The first time you use alcohol or a particular drug, you may experience some intense effects. For example, you might feel euphoric or calm, or find that there is an easing of chronic pain. While these effects may seem desirable, they are usually accompanied by harmful effects, like digestive problems, an elevated heart rate or slowed breathing. In some cases, a substance can result in hallucinations, violence and thoughts of suicide.

The second time you use the drug, you will find that you have to take a little more than you did the first time or order to achieve the desired effects. The third time, you will have to take even more. As you gradually build up your dosage and frequency of use, your body and mind become dependant on the drug until you get to the point where you are not able to function without it.

At the same time, the negative effects may prompt you to want to stop using the drug, but when you try to quit, you experience physical and psychological withdrawal symptoms that are uncomfortable and frightening, and sometimes life-threatening. Many people who try to stop using alcohol or drugs without assistance relapse very quickly, because they are so desperate to escape the unbearable withdrawal symptoms.

Inpatient detox is a drug and alcohol withdrawal method whereby you are given round-the-clock medical care as the substance works its way out of your system. Your withdrawal symptoms are managed as they happen, and you are kept safe from the more intense effects.

For people with severe or long-standing addictions, and for those who have coexisting physical and mental health conditions, inpatient detox is often the only safe choice.

With the wide range of choices available when it comes to detox facilities, it can be difficult to know which ones are the best. There are a few questions that you should ask while you are evaluating your options. These include the following:

• Does the centre have the staff and facilities to deal with your particular addiction?
• Will the centre create a customized detox plan that is specific to what you need?
• If you are addicted to more than one substance, or if you have coexisting physical or mental illnesses, is the centre equipped to provide the right kind of care?
• Will the detox centre be able to refer you to the right kind of rehab facility when your detox program has come to an end?
• What payment/financing arrangements is the detox facility willing to offer? Are any guarantees offered?
• Are the facilities, programs and policies about visitors consistent with what you need in order to begin your recovery?
• For detox centres that have been around for a while, what is the success rate of the programming? What is the relapse rate? Have patients gone on to successfully complete rehab programs?
• For new detox centres, what are the qualifications and experience of the medical staff? Have they worked in detox settings before?

Completing detox is not the end of recovery, but the beginning. Addictions rarely happen in isolation: they are rooted in events and experiences such as the following:

• Child abuse, sexual assault or domestic violence
• Military combat or experiences as a first responder (paramedic, police officer or firefighter)
• Being a victim of bullying
• Physical or mental health problems
• Experiencing or witnessing a traumatic event
• Troubled relationships with family

Detox will get the drugs or alcohol out of your system, but it will not solve the problems that led you to the addiction in the first place. Therefore, if you leave detox and return to the real world without resolving these issues, chances are that you will relapse.

In most cases, it is recommended that detox be followed by rehab. This will give you the opportunity to explore and resolve the issues underpinning your addiction, in a safe and non-judgmental environment. The tools used during rehab include the following:

• Individual therapy
• Group therapy with fellow recovering addicts
• Family therapy to help resolve problems in your relationships
• Art or music therapy
• Nutrition training
• Sports, exercise, yoga and dance

Even after your medical detox rehab program is over, you will continue to need ongoing support. Most good rehab facilities offer an aftercare program that consists of therapy, education sessions and access to help if you fear that you are in danger of relapse.