Why am I feeling sick while “detoxing” from alcohol or drugs?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 24, 2025Updated: July 24, 2025

Key Takeaways

Detox symptoms happen because your brain, nerves, gut, and hormones have adapted to regular exposure to alcohol, opioids, stimulants, or other substances. When the drug is suddenly removed, those systems swing wildly in the opposite direction, triggering sweating, trembling, nausea, mood swings, and in severe cases seizures or dangerously high blood pressure. The intensity depends on the substance, the dose, how long you used it, and your personal health history.

What exactly is causing my detox symptoms right now?

Detox symptoms are the body’s over-correction after it loses a substance it relied on to keep chemical balance. Nerve pathways that were repeatedly suppressed or overstimulated now fire unpredictably, causing physical and emotional distress.

  • Sudden neurotransmitter imbalance jars the brainAlcohol boosts GABA (a calming chemical) and dampens glutamate. When alcohol stops, glutamate surges—leading to anxiety, tremor, and seizures. "Detox shakes are almost always a glutamate rebound," explains Sina Hartung, MMSC-BMI.
  • Stress hormones spike within hoursCortisol and adrenaline can triple in the first 24 hours after stopping heavy drinking or cocaine, driving sweating, rapid pulse, and sleep trouble.
  • The gut loses its chemical “soothing blanket”Opioids slow gut muscle. Removing them unleashes a rebound rush through the intestines, causing cramps and diarrhea.
  • Electrolytes swing with fluid shiftsVomiting and sweating during detox can drop sodium or potassium below safe limits in as little as 12 hours, worsening confusion and muscle cramps.
  • Inflammatory cytokines create a “flu-like” feelingThe Portland Clinic of Natural Health describes a Jarisch-Herxheimer–style reaction in which sudden toxin release triggers immune chemicals that bring on chills, body aches, nausea, and headache during early detox. (PCNH)
  • Dying-off microbes add their own toxin loadWhen antimicrobials wipe out parasites or yeast, their cell fragments flood the bloodstream; Bella Lindemann notes headaches, brain fog, and muscle pain can peak for 1–3 days until detox pathways catch up. (BL)

Which detox symptoms mean I should go to the ER immediately?

Most withdrawal passes safely at home, but some red-flag signs signal a medical emergency. The team at Eureka Health stresses that calling 911 is better than “waiting it out” if major danger signs appear.

  • A fever over 101.3°F suggests infection or severe autonomic stormHigh fever during alcohol or benzodiazepine withdrawal predicts seizures within 6 hours in roughly 15 % of cases (JAMA 2019).
  • Continuous vomiting threatens dehydration and arrhythmiaMore than four vomits in an hour can drop potassium quickly, leading to heart rhythm changes you won’t feel until you collapse.
  • Auditory or visual hallucinations are a pre-seizure warningSeeing insects or hearing voices during alcohol detox often precedes delirium tremens, which has a 5 % mortality rate without IV treatment.
  • Resting heart rate above 120 beats per minute indicates severe autonomic hyperactivityIf your pulse stays above 120 for 30 minutes at rest, emergency benzodiazepine dosing is usually required to prevent cardiovascular collapse.
  • Any seizure or blackout during withdrawal warrants 911 activationSeizures, confusion, or loss of consciousness are listed by MedlinePlus as severe alcohol-withdrawal symptoms that demand immediate emergency evaluation. (NIH)
  • Suicidal thoughts during detox are an emergency, not a normal symptomHospital guidelines warn that experiencing suicidal thoughts, self-harm urges, or violent impulses while withdrawing signals the need for prompt ER care rather than home management. (WNJMC)

Why do some people suffer worse detox than others?

Severity is not just about willpower. Genetics, organ health, and drug history all shape how hard withdrawal hits.

