Private Drug Detox and Withdrawal Programs
What are the different types of private drug detox and withdrawal programs? First, it’s important to know that the goal of any detox program is to allow the body to heal after a long-term drug addiction, by helping the body rid itself of the drug and then stabilizing the person so they can transition to long-term treatment. This can take place in an inpatient or outpatient facility, depending on the severity of the addiction and the presence of any other medical or mental illnesses. Generally, the more severe your addiction and/or having a co-occurring disorder indicates a preference for an inpatient detox program.
Detox from opioids or alcohol can be a particularly dangerous process, during which medical supervision is necessary to ensure the patient’s safe withdrawal.
Some people want to know if they can detox privately at home. The short answer is yes, but there are several reasons it may not be the best choice, including:
- It may not be safe.
- It doesn’t always work.
- Professional detox, in many cases, is safer, more comfortable and effective.
At-home drug detox kits purport to help you through the process on your own, but they are not an advisable option for many reasons, not the least of which is, they are often ineffective and would leave you unsupervised if something were to go wrong.
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The better choice is to talk to medical and mental health professionals about your detox and withdrawal program options.
Drug detoxification, or detox, is the first step in a comprehensive rehabilitation program that offers all the tools required for recovery. Detox can prevent unpleasant or fatal consequences resulting from sudden cessation of use and can aid the patient in becoming abstinent from drugs.
The goal of any detox program is physiological healing after long-term drug addiction – first through stabilization, then through a period of detoxification. According to the National Institute on Drug Abuse (NIDA), after stabilization the focus of detox shifts to the monitoring and support of the various processes of the body as it rids itself of the drug, and to the managing the often unpleasant withdrawal symptoms that result.
Comprehensive Detox Treatment
It’s important to note that detox is not a whole treatment for drug addiction, no matter what the drug of choice. Because addiction is both psychological and physical, patients benefit from psychotherapeutic treatment to address the issues of cravings and changes made in the brain as a result of long-standing substance abuse. Detox alone might help the patient to stop abusing drugs and alcohol in the short term, but without follow-up care and therapy, the risk of relapse into problematic use increases greatly.
First Stage of Drug Detox
The initial period of detoxification can be intense for many patients, and medical and psychiatric staff members will be on hand constantly to provide effective support. For example, within several hours after the last dose of heroin, those suffering from an addiction to the opioid will often experience some of the following withdrawal symptoms:
- Excessive yawning
- Muscle aches
- Increasing watering of the eyes
- Runny nose
Although these symptoms aren’t life-threatening, they can be quite uncomfortable, which is why it’s beneficial for these patients to receive psychiatric and medical care while detoxing from drugs. A number of issues can come up for patients in their first few hours of detox. The most urgent need will be addressed first, followed by the next and the next until full stabilization has been established. Some examples of possible issues include:
- Violence. Some drugs can increase violent behaviors in users. For example, people who abuse synthetic cathinones, or “bath salts,” might be more at risk of hurting themselves or others. Patients who are a danger to others might require sedation or restraint to protect them and medical providers. These measures are only necessary if the patient becomes physically aggressive and attempts to harm staff members.
- Symptoms of psychosis. Psychosis is a dangerous complication brought on by the effects of some drugs, such as cocaine. If someone uses excessive amounts of cocaine, they can become paranoid and even experience full-blown psychosis. Symptoms include visual and auditory hallucinations and delusional thinking. Other reasons for psychosis include the presence of a co-occurring mental health disorder, such as schizophrenia, or a lack of sleep due to stimulant use. Someone who is suffering from psychosis can behave erratically and become unpredictable. It’s important to address this issue and treat the patient appropriately before proceeding with further interventions.
- Injury. In some cases, patients may have hurt themselves while under the influence of drugs or been physically or sexually assaulted before entering detox. For example, phencyclidine, or PCP, is a powerful dissociative drug that can cause feelings of increased strength and invulnerability. Due to this misconception, PCP users are likely to put themselves in harm’s way because they’re under the impression that they won’t get hurt. They’re also at an increased risk for suicidal behaviors, which can result in injury if suicide is not completed. Any physical injury must be treated immediately before addiction treatment is provided.
- Medical illness. Many people who suffer from chronic, debilitating pain are prescribed opioid painkillers. Unfortunately, it’s possible to develop a dependence and subsequent addiction to these medications. As the patient begins to detox from the prescription opioid, their severe pain will return in addition to uncomfortable withdrawal symptoms. It’s important to be aware of the individual’s medical history and treat the symptoms of pain appropriately before proceeding.
- Threat to self. Withdrawal from opioids and other substances can be associated with severe depressive symptoms that might be connected to suicide attempts and completed suicides. Patients who exhibit suicidal behaviors or thoughts must be protected at all times. Once these acute issues have been assessed and identified during evaluation, they’ll immediately be treated until they have passed or the patient has been stabilized. At that time, attention and focus can turn to dealing with withdrawal symptoms associated with detox.
Drug Detoxification Withdrawal Symptoms
- The length of addiction. Daily use for an extended period of time can cause lead to high levels of tolerance and more severe withdrawal symptoms.
- The combination of drugs abused, including alcohol. A comorbid dependence on drugs and alcohol can create a unique constellation of withdrawal symptoms, which might exacerbate one another.
- The dose of the drug when the patient enters detox. Tolerance develops from persistent substance abuse. Thus, doses must be increased in order to feel the desired results. The higher the doses used, the more likely it is that withdrawal symptoms will be severe.
