Drug Detox Program & Withdrawal Management
Going cold turkey. Getting on the wagon. Drying out. If you or someone you love is struggling with substance abuse, you’ve probably heard these terms more than a few times. They all refer to the same thing: Detoxification, the process of clearing any drugs, alcohol, or other addictive substances from your bottom.
Drug detox is a difficult — and sometimes dangerous — process, but it is an important part of the recovery journey. But whether you want help from a drug or alcohol rehab, the right approach to drug detoxification and withdrawal management depends on several factors that differ from patient to patient. Let’s discuss detox, withdrawal, and how you or your loved ones can safely get through this challenging part of recovery.
What is Detoxification?
Drug detoxification is the process of removing any drugs or alcohol from the body, helping you become physically well enough to focus on your treatment. Many substances are physiologically addictive, which means they can make an individual feel very ill if they don’t get more. Many rehab centers believe that a person who is physically unwell won’t be able to tackle the mental and emotional roots of their substance use, and so they require patients to detox from any substances before entering addiction treatment.
Detox can be a medical or non-medical process. Medical detoxification involves the use of medicines (anti-nausea medications, anticonvulsants, etc.) and other medical treatments to facilitate detoxification and prevent or manage its complications, also known as withdrawal. Medically-assisted detoxification and withdrawal management is especially useful in the treatment of opioid dependence, but it is also beneficial for the management of addiction to other drugs.
In contrast, Non-medical detox or “social” detox allows the patients to withdraw from drugs at their own pace while under the care and supervision of medical professionals. Unlike medical detox, social detox capitalizes on psychological and emotional support available in a rehab setting to help the patient while they recover from drug dependence or substance use disorder.
What Does it Mean to Detox from Drugs?
When a person wants to stop using drugs or alcohol, he or she will likely go through some period of detox or withdrawal. This is because of the physically addictive nature of many illicit substances. The body becomes accustomed to the effects of having the substance in its system — and when that substance disappears, the body responds by becoming very (often violently) ill.
Addiction treatment facilities strive to help patients detox from drugs and alcohol in as safe and comfortable a manner as possible. This might mean providing medication to mitigate withdrawal symptoms, but it can also mean simply being available for emotional support. Better Addiction Care can help you connect with an inpatient or outpatient rehab that can support you or your loved one in every way possible during detox and throughout their recovery.
Steps of Detoxification
Detoxification generally involves three essential steps or components: Evaluation, stabilization, and transition. Let’s take a closer look at each of these steps.
Evaluation is the first step in detox for drug addiction. During this step, addiction professionals assess your condition and determine the type of treatment you will receive. The rehab staff may test your blood for the presence of substances and their concentration, and they may screen you for coexisting medical and psychiatric conditions. The results of your evaluation will determine whether medical or non-medical detox is appropriate for you, and it also helps shape the treatment you receive after detoxification.
During stabilization, the rehab center assists the patient through acute intoxication and withdrawal. They may enlist medical and psychosocial services to help the patient safely and comfortably attain a substance-free state. Although pharmacological intervention is almost always required in the stabilization stage, particularly in the management of withdrawal symptoms, the emotional and moral support of the patient’s family and friends are also very important elements in this step.
Supporting Entry into Treatment
The final step in the detoxification process helps the patient prepare to enter a substance abuse treatment program. Rehab professionals will talk with the patient and emphasize the importance of completing the entire treatment program, especially if the patient has a history of failing to follow through. A written treatment contract can be made available to encourage adequate follow through and to complete every step of the care continuum. This contract is not legally binding and is voluntarily signed by patients at the beginning of treatment.
Why Is Detoxification Necessary?
Detoxification is necessary to avoid any adverse consequences of abrupt cessation or withdrawal from drugs. If an individual stops using drugs abruptly and without supervision, he or she can be at risk for severe side effects, including:
- Extreme agitation
Going through detox and withdrawal in a safe environment with trained professionals available to help can decrease the dangers that come with these serious complications.
However, not all patients of substance use disorder need to undergo detoxification. It is most important to detox for drugs that are considered physically addictive For example, long-term treatment of chronic nonmalignant pain with opioids may require detoxification. Primarily psychologically-addictive substances like nicotine, marajuana, or cocaine don’t always require detox — though it is important to note that it may be necessary to detox after long-term use of any kind of drugs.
Which Substances Need Detox for Treatment?
The substances that most often require detox before drug addiction treatment are opioids, methamphetamines, benzodiazepines, and alcohol. This is because these substances are most likely to affect the body on a physical level.
For example, alcohol detox and withdrawal can lead to extreme nausea, high blood pressure, and tremors that can be incredibly difficult to manage. Similarly, individuals who become addicted to prescription pain medication or other opioids often feel depression during detox; this is because their bodies have become accustomed to producing less dopamine due to the presence of the drug.
How Long Does it Take to Detox?
The amount of time it takes to detox varies depending on an individual’s health, how long they’ve been using a substance, and how much they use. Here are some of the typical detox periods for commonly-abused substances:
- Alcohol: Four to five days
- Opioids: Four to ten days
- Methamphetamines: Two to three weeks
- Benzodiazepines: Two weeks to several months (without professional intervention)
Can I Detox at Home?
While there’s no way to predict exactly how long a person may experience detox and withdrawal symptoms, getting help from a detox center or other treatment facility can always ensure that your symptoms are less severe — and that you are in good hands should you experience medical complications. But despite this, some people may prefer to go through detox at home.
Experts discourage detoxing at home, because of the risk of medical complications that comes with detoxification. This is why Better Addiction Care encourages individuals to detox in a safe environment like an inpatient rehab. If medical complications or other situations arise during the process, the professionals at these facilities can recommend appropriate adjustments to optimize treatment or even transfer the patient to the hospital if necessary.
