The first thought that comes to people’s thoughts with the mention of drugs is cocaine or heroin, the hard drugs. Or a mental picture of someone injecting a syringe into their blood vessels or puffing up some powder up their nose. While all these are true, drugs today define more than just the cocaine or heroin. As a matter of fact, the most abused drugs in American society are the prescribed drugs which are often in the form of tablets. Moreover, many overdoses have been from prescription drugs rather than from heroin or cocaine as expected. So it is not just the illegal drugs that are being abused, it is the legal ones as well.
Take alcohol, for instance. Alcohol is the most commonly abused drug worldwide. In America alone, 17.3 million people are alcoholics while 138.3 million people drink alcohol. It is legally and widely available, hence there is no effort made to deal with it as with other illegal drugs. It is a sorry situation.
Drug and alcohol addiction has cost individuals their lives, families their peace and society its well being. The costs of healthcare, lost productive labor and social crime that the society has to bear is very unfortunate. Many divorces and broken homes have been attributed to alcoholism.
Statistics shows that the number of alcoholics and drug addicts is one the rise. It has become important for addicts, their families and the society to champion for detoxification. Detoxification is the beginning of the road to recovery. It helps to rid the body of drugs and alcohol. There are so many benefits associated with the detox process that an addict cannot miss out on.
So, who needs to go through the detox process?
- A person who has developed a drug tolerance and who find that over time the same drug dosage has a diminished effect than before thus he/she needs more of the drug to achieve the same result.
- A person who goes through withdrawal symptoms several hours or days after reduced intake
- A person who continues to take the drug to cover or avoid withdrawal
- A person who has tried to quit without success
- A person who needs more time to recover from hangovers
- A person who continues to abuse drugs even if it aggravates certain health issues he/she may be suffering from such as ulcers, depression etc.
Sometimes, addicts have a difficult time coming to terms with their addiction. More often than not, they live in denial. It becomes paramount for family members to look out for the following signs to establish if their loved one needs to go through the detox process. These signs help in telling an addict. If the person:
- Is withdrawn and secretive
- Neglects their responsibilities
- Exercises poor judgment
- Changes in appearance
- Exhibits maladaptive behavior
- Has drug seeking tendencies
The first step towards treatment of drug and alcohol addiction is the detox. It is the process of allowing any toxins to leave the body simultaneously managing withdrawal symptoms. There are different treatment programs where a detox can be done:
- Inpatient rehab, a fully committed and residential treatment program
- Outpatient rehab, a partially committed and non-residential program
- Teen rehab for teenage addicts
- Dual diagnosis rehab for people suffering from addiction and mental disorders concurrently
- Gender based rehab for particular gender
- Holistic rehab for holistic treatment programs which include meditation, yoga etc.
There are different kinds of detox:
- Medicated detox, which can either be fully or partially medicated. In a fully medicated detox, the patient uses medication to treat withdrawal symptoms and to curb cravings for the drug. They slowly reduce the amount of drugs they take overtime. It is recommended for people who have been addicted for a long time. In a partially medicated detox, the patient only takes medication to treat some withdrawal symptoms such as headaches or insomnia.
- Cold turkey detox. A cold turkey detox is a complete halt of the use of a drug without the supervision of a medical professional. A cold turkey detox can get dangerous and life threatening. The risks if quitting cold turkey include:
- a needless uncomfortable withdrawal
- an increased risk of a relapse
- an increased risk of an overdose arising from a relapse due to the lowered drug tolerance
- death from uncontrolled seizures and convulsion
Due to the withdrawal effects experienced during the detox process, a medically supervised process is highly recommended. This is especially for alcohol, opiate or benzodiazepine withdrawal. Some of the symptoms can be fatal. For example, seizures are common in alcohol withdrawal and if left untreated, they can turn out to be very fatal.
The importance of a detox
The continuous use of a drug can make one physically dependent on the drug such that the body cannot function without the substance in the system. When this kind of dependency occurs, abruptly quitting of certain substances can be life-threatening.
Detoxification helps with:
- Easing the discomfort of withdrawal
- Serious medical situations that may arise
- Creating a smooth path for an individual to travers the difficult time that follows the discontinuation of a drug or alcohol
- Reducing the risks of continued drug use
- Reducing the chances of a relapse to prevent the painful withdrawal
The safety of a detox
A detox is without a doubt a dangerous process that may endanger the life of the individual. The severity of the risks of a detoxification necessitate that the process be medically supervised even before treatment begins.
The drugs that require detoxification
A number of drugs require medically supervised detoxification because the withdrawal symptoms associated with the drug can make the addict dangerously agitated or experience seizures. They include: alcohol, barbiturates, benzodiazepine, opiates, prescription opioids and stimulants.