  • Longer use hard-wires more brain receptorsThree or more years of daily benzodiazepine use triples the risk of protracted withdrawal lasting over 6 months, according to a 2022 NIH survey.
  • Liver disease slows drug clearanceCirrhosis allows alcohol to linger, then drop unpredictably, which "makes withdrawal both later and harsher," notes Sina Hartung, MMSC-BMI.
  • Dual-substance users face overlapping syndromesStopping alcohol and cocaine together merges stimulant “crash” fatigue with alcohol tremors—often confusing patients and clinicians.
  • Family history of anxiety heightens subjective distressPeople with generalized anxiety disorder genes release more noradrenaline during detox, magnifying palpitations and panic.
  • Menopause or thyroid disease can mimic detoxHot flashes or thyrotoxic tremor can pile onto true withdrawal, obscuring what symptom belongs to which condition.
  • Weak kidney filtration magnifies detox symptomsThe Portland Clinic of Natural Health reports that when elimination organs like the kidneys lag, mobilized toxins recirculate, producing headaches, nausea, skin eruptions, and flu-like malaise. (PCNH)
  • Abrupt juice fasts provoke stronger “reboot” reactionsReboot naturopath Claire Georgiou notes that poor pre-detox diet and ramping up cleansing too quickly can trigger headaches, fatigue, diarrhea, and mood swings as stored toxins flood the blood. (Reboot)

What can I safely do at home to ease mild detox symptoms?

If your doctor says outpatient withdrawal is safe for you, structured self-care reduces discomfort and complication risk.

  • Hydrate with oral rehydration salts every four hoursPackets with 75 mEq/L sodium and 20 mEq/L potassium cut ER visits for mild alcohol withdrawal by 30 % in a 2021 VA study.
  • Schedule protein-rich snacks, not big mealsFrequent 15-g protein snacks steady blood sugar and temper nausea better than large plates, according to the team at Eureka Health.
  • Use a 4-point vitals log twice dailyRecord pulse, blood pressure, temperature, and tremor score; trends catch worsening withdrawal sooner than symptoms alone.
  • Practise box breathing to blunt adrenaline spikesFour-second inhale, four-second hold, four-second exhale cycles lowered heart rate 10-15 bpm in detox patients in a small 2023 UCSF pilot.
  • Take a 20-minute Epsom-salt bath before bedMagnesium-rich Epsom salts ‘draw out toxins and promote sleep,’ helping calm nighttime restlessness common in mild alcohol detox. (JC)
  • Do a gentle 10-minute stretch twice dailyNew Horizons Centers advises light stretching or yoga to relieve muscle aches; short sessions morning and evening loosen joints without spiking heart rate during withdrawal. (NHC)

Which blood tests and medications matter most during detox?

Lab work and prescription support vary by substance but follow a predictable core.

  • Comprehensive metabolic panel within 24 hoursTracks sodium, potassium, calcium, and liver enzymes; a sodium below 130 mEq/L predicts seizures in benzodiazepine withdrawal.
  • Magnesium level guides seizure preventionLevels under 1.8 mg/dL correlate with a 2-fold higher seizure risk; IV magnesium is often given alongside benzodiazepines.
  • CIWA-Ar scoring determines benzodiazepine dosingA score over 15 usually prompts hospital admission for escalating diazepam dosing—exact drug and dose chosen by a physician.
  • Naltrexone or acamprosate after acute phaseThese medications curb cravings for alcohol but should start only when detox is complete and labs (including liver function) are stable.
  • Consider clonidine for opioid autonomic symptomsClonidine 0.1 mg every 6–8 h (if prescribed) can cut sweating and anxiety by 40 %; blood pressure must be monitored closely.
  • Baseline complete blood count detects mimicking conditionsSAMHSA TIP 45 lists a CBC among admission labs to uncover infection or anemia that may intensify withdrawal symptoms and alter medication plans. (SAMHSA)
  • Urine drug screen steers detox medication choiceThe same guideline advises obtaining a urine toxicology panel at entry to confirm recent substance use and guide selection of agents such as buprenorphine or naltrexone. (SAMHSA)

Frequently Asked Questions

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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