Drug detox is the first step to a full recovery from drug addiction. It can help people quit using drugs and reduce crime, health care costs, and other problems that stem from untreated addiction.
The detox process usually includes evaluation, stabilization and preparation for addiction treatment. It can be done in an intensive inpatient medically monitored program, or it can be completed at home.
Medically Assisted Detoxification
As a first step to addiction treatment, medical detox helps individuals withdraw from drugs and alcohol. A combination of medications and clinical supervision help manage withdrawal symptoms during the process, which typically lasts a few days to a week.
Detox services must ensure that patients are stabilized and safely moved on to a higher level of care for ongoing treatment. Successful linkage of detox with a sound level of substance abuse treatment reduces the “revolving door” phenomenon of repeated withdrawals, saves money in the short run, and delivers the quality, humane, and medically appropriate levels of care that people need (Kertesz et al. 2003).
A significant challenge is that payers often pay only for detoxification, not the other components of a comprehensive treatment program. This TIP aims to educate clinicians about how to deal with such challenges and offers suggestions on resolving conflicts between the delivery of detoxification services and reimbursement systems.
Medication Assisted Detoxification
Many people try to detox on their own, but they can become ill or overdose. For this reason, it is important to find a detox program that is medically supervised by professionals. Detox programs can be outpatient or inpatient. For people with severe addictions, it is usually better to stay in an inpatient program, where they will be monitored around the clock.
During the detox process, physicians will monitor the patient’s vital signs and will administer medications to treat the symptoms of withdrawal, such as vomiting, diarrhea, headaches, fevers, seizures, and tremors. These medications can also help reduce drug cravings.
The Food and Drug Administration has approved medication-assisted treatment (MAT) for opioid dependence, including methadone. However, no medications have been FDA-approved to treat other substances of abuse such as cocaine or alcohol. In general, MAT involves the use of a combination of benzodiazepines and other sedatives to ease anxiety and insomnia, both of which are common during detox.
Outpatient Detoxification
The outpatient detoxification process involves frequent visits to a drug treatment program for medical and mental health check-ups. Medications are prescribed as needed to help ease withdrawal symptoms and make the experience more comfortable. Patients can also participate in addiction treatment programs during this time, such as one-on-one therapy and group sessions with clients who are in similar stages of recovery.
While outpatient detox is an effective treatment option for many individuals, it may not be appropriate for everyone. Those who have severe withdrawal symptoms, a history of relapse or serious co-occurring mental health disorders may need to undergo inpatient detoxification instead.
Ambulatory detoxification can be a good option for those who have already made arrangements to start an addiction treatment program, have a supportive home environment and don’t have risk factors for severe withdrawal symptoms. However, more research is needed on the effectiveness of this type of detox. Ultimately, the setting in which drug detox takes place does not seem to have a significant impact on treatment outcomes.
Inpatient Detoxification
While inpatient drug detox programs may feel restrictive to some, they provide a safe and structured environment to help you get through the withdrawal process. This allows you to focus solely on your recovery and not on the normal stresses of life. Having your meals, sleep, and other vitals monitored by staff provides an additional layer of security for you during this crucial time.
While there are different models of drug detox, most programs include the use of medication to ease withdrawal symptoms and medically managed withdrawal from opioids, benzodiazepines, alcohol, and some barbiturates. Some residential detox programs have more intensive medical oversight while others do not, depending on the model and setting used.
Successful linking of detox to treatment (as opposed to simply facilitating withdrawal from mood-altering drugs) is critical to foster recovery. It reduces the “revolving door” phenomenon of repeated withdrawals and detox admissions, saves money in the short run, and delivers sound, humane care to patients (Kertesz et al. 2003).