Description: Drug detox is the first step in any comprehensive addiction treatment program, whether the drug of choice is alcohol, prescription painkillers, 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. Medically supervised 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 – 39 percent
- Heroin – 16 percent
- Other opiates (e.g., morphine or opioid painkillers) – 10 percent
- Cocaine – 11.7 percent
- Marijuana – 17 percent
- Stimulants (e.g., methamphetamines, amphetamines, cocaine) – 7 percent
- Other (e.g., tranquilizers, hallucinogens, sedatives and hypnotics, PCP, over-the-counter medications, and inhalants – 1 percent or less
It is noteworthy that 45 percent of patients who entered treatment for alcohol use disorder also reported secondary substance use as well.
Drug detoxification is a difficult time for any individual who seeks a full recovery. This time period is vital, because the temptation to use again is at peak strength. For this reason, a medically-supervised detox is a good idea. Any person who struggles with substance use can benefit greatly from a supportive medical team, a safe and comfortable environment, and some dedicated time away from the people, places, and things that were once associated with substance use or process addictions.
Once detoxification is complete, dedicated residential or outpatient treatment can help the wellness process and insure against relapse. Rehab treatment offers the benefit of a number of therapies designed to address the different effects of addiction on the mind, body and spirit. By taking a look at the causes behind substance use, patients can move past physical dependence and begin to understand the underlying causes of substance use and build 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 substance use has been proven to alter the function of the brain over time. Regular misuse of substances will change the way the brain processes important chemicals and may even impact the individual’s ability to process emotions, thoughts, or sensations, even when the drug is no longer being actively consumed.
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 often experience a brief flood of “happy” chemicals during 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 addicted individuals unable to find happiness or pain relief without drug assistance. Additionally, the person using the substance may also be unable to control certain impulsive behaviors associated with drug abuse – angry outbursts, emotional reactions, paranoia, etc. – even when he or she is not actively under the influence of a substance. The only way to address these changes is to seek drug addiction treatment that starts with a detox program that provides caring assistance from experienced, informed medical professionals. With quality treatment and dedicated effort, it is often possible for individuals to return to more positive mental and emotional states.
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 opioid use disorders (e.g., to treat 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.
Substance detoxification is different for every individual. Variations in drug of choice, duration of substance use, or co-occurring psychological or health issues make recovery unique for each individual. With the right treatment assistance, a licensed medical professional can help adjust doses, pinpoint unique needs, and assist each patient as he or she goes through this period of adjustment.
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, acute cases of opiate dependence may be 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
- Underlying health issues
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 it Work?
The truth is that rapid detox does not work. The 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.
Rapid detox is a process in which patients are heavily sedated via general anesthesia for several hours, while an opiate blocker is administered. This process is presumed to “push” the opiates through the body quickly. However, there is no evidence to prove that this method is faster, effective, or even safe.
Rapid detox programs have long been proven to be ineffective and potentially dangerous. Furthermore, most major health insurance providers will not cover this type of treatment due to its lack of effectiveness and the dangers that it places on patients. There have also been reports of serious medical complications and even death due to previously unknown and undiagnosed medical disorders during this process.
Unfortunately, the patients who undergo this treatment often find themselves back where they started in a relatively short amount of time. According to SAMHSA, the average length of detox is fewer than eight days. 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 or Co-Occurring Disorder Affects Detox
A dual diagnosis (sometimes known as co-occurring disorders) occurs when the patient is diagnosed with both a substance use disorder as well as a mental health disorder like depression, anxiety, eating disorders, schizophrenia, bipolar disorder, PTSD and other issues. It’s a common issue. SAMHSA reports that more than half of those who are in rehab for an addiction issue are also struggling with a mental health disorder.
A thorough evaluation by an experienced medical professional can help assess for a dual diagnosis, and while it is difficult to fully diagnose a person who is in the throes of addiction, an understanding of a possible dual diagnosis can greatly help when it comes to addiction treatment. While the use of many substances can induce psychosis, paranoia, and other behavioral issues, a quality treatment program will be able to treat these symptoms and keep an eye for any underlying mental health diagnoses. Treatment of both addiction and mental illness are absolutely essential for anyone who desires long-term wellness. Dual diagnosis treatment centers are able to offer both substance use and mental illness treatment all in one location, thereby maximizing chances of a more full recovery.
When a dual diagnosis or a co-occurring problem is an issue, it is incredibly important to ensure that patients receive treatment for both the addiction and the mental health disorder at the same time, according to the National Institute on Drug Abuse (NIDA). Only a dual diagnosis rehab program can provide this level of comprehensive care. Psychiatric treatment in addition to medical support and ongoing therapy will be necessary to make sure that a treatment plan addresses the specifics of all of the patient’s issues at once, in one safe and comprehensive program.
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:
- Individualized Treatment: 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.
- Therapy: 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.
- Inclusive Treatment Plans: 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.
- Family Therapy: 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.
- Aftercare: 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.