Drug detox

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  • Drug detoxification can be the first step toward a healthier, more positive future. But the prospect of going through detox and withdrawal is frightening to many drug users. How will withdrawal feel? Will detox be uncomfortable, painful, or embarrassing? How will you handle the stress and emotional pain of life without drugs? Refer to the following content below and become confident about your decision in committing to a drug detox program.

What is drug detox?

Drug detox is a time for your body to cleanse itself of any remaining toxins that stem directly from substance abuse. During this recovery period patients will experience both psychological and physical restorations to their body, as well as undesirable withdrawal effects. With any drug detoxification program it is important to keep in mind the program is not designed to completely cure your addiction, but rather, begin your recovery.

Detox programs are offered in a variety of settings, including hospitals, dedicated rehab centers, outpatient clinics, community health centers, and correctional facilities. Publicly funded detox programs are offered at little or no charge, while private detox centers may accept private payment or health insurance.

Common withdrawal symptoms

Withdrawal occurs when the brain and body are suddenly deprived of a drug after the user has become dependent on the substance. When you become addicted to a drug, your brain comes to depend on the chemical in order to feel good, function normally, and avoid withdrawal symptoms.

Withdrawal symptoms can vary from one drug to another. However, because many drugs target the same neurological processes and influence the production of the same brain chemicals, withdrawal symptoms are often similar. Withdrawal symptoms are never guaranteed to carry the same severity as another persons’ that’s in recovery, as the severity of these symptoms are dependent upon a number of things:

  • The drug(s) abused
  • The length of the addiction
  • The amount of the substance ingested during each use
  • Family history
  • Mental health condition

While withdrawal symptoms can differ depending on the above criteria, they also occur in different forms – emotional and physical. While emotional symptoms are bound to transpire no matter the abused drug, physical symptoms tend to be more selective towards those that abuse alcohol and opiates.

Emotional

  • Depression
  • Headaches
  • Irritability
  • Lack of concentration
  • Mood swings
  • Intense cavings

Physical

  • Tremors
  • Sweating
  • Nausea/vomiting
  • Insomnia
  • Difficulty breathing
  • Muscle tension

Life-threatening

The detoxification process

Choosing to walk through detox is your first step towards a life of sobriety. In this section we cast light on the process of detoxification. This process contains three main steps:

  1. Evaluation
  2. Detoxification
  3. Transition to Further Treatment

Step 1: evaluation

Evaluation is the first step in the drug detoxification process. Each person struggling with drug addiction is unique, as is their addiction. Professionals agree that this may be one of the most important facets understood for a successful detox. Body chemistry, how long one has been taking drugs, what kind of drugs one takes as well as the frequency and amount of drugs used all play a part in addiction. For that reason, to correctly diagnose, plan and execute a detoxification program the first step in the process is a medical evaluation.

What to Expect During Evaluation
During the evaluation phase our medical professionals and staff work with each individual to gather information vital to charting out a successful drug detox. This informational and screening will include some or all of the following activities:

  • An Individual Assessment Specific to Your Needs
  • Blood Tests
  • Co-Occurring Condition Screening
  • Medical Assessment
  • Psychological Assessment
  • Risk Assessment
  • Social Assessment

Step 2: detoxification

This step is often called stabilization as that is the result. Detoxification is the process of removing toxins from the body, thus medically stabilizing the body. This phase varies for each patient, but generally speaking, it is one of the most difficult. To combat drug cravings and withdrawal symptoms, medical and staff professionals carefully monitor each person during the detox process. Discomfort is a given during detoxification. To try to offset it as much as possible comfortable, quiet rooms are provided.

What to Expect During Detoxification
During the detoxification step, we take every possibly opportunity to foster a successful stabilization of the body. During this phase, you can expect:

  • Available, On-Staff Medical Professionals
  • Constant Care
  • Healthy, Nutritious Meals
  • Medication to Aid Withdrawal and Craving

Step 3: transition to further treatment

Detoxification isn’t the same as rehabilitation. Addiction is a mental illness that poses a continual battle. Detox is the first step in combatting addiction. Once the detoxification step is completed, it is time to move on to further treatment. Residential treatment is strongly suggested for individuals to develop recovery skills and regain a life away from substance abuse. In certain situations, other treatment programs may be recommended.

