Choosing the Right Detox for Those Who Want to Break Free from Substance Abuse
What are the different types of Detox Units?
Not all detox environments are the same. That is significant when choosing to stop addictive behaviors. And, just as treatment facilities differ in philosophy and approach, so do detox centers. Addiction treatment has changed over the last three decades with much more information about the nature of addiction, its impact upon the brain, and the behavioral aspects of the addict. All of these must be addressed to break through the stranglehold of addiction. Advances in pharmacology has made it possible to detox from substances in greater comfort, but detox should always be medically supervised.
First, detox is NOT treatment. Detox is the initial step needed to enter treatment. Detox is the process by which the body rids itself of toxic buildup of chemicals in the brain and body caused by substance abuse. The body stores chemicals in the brain, the liver, lungs, kidneys, intestines, lymph glands, and skin. Detox, a complicated process, depending upon the drugs and alcohol consumed, the length of time using drugs and alcohol, the number of times the body has gone through detox, and other medical and mental health disorders that are present can be life threatening.
Everyone who goes through detox goes through the body’s purification process sometimes with the help of medication, sometimes not. Evidence based practices indicates the need for medical supervision during a detox.
There are three different types of detox facilities.
- Stand-alone detox units- These facilities are dedicated to helping people detox. In these stand-alone units, a detox physician should be evaluating the client who will, upon completion of detox, need to be moved to a treatment program. These facilities are not always aligned with a treatment program leaving the client stranded increasing the chances of immediate relapse.
- Hospital detox units- In a hospital detox unit, detox occurs under medical supervision and may result in an incomplete evaluation as the focus is not on diagnosing the mental and physical state of a person. Instead, it is about safely moving the patient through withdrawal symptoms. Those suffering from mental health disorders and substance abuse disorders are often misdiagnosed in hospital detox units as physicians are not specifically trained in co-occurring disorders (mental health disorders and substance abuse). The client may be released with or without a referral to treatment. The client is again left to find his or her way to a treatment facility. Chances of relapse are greatly increased during this gap between diagnosis, detox and treatment.
- Inpatient detox units- Detox in these facilities, if it is a quality facility, will be monitored by an addiction specialist whose evaluation is used to create the patients substance abuse treatment plan. Inpatient detox facilities have the capacity to move the client from detox to treatment immediately. If the facility utilizes evidence-based practices, and its staff is multidisciplinary, then an appropriate diagnosis of co-occurring disorders should be made.
What is the difference between natural detox and medication assisted detox for substance abuse?
It should be understood that substance abuse severely alters normal brain function. The alterations, the body’s struggle to regain normal chemical functioning can produce severe physical and emotional responses. To that end, detox should always be medically supervised. In almost all cases, detoxing the body from drugs and alcohol will provoke intensely uncomfortable symptoms and many times they are life threatening. It is best never to face a detox alone as drug withdrawal or alcohol withdrawal can induce tremors, fevers, stroke, heart attack, seizures to name a few. In other cases, withdrawal symptoms can bring on
- Vision problems
- Psychotic breaks
- Joint Pain
- Slurred Speech
- Respiratory Distress
- Kidney and liver problems
- Mental confusion
As the body struggles to return to normal chemical balance in the brain and stabile communication between neurons and receptors, many other physical and psychological symptoms may arise. Sometimes, psychological conditions that were underlying use will be exposed, and the symptoms will be severe. Sometimes psychological symptoms appear that are extreme but are drug induced and will eventually disappear. Sometimes, symptoms can last for months after the drugs and alcohol are no longer consumed.
There are simply three ways to approach detox:
- 1. Cold turkey- no help, no aids,
- 2. Alternative detox process- using saunas, acupuncture and natural herbs to detox
- 3. Medically assisted detox- Supervised by a physician prescribing medication to address withdrawal symptoms
The problem with the first two detox processes is the withdrawal symptoms. Withdrawal symptoms from Benzodiazepines (central nervous system depressants), Barbiturates (central nervous system depressants), Opiates (central nervous system depressants), Meth (stimulant), are very different. Each class of drugs and alcohol has its own withdrawal symptoms, some more dangerous than others. Combinations of drugs mean more complicated withdrawal symptoms and a more dangerous withdrawal. For example, withdrawal from opiates may be extremely painful, but, it is not life threatening as in the case of barbiturates. Withdrawal from Barbiturates can be life threatening.
A certified addiction physician can make the withdrawal process more comfortable as he or she manages symptoms from diarrhea to anxiety or panic.
What is the difference between Rapid Detox and Medically Monitored Detox?
Over the last few years, many people sought rapid detox to avoid going through withdrawal symptoms caused by substance abuse. This procedure is used usually used on people suffering from opiate addictions such as OxyContin. Clients are put to sleep for one to two days as the opiates are removed from their bloodstream. After completion of rapid detox, many people will experience withdrawal symptoms leaving the client feeling disoriented. Follow up care is necessary. The client does not simply walk away clean. There continues to be much controversy over the efficacy of this form of detox.
Medically monitored detox is a process that usually lasts from a couple of weeks (for the worst of the physical symptoms) to months for cravings and psychological symptoms. Doctors will monitor the body’s response to withdrawal and will issue medications that can stop diarrhea or anxiety, for example.
In a quality detox facility, a person will leave detox and immediately move into treatment. There will be no substation of one addiction for another. In the case of opiates, for example, the client will leave detox free of the effects of opiates in the body and will not have substituted OxycContin for Suboxone, for example, one of the drugs used to manage opiate withdrawal. Only those medications that manage cravings (if needed) and mood will be prescribed, and these will be closely monitored during treatment. As the client stabilizes, drugs dosages should be reduced or stopped completely.
What Happens After Detox?
Regardless of how one goes through detox, treatment for addiction is needed. In treatment, clients learn about drug and alcohol addiction, relapse prevention, co-occurring disorders, life skills, triggers, managing feelings, managing medications, recreational therapy, family dynamics, goal setting, 12 Step Principles, nutritional counseling, exercise, setting boundaries, and other issues that can lead someone back to using drugs and alcohol. During detox, the above named topics are never approached as it is not the job of a detox facility to do drug and alcohol treatment. Treatment protocols for breaking the cycle of addiction can only be found at a dedicated substance abuse treatment facility.
Research has clearly demonstrated over time that a person needs to have a continuum of care. It is recommended that the client moves immediately from detox to treatment, from treatment to aftercare and sober living communities. These are the components that provide individuals with the greatest chance of maintaining long term sobriety.