DETOXIFICATION

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What is detox?

Detoxification or "detox" is the process of eliminating drug or alcohol substances from the body.  It is critical to understand that detox addresses the physical dependence, or the process and experience of withdrawal syndrome, but does not necessarily address the complex emotional, psychological, social, behavioral, or environmental factors that occur with addiction.These issues are handled after detoxification, which is why follow-up care is essential.

The Detoxification Process 

Detoxification is widely considered the first step in drug and alcohol treatment.  Detox can occur in home, outpatient, and inpatient settings.  Withdrawal from certain substances, including benzodiazepines and alcohol, is life-threatening and may be fatal.  Due to the complexity, we recommend medically-supervised detoxification, where trained professionals can monitor and treat the undesirable effects of withdrawal in a safe environment.  Detox may or may not include the use of medications.  Medications for withdrawal are based on the type of drug or substance that was abused, the amount of drug that was typically used, and the length of time of abuse.

The United States Department of Health and Human Services outlines three steps in the drug detoxification process:

1. Evaluation: in the first stage of detox, a person is tested for substances in the body and evaluated by clinicians. 

2. Stabilization: a person is guided through the process of detoxification by clinical staff. This may be done with our without the use of medications. 

3. Guidance: in the final stage of detox, program staff will guide and educate a patient on the next steps of treatment. Various options should be presented to help the person determine where to go from detox and start the recovery process. 

Detox is typically 5 to 7 days, but may be as short as 3 days or up to 14 days depending on the individual's insurance coverage and the facility's capacity

Aftercare: Detox is Insufficient for Recovery

Detox is the first step.  It addresses the acute physical aspect of addiction by helping an individual get through withdrawal, but detox will not solve the mental, emotional, social, behavioral, or environment factors associated with addiction and relapse.  It also does not address Post-Acute Withdrawal Syndrome (PAWS).  It may take weeks or months for the brain to return to normal functioning.

 

A 2012 John Hopkins study found that the release rate post-detox is 65 to 80 percent, but individuals who remain in aftercare treatment are 10 times more likely to stay sober.  Research shows that there is a direct correlations between the length of time in treatment and the rate of relapse.  In other words, an individual's motivation and commitment to remaining in treatment after detox is a major factor in the early stages of recovery. 

Post-Acute Withdrawal Syndrome (PAWS)

In general, withdrawal symptoms subside after several days or up to two weeks.  However, some substances can cause a prolonged or protracted withdrawal, lasting for months and sometimes up to a year. Individuals who consume a large amount of a substance over a long time are more likely to develop this condition.  Post-Acute Withdrawal Syndrome (PAWS) occurs after detox. PAWS is the cluster of ongoing withdrawal symptoms that continue after acute withdrawal syndrome has ended.  Although these symptoms are largely psychological and mood-related, rather than the physical symptoms involved in acute withdrawal, they can be intense and put a person at risk of relapse.  The person may attempt to self medicate or return to drug or alcohol use in an attempt to stop the discomfort.     

Beyond Treatment

Addiction is a chronic condition with physical, emotional, mental, and social aspects.  Completion of a drug treatment program does not mean the end of healing.  It represents the ends of the supervised part of recovery and now the individual must apply the new tools and insights gained during treatment. Medical and mental health are only two aspects of post-treatment care.  Healthy relationships, stable housing, job security, self-care, and social support are important factors to maintain sobriety.  

   

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