Traditional detox for opioid addiction involves a 3 to 7 day overnight stay in a facility that provides some level of medical supervision, daily structured programming, and medication assistance to help alleviate opioid withdrawal symptoms. Detox alone, for moderate to severely opioid addicted persons, has a relatively low success rate.

However, detox followed by several weeks of inpatient treatment & follow-up outpatient counseling, produces a higher rate of success. Particularly so for people with shorter term addictions and a more limited opioid abuse history.

Positive aspects of detox include:

  • medical monitoring of vital signs
  • safe, supportive environment
  • some medication assistance to help with withdrawal symptoms
  • additional evaluation & management of co-occurring disorders (although limited in scope)
  • brief introduction to addiction recovery concepts
  • provides a needed timeout to restore health & address future treatment plans

Negative aspects of detox:

  • can be costly (may or may not be fully covered under insurance)
  • requires absence from family, home, and work
  • withdrawal symptoms may not be completely medicated, so some discomfort may be experienced
  • detox is not treatment, and offers little to no counseling
  • detox alone has a low rate of long-term effectiveness in preventing future opioid abuse
Rapid Detox
Rapid detox is a condensed detoxification process which occurs while under general anesthesia. The opioid addicted person is unconscious while an opioid antagonist is introduced (such as naltrexone) to begin an accelerated withdrawal process. Rapid detox presents with the general risks of going under anesthesia. However, its proponents claim that it helps individuals avoid the pain and emotional distress associated with physical withdrawal from opioids.

Positive aspects of rapid detox:

  • for some people, may eliminate the majority of their opioid withdrawal
  • occurs under careful medical supervision using an anesthesiologist
  • relatively short time requirement, i.e. usually 1 to 8 hours of detox under anesthesia followed by one to two days of direct medical monitoring
  • rapid detox appears to have a well-developed protocol and safety orientation
  • provides a comforting alternative for those who have an intense fear of opioid withdrawal

Negative aspects of rapid detox:

  • expensive
  • some individuals may not feel well from anesthesia
  • no guarantee of total elimination of withdrawal, i.e. some withdrawal discomfort may emerge in the weeks following the procedure
  • does not account for the necessity of counseling, skill development, or support in the addiction recovery process
  • criticized as a "quick fix" approach to a long term problem
  • Some studies have suggested that rapid detox's long term success rates are no more effective than traditional detox protocols although those who provide rapid detox services claim a high success rate

Methadone is one of the most effective opioid addiction treatments available, and has a proven track record of success based on many years of research & supporting statistical data. Methadone is a powerful opioid replacement medication that successfully prevents opioid withdrawal. It works well for a wide variety of opioid dependent persons including those with short-term pain pill addictions, as well as those with chronic & severe intravenous (IV) opioid abuse.

Positive aspects of methadone include:

  • safe, and administered under supervision of a physician
  • highly effective in totally eliminating opioid withdrawal symptoms
  • a stabilizing dose does not produce sedation or a drug high
  • comes in liquid form, quickly & easily swallowed
  • blocks the effects of other opiates and thus discourages opiate misuse
  • can be used with a wide variety of individuals, even those who have developed a very high tolerance to opioids
  • methadone recipients receive regular addiction & recovery counseling
  • methadone recipients are able to resume full, productive lives
  • affordable, and often funded through State & Federal monies including Medicaid
  • is a leading medically-approved treatment for opioid addiction
  • in existence for 40 years with well documented success
  • review a more complete list of benefits here

Negative aspects of methadone:

  • requires a daily visit to the clinic during the first months of participation
  • may produce some mild side effects during first weeks of use such as sweating or constipation (symptoms typically disappear)
  • should not be stopped "cold turkey", and requires a tapering process in order to comfortably come off of the medication
  • review a more complete list of risks here


Suboxone, like methadone, is an opioid replacement medication with a long lasting effect that produces relief from opioid withdrawal symptoms. Suboxone is actually a name brand medication containing buprenorphine (the active ingredient that prevents withdrawal) and naloxone (a secondary ingredient added to prevent injection abuse of suboxone). Suboxone became FDA approved in 2002, and is used today for both opioid detox as well as maintenance therapy. Suboxone is administered as a tablet (or thin film) that is dissolved under the tongue and absorbed through the oral mucosal lining.

Positive aspects of suboxone include:

  • long acting, and is taken once daily
  • completely eliminates withdrawal symptoms (for many individuals)
  • doctors can prescribe suboxone from their office and it can be taken home
  • lower potential for overdose if taken properly
  • reduces opioid cravings & does not produce a high
  • counseling is a requirement for those receiving suboxone
  • can be taken for years if needed
  • gradually tapering down on dose considered to be relatively comfortable

Negative aspects of suboxone:

  • more expensive than methadone
  • may not be effective at controlling withdrawal & cravings for more severe opioid dependencies
  • although rare, liver problems can occur (liver tests may be recommended)
  • mild side effects usually disappear once accustomed to the medication
  • must be safely secured and kept away from children
  • like methadone, suboxone should not be abruptly stopped, and will require a gradual taper to come off of the medication
  • daily suboxone dose may take 5-10 minutes to dissolve while under the tongue