Opiate Detoxification

Medical Detoxification is a controlled and medically supervised withdrawal from addicting drugs, usually under the care of a physician. Drinking alcohol or using drugs can cause physical dependence over time and stopping them can result in withdrawal symptoms in people with this dependence. The detoxification process is designed to treat the immediate bodily effects of stopping drug use and to remove toxins left in the body as a result of the chemicals found in drugs and/or alcohol.

Medical Detoxification: In order to withdraw from certain addictive substances safely, it may be preferable and in some cases necessary to undergo medically supervised detoxification in a hospital or residential treatment center that has a detoxification unit. This would be advisable for patients that have been using an addictive substance heavily for a longer period of time and are more likely to have more severe withdrawal symptoms, or those with other significant health problems. Inpatient detoxification allows the patient to be closely monitored throughout the process and given appropriate medication to prevent severe withdrawal symptoms. It commonly involves the gradual administration of decreasing doses (tapering) of an agent that is related to the original drug of abuse that is now substituted to prevent withdrawal.

Rapid Detoxification: In this procedure drug withdrawal occurs while patients are asleep under general anesthesia. The patient is given intravenous injections of medications called opiate blockers which stop the action of narcotics and opiate drugs as well as injections of other medications that reduce the symptoms of withdrawal such as muscle relaxants or anti-nausea medications. This process results in rapid withdrawal from the physical effects of addiction. Through the use of opiate blockers such as naltrexone, naloxone, and nalmephine, physical detoxification is achieved within 4 to 8 hours. Rapid detox takes place in an intensive care unit of a hospital. Patients are usually discharged within 48 hours following recovery from anesthesia and assessment of their physical status.

Rapid detoxification helps reduce the distress of opiate withdrawal for people who are chemically dependent on narcotics such as heroin, Vicodin, Percocet, Demerol, Dilaudid, Darvocet, OxyContin, opium, morphine, codeine, oxycodone, hydrocodone, prescription painkillers, and all narcotic type drugs. It shortens the detoxification period and spares patients the pain and physical discomforts of withdrawal. It may be of great benefit to patients who suffer from severe withdrawal symptoms and who have failed repeatedly to complete conventional withdrawal programs . However, there are significant costs as well as risks associated with the use of general anesthesia. It is imperative that the procedure be performed by medical professionals who are highly trained in these procedures in a medical setting that is fully equipped to deal with any complications that may arise.

Stepped Rapid Detoxification:This alternative to rapid detoxification provides small doses of Narcan (Naloxone) injected just under the skin and naltrexone orally every hour or so, together with reduced withdrawal management medications, mostly orally, as necessary. This approach using the slower oral and subcutaneous routes rid the body of the opiate more slowly than intravenous Rapid Detoxification . In addition the pacing can be controlled and responsive to any withdrawal symptoms that develop in the patient by having them quickly suck on Buprenorphine tablets under the tongue. There is less need for withdrawal management medications. The patient is alert and directly communicating with medical staff until the situation has been resolved. It is possible to be detoxified and stabilized on Naltrexone Maintenance Therapy with 2 to 4 small manageable bites. If someone tries to use any kind of opiate while they are on Naltrexone, they feel no effect because all of the receptors are completely blocked.

Ultra Rapid Detoxification: This procedure involves putting patients under general anesthesia and giving them a drug called Naltrexone which blocks all of their endorphin receptors. This accelerates the withdrawal process, pushing them into 100% detoxification within a 5-30 minute period. Although this is an extremely painful process it is tolerable under anesthesia. As with rapid detoxification, it is very costly and has significant medical risk.

Outpatient Detoxification: Outpatient medical detoxification is usually safe and effective for people who are more likely to have mild to moderate withdrawal symptoms. For instance, opiate detoxification in the outpatient primary care setting can be accomplished with a variety of medications such as buprenorphine-naloxone (BUP/NX) or clonidine alone or combined with naltrexone. Buprenex, approved by the FDA, can be given on an outpatient basis by physicians who receive a required eight-hour training. Using Buprenex, the detoxification can take between 7-14 days.

Methadone: The most common method of opiate detoxification is to use Methadone in an approved clinic and slowly taper the patient down from the usual dose to zero over a period of approximately 21 days. This process still entails an uncomfortable withdrawal period and patients often use drugs during the withdrawal period.

Updated November 21, 2014