Medical Detoxification is a process in which individuals are systematically and safely withdrawn from addicting drugs, usually under the care of a physician. Drinking alcohol or using drugs causes physical dependence over time in some people. Stopping the use of alcohol or drugs results in physical withdrawal from these substances in people with a physical dependence. The detoxification process is designed both to treat the acute physiological effects of stopping drug use and to remove residual toxins in the body left as a result of using the chemicals found in drugs and/or alcohol.
Many patients experience mild to moderate symptoms during withdrawal and can undergo detoxification without medications if they receive supportive care and monitoring. Inpatient medical detoxification services are appropriate for alcoholics at risk for serious complications of withdrawal or those with co-existing medical conditions. These patients and those with previous alcohol withdrawal seizures, delirium tremens, or moderate to severe withdrawal symptoms should receive benzodiazepines to reduce the risk of adverse events. Other medications have also been used in the detoxification process including clonidine, an alpha-adrenergic agonist, and carbamazepine, an anticonvulsant used to prevent seizures or delirium.
More recently, outpatient detoxification has been shown to be as effective as inpatient treatment and less costly for people with less severe alcoholism. This requires daily follow-up and monitoring.
Outpatient detoxification is commonly performed by using a tranquilizer such as chlordiazepoxide 50 mg, oxazepam 15 to 30 mg, diazepam 10 mg, or lorazepam 2 mg every 6 hours for the first 24 hours. Additional medication can be provided as medically necessary and doses can be decreased as symptoms resolve. Supportive care for patients undergoing detoxification includes providing treatment for nutritional and electrolyte deficiencies, monitoring withdrawal severity and abstinence, and providing referrals to alcoholism recovery programs and self-help meetings.