It is important to remember that no two people are the same. So when it comes to recovery, the process should be handled on a person by person basis. Everyone’s needs are different. What recovery process has worked for one person, may not work for you at all. It is good to know all of your options and choose what is going to help you the most. There are several different options to help with your recovery process. Detox, rehabilitation, sober living homes and even medications to help with substance cravings. Along with Psychosocial Therapy, Medication Addiction Treatment is the most effective intervention to treat opioid use and is even more effective than behavioral interventions or Medication alone.
Medications for Addiction Treatment (MAT)
Medications prevent overdoses and support long-term recovery. There are three drugs approved by the FDA for the treatment of substance addiction: Buprenorphine , Methadone and Naltrexone.
Buprenorphine (also known as Suboxone): Sometimes referred to as a narcotic, it is also used to treat narcotic dependency. It is an oral tablet or film that is used daily to help with cravings
Methadone: This treats moderate to severe pain and can also treat narcotic drug addiction. Its primary use is in detox and maintenance of people who are dependent on drugs. This comes in the form of a liquid that is taken orally
Naltrexone: This is used to help prevent a relapse back into alcohol and/or drug abuse. This comes in the form of a once monthly injection
Using medication as a form of addiction treatment is misunderstood a lot of times. One may think that all you are doing is substituting one drug for another. In reality, these types of medications are no different than a person who takes medicine for diabetes or depression. When properly used, it will not create a new addiction but can actually help with an existing one.
Medications prevent overdoses and support long-term recovery. The use of medications reduces the death rate among addicted persons by at least 50%. Addiction changes the brain and these medications can help.
Even as drug or alcohol addiction threatens to rewrite a person’s life, anti-craving medications are one treatment option that can begin to help the person achieve health, balance and happiness.
An outpatient detox center allows people to seek help at the facility during the day and return to the comfort of their own homes at night. For many people, outpatient treatment is preferable to inpatient care. They can continue to work and keep up with familial responsibilities while getting the addiction treatment they need. These types of programs also tend to be more cost-effective as people don’t have to pay for 24-hour care.
What to Expect
Detox involves the body processing out substances of abuse. With medical detox, medical supervision is provided.
In outpatient detox programs, the team of professionals guiding treatment will come up with a personalized plan to meet each client’s specific needs. An individual’s entire medical history needs to be considered as well as their history with substance abuse and attempts at recovery.
Outpatient programs work best for people who have a stable and safe home life. If the person lives in an unsafe home environment or with people who abuse drugs or alcohol, inpatient treatment is a better choice.
If the person is dependent on alcohol, benzodiazepines, or opioids, inpatient detox is recommended since the risk of relapse is incredibly high with these drugs. In addition, withdrawal symptoms from alcohol and benzodiazepines can be life-threatening in some instances.
Medications may be prescribed to ease withdrawal symptoms and reduce cravings. In some instances, medications are used to replace the drug of abuse; clients are then slowly weaned off the maintenance medication over weeks or months.
For opioid detox, Suboxone is commonly prescribed. According to the Drug Enforcement Administration, in 2013, there were 16,000 doctors in the US permitted to prescribe Suboxone. The medication successfully activates the same part of the brain that’s triggered by opioid abuse, but it doesn’t produce the same high. The brain is satisfied, however, because it thinks it’s still getting the substance of abuse. This keeps withdrawal symptoms at bay, helping the individual to focus on therapy and reducing the likelihood of relapse.
Medications are also given to address specific withdrawal symptoms, such as anti-nausea medications for intestinal issues or over-the-counter painkillers to ease aches and pains. Alternative forms of pain and symptom management may also be provided during outpatient detoxes, such as balanced nutrition, adequate hydration, and massage therapy.
While the bulk of therapy takes place once the person has stabilized after withdrawal, some therapeutic meetings may begin during detox. Psychological support is a key component of this early stage of recovery. Without adequate support during detox, relapse is likely.
Clients will meet with counselors and support staff when they come to the clinic for outpatient detox. Ensuring the client has a strong support system at home in the form of friends and family will also be a critical part of the planning process at admission.
The Withdrawal Process
The length of the detox process and the specific symptoms experienced depend on the individual as well as the substance of abuse. Someone who is withdrawing from alcohol will have a different experience than someone who is withdrawing from opioids. While individual differences, such as a person’s age, gender, metabolism, history of substance abuse, and physical and mental health status, will determine specifics of the withdrawal process, there are some things you can expect when withdrawing from certain substances of abuse.
Marijuana withdrawal: The general symptoms are typically mild and resolve within a few days to two weeks. The person might feel anxious, tired, and irritable. Their appetite may be affected as well.
