Detox or detoxification is the first step of most rehab programs, and something that anyone with a substance dependence problem can benefit from. Here, detoxification is quite simply the process of controlling withdrawal to prevent adverse psychological or physical effects. While many people can safely detox without medical intervention, many others require or could benefit from medical assistance to prevent dangerous withdrawal symptoms and side effects. Medically assisted detox is also popular, even when not-medically required, because it can greatly reduce withdrawal symptoms and increase the physical and mental comfort of the individual going through detox.
If you’re looking into detox solutions for yourself or a loved one, it’s important that you understand what medically assisted detox is, how it can help, and if it helps or has benefits over social model (without medication) detox.
What is Medically Assisted Detox?
Medically assisted detox is quite simply the process of using prescription medication to reduce and manage or control the symptoms of withdrawal. Here, drugs such as opioids, alcohol, and amphetamines cause extreme and dangerous withdrawal symptoms. For example, alcohol can cause seizures, opioid detox can cause extreme cold and flu symptoms resulting in dehydration and possible death, and amphetamines can cause grand mal seizures. Controlling even minor symptoms helps to alleviate symptoms and reduce the danger of withdrawal for both patient comfort and safety.
In most cases, drugs are used to relax muscles, reduce the effects of the drug the patient was or is addicted to, and calm agitation or anxiety caused by withdrawal. In detox, medication is primarily used to treat withdrawal symptoms. However, it may also be used for relapse prevention, and most medically assisted detox programs move into using substances for relapse prevention.
What Medications are Used in Detox?
In most cases, your doctor will determine a treatment schedule including medication that meets your specific needs. However, specific drugs are
- Naloxone – Naloxone or Narcan is an opioid receptor agonist, which attaches to the opioid receptors throughout the body, preventing opioids such as those found in heroin or a prescription narcotic from binding with those receptors. In detox, it is used to facilitate a faster withdrawal after immediate detox is over. Naloxone is also used in maintenance because it prevents relapse by blocking the effects of opioids. Naloxone can be fatal in individuals still using opioids.
- Methadone – Methadone is an opioid drug used to treat and manage opioid addiction by replacing more dangerous opioids and blocking their effects. Methadone is controlled and distributed once-per-day by licensed clinics, typically in pill form. While it can be abused, methadone is very effective in switching patients to a less-addictive opioid, reducing withdrawal symptoms, and tapering users off opioids without forcing them to go through dangerous withdrawal symptoms.
- Buprenorphine – Buprenorphine is an opioid used to block the effects of more addictive opioids, allowing patients to recover and seek out treatment without going through withdrawal. Unlike methadone, buprenorphine is difficult to abuse because it is difficult to get “high” with the drug. Most studies suggest Buprenorphine is one of the best solutions for treating opioid withdrawal because it has a lower withdrawal profile and a similar success rate to methadone.
- Benzodiazepines – Benzodiazepines are psychoactive drugs used to relax the muscles and relieve anxiety, to treat insomnia, anxiety, convulsion, seizures, muscle spasms, and panic in withdrawal. They are commonly used in short periods (typically 3-7 days) to treat withdrawal symptoms including seizures and short-term anxiety and paranoia, especially in alcohol withdrawal. Here, a long-acting benzo such as Chlordiazepoxide or diazepam are used to help patients withdraw from alcohol or a drug more easily without becoming addicted to the benzodiazepine.
Other medications including beta blockers, nutritional supplements, and various muscle relaxers are also used in treating withdrawal symptoms. Other types of opioid agonists are also commonly used including clonidine, oxazepam, and others.
Medically Assisted Detox for Opioids – Opioids are one of the most commonly abused drugs in the United States but also one of the most difficult to quit. With individuals struggling with both street drugs such as heroin and morphine as well as prescription painkillers like fentanyl, morphine, codeine, Vicodin, and OxyContin, opioid abuse is hugely dangerous and problematic. At the same time, opioid withdrawal is extremely difficult with many individuals suffering potentially life-threatening side effects including nausea and vomiting, chills, diarrhea, muscle aches and pain, restlessness, insomnia, agitation and anxiety, irritability, and paranoia. While not generally life threatening, medications including buprenorphine, suboxone, methadone, Subutex, and naloxone are used to reduce symptoms and prevent relapse by removing cravings. They are often used as part of a maintenance schedule to prevent individuals from relapsing long after they leave treatment. Other drugs such as muscle relaxers, typically benzodiazepines, are used to reduce anxiety and paranoia to manageable levels during withdrawal.
Medically Assisted Detox for Alcohol – Alcohol is one of the most commonly abused substances in the world, but also one of the most dangerous to detox from. With strong withdrawal symptoms including fever, agitation, hallucinations, confusion, seizures, cold and flu symptoms, and pain, detoxing alone is not only difficult but sometimes life threatening. Between 5 and 24% of patients also suffer from further complications including Delirium Tremens. Alcohol withdrawal is typically treated using benzodiazepines to stabilize seizures and mood alongside beta blockers and nutritional supplements to prevent crashing and depression or paranoia related to nutritional deficiencies.
Medically Assisted Detox for Benzodiazepines – Benzodiazepines are commonly used in recovery for other drugs, but with a strong potential for abuse and a highly addictive profile, many people require a great deal of assistance when detoxing. However, many benzos require a long tapering schedule to reduce long-term withdrawal symptoms, which primarily requires long-term medical supervision to ensure that complications do not occur. In some cases, individuals addicted to short-acting benzodiazepines such as Xanax or Ativan will be switched to a longer acting benzodiazepine, typically diazepam, to smooth out withdrawal symptoms.
Is Medically Assisted Detox Necessary?
Many people can detox safely and effectively with minimal medical monitoring and care. Medication often is not necessary and won’t achieve anything but adding to the comfort of the person in withdrawal. Many drugs have a relatively low dependence profile, which means that withdrawal symptoms are light and won’t likely require a great deal of medical supervision.
Some drugs also require a longer and more drawn out detox period, with a controlled tapering schedule to reduce potential harmful side-effects. Here, medically assisted detox may be necessary to allow a patient to continue to work, participate in their daily life, or to go to recovery and therapy while enduring a long recovery schedule.
Does Medically Assisted Detox Work?
Medically assisted detox can be essential in some cases but is often used to ensure clinical comfort, so that patients can focus on recovery and therapy instead of simply feeling sick. Medically assisted detox may also be necessary in cases where withdrawal is severe and could be dangerous, such as those addicted to amphetamines or heavily addicted to a drug such as opioids or alcohol.
Contrary to the popular belief that a hard withdrawal period will scare addicts into staying sober, receiving medical support during detox often has the opposite effect. Patients are allowed to detox in comfort so that they can focus on recovery and treatment rather than on making it through what is essentially an illness. In fact, most studies report a slight increase in positive outcomes for patients going through medically-assisted detox versus without.
Medically assisted detox is primarily about providing clinical comfort and helping patients to recover more quickly. If someone you know is suffering from a drug addiction problem, medical assisted detox is a valid and effective way to treat substance abuse, to get users into therapy and treatment more quickly, and to speed up the withdrawal process by preventing withdrawal symptoms and their complications.
To learn more about Medically assisted detox, please contact Lighthouse Treatment Center today for more information. We are here to help and happy to provide a no-cost, no-obligation consultation with one of our experienced treatment advisors.