When it comes to treating a drug or alcohol addiction, everyone has different needs. The severity of addiction may range from mild to severe, depending on how many symptoms one has and how badly these symptoms affect their life. The care they need to break this cycle and get out of the crippling addiction depends on where they fall in this range.
Most people who become dependent on alcohol or drugs experience sudden withdrawal symptoms when they try to quit. The effects of these withdrawal symptoms on their mind and body can be extremely uncomfortable and potentially dangerous. To safely get through them, it is necessary to seek professional help. This is where the role of detox comes in.
Detoxification is medical assessment and management of intoxication or withdrawal, with support to become stable and engage in continuing treatment. It is not simply removing every trace of a substance. Not everyone needs a separate detox phase, and detox alone does not treat all aspects of a substance-use disorder.
Professional withdrawal-management programs offer different levels of support according to each person’s needs. Medical monitoring, staffing and access to emergency treatment vary by setting.
Withdrawal management can be offered at several levels, from monitored outpatient care to intensive hospital treatment. Terminology varies between health systems. The following describes the main types of support:
Ambulatory Detoxification Without Extended On-Site Monitoring
This level of care includes an organized outpatient service monitored by experts at predetermined intervals. Some examples of this type include a detox that takes place in a physician’s office or under the care of a home health care agency.
Ambulatory Detoxification With Extended On-Site Monitoring
This type of detox is very much similar to the level of care described above but takes place under the supervision of credentialed nurses who keep monitoring all enrolled patients for several hours a day.
Clinically Managed Residential Detoxification
This particular type of detox ensures the provision of 24/7 supervision. Sometimes called as social detoxification, it comes with minimal medical oversight and instead relies on social and peer recovery support.
Medically Monitored Inpatient Detoxification
This placement level of care is much more restrictive than the one described above, as it comes with round-the-clock support and supervision for people experiencing withdrawal symptoms.
Medically Managed Intensive Inpatient Detoxification
As the most restrictive placement level of care for detoxification, it provides help and support to the patients round the clock in an acute care inpatient setting.
The choice of a detox type largely depends on the patient’s severity of withdrawal symptoms, duration of addiction, and current medical health.
A clinical assessment determines the safest setting and treatment for withdrawal. Depending on the substance and health risks, this may be monitored outpatient care, a specialist unit or a hospital. Care generally includes the following steps:
Detailed Evaluations
Prior to commencing detoxification, most rehabs conduct detailed evaluations and assessments on each client. These assessments aim to establish an accurate and clearer picture of their individual needs. During an assessment, an expert asks questions from a patient regarding their addiction history, past medical history, and current health status. If necessary, they may perform some blood tests as a part of this evaluation. Based on the results of these preliminary exams and investigations, the experts devise a personalized detox plan for each client that is likely to best suit them.
Withdrawal Stabilization
Once a detox plan is in place, an individual can officially begin the process. Many rehabs offer a medically-supervised detoxification experience in which a highly-trained and experienced medical team monitors each patient throughout their withdrawal process to stabilize them as much as possible. Most people in detox experience highly uncomfortable withdrawal symptoms, the severity of which depends on how long they have been addicted to alcohol or drugs, the type of substance they are addicted to, its regular dose, and the patient’s overall physical and mental health.
It is important to remember that every person goes through detox differently. Moreover, each detox can be an entirely different experience, even for someone who has already gone through it.
Some common physical withdrawal symptoms that may take place during detox include:
- Nausea and vomiting
- Muscle and bone pain
- Sweating
- Increased blood pressure
- Shaking and shivering
- Exhaustion
- Headaches
- Increased heart rate
- High temperature and chills
- Abdominal cramps
- Vivid and unpleasant dreams
- Runny nose
The psychological withdrawal symptoms of a drug and alcohol detox may include the following:
- Intense cravings for the substance
- Irritability
- Depression
- Confusion
- Anxiety
- Inability to concentrate
- Insomnia
- Paranoia
- Extreme mood swings
- Agitation
Medication Therapy
Medication depends on the substance, symptoms and medical history. Alcohol withdrawal may require a clinician-prescribed benzodiazepine regimen and thiamine. Opioid-use disorder can be treated with medicines such as buprenorphine or methadone, which may continue beyond withdrawal. The medicines below have different roles and are not interchangeable:
- Acamprosate helps maintain abstinence from alcohol after withdrawal; it does not treat acute alcohol withdrawal.
- Disulfiram is an option for selected people seeking abstinence after assessment. It causes an unpleasant and potentially dangerous reaction with alcohol and does not treat acute withdrawal.
- Naltrexone can help prevent return to drinking or opioid use in suitable patients. It does not relieve acute withdrawal and can precipitate severe opioid withdrawal if started before an appropriate opioid-free period. A clinician must assess timing and suitability.
- Buprenorphine treats opioid-use disorder and can relieve withdrawal when started appropriately. Starting it too soon after some opioids can precipitate withdrawal; initiation and ongoing treatment require clinical guidance.
Round-the-clock Support
Inpatient services may provide round-the-clock nursing and medical support, while outpatient programs use scheduled monitoring. The service must match the person’s risk and have a clear emergency transfer plan. Support reduces risk but cannot guarantee freedom from complications; seizures, confusion, collapse or breathing difficulty require emergency care.
Healthy and Nutritious Meals
Throughout the detox process, clients receive specialized meals thrice a day that are rich in minerals and vitamins that their bodies need to maintain energy and vitality. These meals are not only high in nutrients but are also a light on the stomach so that those going through a detox can easily digest them.
Private Accommodations
Detox can be an extremely emotionally and physically challenging time. Many rehabs offer clients a private space to recover to make it as comfortable as possible. These accommodations maintain their privacy and do not allow anyone to break their confidentiality or cause unnecessary disruptions.