Alcohol withdrawal: These symptoms can be severe and life-threatening, so medical detox is required. Nausea and vomiting are common. In addition, the person might experience an elevated heart rate, tremors, anxiety, and insomnia. Inpatient detox is generally recommended for alcohol withdrawal due to the potential severity of symptoms and the risk of developing delirium tremens.
Opioid withdrawal: Opioid detox can be intense with symptoms such as excessive sweating, muscle cramps, hot flashes, chills, diarrhea, anxiety, and nausea. Individuals shouldn’t quit opioids cold turkey. As mentioned, medication-assisted treatment, such as buprenorphine, may be prescribed to ease the withdrawal process.
Benzodiazepine withdrawal: Medical detox is required for benzodiazepine withdrawal due to the severity of symptoms. Usually, doctors prescribe a tapering process where the dosage of benzodiazepines is slowly lowered over a period of time until the person is eventually fully weaned off the drugs. Withdrawal symptoms include anxiety, irritability, muscle aches, poor concentrations, and insomnia. In some instances, life-threatening seizures can develop.
Stimulant withdrawal: Withdrawal symptoms include increased fatigue, depression, sweating, muscle aches, and irritability. If psychiatric symptoms are severe, the individual will be referred to inpatient care. In both inpatient and outpatient stimulant detox, individuals are monitored for signs of depression.
Is an Outpatient Detox Program the Right Choice?
The supervising physician must determine if an outpatient detox program is appropriate. Again, those withdrawing from alcohol are not good candidates for outpatient detox. In most cases, those withdrawing from opioids and benzodiazepines will be recommended to inpatient detox; in all cases, those detoxing from these substances should be under medical supervision if outpatient detox is selected.
Research published by the Journal of Addiction found a correlation between increased relapse rates and outpatient opioid detox programs. Those in outpatient detox programs were more likely to encounter triggers to use opioids that led them back to opioid use. Since clients don’t reside at a facility during detox, temptations to return to opioid use are present and access to the drugs isn’t restricted. As a result, relapse is more likely with outpatient detox versus inpatient detox.
This doesn’t mean that outpatient detox can’t be successful. If someone has a strong support system, a safe home environment, and life responsibilities they can’t take a break from, outpatient detox may be the best choice. The key is to develop a plan of action before the process begins to limit access to substances of abuse as well as opportunities to encounter triggers.
How to Choose the Best Program
Once someone decides that an outpatient detox program is the best choice, they can start narrowing down their options. Here are the questions to ask about prospective treatment facilities:
Does this program suit my needs? Different programs are tailored to address withdrawal from different substances of abuse. For example, a program may have the capacity to prescribe MAT during the detox process for certain substances.
Do you feel comfortable? You should feel comfortable with the staff members and other clients in a detox center. You don’t need to surround yourself with people who like you, but you do need to feel that you can be yourself. Certain treatment programs cater to specific demographics, such as programs that specialize in LGBTQ individuals or young adults.
Can you afford it? Many detox centers accept insurance, so make sure you choose one that will work with your provider. An outpatient program is often much cheaper than inpatient options, and many programs offer payment plans to finance the portion that insurance doesn’t cover.
Do you have transportation? Choose a clinic you can easily get to every day. The recovery process has to be manageable for your lifestyle.
Set Yourself up for Success
Because clients retain control of their movements, an outpatient detox program allows people to be in charge of their own recovery. While there are more temptations with outpatient detox since clients live in the outside world, they also have the opportunity to put lessons learned into practice right away.
Again, support is critical. With the assistance of medical professionals in an outpatient detox program as well as a strong support system at home, individuals can successfully complete the withdrawal process and move on to addiction therapy.
Often, the first step in the recovery process is detox, which is what clinics use to get the drug or alcohol out of your system. Detox can last a few days to a couple of weeks, depending on how severe your situation is. Getting the addiction out is one thing, going back to your life is another. People, like you, often ask us what happens after going to detox?
The answer is somewhat simple. You would need to attend some type of recovery program to take rehab to the next step. What type you attend depends on your own unique addiction. The main types include inpatient and outpatient programs, and aftercare. Here we’ll briefly look at each one to see which one might work better for you.
Attending Inpatient Rehab After Detox
Once you have a handle on drug or alcohol withdrawals, then it’s time to tackle the addiction. For severe addictions, they recommend an inpatient program. This way the center’s experts can monitor how the recovery is going, and they can interfere if things are getting worse. They conduct all counseling and group sessions at the clinic a certain number of times a week, and you’re responsible for attending the ones prescribed for your situation. During your off times, you are free to relax and do what you want, minus addiction-related things. You must stay at the clinic, however, unless special arrangements have been made by the staff.
