The Fear of Detox

Addicts are full of fear. Perhaps their biggest is fear of detox.  When the disease progresses to the point that addicts make nearly daily resolutions to quit, the intense fear of detox kicks in with overwhelming force. That fear keeps them from following through with their resolutions no matter how sincere they were when they made them.

Objective observers like doctors and addiction researchers note that for most addicts, withdrawal, though painful, pales in comparison to the discomfit of other diseases and their treatments. After all, detox doesn’t involve slicing open your body and fiddling with any vital organs.

Doctors commonly refer to withdrawal as akin to a really bad flu, and for good reasons. Detox triggers a similar immune response as to the flu (for more, click on Hangover Constrasted with Withdrawal). Yes, you feel miserable. But, doctors say, it’s reasonably bearable misery, comparatively speaking.

Having volunteered at a rehab hospital for several years and seen hundreds detox, I’d agree that objectively many detoxes involve relatively moderate pain. But it’s easy to categorize pain as relatively moderate — when it isn’t yours. When it is, it’s indescribably excruciating.

Most importantly, the physical pain of withdrawal is only part of the story and the easier part at that. As a serial self-detoxer and the survivor of an 11-day hospital withdrawal from hell, I can attest that the bodily discomfort, even when severe, pales beside the psychological panic. When you’re convinced your drug of choice, your medicine, is more important than eating and sleeping and bathing, jobs and friends, and even your closest loved ones, contemplating giving it up is beyond disorienting. It’s unfathomable. Extreme dread stems from the depth of the identity crisis impending sobriety provokes. Those who have built entire lives around obtaining and using drugs haven’t a clue what life will be like without them and it’s hard to overestimate the terror of that prospect. They literally fear they don’t know how they’ll survive without drugs.

And they fear that every moment of every waking day will be an endless series of exhausting emotional battles between their cravings and their weakness, repeating itself like the movie Groundhog’s Day. This fear isn’t easily quantifiable scientifically, but it’s so daunting, most addicts will avoid it like the plague.

The best analogy I’ve heard to illustrate the combination of physical pain and emotional upheaval during detox is this: Imagine being dumped by your one-and-only true love while suffering from a flu that’s ten times worse than any you’ve ever had. Take your worst broken heart, add physical pain in every part of your body, stir in an unhealthy dose of existential panic, and you can begin to comprehend the depth and breadth of the torment, anguish, dislocation, and bewilderment of detox.

Addicts who have undergone successively worse detoxes over time know how that combination of physical and emotional pain feels. They fear it. They exaggerate it in their minds unknowingly. And they’ll keep using to prevent it.

Neuroscientists explain the over-sized fear of withdrawal as another example of the way addiction causes short-term emotional needs to vastly outweigh longer-term rational ones. Psychologists chime in that transference takes place, concentrating all addicts’ sobriety-related fears onto withdrawal.

The fear of withdrawal and the conviction that they literally won’t be able to live sober prevents addicts from breaking through their denial and seeking help.

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