Drug and alcohol detoxification, also called detox, is often the first step in an addiction recovery program. Detox is the process which allows an addicted person to rid his or her body of the harmful toxins gained from abuse and restore health so they can continue to treatment.
What Is A Medically-Supervised Detoxification?
A medically-supervised detoxification program is made up of two components: a medical detox and the medical staff who oversee the individuals in detox. A medical detox is a treatment program that allows patients to safely withdraw from the drug of abuse. Some drugs of abuse can cause unpleasant, even dangerous, symptoms during the detoxification phase.
A medical detox provides the medication (when needed), support, and supervision necessary to succeed in detox. A medically-supervised detoxification is a program which provides access to clinicians, staff, and medical personnel who ensure close monitoring of vital signs, administration of medication, and mental and emotional support throughout the process.
Medically-supervised detox programs may be found in treatment facilities such as hospitals and drug and alcohol rehab centers. The best rehab centers provide a corresponding addiction recovery program to immediately follow the detox program.
What Drugs Require A Medical Detox?
Drugs of abuse which require a medical detox typically include those drugs which cause a physical addiction, also called dependence. These drugs usually create a psychological dependence, known as addiction, as well as dependence. When someone is physically addicted to a drug, he or she will experience withdrawal symptoms when not taking it.
For some drugs of abuse, these withdrawal symptoms can be dangerous or life-threatening, so it’s important to know which drugs of abuse require a medical detox. For people seeking addiction recovery, it’s best to consult with the rehab center of choice before making any decisions about medical detox. Not everyone who enters drug or alcohol rehab will need medically-supervised detox, and the only way to know for sure what an individual need is to get a full clinical assessment before entering a treatment program.
Whether a person needs to enter medical detox prior to an addiction recovery program will depend on the drug of abuse, duration of abuse, the frequency of abuse, presence, and severity of dependence, and the individual.
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Addiction Vs. Dependence
What is the difference between addiction and dependence? A person who is mentally addicted, but not physically dependent, will likely not experience withdrawal symptoms if he or she tries to quit using a drug of abuse. Instead, that person will be driven to continue seeking and using a drug due to the psychological addiction; the mind convinces the person to keep seeking the drug due to symptoms such as strong cravings.
People addicted to dependence-causing drugs experience actual, physical withdrawal symptoms: a headache, nausea, vomiting, and more. More severe drugs of abuse may cause seizures, and increased or decreased heart rate, body temperature, and blood pressure—all vital body functions.
Withdrawal symptoms for each drug differ according to the drug, the person using it, how long he or she has used it, and how often.
Medically-Supervised Detoxification For Alcohol
Alcohol is a drug which can cause life-threatening withdrawal symptoms. For this reason, detoxification from alcohol should not be attempted alone.
Alcoholism, also called alcohol use disorder, can cause painful, uncomfortable, and dangerous withdrawal symptoms. Withdrawal from alcohol may happen in stages, especially for those individuals suffering from long-term alcohol use disorder.
The first phase may happen as early as a few hours after the last drink and may include abdominal pain, nausea, sweating, and vomiting. The second phase is more severe and may cause increases in blood pressure, body temperature, heart rate, and mental confusion.
The third phase is only experienced by some people, often those with severe and prolonged alcoholism. Known as delirium tremens (or DTs), people in this phase of withdrawal may experience extreme agitation, hallucinations, high fever, and seizures.
A medically-supervised detoxification program for alcohol can help people safely withdraw from alcohol. Even though alcohol withdrawal symptoms may be intense, most tend to go away within a week, and medications can help ease some or most of these symptoms.
During medical detox, patients are regularly assessed to ensure safety and administered medication as needed. During this time, patients can also be assessed for any other physical problems, such as those commonly associated with severe alcohol dependence, like vitamin deficiencies. People who struggle with a dual diagnosis, also called co-occurring disorders, of a mental health issue, can receive help with this issue during detox as well.
Medically-supervised detox for alcohol is important for the safety of an alcohol-addicted individual. If someone has never undergone withdrawal from alcohol, he or she may not understand the risks associated with it. Medical detox programs help patients stay safe and regain their health so they can move on to addiction recovery.
Medically-Supervised Detoxification For Barbiturates
Barbiturates also cause dependence and withdrawal symptoms which may be life-threatening. Barbiturates are a class of depressant drugs which have largely been replaced in medical use by benzodiazepines. However, barbiturates still see instances of abuse and are highly addictive drugs.
Commonly prescribed to treat insomnia, seizures, and anxiety, barbiturates are abused for the sedative and hypnotic effects produced by the drugs. Abuse of barbiturates may produce feelings of euphoria, enhanced calm, and relaxation.
When people try to abruptly stop using barbiturates and have become dependent on them, they may experience the following withdrawal symptoms:
In addition to withdrawal symptoms, excessive doses of barbiturates can result in shallow and irregular breathing, reducing access to oxygen in the brain and leading to overdose. Barbiturate overdose can cause heart failure, hyperthermia (severely increased body temperature), coma, and death.
A medically-supervised detoxification program may help individuals addicted to barbiturates slowly and safely taper off use of the drugs. Using a tapering method, or slowly decreasing use of medications which replace the effects of the drugs and ease withdrawal symptoms, can help a person effectively and safely quit use of barbiturates.
Medical detox for barbiturates may be vital for people who have become dependent on barbiturates. The difference between a safe dose and a lethal dose of barbiturates is very small, so abuse of these drugs is always dangerous, and quitting them requires the help of medical personnel.