Inpatient programs can last anywhere from one to six months, depending on what each person needs. They provide 24-hour medical support for all residents, especially those with other medical and mental issues. If prescriptions are needed, experts can oversee the administration of them, to ensure the client’s health remains safe. Costs are typically high, but many insurance plans cover a good portion of the treatment. Also, counseling sessions are intense while you work through the issues that caused the addiction in the first place.
Attending Outpatient Rehab After Detox
If inpatient rehab isn’t needed, or if you need to remain working while you go through treatment, then they’ll prescribe an outpatient program. This is where you attend a certain number of counseling sessions and group meetings a week while staying at home and going to work. All the appointments get scheduled around what you have going on in your daily life. If you need to work, or have other responsibilities, you can attend your meetings before or after them, depending on what your work times are.
Outpatient programs don’t have as much monitoring as the inpatient ones have. You go home after your day’s sessions, and take care of your family or go to work, whatever you need to get done. This kind of program can last about three months to a year because you’re only attending on a part-time basis. With about 10 hours a week, possibly more, you still have time for yourself to spend with your family and friends. Costs are lower than the inpatient because you’re not staying at a clinic, you’re staying at home. You just come to the center when you’re scheduled
Most of the skills you learn will be during your time at the inpatient or outpatient programs. Once you’ve completed those treatments, you might still need some kind of ongoing care to prevent falling backward in your recovery and going back to the addiction. This type of treatment could involve mentorships, therapy sessions an hour or two a week, or, in some cases, a sober living environment.
Aftercare is a transitional part of the program, enabling addicts to learn how to go back into their normal lives. When an addiction takes hold of a person, they get used to negative behaviors and patterns that send them spiraling out of control. You have to learn how to replace them with better ones, and then put them into practice. Aftercare will help you use those skills in real-life situations, so you can form better habits. Some of the things you’ll learn are:
How to handle relationships
How to identify the things that trigger your addiction
How to evaluate your performance when using what you’ve learned in the real world
Detoxification, or detox, is the process of letting the body remove the drugs in it. The purpose of detox is to safely manage withdrawal symptoms when someone stops taking drugs or alcohol.
Everyone has a different experience with detox. The type of drug and how long it was used affect what detox will be like.
Medications used in detox help keep former users comfortable while the drugs leave their bodies.
It can take days or months to get through withdrawal symptoms for most drugs. The length of withdrawal depends on a number of factors, including:
Type of substance the user is addicted to
The duration an addiction has lasted
The severity of the addiction
Method of abuse (snorting, smoking, injecting, or swallowing)
The amount of a substance the user takes at one time
Underlying mental health conditions
Speak with someone who can help you find a medically assisted detox.
Can I Detox at Home?
Choosing to detox at home can be deadly. Quitting “cold turkey” or without medical supervision can lead to serious issues such as seizures and severe dehydration.
There are inpatient and outpatient detox programs that help prevent dangerous complications. People with severe addictions should seek inpatient detox because withdrawal can be fatal. Inpatient detox includes 24-hour support and monitoring.
The Process of Detoxification
Everyone’s detox needs are different. The drug detox process helps addicted people get personalized treatment. In most cases, the process involves three steps:
EvaluationThe medical team screens incoming patients for physical and mental health issues. Doctors use blood tests to measure the number of drugs in the patient’s system. This helps to determine the level of medications needed. There is also a comprehensive review of the drug, medical, and psychiatric histories. This information sets up the basis for the patient’s long-term treatment plan.
StabilizationThe next step is to stabilize the patient with medical and psychological therapy. The goal of stabilization is to prevent any form of harm to the patient. Doctors can prescribe addiction treatment medications to prevent complications and reduce withdrawal symptoms.
Preparing Entry into TreatmentThe final step of detox in preparation for a treatment program. Doctors familiarize their patients with the treatment process and what to expect. Inpatient rehab offers the best chances of success after detox.
Side Effects of Detox
The process of drug detox can be painful and dangerous. This is why medical detox is so important. Detox with medical supervision allows patients to detox in a safe and comfortable environment. The extent of supervision is different in inpatient and outpatient rehab.
A medically supervised detox prevents dangerous complications of drug and alcohol withdrawal.