What to Expect During the Transition to Further Treatment
Once stabilized, the transition begins to focus on developing recovery skills and regaining a life away from substance abuse. During the transition to inpatient treatment, expect:

  • Availability of the Staff met during Intake and Detox
  • Review of Your Treatment Program
  • Tips and Coping Mechanisms to Encourage a Successful Treatment Program

Throughout the entire process, be assured that our staff of professionals will be in your corner. Our goal is to help break to bonds of addiction, and we take every individual’s unique challenges on as our own. For a first-hand account of the detoxification process watch this video featuring two recent individuals who made it through detox and are far along the path to recovery.

Types of drug detox

There are many possible approaches to drug detox, ranging from do-it-yourself detox using nothing but home remedies to state-of-the-art detox programs that include pharmaceutical therapy and 24-hour monitoring. If you aren’t sure where to start call our drug abuse hotline. Listed below are a few of the most commonly used detox options:

  • Quitting cold turkey. The only advantage to quitting drugs cold turkey is that you can save money on the cost of a detox program; however, this is probably the most dangerous and least effective way to break free from addiction. Without medical supervision, you could be at risk of changes in blood pressure, seizure activity, convulsions, hallucinations, confusion, and other serious side effects of withdrawal. For many people who try to detox alone, the cravings, agitation, depression, and anxiety cause a relapse before they’ve completed the withdrawal process.
  • Home detox kits. Home detox kits, available at drugstores, health food stores, and online, contain a combination of herbs, vitamins, and minerals that supposedly help you flush drugs from your system. Many users purchase these kits in the hope of clearing drugs like marijuana from their system before a urinalysis. But according to Columbia University, home kits are rarely effective. For the user who’s serious about leading a drug-free life, a home detox kit can’t cause the behavioral changes or psychological transformation that are necessary for long-term sobriety.
  • Outpatient detox programs. Outpatient detox programs are conducted at clinics, private doctors’ offices, rehab facilities, mental health centers, and other locations within the community. These programs allow patients to receive medical monitoring by doctors or nurses during business hours, and to take detox medications under supervision while living at home or in a transitional housing situation. Outpatient detox is appropriate for patients who are motivated to keep their appointments and adhere to the requirements of the program without extensive supervision or structure.
  • Inpatient detox. Inpatient detox programs provide intensive monitoring, pharmacotherapy, and 24-hour supervision for drug users who are at risk of serious side effects or relapse. In an inpatient program, patients stay on site while they undergo treatment. In order to provide continuity of care, an inpatient detox program may transition to a full rehab program within the same residential treatment facility.
  • Holistic detox programs. Holistic detox programs draw from a variety of alternative or complementary therapies, as well as traditional medical approaches, to detoxify the mind and spirit as well as the body. A holistic detox program may include nutritional counseling and spiritual support, as well as complementary detox therapies like massage, acupuncture, or yoga. Herbal remedies may be combined with conventional Western medicine to provide the best outcome.
  • Sub-acute detox. Sub-acute detox programs may be offered through an inpatient treatment facility, such as a hospital or rehab center, or at an outpatient clinic. Sub-acute detox is recommended for patients who are generally in good physical and mental health, and who are currently medically stable. This level of treatment is appropriate for patients who don’t require 24-hour supervision and who are committed to a recovery program. Medication and counseling may be provided as part of the program.
  • Medical detox. This level of detox is often conducted on an inpatient basis; however, intensive outpatient programs may offer medical detox, as well. A medical detox program is appropriate for patients who need pharmaceutical therapy as well as other clinical services, such as medical monitoring, IV fluid replacement, or nutritional support. According to the S. Department of Health and Human Services, the primary purpose of medical detox is to ensure that the patient remains safe and stable during withdrawal, avoiding seizures, delirium, and other life-threatening side effects.

