According to government data, there are over 72,000 drug deaths a year and 88,000 annual alcohol-related deaths in the United States. There are tens of thousands more that struggle with some kind of substance abuse disorder whether it be alcohol, illicit drugs, or prescription painkillers. According to data from the White House, over 2 million people deal with an addiction to opioids. If these people with substance abuse problems are not careful, it could get the best of them and they could be a contribution to next year’s drug and alcohol death statistics that seem to be rising every year.
Seeking treatment for drug or alcohol addiction is a tough thing to do. Admitting that a problem that has gotten out of control may seem dreadful, but admitting the problem is the first step in putting you back into control and it could also save a life. Treatment is not something that people seeking recovery should fear. The medical personnel involved in treatment are there for one thing: to help. During treatment you will go through a lot, most of which can be broken down into three categories: detoxification, inpatient treatment and intensive outpatient care.
Detoxing the body from drugs is the very first step during the recovery process. Going through the detoxification process not only ensures that your body is stabilized after dealing the the initial withdrawal symptoms associated with drug addiction but also frees up the mind and body to focus on the next steps in the treatment process.
Detox refers to ridding the body of dangerous and life-threatening levels of drugs and alcohol and for the safest results drug and alcohol detoxes should be done at a hospital or rehabilitation clinic. It is characterized by the use of a physician and nursing staff and the administration of medication to assist people through withdrawal safely.
Drug detoxification is a medical intervention that cleanses the toxins from the body of a patient who is acutely intoxicated and/or dependent on substances.
Although detoxification alone is rarely enough for addicts to achieve long-term sobriety is a the best first step for dealing with substance abuse issues.
According to the U.S. Department of Health and Human Services, there are three components to the detoxification process: evaluation, stabilization, and fostering for treatment.
The evaluation portion of the detox process includes the testing for the presence of substance abuse in the bloodstream, measuring the concentration and screening for other mental or physical conditions. Evaluation is essentially an assessment of the patient’s medical and psychological conditions they are facing. It also examines the social situations that may have caused or contributed to the problem. All of this determines the the appropriate level of treatment the will receive following detoxification.
The stabilization step of the detoxification process is what people mainly think of when they think of detox. Stabilization includes assisting the patient through acute intoxication and withdrawal until the patient attains medical stability, fully supported in a substance-free state. During this time, some medical professionals may seek out the involvement of a patient’s loved ones or employers when appropriate.
Fostering the Patient for Treatment
Detoxification and becoming sober sometimes isn’t enough. Normally, those in drug or alcohol treatment see their best results if they go through a complete substance abuse recovery program that can help educate them on the dangers of these substances and methods that may help prevent a relapse.
While there are normally certain steps for all cases of detoxification, each detox is different based on the certain circumstances, the most important being what type of substance is being used.
Opioids are a highly addicting and chronic use can lead to withdrawal symptoms that, while they may not be fatal in all cases, can cause intense discomfort. Opioids consist of illicit drugs like heroin and synthetic opioids like morphine and fentanyl. Prescription opioids have become increasingly popular over the past decade and lead to almost half of all overdoses in the country now.
Most opioids produce similar withdrawal symptoms but can change depending on the level of severity of the addiction. Some withdrawal symptoms include:
- Abdominal Cramps
- Muscle and bone pain
Medical professionals normally will use intoxication and withdrawal measures as guides for medication during medically-supervised detoxification. Clinicians will normally manage significant opioid withdrawal symptoms with the use of medications. Methadone tends to be the most frequently used agent for detoxification. Medications are used to help clinicians not only treat the withdrawal symptoms that patients will inevitably face, but also to help wean the patient off their respective opioid slowly.
Stimulants like cocaine and amphetamines are some of the most frequently abused substances in the country. Cocaine alone contributes to over 14,500 drug deaths every year. Meanwhile, amphetamines contribute to almost 10,000 annual drug deaths.
People who use stimulants generally do so in binge episodes followed by periods of withdrawal. Some symptoms associated with opioid withdrawal include:
- Poor concentration
Stimulant withdrawal is not normally linked to medical complications. However, cocaine use is one stimulant that can lead to cardiac complications. These can lead to cardiac rhythm disturbances, chest pain and even seizures during detoxification.
Alcohol-based detoxification is, like all forms of detoxes, slightly different in treatment method. The treatment also depends on the blood alcohol level and the developed tolerance of the patient. Levels of intoxication range from loss of muscle coordination and changes in mood to slurred speech and vomiting to coma and eventually respiratory and cardiovascular failure.
The goals of treatment for alcohol intoxication are to preserve respiration and cardiovascular function until alcohol levels fall into a safe range.
Some withdrawal signs that are associated with alcohol include:
- Restlessness and irritability
- Poor concentration and impaired judgement
Despite the fact that seeking medical help during the detoxification process is the safest way to go, there are still health risks involved with alcohol withdrawal, including death. Seizures and imbalance in body temperature, pulse, and blood pressures are all outcomes of severe alcohol dependence that can lead to death even in a medical setting.