Which Drugs Require Medically-Supervised Detox?
While some substances (like marijuana or nicotine) do not have severe withdrawal symptoms, others require medical supervision during the detox process. These drugs include the following:
- Opioids, including prescription drugs and heroin
- Benzodiazepines, including Xanax, Valium, Klonopin and Ativan
It is highly recommended to get professional help when detoxing from these drugs, as the risk of severe and even life-threatening symptoms is much higher than with other substances.
In order to better understand withdrawal management, its benefits, and how it’s done, it is best to discuss withdrawal symptoms first. Withdrawal symptoms become present in the body when a person stops or reduces their intake of a substance, such as opioids or alcohol.
The duration and intensity of withdrawal symptoms vary in each patient according to the severity of their dependence and the drug type, but they generally manifest as nausea and vomiting, diarrhea, anxiety, and insomnia.
Withdrawal Symptoms Associated With Specific Substances
- Difficulty sleeping
- Hot and cold flushes
- Excessive sweating
- Muscle cramps
- Nausea and vomiting
- Easily angered
- Difficulty concentrating
- Increased appetite
- Depressed mood
- Increased appetite
- Increased time sleeping
- Muscle aches
- Poor appetite
- Sleep disturbance
- Nocturnal perspiration
- Excessive perspiration
- Tremors, specifically on the hands
- Increased heart rate
- Increased blood pressure
Withdrawal management refers to the treatment of withdrawal symptoms. Treatment approaches for withdrawal symptoms range from medical care to psychological and psychosocial support.
Withdrawal management cannot be considered as a stand-alone treatment for substance abuse; rather, it is a crucial part of the overall management of substance use disorder. In general, withdrawal management facilities provide medical assistance to patients of substance use disorder through close supervision and access to pharmacological options in order to prevent complications of withdrawal.
Withdrawal Management of Specific Substances
The management for opioid withdrawal typically depends on the severity of the patient’s withdrawal symptoms. Mild opioid withdrawal can be managed with proper hydration and vitamin supplementation coupled with symptomatic treatment as opioid withdrawal usually manifests as nausea and vomiting, muscle cramps, and insomnia.
Moderate to severe opioid withdrawal necessitates medical care. Clonidine, buprenorphine, and methadone are some of the most commonly used medications in managing opioid withdrawal of this degree. These medications have the ability to reduce withdrawal symptoms and decrease cravings.
Nicotine replacement therapies (NRTs) are the first-line treatment for managing nicotine withdrawal. NRTs replace the nicotine from tobacco, thus preventing the development of withdrawal symptoms in the patient. Some of the approved formulations include transdermal nicotine patches, nicotine lozenges, nicotine inhalant spray, and nicotine gums. Behavioral therapies used as adjunctive treatment to NRTs also increase smoking cessation rates. Medications such as bupropion and varenicline also have proven benefits in managing nicotine withdrawal and improving quit rates.
Stimulants are psychoactive substances such as cocaine and methamphetamine. Patients who are experiencing symptoms of stimulant withdrawal must be closely monitored as they may develop complications such as anxiety and depression. There may also be increased risk of self-harm. Symptomatic treatment may be offered to address other concerns such as aches.
Some patients who have symptoms of stimulant withdrawal may develop psychotic symptoms such as hallucinations, paranoia, and agitation, which can present as dangers to the patient or to others. In this instance, behavioral management strategies may be employed. Diazepam may also be initiated in some cases. Severe agitation that is not adequately pacified by medications prompts transfer to a hospital care.
Cannabis withdrawal only manifests with mild symptoms and is best managed by providing psychosocial care. Patients must be placed in a secure, nurturing environment where adequate emotional and psychiatric support is available, as some patients may develop psychiatric disturbances in the process. Some of the complications of cannabis withdrawal include anxiety and dissociation. Close supervision of patients must be observed during therapy.
Abrupt cessation of benzodiazepine intake can cause life-threatening complications, so gradual reduction in the quantity and frequency of intake is instead recommended for patients. There are no hard and fast rules as to the process of tapering off; rather it depends on the starting dose, duration of therapy, tolerance of the patient, and the patient’s risk of relapse.
Benzodiazepine substitution may also be done with the use of anticonvulsants such as carbamazepine and pregabalin, which have been proven to have modest benefit and without significant withdrawal symptoms. Flumazenil is also useful to some degree. The use of antidepressants and beta blockers have yet to be proven.
Mild alcohol withdrawal can be managed through supportive care. The focus of treatment is alleviating symptoms and correcting metabolic derangements that could follow as consequences of long-term alcohol dependence. Multivitamin supplements, especially vitamin B1 must be given in order to prevent subsequent problems in cognitive functions.
Benzodiazepines such as diazepam may be used to control agitation. Diazepam is used in cases of moderate alcohol withdrawal alongside supportive care, but patients must be monitored closely for excessive sedation. Diazepam is also the therapy of choice in severe alcohol withdrawal, although high doses may be required in order to achieve desired effect.
The process of detoxification and withdrawal management can be long and difficult for patients of substance use disorder. Patients should be placed in a safe and nurturing environment. Treating patients with utter compassion and understanding can be critical for a successful recovery. Caregivers, family, friends, and other significant people must extend care and empathy to the patients as they will be needing a great deal of moral and emotional support throughout the entire process of treating their addiction.
Detox Safely with a Rehab Center
Don’t let drug detox keep you from enjoying a life of freedom from addiction. Call Better Addiction Care today and let our treatment advisors connect you with rehab locations near you that can help. Calls are free, confidential, and available 24/7. Whether you need to find a rehab facility that accepts your insurance or simply want to talk about your options, Better Addiction Care is here to help you take control of your life and stand up to your addiction. Call us today at (800) 429-7690.
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