Detoxification

Medical Detox

If needed, medical detox can be the first step in recovery.

It It helps you safely withdraw from drugs or alcohol, usually under the care of a physician. It treats the immediate symptoms of withdrawal and safely manages you through the withdrawal process.

Detox can be done as an outpatient at mental health centers and addiction clinics or as an inpatient at a hospital or residential treatment center. With inpatient detox your are monitored closely and the detox process is quicker. Outpatient detox fits into your life more easily and costs less. The choice depends on which substance you are using, how long and severe your use has been, your age, and any other health conditions you may have.

While treatment centers often have their own detox facilities, others make arrangements for patients to use detox programs at nearby sites, including hospitals and clinics.

There are licensed detoxification facilities in most areas of the United States.

To Find Detoxification Programs

Alcohol Detoxification

Many patients have only mild to moderate symptoms during withdrawal and do not need medications during detox. For those with less severe alcohol use disorder, outpatient detox with daily check-ins works as well as inpatient detox and costs less. Anti-anxiety medication is used every 6 hours for the first 24 hours and decreased as symptoms lessen.

Inpatient detox is best for people at risk of serious complications from withdrawal or those who have other medical conditions. Medications are used to help reduce symptoms such as tremor, mild depression, high blood pressure, anxiety and tension, and to prevent seizures or delirium.

Cocaine Detoxification

Withdrawal from chronic cocaine use can cause anxiety, depression and intense cravings for the drug. Different types of medications handle these issues in different ways.

• Antidepressant and anti-anxiety medications treat the changes in mood that can be brought on by cocaine withdrawal.

• Amantadine, a drug used to treat Parkinson's Disease, may also work for severe cocaine withdrawal symptoms and cravings.

• Bromocriptine, a drug that works on the brain's chemical system, reduces cocaine cravings during detox and helps even out the emotional ups and downs.

• Propanolol, a drug used to treat high blood pressure, calms the body's response to stress, including rapid heartbeat and sweating, and reduces cocaine craving. But its use for cocaine detox has risks and can lead to heart rhythm problems and a severe rise in blood pressure. Because of this, its use for detox requires careful medical monitoring and caution.

Opioid Detoxification

There are several ways to detox from opioids. To be safe, itmay be best and sometimes necessary to have medically supervised detox in a hospital or a residential treatment center that has a detox unit. This is especially important if you have been using opioids heavily for a long period of time or have major health problems. Medical detox allows you to be closely monitored during the process and given medication to prevent severe withdrawal symptoms.

Rapid Detox: Rapid detox eases the symptoms of opioid withdrawal if you are dependent on opioids such as heroin or prescription opiate painkillers. It shortens the detox period and may help you complete detox even if you weren’t successful in the past because of severe withdrawal symptoms.

In rapid detox you are asleep under general anesthesia in a hospital intensive care unit. Injections of medications called opioid blockers are given as well as muscle relaxants and anti-nausea medications. Withdrawal happens over 4 to 8 hours with discharge in 48 hours.

But there are high costs and risks with the use of general anesthesia. Rapid detox must be done by well trained medical professionals in a medical setting that is fully equipped to deal with any medical problems that may arise.

Stepped Rapid Detox: This is done in a medical clinic or hospital with specialized doctors and nurses. Very small doses of Narcan (Naloxone) are injected under the skin and naltrexone is given by mouth every hour. This removes the opioid from the body more slowly than intravenous Rapid Detoxification. The pacing can be controlled and any withdrawal symptoms can be quickly reduced by giving Buprenorphine tablets under the tongue. You are awake during the process and can then be stabilized on naltrexone which blocks all the opioid receptors.

Ultra Rapid Detox: In this form of detox you receive the drug naltrexone while under general anesthesia. This speeds up the withdrawal process, pushing patients into 100% detoxification within 5 to 30 minutes. Although this is an extremely painful process it is tolerable under anesthesia. As with rapid detox, it is very costly and has significant medical risks.

Outpatient Detox: This is usually safe and works well if you have mild to moderate withdrawal symptoms. It can be done with a variety of medications such as buprenorphine-naloxone (BUP/NX) or clonidine alone or combined with naltrexone. Detox usually occurs between 7-14 days.

Methadone: The most common method of opioid detox is to use Methadone in an approved clinic. It is slowly tapered down from the usual dose to zero over a period of 21 days. There is still has an uncomfortable withdrawal period and people often use drugs during this time.