Drug detox is the first step in any comprehensive addiction treatment program, whether the drug of choice is alcohol, OxyContin, heroin, cocaine or a combination of substances. Depending upon the drug of addiction, the type of detox that will be most effective may vary, but the goal for each style of care is the same – physical and mental stabilization.Entering into treatment can be traumatic and for many patients, the first few days of rehab are a rollercoaster. When withdrawal symptoms are an issue, it can mean serious physical illness and when there is a co-occurring mental health disorder as well, detox can become even more complicated. In some cases, medication may be necessary in order to help the patient stabilize.
According to the National Institute of Drug Abuse (NIDA), drug detox is the process of letting the body flush all illicit substances and toxins out of the system while offering care for the resulting withdrawal symptoms. Detox is a highly effective treatment for physical dependence upon any drug of addiction when the detoxification period is followed through to completion. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the substances most often responsible for detox admissions include:
- Alcohol – 46.6 percent
- Opiates (e.g., heroin or opiate painkillers) – 34.8 percent
- Cocaine – 11.7 percent
- Marijuana – 2.6 percent
- Crystal meth – 2.5 percent
- Other – 1.6 percent
No matter what the substance of choice or the method of detox chosen, one thing stands true across the board – no matter what style of detox is chosen or what the focus substance, it is important to follow up with psychotherapeutic addiction treatment. By enrolling in a variety of therapies designed to address the different effects of addiction on the mind, body and spirit, patients can move past physical dependence and begin to sift through the psychological impetus for the initial development of addiction while learning effective coping skills for handling similar emotional struggles in the future – without turning to alcohol or drugs of any kind.
- Cocaine Detoxification Essentials
- The Basics of Heroin Detox
- Two or More Addictive Substance in the Body
How Drugs Affect the Brain
Drug detox is necessary because of the mechanism of drugs and alcohol on the function of the brain over time and regular abuse and addiction behaviors. According to the National Institutes of Health (NIH), drugs interfere with the brain’s communication system, disrupting how nerve cells use neurotransmitters to control brain function. Some drugs do this by mimicking natural neurotransmitters while other drugs disrupt function by blocking the normal flow of these chemicals in the brain.
Drugs also work by triggering the release of a large amount of certain chemicals associated with pleasure, like dopamine. They also block the natural recycling mechanism in the brain that reabsorbs those chemicals when appropriate. As a result, those who are under the influence of drugs experience a flood of “happy” chemicals and the high associated with drug use – seeking a repeat experience of this high is one of the primary reasons for the development of drug addiction, even as a tolerance to the drug of choice builds with each use.
Over time, the changes caused by acute drug abuse can become permanent or semi-permanent. The ability to self-regulate mood and fight pain naturally can be diminished, leaving patients unable to find happiness or pain relief without drug assistance. Additionally, patients may also be unable to control certain impulsive behaviors associated with drug abuse – angry outbursts, emotional reactions, paranoia, etc.– even when they are not actively under the influence of their drug of choice.The only way to address these changes is to seek drug addiction treatment that starts with a detox that may or may not include medications from consulting physicians to help the patient return to his or her pre-addiction mental and emotional state.
Management of Drug Detox with Medication
Medication is commonly incorporated into drug detoxification programs that include medical supervision from consulting physicians and psychotherapeutic support from your treatment team. There are a number of different medications that may be appropriate for the treatment of physical detox in setting supervised by your physician. For example, according to the U.S. Department of Health and Human Services, there are a number of medications approved for the treatment of opiate dependence (e.g., to treat a dependence on heroin, Vicodin, OxyContin, hydrocodone, etc.), including naltrexone, buprenorphine/Suboxone, and methadone. Each one requires a slightly different regimen and
the upholding of different regulations as defined by the federal government.
No matter what the drug of choice and the most appropriate medication, patients will experience different effects and go through a period of adjustment as the right dose is found by consulting physicians, but in most cases, they will quickly be able to begin the process of healing on a psychological and emotional level as their physical discomfort dissipates and they begin to feel more balanced.
Management of Detox Without Medication
Managing detoxification without medication is an effective option for some drugs of addiction but not necessarily recommended across the board, according to the National Center for Biotechnology Information. For example, opiate dependence is best treated with one of the medications listed above due to the intense nature of the withdrawal symptoms; however, detox from cocaine, alcohol, marijuana and other substances may be just as effective without medication. The appropriateness of this method may be based on a number of factors that will vary from patient to patient, including:
- Length of addiction
- Dependence upon other substances
- Amount of dosage at time of detox
- Diagnosis of co-occurring disorders
Patients are encouraged to discuss their drug history, medical history, mental health history, and previous attempts at drug addiction rehab with their intake team and consulting physicians in order to more quickly determine whether or not medication is the right option for their needs.
