What to Look for in a Drug Detox Center

Medical detoxification is a critical early step in the treatment of a drug addiction (clinically referred to as a substance use disorder). The term step is used deliberately; detoxification is necessary in most cases but not sufficient to help a person maintain abstinence. As the National Institute on Drug Abuse (NIDA) explains, addiction is a complex disease, and treatment responses must, in turn, be designed to address the many layers involved (i.e., the emotional, psychological, and behavioral factors). NIDA advises that a person who completes a medical detox program must immediately transition into the second phase of drug recovery treatment, which involves therapy (individual and group) and a host of supportive rehab services (e.g., recovery group meetings, family therapy, expressive therapy, exercise, and wellness treatments).

When a person is seeking to detoxify from a drug, there are at least two immediate options. One is medical detox, and the other is the cold-turkey approach. Medical detox is a supervised process that involves being under the care of a doctor, support staff (e.g., nurses), and addiction specialists. A cold-turkey approach, which is seldom (if ever) advisable, is often what a person employs when they attempt to detox on their own at home.

There are numerous reasons why the cold-turkey or do-it-yourself approach is disfavored, including that withdrawal can be dangerous. Symptoms range from moderate to severe and, in some instances, can be fatal. Another main reason to avoid at-home detox is the risk of a relapse during this period. In addition to withdrawal symptoms being uncomfortable or painful, drug cravings generally emerge. To use a visual aid, a person standing on a shoreline (the start of the recovery process) has a better chance of getting passed the choppy waves (the symptoms) with a boat and a crew (medical detox and the attending staff) compared to trying to swim out alone (a DIY approach).

Medical detoxification targets the biological reality of addiction; however, recovering clients are also provided with psychological support. In order to safely engage in the recovery process, a person must necessarily eliminate the drug of abuse from the body. In some instances, individuals are provided with substitution therapy, which is not a complete detoxification per se. Anyone who is interested in medical detox will quickly learn that the process is individually tailored, and treatment settings vary. Medical detox can occur at a rehab center, a standalone facility, a hospital, and any other qualified, well-equipped setting.

 

During the consultation or admissions process, a trained counselor will do an intake with the prospective or incoming client. The intake is the counselor’s opportunity to learn about the client’s history of drug abuse, any physical or mental health diagnoses, immediate detox goals, long-term recovery goals, and drug treatment history (if any). The counselor will take the information and relay it to the assigned doctor (who may confer with a team of addiction specialists). The doctor (and possibly a team of addiction specialists) will create a tailored detox plan for the client.

The detox plan may include a full detoxification (i.e., ridding the body of the drug entirely), a tapering approach (as in the case of benzodiazepine withdrawal), or medication-assisted treatment (discussed in further detail below). In addition, benzodiazepines, and other FDA-approved medications, can be used to help a person withdraw from alcohol.

Within the field of addiction recovery, there is a pharmacologically based treatment that is clinically referred to as medication-assisted treatment (MAT) for opioid addiction. The following is a list of some of the component parts of MAT.

• The medications approved for use are methadone, buprenorphine, and naltrexone. Naloxone is used in emergency cases of opioid overdose.
• All addiction medications that are used in MAT have received approval from the US Food and Drug Administration.
• These medications may be used in the detox phase as well as in the abstinence maintenance phase as a substitution therapy, which means that the recovering person transitions from the drug of abuse to a medication that is safer. Depending on the individual, the substitution therapy can last weeks, months, a year, or longer.
• MAT is research-based for the drugs of abuse for which it is indicated.
• As MAT is considered to be an effective treatment, pharmaceutical companies are working on addiction treatment medications that can target other drugs of abuse, such as cocaine.

It is also helpful to understand what MAT is not. MAT medications do not cure addiction. Rather, they are intended to help a recovering person safely avoid a relapse. A main benefit of MAT medications is that they can stop, or lessen, withdrawal symptoms, such as drug cravings. MAT is not the same as over-the-counter drugs or prescriptions (mild to moderate) medications that a doctor gives a patient to help with withdrawal symptoms. For instance, if a person is withdrawing from stimulant abuse and experiencing a migraine, a doctor may provide a headache relief medication. That medication, even if it is a prescription, is not MAT.

After the intake process is complete, and should a medical detoxification plan that includes MAT be proposed, the benefits and any drawbacks entailed in using MAT will be discussed. In many instances, MAT is a recommendation made to help ensure safety in the detox process (and possibly later, during the abstinence maintenance phase). The attending doctor can collaborate with the client, and any concerned loved ones, to arrive at the most suitable course of treatment.