The United States is currently struggling amid the worst drug crisis in modern history. As a direct result of this occurrence, there has never been a more critical period to end the stigma often associated with substance use disorders.
According to a recent news story released by The United Nations News, two-thirds of global drug deaths are now from opioids. The study highlights the severity of this epidemic leaking out of the borders of the United States into the rest of the world. On a global level, nearly 271 million people are struggling with substance use disorders, and the number is expected to rise continually.
Cocaine use and production have reached unprecedented levels, and in 2017, manufacturing from South America reached an all-time high.
Unfortunately, only one in seven will receive treatment, and not enough individuals with substance use disorders are being adequately treated. Effective treatment, which is based on scientific evidence is not available or accessible in a manner in which it should.
Addiction is a complex but treatable disease that affects brain function and behavior. No one is exempt from becoming addicted, and it’s important to remember that no single treatment is appropriate for everyone. Treatment must be readily available, and it must address multiple needs affecting the user. Medications are a significant element in treatment when combined with counseling and therapy, and the approach must be modified to meet changing needs. An important step is to detox is to ensure a safe transition into a newly founded state of sobriety.
While getting proper addiction treatment services has always been important, in the midst of the drug crisis that currently holds the United States in its grip, it’s never been more crucial for those struggling with a substance use disorder or their loved ones to seek out professional addiction recovery treatment.
For many years, there has been an intense stigma surrounding substance abuse that’s not only unfortunate and untrue but also dangerous, as it has led to people feeling like they need to hide their problem with drugs or alcohol rather than getting the help and treatment that could save their lives.
But as drug overdose rates continue to rise, there has never been a more necessary time to end the negative stereotypes and stigma towards addiction and recognize that it is a chronic illness and, just like any other kind of illness, both requires and deserves not only empathy and support, but professional treatment.
And the first step in substance abuse recovery treatment is getting the individual in need of treatment medically stabilized and flushing out the harmful substances and toxins from their system, which starts with a detoxification program.
As with nearly all aspects of addiction rehabilitation treatment, the process of detox is not a one-size-fits-all situation, and what works for someone may not be an effective treatment for someone else. With this in mind, it is important to note that there are different options available to those seeking medical detox treatment, such as whether to opt for private detox or detox hospitalization.
What is Detox?
Before being able to make an informed decision regarding which detox program will best fit someone’s needs, it is first necessary to properly explain exactly what detox is and what it involves. Detoxification is the process of removing addictive substances from the body to stop the physical and psychological harm caused by the heavy chronic use of drugs or alcohol.
Detox treatment, specifically, is a form of treatment that provides medical resources, interventions, and support to help manage any complications arising from acute intoxication. This includes treating the withdrawal symptoms that inevitably follow stopping the use of a substance an individual has become dependent on.
Detox ensures that people in withdrawal make it through safely, successfully, and with the least amount of discomfort as is possible through the use of medications and careful monitoring by a medical team that is well-versed with the ins and outs of addiction treatment.
Withdrawal symptoms are caused by the body attempting to regulate itself as it struggles to cope without the substance it has become used to regularly receiving. Continued heavy use of drugs and alcohol alter the chemistry and wiring of the brain and body, and it can often take a significant amount of time for everything to adjust and return to normal. Depending on the substance of abuse, it can be anywhere from days to weeks and sometimes even months.
Supervised medical detox is broken down into a three-step process that begins with an evaluation, a stage that entails being screened by the facility’s medical team to gather important information. During this period, doctors will:
- Administer blood tests to measure the levels of drugs or alcohol in someone’s system so they can determine which medications and what dosage of them will be necessary.
- Screen for any physical or mental co-occurring disorders that will also require treatment in tandem with detox.
- Conduct a general examination of overall physical health.
- Take all the information gathered and use it to make a risk assessment to predict how severe the individual’s withdrawal will most likely be.
- Use the data gathered during these screenings and tests to create an effective post-detox treatment plan.
The next step in the detox process is stabilization, which is exactly what it sounds like: keeping the person undergoing detox in stable condition throughout the withdrawal period, and keeping them free from harm and as comfortable as possible. This is accomplished through the use of methods such as:
- Medications to help make the symptoms of withdrawal easier to manage
- Ensuring that the individual in their care is provided with the proper diet and nutrition
- Employing psychological therapy if it is deemed helpful to the process
- Giving them an idea of what they can expect during the next step in the recovery process as they reach a sober state of stability
Finally, the last stage in the detox process is transition. At this point, the individual will have made it through the withdrawal period and, while they can technically exit care after this. However, it will not be at all effective without long-term addiction care so the medical staff will strongly encourage moving on to ongoing care as well as:
- Providing information and resources on different recovery treatment programs to help find one that will be most effective that someone can easily transition into.
- In the case of inpatient detox or detox hospitalization, completing the actual transition from detox to ongoing care within the same facility or an adjacent one.
Why Should I Detox?
Detoxification is never a particularly pleasant experience to have to go through, but it is an unavoidable first step to lasting recovery from a substance use disorder. Many treatment programs will begin with medical detox or detox hospitalization anyway as part of the overall treatment program.
A person can’t start their recovery if they still have drugs or alcohol in their systems; sobriety is a key part of rehabilitation. Similarly, recovery requires someone’s full attention and focus, and that simply cannot happen when that person is dealing with withdrawal symptoms that can range from distracting and uncomfortable to painful and even life-threatening.
