Drug Detox
First Stage of Detox
Withdrawal Symptoms
Types of Detox
Duration of Drug Detox
Medications Used
First Step to Recovery
Find a Detox for Your Needs
Drug detox is the first step in a comprehensive rehab program that offers all the tools required for recovery. The focus of detoxification is physiological healing after long-term drug addiction – first, through stabilization and then through detoxification. According to the National Institute on Drug Abuse (NIDA), after stabilization, the focus of detox is on the processes of the body as it rids itself of the drug of choice and treating the withdrawal symptoms that result.
It is important to note that detox is not a whole treatment for drug addiction no matter what the drug of choice. Because addiction is both psychological and physical in nature, it is imperative that patients undergo psychotherapeutic treatment to address the issues of cravings and changes that were made in the brain by chronic abuse of the drugs. Detox alone may help the patient to stop abusing drugs and alcohol, but without follow-up care and therapy, relapse will soon follow and a return to full-blown addictive behavior is rarely far behind.
If you would like to learn more about the detox and addiction treatment resources available to you or if you need assistance determining which type of rehab program will best treat your issues with drug abuse and addiction, contact us today. Our counselors here at RehabInfo are available around the clock and waiting for your call. Don’t wait to start your new life without drug dependence.
The First Stage of Drug Detox
The first hours and days of detoxification can be intense for many patients, and medical and psychiatric staff members will be on hand constantly to provide effective support. Any number of issues can come up for patients in their first few hours of detox and the most urgent need will be addressed first followed by the next and the next until full stabilization has been established. Some examples of possible issues include:
Violence
Patients who are a danger to others may require sedation and/or restraint in order to protect them and medical providers. These measures are only necessary if the patient becomes physically aggressive and attempts to harm staff members.
Symptoms of psychosis
When patients have been awake for days under the influence of a stimulant drug, when there is a co-occurring mental disorder present, or when substance-induced psychosis is an issue, they can behave erratically and have the potential to hurt others or themselves. It’s important to address this issue before proceeding with treatment.
Injury
In some cases, patients may have hurt themselves while under the influence of drugs or been physically or sexually assaulted prior to entering detox. Any physical injury must be treated immediately.
Medical illness
Withdrawal symptoms associated with detox and/or physical ailments related to underlying medical disorders can cause complications. It is important to isolate the cause of these symptoms and treat them before proceeding.
Threat to self
Patients who are suicidal must be protected at all times.
Once these acute issues have been assessed and identified during evaluation, they will be immediately treated until they have passed or the patient has been stabilized. At that time, attention and focus can turn to dealing proactively with withdrawal symptoms associated with detox.
Drug Detoxification Withdrawal Symptoms
According to a study published in the journal Addiction, 1994 Nov;89(11):1483-9, different classes of drugs mean different withdrawal symptoms. Additionally, the specific withdrawal symptoms experienced and their intensity will also vary from person to person depending upon:
- The length of addiction
- The combination of drugs abused, including alcohol
- The dose of the drug of choice at the time that the patient enters detox
- The existence of co-occurring physical or mental disorders
According to the Addiction study, common withdrawal symptoms that affect patients no matter what their drug of choice include:
- Mood disturbances. This can mean mood swings, irritability and/or agitation.
- Sleep disturbances. Insomnia despite intense fatigue is common.
- Physical issues. These may include chills, sweating, tremors or shaking, flu-like symptoms including runny nose and headache, nausea and vomiting.
- Cravings. The desire to use the drug of choice in order to stop the withdrawal symptoms is strong.
Different drugs can bring about substance-specific withdrawal symptoms in addition to the symptoms listed. Alcohol, opiate-based medications, and benzodiazepines can cause seizures and/or aural and visual hallucinations during the detox period. Heroin and other opiates can also cause muscle and bone pain. When detox from stimulant drugs like cocaine and crystal meth is an issue, depression and suicidal thoughts and feelings are often a significant issue.
No matter what the drug of choice, detox at a medical facility is always the safest choice, especially when co-occurring mental health disorders are an issue. On rare occasions, withdrawal symptoms can lead to complications and serious health issues that require immediate medical attention; for this reason, it is never recommended that patients attempt detox at home. Instead, enrollment at an inpatient detox program that provides 24-hour medical assistance if necessary, ongoing medical monitoring, and a therapeutic follow-up program is recommended.
Types of Detox
There are a number of different types of detox and, depending upon the drug of choice and the withdrawal symptoms experienced by the patient, different types of detox may be more or less appropriate. Some choices include:
Outpatient detox
It is rare that this is recommended, but in some cases where medication available by prescription or a methadone clinic will provide acceptable detox care, then an outpatient program may be a good choice. In instances where money is an issue or the patient must stay engaged at work or home, coming into an outpatient detox program regularly will provide adequate treatment.
Inpatient detox
In most cases, inpatient or residential detox is recommended in order to help patients avoid relapse and make sure that they have medical care in the event of an emergency. Most detox options are inpatient and the most effective ones will be packaged with an inpatient addiction treatment program that addresses the psychological issues related to addiction as well.