The detox process
The Substance Abuse and Mental Health Services Administration outlines three essential steps in the detox process. These steps are:
Developing a treatment plan tailored to the individual needs of a patient is very important. During this period of evaluation, the treatment providers can gather information about the patient in order to come up with a suitable treatment plan. Evaluation involves:
- Blood tests. Blood, urine and saliva tests can detect drugs for 1-4 days after they are used. So what the interview questions will not answer, the tests will. They reveal what addicts desperately want to keep hidden.
- This is to determine if there are any co-occurring conditions such as mental disorders
- A very detailed assessment of the medical and psychological status of the patient. While this may seem intrusive and a patient may be tempted to lie, they should not. It is paramount for the team to know the scope of the problems the addict is facing.
- An assessment of the patient’s social situation. The social situation decide what kind of treatment would be most ideal for the patient. What kind of social background are they coming from? Do they have the support they need during the detox process? Will it be inpatient or outpatient? All these questions help in clearly outlining what the efficient detox process for the patient should look like.
- A risk assessment to determine the severity of withdrawal and need for medical supervision. This assessment is useful in finding a limit to what drugs can and cannot be used in the detox process. What are the chances of the patient becoming addicted to the medication? What dosages do they need? How strict should the medical supervision be? Answering these questions will help the team establish what kind of medication program is suitable for the patient.
The evaluation process can get uncomfortable for an addict since addictions are surrounded with a lot of secrecy. Addicts dedicate time to develop skills that help them avoid any questions regarding their addiction. However, during evaluation they will have to answer questions concerning:
- Frequently used drugs
- Occasionally used drugs
- Dosage frequency
- Drug sources
The stabilization part of the detox process involves medical and psychosocial processes to help with the acute intoxication and withdrawal. This process involves:
The detox period is associated with a number of withdrawal symptoms whose level of severity depends on the duration of addiction and the type of drug. People who have been addicts for a longer period will often have more pronounced withdrawal symptoms as compared to those who have been addicted for a shorter period. When it comes to the type of drug, some like benzodiazepines have detrimental withdrawal symptoms that need to be treated or otherwise turn fatal. Some of the common withdrawal symptoms include:
The medications used during the detox process vary from drug to drug. We can have:
- Barbiturates, diazepam, valium, Ativan and Librium to treat alcohol withdrawal symptoms
- Clonidine, buprenorphine, naloxone, methadone and naltrexone to treat withdrawal symptoms associated with opiates.
- Desipramine and benzodiazepine sedatives to treat withdrawal symptoms from stimulants.
Unfortunately, even with these medications, there is a risk of getting addicted to them. For example, valium has become one of the most abused drugs in the name of alcohol treatment. Nevertheless, under the direction of a medical professional, the medication can help patients mitigate some of the withdrawal symptoms.
- Proper diet and nutrition
As mentioned, some of the withdrawal symptoms during detoxification are nausea and vomiting. These symptoms can prevent the patient from giving nutrition to the body. Nausea is often accompanied with a lack of appetite. However, patients need all the nutrition they can get during this period because their bodies are under immense stress. If they lack nutrition, then the immune system will be weak and unable to cope with conditions that may arise in the detox process.
The good news is that stabilization helps restore proper nutrition to the body. For example, vitamin B supplements are often used to aid the body with diet and nutrition.
- Familiarizing the patient with what to expect in treatment and recovery
The stabilization step is also important to prepare the individual on what they should expect next in the forthcoming journey. By doing so, they will be prepared psychologically to face the challenges they are bound to face in treatment and recovery. Mental preparation may just determine if they successfully complete the whole process of drug addiction treatment. Furthermore, the patient will make a decision if they intend to go on with the process and see it to the end.
- Involving friends and family when appropriate
The detox process is not easy. It takes a toll on one’s physical and mental health. Therefore, a support system from friends and family is so important. Moreover, the family needs to be informed on what to expect from the patient and how to deal with such situations. Their mental preparedness is important as well.
- Transitioning to treatment
This is the point where the rubber meets the rod. It basically involves preparing the patient to enter into substance abuse treatment. After the detox, the patient will be encouraged to follow through with the treatment program and aftercare. For many programs, after the detox, the addict can transition into their treatment program. It is not compulsory to attend their programs since the addict can choose to go for another kind of program.
Whatever the decision, it is paramount that the patient go into substance abuse treatment. The detox process is only the first step of the long journey ahead. Without the detox, the other steps of recovery are meaningless. In the same way, without the other steps of treatment, the detox in itself is pointless.
