Acute care generally refers to hospitalization and 24-hour supervision due to the potential for serious side effects while sub-acute care is for people in good mental and medical health, who are generally more physically stable and committed to a recovery program, and who don’t necessarily require medical care or monitoring around the clock.
Sub-acute detox programs may be either residential, where you stay in a specialized treatment facility for a period of time, or outpatient, when you attend treatment during the day but reside off site.
Detox is the purging of drugs or alcohol from your system, and sub-acute detox may utilize counseling, therapy, and pharmacological methods to obtain physical and mental stabilization. Sub-acute detox may be a second-tier treatment for someone who has already completed a more rigorous inpatient detox program and has reached a safe and stable physical level.
Drug and alcohol abuse makes changes in the brain, and chronic abuse can lead to a dependency on these substances. Sometimes, removing these substances from the body can have life-threatening results if not managed carefully. Some substances of abuse are never recommended to stop “cold turkey” due to difficult, potentially dangerous, or even fatal consequences. These substances include:
- Opioid prescription narcotics, such as OxyContin, Percocet, Vicodin and hydrocodone
- In 2013, the National Survey on Drug Use and Health (NSDUH) estimated that more than 21 million American adults over the age of 11 were classified with substance abuse or dependency. Sub-acute detox programs can help manage difficult withdrawal symptoms and drug cravings by providing a safe and secure manner for removing these dangerous toxins from the bloodstream in a slow and controlled way. In addition, these programs set individuals up for a successful recovery from substance abuse and dependency via the use of therapy.
- Sub-acute detox may utilize medications in order to maintain a safe physical balance by managing withdrawal symptoms and curbing cravings. Counseling and therapy sessions can also help to modify negative or self-destructive thoughts and behaviors in order to achieve a healthier emotional state. Holistic, or alternative methods, may also be effective when employed during sub-acute detox programs in reducing relapse rates and improving overall well-being. The particular sub-acute detox program that is right for you may depend on your level of dependency and length of time abusing substances as well as the type of substance abused.
Withdrawal symptoms, such as nausea, restlessness, insomnia, tremors, anxiety, mood swings, and sweating, may begin within six hours of the last drink. According to the NIAAA, about 10 percent of those heavily dependent on alcohol will experience more severe withdrawal symptoms that may also include fever, rapid breathing, and an irregular heart rate, and 5 percent may also have seizures.
The most severe and potentially fatal form of alcohol withdrawal is called delirium tremens. Along with seizures and fever, it is also indicated by hallucinations and severe confusion. Generally, withdrawal from alcohol is more moderate. Symptoms are uncomfortable but not typically life-threatening when treated properly.
Alcohol detox programs may use either short-acting or long-acting benzos, which are sedatives that calm and relax the central nervous system and help to quell anxiety and tremors. Antidepressants may be used as adjunct medications to manage alcohol withdrawal as well. During sub-acute detox, you may already be beyond the most severe withdrawal symptoms and will instead be in the maintenance phase, so longer-acting medications may be more appropriate. You may also be only moderately dependent on alcohol, and medications may not be necessary. While sub-acute detox may not require around the clock medical monitoring, if you are taking medications to manage potential withdrawal symptoms, regular assessments and appointments will be necessary to ensure that the drugs continue to be effective, safe, and used appropriately.
In addition to medications, sub-acute alcohol detox also utilizes several treatment methods to promote healthy emotional balance as well. Peer support and 12-step groups are non-professional programs that can provide a positive network as well as a sense of unity and community while facilitating continued abstinence from drinking. A study published in Addiction found that those who sought some form of treatment – Alcoholics Anonymous (AA), a formal treatment program, or both – were less likely to relapse or engage in problem drinking.
Opioid withdrawal has both physical symptoms that may mimic flu side-effects and emotional ones, such as depression, irritability, restlessness, and anxiety. Sub-acute withdrawal is characterized by moderate physical symptoms, such as abdominal cramps, excessive tearing, yawning, dilated pupils, muscle aches, and a general sense of not feeling good.
Opioid withdrawal can be managed by Suboxone, Subutex, and Zubsolv. The buprenorphine products and partial opioid agonists can be prescribed by your doctor and picked up at a pharmacy. They can be taken during sub-acute detox, either at home or in a residential setting. Partial opioid agonists act on the same receptors in the brain as the full agonists do, just to a lower extent and reaching a plateau at a certain point.
Suboxone and Zubsolv also contain naloxone, which is an opioid agonist that remains dormant unless the drug is abused, and then it can quickly precipitate intense withdrawal symptoms. Sub-acute opioid detox may utilize these medications, slowly lowering the dosage over time. Opioid detox will also include psychotherapy sessions to help you define self-destructive behavior patterns that may act as triggers for drug abuse and teach you new life skills.
Sub-acute detox from stimulants and sedatives
The NSDUH reported that in the month prior to the 2013 survey, 1.7 million Americans over the age of 11 abused tranquilizers, such as benzodiazepines, and 1.4 million abused stimulants, including Adderall and Ritalin. Over time, your body develops a tolerance to these drugs as they build up in your system, requiring you to take more and more to have the same desired effect. For a smooth recovery, this process needs to be slowly reversed as the drugs are flushed from your body.
There are currently no approved medications specifically for detox from benzodiazepines or stimulants, although often long-acting drugs may be substituted for short-acting ones during a slow and controlled tapering schedule. Withdrawal symptoms for benzodiazepines may be largely psychological and include insomnia, depression, low energy levels, decreased focus, and concentration, as well as a rebound effect of the symptoms benzodiazepines are meant to suppress, such as panic, anxiety, and paranoia.
Stimulants include prescription medications, cocaine, and methamphetamine. The NSDUH published that in 2013, in the month prior to the survey, 1.5 million Americans aged 12 and older abused cocaine. In the same year, 1.2 million abused methamphetamine, as reported by NIDA. Stimulant withdrawal generally has side effects, such as intense mood swings, trouble sleeping, depression, headaches, fatigue, low energy levels, anxiety, and drug cravings.
Finding a treatment program that meets your individual needs is essential. The Recovery Village provides multiple levels of care offered by expert staff members. For more information on the best sub-acute detox program for you or your loved one, contact an admissions specialist at The Recovery Village today.