Other complications associated with alcohol withdrawal include:
- Gastrointestinal bleeding
- Cardiomyopathy (dilation of the heart with ineffective pumping)
Risks of At-Home Detox
It is clear that even in a medical setting, detoxes can be a dangerous thing whether is be stimulants, alcohol, inhalants, or another drug that can cause complications. These medical risks are exacerbated even more if the detoxes are not done in a treatment center or hospital.
Attempting an at-home detox can lead to detrimental effects, even death. It is recommended that if you are looking into drug or alcohol detoxification, you should look into going to a recovery center or hospital as it is the safest option for the withdrawal symptoms that patients will undergo.
Not only is going through an inpatient treatment detoxification program safer and reduces risk of a major health problem, but it also normally leads to longer retention rates of patients and increased treatment efforts.
During treatment, some medical clinics elect to use medication to help patients come down from their addiction and to slowly wean them off the substance that they are abusing. Medication-Assisted Treatment (MAT) can be effective in leading patient to a sober and healthy lifestyle that they are seeking.
As mentioned before, methadone is a common form of MAT for patients who are suffering from opioid substance abuse. Federal regulation allows for the use of methadone in a short-term detoxification treatment of less than 30 days, and long-term treatment of 30 to 180 days.
It is a long-acting agonist that can help reverse opioid withdrawal symptoms. Once a methadone dose is established, it is generally given once daily and tapered over 3 to 5 days in reductions of the dosage.
While methadone can be effective in helping patients wean off their opioid dependency, if not done correctly it can lead to overdose.
Suboxone is a brand of medication that uses buprenorphine and naloxone to treat addiction to opioids and painkillers. It is a partial opioid agonist suppresses the withdrawal symptoms and cravings for opioids. While patients can get high on methadone and overdose, Suboxone can only get patient so high before it stops working, something that is called the “ceiling effect”.
Vivitrol is one form of MAT that has proven to be effective in preventing relapses. It is a non-addictive antagonist that is used for opioid and alcohol addiction. Following the detoxification of a patient, vivitrol is injected. Vivitrol creates a barrier that blocks opioid molecules from attaching to opioid receptors by blocking the receptors in the brain, essentially it eliminates the euphoric effects associated with opioids.
A 6-month study of vivitrol found that patients had less cravings, were opioid-free for longer, were 17 times less likely to relapse, and were more likely to stay in treatment for longer.
The effects of vivitrol last for one month.
To reiterate an important point, in order for the best, longest-lasting results, detoxification and MAT should be used in conjunction with inpatient and outpatient treatment. Detoxification should not be used in place of those other forms of treatment.
History of Detoxification
There were many factors that went into the change in the medical field that encouraged detoxification. Some of this including shifts in perceptions of addiction and social change but there are a few notable events in particular that contributed to the change.
In 1958, the American Medical Association officially took the position that alcoholism was a disease. Changing the perception that alcoholism was a medical problem that required medical attention not only changed the way that the medical community looked at alcohol abuse but it began to change how the general public perceived it as well.
In 1968, Congress passed the Alcoholic Rehabilitation Act of 1968. It was the first federal law that dealt with the treatment of alcoholism. It declared that dealing with chronic alcoholics in the criminal justice system simply perpetuates the problem of alcoholism. Whereas treating it as a health problem contributes to early detection and prevention of the issue, leading to more effective treatment and rehabilitation.
Then, in 1971, the National Conference of Commissioners on Uniform State Laws adopted the Uniform Alcoholism and Intoxication Treatment Act. It was designed to provide states with the framework for which they were supposed to approach alcoholism and public intoxication. Essentially, the Act recommended, but did not require, that alcoholics not be subjected to criminal prosecution but treatment.
These changes opened the doors for increased medical attention to alcoholism and, eventually, drug addiction as well.
Different types of detoxification methods have been tried including “the social model” which rejects the use of medication and medical support and instead relies on the use of a non-hospital environment to ease the passage through withdrawal.
Just as the perception surrounding drug and alcohol addiction has changed over the years, so has the changes in methods of detoxification. Similarly, the changes in time in popularity of cocaine, heroin, and other substances have led to different kinds of detoxification services.
As the methods used for drug and alcohol detoxification are likely to change in the future, the AMA still maintains that substance abuse is a disease and encourages physicians and other clinicians to base activities upon this premise.
Drug and alcohol addiction is something that causes the deaths of tens of thousands of people annually in the United States and affects millions more. Drug and alcohol addiction is a tough thing to overcome on your own and it can be more effective to seek out a drug treatment or alcohol treatment center that can help you through it. At Landmark Recovery, we offer our patients support as they go through the detoxification, inpatient and intensive outpatient care that they need. You don’t have to face your drug or alcohol addiction alone, reach out to our admissions staff today to learn more about our treatment centers and your personal path forward.