Although medical detox limits the symptoms of withdrawal, some are unavoidable. Some of the most common side effects may include:
Nervousness or anxiety
Many addiction treatment center centers that have detox included are opening across the country in light of increased awareness of addiction. Great variety exists when it comes to rehab/detox centers. You must choose between private or state-funded, America Model or more traditional, holistic or no-frills, and several other factors. The variety and number of factors you must consider can make finding the best rehab center perplexing. A rehab/detox center is a major financial and emotional investment; therefore, you should not be forced to simply go online and take a stab at the first ones that pop up on your computer screen.
How to Find the Best Rehab Center that Has an On-Site Detox
Features of superior rehab/detox centers are:
Chiropractic care, acupuncture, bio sound therapy and many more cutting-edge treatment centers are being integrated with the medical care of detox. While medication and monitoring from medical staff is the most important part of detox, other treatment centers are helpful in making the process quicker and less painful.
Accreditation from a Reputable Accrediting Body
Many facilities are being opened for fraudulent purposes or the sole purpose of making a profit without caring about the welfare of the clients. Rehabs that are accredited from a reputable accrediting body are verified to be experienced, ethical, and high-quality. The best accreditation a rehab can have is from the Joint Commission.
24/7 Medical Staff
Withdrawal can be fatal, and changes in condition can happen at any time. A detox must have a 24/7 medical staff to monitor changes around-the-clock and respond to emergencies. The medical staff should include experienced, well-educated doctors, nurse practitioners, and nurses.
Holistic Psychological Treatment
The majority of addictions are caused by a root psychological cause and/or co-occurring disorder. While talk therapy is the most direct way to reveal thoughts and feelings, it does not always tell the entire story and does not address certain aspects of addiction. A superior rehab center will use other therapies to help you reveal subconscious thoughts and emotions and cater to your social and physical health along with your psychological health. Treatment is not boring. As a matter of fact, many people who go to quality facilities do not want to leave.
A rehab that addresses all parts of addiction will understand the importance of the families’ role. A good treatment center will offer a variety of program options for the clients and a program for the family to help them understand addiction and heal their wounds. Having a supportive family system to go home to will significantly increase your chances of achieving lifelong recovery. There are many myths and misconceptions circulating about addiction; therefore, those closest to you need to understand the scientific truth in order to understand what they are dealing with.
Why a Rehab with an On-site Detox is the Way to Go
Choosing a rehab with an on-site detox is better than going to separate detox and rehab centers. The cost of the total treatment center will be less because detox will be included in the rehab price. Having to pay separate facilities may rack up the cost. If you are going to rehab far from home, you are better off going to one with detox so you will not have to arrange transportation from one to the other.
While you do not do much psychological counseling during the detox period, you will be providing your psychosocial history. If you are going through detox at the same facility, you won’t have to answer the same questions, and the staff can communicate easier. Easier communication between staff can prevent misunderstandings and having to repeat speaking about painful subjects.
Why Detox is Necessary
Detox is the most important aspect of addiction treatment centers. After prolonged substance use, changes occur in the body. As you may already know, when you quit using cold turkey, your body goes into a shock-like state; therefore, you feel ill. While withdrawal from other drugs can be deadly as well, withdrawal from alcohol is the most notorious for being deadly.
In order to safely quit your addictive substance, you must slowly come off of it with medical help. Medical staff will give you drugs to manage the symptoms and behave similarly to your addictive substance to help you slowly come off of the addictive substances. You should never go through withdrawal on your own; medical supervision is always necessary.
The Length of Your Detox and What to Expect
The length of detox is different for every individual. Some people who do not have as severe of a substance use disorder only need detox for a couple of days. People who have a severe progressed substance use disorder may need up to two weeks of detox. Other factors that will determine your length of detox are gender, size, age, and length of addiction.
When you arrive at detox, you may feel nervous. Rest assured there is nothing to be nervous about. The individuals you meet will be non-judgmental and are only intending on helping you. The admissions staff and medical staff will ask you questions about your psychosocial history. You’re honestly in imperative. After you go through a series of tests, you will proceed to your detox. You will be woken up throughout the night to have your vitals checked. You will be given medications orally and intravenously. You may also receive other chiropractic care and other therapies. After you have completed detox, you will proceed to a treatment center.
Detoxing from alcohol may differ for all individuals. The severity of symptoms and length of time a detox program will last is dependent on the level of an individual’s dependency on alcohol. Detox is the first stage of treatment for alcoholism. Detox involves completely flushing alcohol from the body. Alcohol is a depressant, which the body will begin to rely on over the duration of months and years of consistently drinking. The brain will begin to stop the production of chemicals that it receives from alcohol, which causes dependence.