Detox programs

At The Recovery Village we offer detox programs covering an array of substances including:

Withdrawal medications

Here are a few of the medications used to help reduce withdrawal symptoms during detox.

  • Anti-anxiety medications. Sedatives in the benzodiazepine family may be prescribed on a short-term basis to help reduce the anxiety, restlessness, and muscle spasms associated with drug withdrawal. Because these drugs have the potential to be addictive, their use should be limited and carefully monitored.
  • Medications for alcoholism. There are several medications used in the treatment of alcohol addiction. The oldest of these drugs, disulfiram, discourages alcohol abuse by causing unpleasant side effects when the user is exposed to any product containing alcohol. Newer medications, including Acamprosate and naltrexone, work by blocking the pleasurable effects of drinking rather than by causing an aversion to alcohol.
  • Drugs for opiate abuse. For centuries, pharmacists have worked to develop drugs that could resolve the problem of opiate abuse. Ironically, heroin was proposed as a cure for morphine addiction in the late 1890s. Since the 1960s, the most popular detox medication for opiate addiction has been methadone, a synthetic opiate that helps the user manage cravings and avoid relapse. Two other drugs, Buprenorphine and naltrexone, have also been used to help opiate addicts get through the detox process and stay on track with their recovery program.
  • Drugs to alleviate secondary withdrawal symptoms. A number of prescription drugs and over-the-counter medications can be prescribed to relieve physical withdrawal symptoms, such as nausea, diarrhea, headaches, or muscle pain. These drugs make it easier to cope with the side effects of withdrawal, so you can move into the next phase of recovery.

Specific detox medications

There are many types of medications used during detox. We’ve listed a few, but you can also find others here.

Acamprosate (brand name: Campral Rx, manufactured by Forest Laboratories) is prescribed primarily for the treatment of alcoholism, but it has also been used to treat addiction to benzodiazepines, a group of sedatives that includes drugs like diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), and Alprazolam (Xanax). Approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol dependence in 2004, acamprosate has been prescribed legally in Europe since the late 1980s. The active ingredient in Campral is calcium acetyl homotaurinate. Taken orally as delayed-release tablets, acamprosate works by restoring the normal function of neurotransmitters — especially gamma-aminobutyric acid (GABA) — to a brain damaged by alcohol abuse. In a detox setting, acamprosate can help relieve the anxiety, restlessness, and sleeplessness associated with alcohol or benzodiazepine withdrawal. By restoring healthy brain function, it can also promote abstinence in long-term recovery. The half-life of a dose of two 333-mg Campral tablet ranges from 20 to 33 hours, according to the National Library of Medicine. Because Campral is cleared by the kidneys, it is not recommended for people with impaired kidney function. Some users have reported kidney failure, while others have experienced suicidal thoughts while taking acamprosate. However, in comparison to other detox medications, acamprosate has relatively few side effects.
Buprenorphine, a semi-synthetic opioid, was first synthesized in the 1960s as an analgesic. In 2002, the FDA approved the use of buprenorphine for the treatment of opioid dependence. Buprenorphine is only the second drug to be approved for this purpose, after methadone. Currently, the most popular formulation of the drug is Suboxone (manufactured by Reckitt Benckiser Pharmaceuticals), a combination of buprenorphine and naloxone. Naloxone, an opioid agonist, was added to buprenorphine to reduce the risk of fatal reactions if the user should abuse the medication by taking it intravenously. Suboxone is now available as a film that can be taken under the tongue, preventing users from taking the drug intravenously.

Like methadone, buprenorphine helps to minimize opioid withdrawal symptoms and prevent relapse by replacing the effects of more addictive opioids, like heroin. Buprenorphine is less dangerous in overdose than methadone or other opiates, and less likely to cause respiratory failure. Unlike methadone, which must be dispensed through an authorized opioid addiction treatment program, buprenorphine can be dispensed by any medical professional who has been trained and certified in its use for opioid treatment.