In a medically-supervised detox program for barbiturates, individuals can receive round-the-clock, daily care to ensure the safety of vital functions, monitor and prevent seizures, and administer medication as needed, as well as assess progress. Like alcohol, detox from barbiturates should be followed by an integrated addiction recovery program.
Medically-Supervised Detoxification For Benzodiazepines
Benzodiazepines, or benzos, are some of “the most commonly prescribed depressant medications in the United States,” according to the Center For Substance Abuse Research (CESAR). These drugs are prescribed to treat a number of conditions, the most common of which include anxiety and depression. The drugs have a high potential for abuse due to the sedative properties they produce.
Commonly abused benzodiazepine prescriptions in the United States include Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), Restoril (temazepam) and Valium (diazepam).
Benzodiazepines may also cause dependence and can result in severe withdrawal symptoms. Some people may quickly develop tolerance to these medications, which means they no longer feel the effects of them, and begin increasing dosage to get the desired effects.
However, increasing dosage of benzos leads to increased risk of overdose and adverse effects, and may also lead to the risk of developing dependence and experiencing uncomfortable or severe withdrawal symptoms.
Some common benzodiazepine withdrawal symptoms may include:
- memory loss
- mental confusion
- panic attacks
- abdominal cramps
- body aches
- digestive issues
- feelings of numbness or tingling
- increased blood pressure/heart rate
- insomnia/sleep troubles
- muscle pain
People who quit benzodiazepines after becoming addicted to or physically dependent on the drugs may experience the same conditions for which they were taking the medication, such as anxiety or depression. This is called the “rebound effect,” and may be responsible for keeping people addicted to benzos.
In a medically-supervised benzodiazepine detox program, individuals may taper off the use of benzos, receive medication to ease withdrawal symptoms, and be monitored to ensure safety, as well as be assessed daily for progress in restoring health and wellness. Detox from benzos should be followed by an effective addiction recovery program.
Medically-Supervised Detoxification For Opioids
Opioids are a class of drugs which produce feelings of relaxation and euphoria, among others when abused. Opioids include illicit drugs, like heroin, and prescription drugs like oxycodone (OxyContin) and hydrocodone (Vicodin).
Opioids are both powerful and addictive, and many of the drugs come with a high potency. People who take opioids may be unaware of just how potent the drugs can be, particularly those who buy opioids on the street which may be laced with other, more powerful opioids.
Common opioids of abuse in the United States include Rolatuss (codeine), Actiq (fentanyl), Vicodin (hydrocodone), Dilaudid (hydromorphone), Demerol (meperidine), Dolophine (methadone), Duramorph (morphine), OxyContin (oxycodone), Opana (oxymorphone), heroin, and synthetic opioid combinations, such as Gray Death.
Prolonged abuse of opioids like heroin can change the structure of the brain and may create nerve and hormonal imbalances. Though heroin is a potent, and highly addictive drug, other opioids, such as fentanyl, may be more potent. Fentanyl-laced heroin is becoming more and more common, and a person buying heroin on the street never knows when he or she may be consuming a much more potent opioid than he or she is used to.
Combining opioid drugs greatly increases the risk of overdose and development of dependence, which can occur quickly when abusing opioids. People trying to withdraw from opioids should seek medical supervision, as intense withdrawal symptoms may keep them going back to the drugs.
Opioid withdrawal symptoms may include:
- agitation or anxiety
- excessive yawning
- fever and/or chills
- hot and/or cold flashes
- increase in blood pressure and/or heart rate
- loss of appetite
- nausea, vomiting, and stomach cramps
- pupil dilation
- restlessness, insomnia, or sleep troubles
- a runny nose and watery eyes
- tremors, muscle and bone pain, body aches
A medically-supervised detox program for opioids may include medication and constant monitoring to ensure safe levels of vital functions. Many medications have proven effective at helping addicted individuals overcome opioid abuse, such as buprenorphine (brand names Suboxone and Zubsolv). A comprehensive treatment program, which treats all aspects of addiction and dependence, should follow a medical detox for opioids.
Is Medical Detox Necessary?
Medical detox may be necessary for a person who is dependent on a drug, especially if that dependence has lasted for several months or more. The only way to know if someone who is addicted to a drug needs medical detox is to receive a full clinical assessment, and many drug and alcohol rehab centers provide one.
The following are ways in which a medically-supervised detox may help individuals in addiction recovery:
- reducing the severity of withdrawal symptoms
- easing pain or discomfort, sometimes with the use of medication
- ensuring safety and health during detoxification with round-the-clock care
- assessing, identifying, and treating other physical symptoms during detox
How Much Does Detox Cost?
The cost of a medical detox program will vary from one rehab center to the next, and will depend on a number of factors, including if the patient enters a short-term program following detox (usually 28-30 days), a long-term program, and which treatment methods are used, as well as if the patient has insurance.
Many insurance plans will cover a medical detox program if it’s deemed medically necessary. If detox is deemed medically necessary, it’s likely the individual will also need to enter an addiction recovery program, which is why many rehab centers offer both a medically-supervised detox program and addiction treatment.
What Happens After Detox?
Detox alone is not the treatment for addiction; detox simply allows a person to restore physical health so they may respond to a treatment program. Detox is almost always followed by an addiction treatment program. Treatment methods included in the program should vary according to individual need and may include behavioral therapy, counseling, medication, holistic and alternative treatments, and more.
To learn more about medically-supervised detoxification and addiction recovery, call us today.
American Society Of Addiction Medicine—Opioid Addiction: 2016 Facts And Figures
Center For Substance Abuse Research—Benzodiazepines
National Institute On Drug Abuse—Commonly Abused Drug Charts, What Are The Long-Term Effects Of Heroin Use?