The Medical Detox Process
In the evaluation component of medical detox, individuals undergo blood testing to determine which substances are in their systems, as well as a complete medical history to screen for any co-occurring medical or psychiatric diagnoses. This is important because the National Alliance on Mental Illness has reported that approximately a third of individuals with a mental health diagnosis also battle a substance use disorder. Their personal situation, including their home environment, will also be assessed to determine what treatment type will be most appropriate. This serves as the basis for the first treatment plan once withdrawal has been completed.
Stabilization occurs when individuals are assisted through the acute intoxication and withdrawal processes and have attained a medically stable and substance-free state. This may be done with or without medications. In some instances, such as with opiate detox, maintenance medications may be used, and individuals may proceed to the therapeutic portion of care before they are completely substance-free. During the stabilization phase, clients learn what they can expect – and what is expected of them – during the treatment and recovery process. This is also the stage when families may become involved if they wish.
The final component of fostering individuals into comprehensive treatment is accomplished by preparing clients for treatment. Detox in and of itself does not constitute addiction treatment. Those who simply detox without comprehensive care following the medical process are likely to return to drug or alcohol use. Detox only addresses the physical component of addiction; therapy addresses the psychological component, which is necessary to maintain sobriety.
Variations in Experience
Withdrawal is a different experience for each individual, depending on personal specifics as well as the substances of abuse and the duration of abuse. Withdrawal symptoms can be treated on an individual basis as appropriate. In some instances, medications may be prescribed to help individuals cope with specific withdrawal symptoms. Such medications may include anti-anxiety medications, antidepressants, anti-nausea medications, medications to promote sleep, and mild pain management medications.
Detox is defined as a process wherein toxins inside the body are broken down so they may be more easily removed by the body.
Medical detox involves undergoing the process in a treatment center under the care of medical staff members. A successful detox is not measured by how many toxins are removed or whether or not an individual experiences cravings after detox; a successful detox minimizes harm to the individual and gets the person safely through the withdrawal process, readying the person for the therapeutic portion of care.
At times, individuals will be weaned off a substance, meaning that the dose will be gradually reduced until the person is able to safely stop taking the substance altogether. This tapering process is used when stopping a substance cold turkey can be dangerous, such as with benzodiazepine withdrawal. This helps the body maintain gradually decreasing levels of the drug in the bloodstream so it does not go into shock. This process will also be different for each individual, as each individual has a different metabolism. Determinations on tapering dosages should be made on a case-by-case basis by supervising physicians.
Length of Detox
There are no set timeframes when it comes to medical detox. Again, each individual has a different metabolism, and some individuals’ bodies will be able to eliminate substances faster than others. Also, each substance has a different half-life – the time it takes for half of the substance to leave the body – which affects how soon the substance will completely leave the system.
As a broad generalization, the most intense symptoms of withdrawal pass within 5-7 days. As a result, medical detox often takes up to a week. In some instances, medical detox may take up to 10 days.
Type of Detox
Medical detox can be done on an inpatient or outpatient basis. Relapse is more likely on an outpatient basis, because individuals are less equipped to deal with uncomfortable withdrawal symptoms on their own. Relapse is less likely with inpatient detox, due to the fact that individuals will be in a treatment center where they do not have access to the substance, so they can’t begin using again if the symptoms become difficult to bear. Instead, withdrawal symptoms are managed by medical personnel.
Since some substances can cause a life-threatening withdrawal syndrome, this will also play a role in whether or not the individual can detox on an outpatient basis. Inpatient medical detox is always required for alcohol or benzodiazepine withdrawal and most often also required for opiate withdrawal.
Although medical detox is an important first step, individuals are not “cured” or in recovery after completing it. Detox addresses only physical withdrawal symptoms, and individuals need to pursue an entire treatment
plan that will assist them with the psychological aspects of their addiction. The National Institute of Drug Abuse
summarizes that while medical detox is the first step and allows individuals to get clean, they will need to
participate in full treatment to achieve recovery.