Rapid Detox Does Not Work
A myth about the efficacy of an ultra rapid detox that allows the patient to be free from opiate addiction overnight has been devastating to patients. Too many believe that it is possible. Others look for the “quick fix” and base their choice in detox and treatment on how quickly they can complete the program. Though there are ultra rapid detox options that sedate the patient under general anesthesia for several hours while under the influence of an opiate blocker the pushes them through the withdrawal symptoms, NIDA Notes Vol. 21, No. 1 (October 2006) says that there is no evidence to support the effectiveness of this approach. It is not an approved procedure for the treatment of opiate detox and is not covered by insurance. There have also been reports of serious medical complications due to previously unknown and undiagnosed medical disorders.
Unfortunately, the patients who undergo this treatment often find themselves back where they started in a relative short amount of time. According to SAMHSA, the average length of detox is four days until extended maintenance medications are used. Success rates among those who try to turn detox into a full treatment for addiction is low; the best results come to those who follow up detox with both addiction treatment and aftercare services that provide continued support.
How a Dual Diagnosis Affects Detox
A Dual Diagnosis occurs when the patient is diagnosed with both an addiction or drug dependence as well as a mental health disorder like depression, anxiety, eating disorders, schizophrenia, bipolar disorder, PTSD and other issues. It’s a common issue. The Journal of the American Medical Association [1990 Nov 21;264(19):2511-8] reports that more than half of those who are in rehab for an addiction issue are also struggling with a mental health disorder. It’s an issue that patients would do well to determine early on – the effects of both a drug-induced mental health problem and pre-existing mental health disorder can make detox far more difficult. In fact, it is often due to the effects of psychosis, paranoia, and other mental health problems that consulting physicians provide medications or even sedation to patients when they first enter treatment and begin detox; it’s the only way to ensure that they don’t inflict harm upon themselves or the substance abuse treatment professionals who are providing them care.
The primary concern when a Dual Diagnosis is an issue to ensure that patients receive treatment for both the addiction and the mental health disorder at the same time, according to Medline Plus. Only a Dual Diagnosis rehab program can provide this level of comprehensive care. Psychiatric treatment in addition to medical support from consulting physicians and ongoing therapy will be necessary to make sure that a treatment plan that addresses the specifics of the patient’s issues with both problems rather than treating first one then the other – and potentially making healing from the co-occurring issue more difficult.
Detoxification Is Not Enough
Drug detox is a crucial first step in addiction treatment and patients who experience withdrawal symptoms when they stop abusing their drug of choice cannot skip this step. However, according to the Principles of Effective Treatment published by NIDA, detox alone is not a total treatment. Instead, the following should be a part of a comprehensive drug rehab program:
Attention to personal needs. Drug addiction is the primary focus of detox and addiction treatment, but patients should also get the help they need for other issues as well. Problems at home, obstacles to employment or education, legal problems, health problems – all these should be addressed if they in any way exacerbate issues with addiction and trigger patients to relapse.
Therapies that address daily needs in recovery. Nutritional counseling, exercise and workout training, yoga classes, meditation, acupuncture sessions, massage therapy, and even resume assistance or help getting copies of important documents that will aid in gaining employment or signing a lease – all these things can help patients to take care of the tangible details that will pave their way in recovery and set them up for success.
Ongoing check-ins and updates to the treatment plan. Treatment is a fluid process. In some cases, patients will progress rapidly, making significant progress that was unexpected. In other cases, a patient may get hung up on a specific issue and take a bit longer than originally thought to achieve a treatment goal. In both cases, regular check-ins with a therapist at a one-on-one appointment that is scheduled into the week will enable patients to adjust and modify their treatment plan as needed.
Inclusion of family in therapy. Addiction deeply affects the patient’s experience with family members, and the rifts that it causes as well as ongoing issues from childhood can be a constant source of pain – and a trigger for relapse – for the recovering addict. By incorporating family therapy, educational workshops, support groups for family members, and visitation options into the treatment plan, patients and their families can lay the groundwork for the healing that will inform a more positive relationship going forward.
Ongoing support after treatment through aftercare services. Whether the patient opts for the more comprehensive, inpatient sober living aftercare option or a carefully chosen schedule of outpatient aftercare services, it is important to make sure that recovery continues long after rehab is over. Patients can choose the option that is appropriate for their comfort level as they get closer to the end of treatment. If there is a question about what will best serve them, they can create an aftercare plan with the aid of their therapeutic team.
Learn More About the Detox Process at Michael’s House
Here at Michael’s House in Palm Springs, California, we offer a wide range of detoxification options for patients, provided by staff members who specialize in the treatment of substance abuse. We collaborate with consulting physicians and follow up with comprehensive addiction treatment and a range of aftercare services as well – all chosen and incorporated into a unique treatment program to meet the needs of each individual patient.
Contact us today for more information on how we can help you or your loved one begin the healing process after drug and alcohol addiction.