According to Drugs.com, Suboxone is prescribed in an 8-mg sublingual film on the first day of treatment, with a target dose of 16 mg per day. The dose is increased quickly, usually in 2- to 4-mg increments, to help the user manage withdrawal symptoms and cravings. Metabolized by the liver, buprenorphine has a half life ranging from 24 to 60 hours.

Disulfiram is one of the oldest detox medications prescribed today. Initially developed in the 1920s, the drug was the first medication approved by the FDA for the treatment of alcoholism. In 1947, Danish researchers who were studying the drug as a treatment for parasitic infections discovered that it caused extremely unpleasant reactions after the user had consumed alcohol. In 1951, the drug received FDA approval for the treatment of alcohol dependence, and the drug was manufactured by Wyeth-Ayerst Laboratories as Antabuse. Antabuse is now manufactured by Odyssey Pharmaceuticals.

Disulfiram discourages alcohol abuse by blocking the body’s metabolism of alcohol, causing severe side effects within a half-hour after an alcohol exposure. Reactions may include sweating, facial flushing, breathing problems, headaches, nausea and vomiting, chest pain, an irregular heartbeat, dizziness, fainting, weakness, and seizures. The reactions to Antabuse are so severe that the alcoholic develops an aversion to drinking. Combined with talk therapy and relapse prevention treatment, Antabuse can be an effective recovery tool; however, the side effects can be so extreme that many alcoholics are unable to comply with treatment. A study published in Alcoholism, Clinical and Experimental Research proposed that compliance could be increased through patient education, treatment incentives or rewards, and patient contracts.

The active ingredient in Antabuse is tetraethylthiuram disulfide. Antabuse is available in the form of oral tablets. A typical initial dose is 500 mg per day in the early stage of recovery, tapering down to a maintenance dose of 250 mg per day. The medication has a half-life of 60 to 120 hours. Because Antabuse can cause severe side effects — aside from the reactions caused by taking the medication while drinking alcohol — the drug should only be taken under medical supervision as part of a comprehensive alcohol recovery program. Antabuse has been linked to liver damage, memory loss, nerve pain, seizures, and psychosis in some patients.

First developed in the late 1930s, methadone hydrochloride was initially synthesized as a treatment for moderate to severe pain. Although methadone is still prescribed for pain relief, its primary use in the US is the treatment of opioid dependence. Sold as Dolophine (manufactured by Mylan Institutional) or Methadose (manufactured by Mallinckrodt) and other brand names, methadone was first produced by German pharmacists in 1937 and was introduced in the US in 1947. Since that time, methadone has become one of the most widespread, effective forms of therapy for opioid addiction.  Like heroin and other opiates, methadone binds with opioid receptor cells in the brain, reducing sensations of pain. However, methadone does not cause the same euphoric sensations as heroin. When taken as part of a detox program, methadone can promote abstinence by interfering with the pleasurable sensations of other opioids while preventing opiate withdrawal symptoms. Some methadone users take the drug as part of an opioid replacement plan during early recovery, before being weaned off opiates completely. Others continue to take the medication as a form of maintenance, so that they can lead normal lives in recovery. There are a number of disadvantages to using methadone. As a central nervous system depressant, it can cause many of the same side effects as heroin or other opiates, including respiratory depression, a slow heart rate, and shallow breathing. Long-term methadone use can also lead to physical dependence, even if the drug is taken as prescribed. However, many users have successfully freed themselves from opiate addiction by replacing heroin or other drugs with methadone.

Methadone is available in several formulations: as oral tablets, dispersible tablets, an injectable solution or an oral solution. Methadone has a long half-life, ranging from 15 to 60 hours or from 10 to 40 hours, depending on the chemical formula, according to the National Highway Traffic Safety Administration. The typical dose for opioid addiction therapy can range between 30 mg and 120 mg, depending on the extent of the user’s opiate abuse and his or her tolerance to the medication.