Also, as previously highlighted, due to the ways in which addiction changes the functions of someone’s body and mind, stopping the use of drugs or alcohol once addicted is incredibly difficult, especially without help, and when someone does stop, they must deal with the mental and physical effects that come with it.
Depending on the substance someone was abusing and the severity of their dependence on it, withdrawal symptoms can range from more mild, such as:
- Muscle pain
- Fever, chills and other flu-like symptoms
- General mood swings
These symptoms are common to nearly all substance withdrawal. However, there are other symptoms more specific to substances such as alcohol or benzodiazepines that are much more difficult to manage and sometimes even dangerous, including:
- Delirium tremens
- Panic attacks
- Irregular heartbeat
- Suicidal behavior
If someone attempts to quit using drugs or alcohol “cold turkey” rather than through detox, they are much more likely to experience symptoms like suicidal thoughts and seizures due to the immense shock to the system quitting all at once triggers.
Is it Dangerous to Detox at Home?
Attempting to detox on your own creates a lot of unnecessary risks and means leaving yourself open to the consequences of some of the symptoms outlined above, like seizures or delirium tremens.
It also is much less likely to be successful, as many people find the symptoms of withdrawal associated with drug and alcohol detox too much to handle and will often relapse mid-detox.
This also raises the risk of accidentally overdosing, which frequently occurs when someone relapses and takes a much larger dose of a substance than they usually would to try and get relief from extreme withdrawal symptoms and drug cravings.
Finally, if someone experiences the combination of common withdrawal symptoms like depression and confusion along with hallucinations or suicidal thoughts, there is a very high risk of them harming themselves or worse.
Medical detox or detox hospitalization avoids these issues by mitigating withdrawal symptoms with medications and other therapeutic treatments while also keeping those in withdrawal in a safe, controlled environment where they are carefully monitored 24-7 and cannot hurt themselves or relapse.
Hospital Detox vs. Private Detox
Now that we’ve gone over exactly what detox entails, why it’s important, and why it should not be attempted at home or without some level of medical intervention, we can break down the different options for undergoing the detox process.
The two main types of detox programs are categorized as inpatient and outpatient. Outpatient detox treatment does not involve staying onsite at a facility but rather continuing with normal life and responsibilities while attending regular appointments at either a doctor’s office or outpatient detox clinic for medication and support during the withdrawal process. Outpatient detox is really only effective for those with less severe addictions that will result in mild withdrawal symptoms.
Inpatient detox, conversely, involves being removed from regular life and placed under round-the-clock care and supervision, which is the most effective option for those with a history of relapse who cannot detox successfully outside of the controlled environment of a treatment center. Inpatient detox also allows for a smoother transition into continued care post-detox.
Both private detox and hospital detox are forms of inpatient detox, and each has its own benefits and drawbacks, depending on what someone is looking for in a detox program. The main difference between the two is that detox hospitalization takes place, as one might expect, in a hospital, while private detox occurs at an independently-operated facility that provides all of its services in-house.
At a private detox center, the main drawback is the expense, and how much of it will be covered by an insurance company. The benefits, however, are fairly numerous, including:
- A wider range of amenities than hospital detox, such as semi-private rooms
- Being privately owned often means more money can be delegated to higher quality treatment and amenities
- A private detox facility is specifically dedicated to addiction treatment, whereas hospital detox is just one section of a hospital, which does not specialize in addiction treatment
- Private detox centers can provide a more individualized addiction treatment experience
Hospital detox, on the other hand, is a more institutionalized form of detox treatment. This can be necessary for those in the process of extremely severe withdrawal that needs intense medical attention and care that a private center may not be able to adequately provide.
However, detox hospitalization tends to operate under a stricter set of parameters and “lock-down” mode. Funding for hospitals also tends to be much more limited than private facilities, so there will be far less in the way of amenities and availability of certain creature comforts. While hospital detox will still provide a safe medical detox with the least amount of discomfort as is possible, this is essentially all that they can give due to the limitations in place.
There are several different types of medications that will be used during detox. The type of medication a physician administers will depend on the types of drug the user was consuming. Over-the-counter medicines have been proven to be effective in treating specific ailments associated with addiction. Medications such as Dramamine can treat nausea, while Tylenol can alleviate some aches and pains. In many cases, melatonin will be used to treat insomnia.
Opioid withdrawal is not life-threatening, but it is incredibly uncomfortable and could force someone to relapse that may not be using medications. The fear of being sick is a significant factor when it comes to stopping drugs. Detox medications can help the user cope with cravings and make the weaning process more tolerable. Drugs used in detox include:
Alcohol, benzodiazepines, and barbiturates are central nervous system (CNS) depressants, which means that stopping these drugs without help can become deadly. Medical intervention is the safest way to alleviate and reduce the chance of fatal symptoms. Benzodiazepines are used to treat withdrawal symptoms, and Valium is a common anticonvulsant that carries a low risk of adverse interactions.
Detox for stimulants is much different than other drugs we’ve mentioned. The reason behind this is that stimulants are psychological and mood-based, which means they carry similar effects to heroin or opioids. While there are no designated medications for stimulant withdrawal, detox centers commonly provide anti-depressants, muscle relaxers, or modafinil, which treats sleep disorders.