The other steps of recovery include:
- Behavioral therapy to establish what is the underlying cause of addiction
- Individual counselling to deal with the issues arising from behavioral therapy
- Group counselling to connect and interact with other struggling addicts
- Family therapy to involve the family in the treatment process and for them to receive closure as well.
- After care to help the patient transition into normal societal life after successfully completing the treatment program. After care is also important to keep the patient from relapsing.
The rapid detox process
In recent years, the popularity of the rapid detox has steadily risen. This rapid detox has been portrayed as a ‘painless’ detox process where a patient ‘sleeps through the withdrawal’. Basically, the rapid detox process involves placing the patient under anesthesia while they undergo through the detox process. It is supposed that people go through detoxification within hours rather than taking several weeks or days.
The rapid detox process is designed to speed up the detoxification process. Unfortunately, the process has been widely criticized by the Centers for Disease Control and Prevention. It has been shown to have substantial risks including death. Furthermore, there has been no evidence to prove that it actually speeds up the detox process.
The duration of the drug detox process
The length of a drug detox process varies from person to person. It depends on:
- The substance: some drugs take longer to wane the body off them
- The dosage: the detox process for higher dosages of a drug takes longer
- The duration of addiction: the longer the period of addiction, the longer the detox process.
Generally, the detox process ranges from a few days to a couple of weeks.
The cost of the detox process
The cost of the detox process depends on factors such as:
- The type of detox
- The type of rehab or treatment e.g. Is it inpatient or outpatient
- The type of facility i.e. is it private or publicly funded facility
- Medication used in the detox process. Some medications used to treat withdrawal symptoms in the detox process are quite expensive.
What a patient can do to help the detox process
It is the patient who stands to gain if they successfully complete the detox process. Sometimes, their behavior or misgivings can curtail the effectiveness of the process. To avoid this, the patient should:
- Know the rules of the detox process. Every treatment program has the same purpose but goes about that purpose in a different manner. For example, some rehabs do not allow hair products with alcohol while others do. Since it is the decision of the patient to join that specific program, they should abide by its rules.
- Time the last hit and how it was taken before they decided to enroll to a rehab. The information will help the team create a specific program for the patient
- Be completely honest during the evaluation period. It might be intrusive but it is for their won benefits. Questions should be answered truthfully and to the best of their knowledge. They should not try to hide or dodge anything. Doing so will only be to their detriment.
- Be willing to undergo all blood, urine and saliva tests. The patient should not find excuses to avoid these tests. They should give their specimen willingly.
- Surrender to the symptoms. The point of the detox program is to help people move through the withdrawal period safely and in a controlled manner. Discomfort is expected but it should not be a hindrance.
- Take their medications. The withdrawal symptoms associated with the detox process are quite severe. The patient should therefore follow the doctor’s instructions to the letter
- Commit to the program. The process gets hard and the patient must be willing to see it through. Really, nothing in life comes easy.
- Continue to recovery. After the detox process, the patient should follow through with treatment and recovery.
What patients should avoid during the detox process
There are a couple of things that a patient should avoid during the detox process if they want to achieve the intended results. They should avoid:
- Thinking that the detox is enough because the detox is only the beginning
- Being overly concerned with withdrawal symptoms as it will ingrain a fear of the detox process in them
- Entertaining a bad attitude. If a patient thinks about how terrible the process will be, then it will turn out to be exactly that. The patient should maintain a positive attitude
- Staying in isolation. Introverted addicts find it easier to isolate themselves during the detox process. Unfortunately, such isolation can cause depression which is not something an addict should be struggling with especially in the detox process. The support of others will make all the difference.
- Dismissing things immediately. Throughout the detox process, it is common to receive suggestions from staff, therapists and doctors. Such suggestions should not be taken lightly.
- For some patients, the detox process is smooth and easy which may tempt them to believe that the recovery process is easy as well. However, this may not be the case. Complacency puts the patient at risk of relapsing
- Giving up. There is no room to give up in the detox process. The decision to begin the detoxification journey is a huge step in the right direction. Therefore, the patient should have a clear vision of the target in their mind. Overcoming the challenges of the detox process is enough motivation to complete the whole program.
It is highly recommended that a patient should enter treatment immediately after a detox just to create a smooth transition. Most programs incorporate an initial period of structured detox in the program design. As mentioned earlier, there are different kinds of treatment that a patient can pursue and different options can be used throughout the treatment period.
The detox process is important for any addict who wants to get out of an addiction. It is not surprising that many treatment programs require that the patient go through the detox process before beginning treatment. But remember, detoxification is the first step and not the only step.
Individuals who need to go through the detox process should not be afraid of doing so. Despite all the effects the process will have on their persona, they should make a decision to commit to the process. Eventually, they stand to gain the most.