Naltrexone hydrochloride, an opioid antagonist, was produced for the first time in 1963 to treat opioid dependence. In 1984, the FDA approved naltrexone for the treatment of opioid addiction, and the drug, which was manufactured by DuPont, was sold as Trexan. Through clinical studies of the drug, scientists discovered that naltrexone could discourage alcohol consumption by blocking the pleasurable feelings associated with alcohol. In 1994, the FDA approved naltrexone for the treatment of alcoholism, and the drug was marketed as ReVia. The current manufacturer of ReVia, an oral formulation, is Barr Pharmaceuticals. The drug is also sold by Mallinckrodt as Depade, and by Alkermes, Inc., as Vivitrol, an extended-release, injectable form of the drug. Today, naltrexone is prescribed both for opioid addiction treatment and for alcoholism. The drug is recommended for patients who have already been through alcohol treatment or opioid detox, and who have moved on to the next phase of recovery. Naltrexone can discourage the abuse of these substances by blocking the sensations of relaxation, euphoria, or contentment that these drugs can provide. In alcoholics, naltrexone can help curb cravings for alcohol, making it easier to get through rehab. Naltrexol, the active compound in naltrexone, has a half-life of 13 hours when the drug is taken orally, according to the Center for Substance Abuse Treatment. The recommended dose for healthy adults is 50 mg per day, but higher doses of 100 to 150 mg have proven effective in clinical trials.

Recent studies indicate that naltrexone may also be used successfully to treat cocaine dependence. In a study of 85 participants in a cocaine addiction treatment program, naltrexone was found to be effective at reducing the risk of relapse, when combined with relapse prevention therapy. Very few side effects were noted, and the participants tolerated treatment well. The study, published in Addictive Behaviors, indicates that naltrexone could help cocaine abusers recover from this deadly addiction.

Because naltrexone is metabolized by the liver, high doses of the drug can cause liver toxicity and liver failure. However, for individuals struggling to overcome alcoholism, the risks of side effects from naltrexone are minimal compared to the severe liver damage caused by heavy drinking.

Medication alone isn’t a thorough treatment for the disease of drug addiction. In order to achieve long-term recovery, detox medications must be combined with services like individual psychotherapy, group counseling, behavioral modification classes, 12-step programs, and holistic therapies. When you’re searching for a drug treatment program, look for a facility that offers a full range of resources.

Duration of drug detox

Detox programs can last anywhere from three days up to a couple of weeks; this is dependent on the type of drug(s) abused, the dosage of the drug(s) consumed at each use, as well as the severity of the addiction. Though while detox may last up to a couple weeks, depending on how severe the addiction may have been, withdrawal symptoms may still be apparent after initial detox treatment.

It is also important to keep in mind that there are many people who are unable to complete a detox program within first attempt. Multiple attempts at detox is not uncommon and should not deter you or loved one from continuing a life of sobriety.

Beyond detox

Detox is only the beginning of a long but gratifying journey toward recovery. One of the goals of detox is to prepare the patient for the next step in the rehab process. After completing a detox program, which may last from two or three days to two or three weeks or more, the patient is introduced to a more advanced stage of recovery, which includes services like individual therapy, group therapy, family counseling, 12-step programming, relapse prevention training, behavioral modification, and life skills classes. This phase may take place at a residential treatment center, outpatient facility, or through a partial hospitalization program.

Getting your loved one into a detox program

Pointing a loved one in the direction of professional medical care can be intimidating for both the victim and the intervening person. If you or a loved one are considering detox treatment, feel free to reference the following resources to help build your confidence in making the commitment to a life of sobriety:

 If you have more questions about drug detox, detox medications, or your options for treatment after detoxification, call The Recovery Village at any time. Our admissions specialists are ready to provide the answers and support you’re looking for.

Drug Detox was last modified: May 18th, 2017 by The Recovery Village