Detox and withdrawal: staying safe

Deciding to stop using a substance is a huge and courageous step, and making sure that step is medically safe is just as important as the decision itself.

What it is

Detox is the process of a substance leaving the body after regular use stops, and withdrawal refers to the physical and psychological symptoms that can occur during this time. Depending on the substance - especially alcohol, benzodiazepines, and opioids - withdrawal can range from uncomfortable to genuinely medically dangerous. This is different from simply having strong willpower; the body has adapted to the substance being present, and removing it suddenly can cause serious physiological reactions. This is why "going cold turkey" alone at home is not safe for every substance, even when the intention behind it is a good one.

Signs to notice

• Shaking, sweating, nausea or vomiting after stopping or reducing use
• Rapid heart rate, high blood pressure, or confusion
• Seizures, hallucinations, or severe agitation - these are medical emergencies
• Intense anxiety, insomnia or low mood in the days after stopping
• Strong cravings alongside physical discomfort

What helps

• Speak to a doctor before stopping a substance you use regularly, especially alcohol, benzodiazepines or opioids
• Ask about medically supervised detox options, which can manage symptoms safely and more comfortably
• Stay hydrated, rest, and eat when you can manage it during withdrawal
• Have someone with you, or checking in on you, during the withdrawal period
• Avoid making major decisions during withdrawal, when mood and judgement are affected
• Plan for what comes after detox - ongoing support significantly improves the chances of lasting change

When to reach out for help

Seek emergency medical care immediately if withdrawal involves seizures, hallucinations, severe confusion, chest pain or extreme agitation. For alcohol, benzodiazepines and opioids in particular, speak to a doctor before stopping, since withdrawal from these can be life-threatening without medical support.

Getting help in South Africa

Speak to your GP or a hospital about medically supervised detox options. Cleared Mind's EAP counsellors can help you plan for detox and the recovery support that follows it. SADAG's Mental Health Line (011 234 4837) can help you find detox and rehabilitation services. In a medical emergency, call 10177.

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If you or someone else is in immediate danger, reach out now. SADAG Suicide Crisis Helpline (24h): 0800 567 567 or SMS 31393. SAPS 10111, ambulance 10177, GBV Command Centre 0800 428 428.