Opiate detox
Opiate detox is a bit different than detox options provided for other substances of abuse and addiction. There are medications that have been FDA-approved for nothing but the treatment of opiate addiction and these new medications have given rise to a number of different opiate detox treatment approaches, according to a study published in the Annals of Clinical Psychiatry, 1993 Mar;5(1):53-65. Whether heroin or prescription painkillers are the opiate of choice, inpatient care and/or medication is recommended for optimum safety.
Alcohol detox
If withdrawal symptoms are experienced when a patient stops drinking, there can be significant physical complications if there is an underlying disorder. Residential care is recommended.
Psychological withdrawal and detox
Some drugs have few specific or significant physical withdrawal symptoms but cause intense psychological withdrawal symptoms. Detox from stimulant drugs like crystal meth and cocaine, for example, can result in serious depression and suicidal thoughts. Inpatient detox is recommended in these cases to ensure the safety of the patient.
Patients should discuss the specifics of their situation with their medical and therapeutic team in order to choose the best type of detox for their needs.
Duration of Drug Detox
Drug detox will last as long as the withdrawal symptoms and for as long as it takes for the patient to stabilize physically and mentally, according to NIDA. In addition to stopping the abuse of addictive substances safely and supporting the patient through withdrawal symptoms, another goal of detox is to help prepare the patient physically and mentally for the work that lies ahead in therapy. In some cases, antidepressant medications or antipsychotics may be necessary if there are co-occurring issues of depression or a mental health disorder. Finding a stable dose on these medications will help to prepare the patient to begin the process of working through other issues that may be driving their addiction issues or making them worse.
It is important to note that not every patient will successfully complete detox on the first try. In some cases, multiple attempts will be made before sobriety takes hold. Addiction is defined by relapse and is chronic by nature. There is always hope even when relapse seems constant. The only way to create lasting change is to keep trying.
Medications Used
Medications can be extremely effective in helping patients to safely stop abusing drugs and alcohol. They may address the changes in the brain that occur due to chronic drug abuse or help to mitigate cravings. In some cases, they may even mimic the action of the addictive drug in the brain and help patients to avoid the bulk of withdrawal symptoms. Research is ongoing in this area and there are even vaccines in development that may one day help people to avoid ever experiencing the addictive high that often triggers addiction.
Not all substances of addiction have medications that are approved for use during the withdrawal process, but according to the National Institutes of Health, the following drugs may assist with detox:
Methadone
Used for the treatment of opiate addiction, methadone is highly restricted and must be taken in the presence of a medical professional when it is prescribed for the treatment of addiction. Patients must go to a methadone clinic daily to get their dose. Over time, as long as they remain drug-free and come in daily, they can earn “take-homes” or doses of medication to take at home so they don’t have to come in every day.
Buprenorphine
Prescribed as either Suboxone or Subutex, buprenorphine is the only drug approved for nothing but the treatment of opiate addiction. Available by prescription from doctors qualified to dispense the medication, the drug has also been shown anecdotally to have antidepressant effects as well. According to the National Drug Intelligence Center, there is a low chance for abuse among patients in recovery.
Naltrexone
Whether prescribed alone or in combination with buprenorphine in the form of Suboxone, naltrexone binds to opiate receptors in the brain and blocks the effects of opiate drugs taken in an attempt to get high. It has also been shown to be effective in alcohol detox; in both cases it can help to reduce cravings.
Acamprosate
This drug is prescribed when there are long-lasting withdrawal symptoms associated with drug and alcohol detox like insomnia, restlessness and anxiety.
Disulfiram
This drug may be prescribed to patients after alcohol detox when they are stabilized but attending addiction treatment and fear relapse. The medication can make the patient feel nauseous and vomit if he or she drinks while taking it.
Drug Detoxification Is the First Step to Recovery
Detox alone is not a complete treatment for addiction to any drug, including alcohol. In many cases, pre-existing psychological issues due to sexual trauma, grief, violent attack, and major changes in life like divorce or loss of employment can increase the chances of addictive behavior when drinking or abusing other drugs. These issues must be addressed in therapy once the withdrawal symptoms have passed and the drug toxins are no longer in the body. According to Principles of Drug Addiction Treatment published by NIDAMED, some effective therapies include:
- Personal therapy. Here the real work on underlying issues will occur.
- Family therapy. Family members can make or break effectiveness of treatment. Therapy that addresses problems at home will increase the chances of success.
- Medical services. For chronic illnesses and/or co-occurring disorders, proper medical care can help patients avoid self-medication with drugs and alcohol.
- Educational classes. Learning the effects of drugs and alcohol on the brain and body can help patients to avoid relapse.
- Relapse prevention. Creating an actionable plan to implement when faced with temptation will increase the chances of avoiding relapse.
- Life skills classes. Learning how to function and keep up with normal responsibilities will help addicts to feel more in control and less likely to turn to drugs and alcohol.
Find the Best for Your Needs Today
RehabInfo counselors are standing by at the phone number listed above to help you find a drug detox that is right for you and your circumstance. Whether you are experiencing physical or mental withdrawal symptoms, there is a program that can help you to move forward and heal. Call now for more information.