs to Detox From

Drugs all increase pleasure when they are abused, making chemical changes within the brain.  Most substances of abuse affect the production and absorption of the neurotransmitter dopamine, which is tied in with how a person experiences reward and feel pleasure.  Mood regulation will power, memory, and decision-making are all also impacted by drug use.  As drugs are used for a long period of time and in increasing amounts, these changes become more permanent.

With dependency on drugs comes withdrawal symptoms which can be either physical or psychological in nature and can sometimes even be life-threatening.  Because of this, it is not recommended to stop these substances suddenly and without professional help.  Medical detox is often necessary for those who are dependent on substances.

Heroin and Opioids

Heroin is a fast-acting opioid that is usually snorted, smoked, or injected for a mellow feeling and a high.  Prescription opioid drugs include Vicodin, Oxycontin, fentanyl, and methadone, and are abused by large numbers of people in the United States.  Over 4 million people in the United States currently abuse prescription opioids.

Intoxication to opioids not only causes a rush of pleasure but also pain relief and relaxation.  The American Society of Addiction Medicine (ASAM) reported that almost a quarter of people who use heroin will eventually become addicted to it, and more than 500,000 Americans struggled with addiction to heroin use disorder in 2014.  Another 2 million people in the US suffered from an addiction to prescription opioids in the same year.  

While these drugs can make an individual feel good while providing a temporary escape from reality, they also cause withdrawal symptoms when they wear off.  These withdrawal symptoms cause the people taking them to want more so that they keep feeling good and keep the withdrawal symptoms at bay.  Users who are intending on going through a heroin detox or fentanyl detox should be prepared to feel an extended period of withdrawal when they are coming off these drugs.  Do not attempt to go at it alone!  Consult help from a treatment center, where professionals can assist you in your detox.

Withdrawal from opioids starts around 12 hours after the last dose, and peaks at about 48 hours.  Withdrawal feels like a very bad case of the flu and causes shaking, sweating, chills, vomiting, nausea, aching muscles, headaches, yawning, and tearing.  People might feel depressed, anxious, agitated, irritable, and with a lack of mental clarity.

Fentanyl detox and Heroin detox often include the use of medications such as buprenorphine, as do most other detoxes from opioids.  These medications fill opioid receptors in the brain, like fentanyl and heroin do, but do not cause the same effects.  Anti-anxiety and antidepressant medication can also be helpful.  Medication like clonidine, which is also prescribed for high blood pressure, is known to lower functions of the central nervous system, causing a slight respite from the symptoms of fentanyl detox and heroin detox.


Cocaine is a powerful stimulant that can cause an intense rush of pleasure when it is used.  It comes in either a white powder or in rock, known as a rack.  Cocaine is usually snorted, injected, or smoked for a rapid high which is short-lived and gives users feelings of euphoria, alertness, and excitement.

Its short method of action means that people who use cocaine often binge on it, whereby they continue to take doses to keep the effects going.  When people come down from a cocaine binge, they suffer a crash, meaning that they feeling fatigued, depressed, and mentally drained.

The depression from a cocaine binge can last for several days.


Meth, like cocaine, is a stimulant that is often taken in a binge pattern.  It is available in either a powder or crystal and can be injected, smoked, or snorted for a high which comes on quickly and powerfully.  Hallmarks of meth abuse are aggression, psychosis, and violence.

Long-term meth use can damage the brain, and cause problems with emotional regulation and memory.  Depleted dopamine levels can make it hard to feel pleasure, which leads to mood swings and depression.  Meth withdrawal is known to be one of the more drawn-out withdrawals, and it can take months or even years for users to feel themselves again.


Prescription sedatives like Valium, Klonopin, Xanax, and Ativan are medications that are designed to lower levels of anxiety, help people sleep, and provide relaxation.  These drugs also produce a high similar to that from taking alcohol.  Even when they are used as directed, benzodiazepines can be habit-forming and lead to addiction.