When an individual who has an alcohol dependence abruptly stops drinking alcohol, they will begin to experience withdrawal symptoms within six to 24 hours. Withdrawal symptoms can begin to appear even when an individual has alcohol still in their bloodstream. Withdrawal symptoms can range from mild to severe and life-threatening. Symptoms of alcohol withdrawal can include anxiety, depression, insomnia, hallucinations, shakiness, and changes in blood pressure. Delirium tremens can also occur, which is a life-threatening condition that causes confusion, fever, restlessness, hallucinations, and seizures. Withdrawal symptoms typically last for a few days up to a week. The symptoms will be at their most intense state after 24 up to 72 hours from your last drink.
Alcohol Detox Programs
Individuals who feel as though they need to consume alcohol to feel normal most likely need to go through an alcohol detox program. Quitting alcohol alone without medical assistance is not recommended due to the severe symptoms that are associated with alcohol withdrawal. In some cases, withdrawal from alcohol can be life-threatening. A detox program will give around the clock care and support throughout the stages of alcohol withdrawal. Detox programs also prescribe medications to make withdrawal more comfortable and manageable. Further, detox programs typically provide care for any other medical or mental health conditions an individual may have.
Detox programs typically begin with an intake exam. This will allow the medical team to understand what type of support an individual needs during their detox. The medical team may also do blood work, discuss your drinking history, health history, and conduct assessments to evaluate physical and mental health. Detox support usually includes prescription medicine to ease withdrawal symptoms. Detox will also care for any other health issues or symptoms that arise during the program. The overall goal of a detox program is to make sure that a patient is physically and mentally stable. Typically, detox programs monitor vital signs around the clock, which include temperature, heart rate, blood pressure, and breathing.
Alcohol Detox Medications
Medications used during alcohol detox programs reduce the severity of withdrawal symptoms, while also aiding the body in keeping chemical levels balanced. This will help to lower the risk of severe complications. A doctor or nurse will administer medications and monitor the effects of the medication around the clock. If a medication causes side effects or begins to interfere with the overall detox process, the medication will be replaced. Medications that are commonly prescribed during detox include benzodiazepines, naltrexone, acamprosate, and disulfiram.
Benzodiazepines are the most commonly used medication in alcohol detox programs. They are used to treat and ease alcohol withdrawal symptoms. Benzodiazepines are used to calm the central nervous system. They also help treat anxiety, muscle spasms, and insomnia. Benzodiazepines come in both short-acting and long-acting formulations. Long-acting benzodiazepines are typically administered for three days or they are taken as needed. Librium and Valium are the most common benzodiazepines that are prescribed in alcohol detox programs. Naltrexone is another medication that is commonly prescribed in alcohol detox.
Naltrexone reduces alcohol cravings during detox. If an individual relapses during detox, naltrexone works to inhibit the euphoria that alcohol may cause. Naltrexone is administered either in pill form or through injection. Acamprosate is another medication that is used often in alcohol detox. It helps the brain to function normally after alcohol use has ended. It also reduces alcohol cravings, insomnia, restlessness, and anxiety. Disulfiram is also commonly prescribed in alcohol detox. It works by producing a severe reaction if alcohol is consumed. If an individual drinks alcohol while taking disulfiram, they will experience nausea, headache, facial flushing, low blood pressure, and weakness. These negative effects are meant to deter individuals from consuming alcohol.
The Timeline Of Alcohol Detox
Symptoms of alcohol withdrawal can begin two hours after an individual’s last drink. The worst symptoms usually are over within a week after the last drinking. Milder symptoms can last anywhere from a month up to a year. There is not an exact timeline for how long withdrawal will last as it is unique for every person. There is a common timeline for most individuals for how detox will occur. During the first six to 12 hours, the initial symptoms occur, which are usually mild. These symptoms typically include anxiety, headaches, nausea, irritability, and shaking. After 24 hours of detox, the symptoms usually become more severe. Symptoms like disorientation, seizures, and hand tremors may begin to occur during this time. After 48 hours, hallucinations and panic attacks may occur.
These symptoms are common during this time period as the body is trying to eliminate all alcohol from its system. From the third day to the seventh day of detox the withdrawal symptoms may dissipate or worsen. During this time period, individuals may produce life-threatening conditions like delirium tremens. After the first week of alcohol detox, some symptoms will begin to disappear. Some symptoms may still remain and they are often able to be treated by medication. During this time period, individuals are at risk for developing post-acute withdrawal syndrome. Post-acute withdrawal syndrome involves prolonged symptoms of alcohol detox which can include insomnia, anxiety, lethargy, and delayed reflexes. Post-acute withdrawal syndrome can last a few months up to a year.