- The existence of co-occurring physical or mental disorders. If a patient suffers from a mental health disorder such as depression or anxiety or a physical condition such as chronic pain, these symptoms could be amplified due to withdrawal and cause significant distress.
- Half-life of the drug. In general, if the drug is short-acting, withdrawal symptoms will occur more immediately after the last dose. If it’s long-acting, withdrawal syndrome may be delayed a few days.
According to the Addiction study, common withdrawal symptoms that develop in association with a number of drug types include:
- Mood disturbances. This can mean mood swings, irritability, and/or agitation.
- Sleep disturbances. Insomnia despite intense fatigue is common.
- Physical issues. These may include chills, sweating, tremors or shaking, as well as flu-like symptoms, including runny nose and headache, nausea, and vomiting.
- Cravings. The desire to use the drug of choice in order to stop the withdrawal symptoms is strong.
Different drugs can bring about substance-specific withdrawal symptoms in addition to the symptoms listed. Below are symptoms specific to withdrawal from the types of drugs listed:
Alcohol and benzodiazepines. These drugs have very similar withdrawal syndromes due to their similar mechanisms of action. Withdrawal symptoms can include:
Opioids, such as heroin and painkillers. Withdrawal symptoms from opioids can include:
- Muscle aches.
- Bone and joint pain.
- Increased sensitivity to pain.
- Gastrointestinal distress.
Stimulants, such as cocaine and methamphetamines. Withdrawal from stimulants can cause mental health complications such as:
- Suicidal thoughts and behaviors.
Marijuana. Contrary to popular belief, marijuana is addictive and can cause withdrawal symptoms with cessation of use. These symptoms can include:
- Physical symptoms such as fever, sweating, tremors, and stomach pain.
“Bath salts.” Also known as synthetic cathinones, bath salts can produce a number of unpleasant symptoms when going through detox. These include:
- Sleep disturbances.
Ketamine. Although much more research on ketamine withdrawal symptoms is needed, there have been some reports of symptoms including:
No matter what the drug, detox at a medical facility is always the safest choice, especially when co-occurring mental health disorders are an issue. On rare occasions, withdrawal symptoms can lead to complications and serious health issues that require immediate medical attention.
For this reason, it’s rarely recommended that patients attempt detox at home when significant substance abuse issues are present. Instead, enrollment at an inpatient detox program that provides 24-hour medical assistance if necessary, ongoing medical monitoring, and a therapeutic follow-up program is recommended.
Types of Drug Detox
There are different types of detox. The specific types of substances having been abused as well as the spectrum of withdrawal symptoms experienced by the patient will influence which type of detox is appropriate. Some choices include:
- Outpatient detox. It’s rare that this is recommended, but an outpatient program might be a good choice in relatively less severe cases of addiction, where regular check-ins with the treatment team and medication available by prescription or a methadone clinic can provide acceptable detox care. In instances where money is an issue or the patient must stay engaged at work or home, coming into an outpatient detox program regularly could provide adequate treatment.
- Inpatient detox. In most cases, inpatient or residential detox is recommended in order to help patients avoid relapse and make sure that they have medical care in the event of an emergency. Most detox options are inpatient. Some are stand-alone programs will arrange for a seamless transfer to ongoing substance abuse treatment at detox completion, while others will be packaged with an inpatient addiction treatment program that addresses the psychological issues related to addiction as well.
Opioid detox is a bit different from detox options frequently provided for other substances of abuse and addiction. There are medications that have been approved by the Food and Drug Administration (FDA) solely to treat opioid addiction. These new medications have given rise to a number of different opioid detox treatment approaches. Whether heroin or prescription painkillers are the opioid of choice, inpatient care or medication is often recommended for optimum comfort and safety.
Medications used to manage opioid dependence can help to alleviate the unpleasant withdrawal symptoms associated with opioids. The FDA-approved drugs are buprenorphine and methadone. These two medications – which are partial and full opioid agonists, respectively – are administered to stabilize the patient. Then they’re gradually tapered off so as not to experience withdrawal symptoms.
The duration of withdrawal symptoms strongly depends on whether the opioid is long acting or short acting. Heroin is relatively short acting. Withdrawal symptoms will appear within hours after the last dose and may dissipate within a few days, while longer-acting opioid painkillers may not elicit withdrawal symptoms until a few days after the last dose, possibly lasting for weeks.
Cessation of heavy alcohol abuse can lead to distressing and potentially life-threatening withdrawal symptoms. Some non-fatal withdrawal symptoms include:
- Slow movements and thoughts.
- Nausea or vomiting.
Delirium tremens is a severe form of alcohol withdrawal that’s most commonly associated with heavy and prolonged use. It’s a medical emergency and can result in death if it goes untreated, though it occurs in no more than 10% of those experiencing alcohol withdrawal symptoms. Some symptoms of this condition include:
- Confusion or disorientation (delirium).
- Changes in mental function.
- Deep sleep that lasts for one or more days.
This severe alcohol withdrawal syndrome requires medical attention immediately. It’s always recommended that someone who has a severe addiction to alcohol receive medically supervised detoxification in order to safely remove the substance from the body. Benzodiazepines – which are used to treat anxiety, insomnia, and seizures – are often given to the patient in a clinical setting to alleviate their withdrawal symptoms.
Psychological Withdrawal and Detox
Some drugs have few significant physical withdrawal symptoms but cause intense psychological withdrawal symptoms. Detox from stimulant drugs like methamphetamines and cocaine, for example, can result in serious depression and suicidal thoughts. Inpatient detox is recommended in these cases to ensure the safety of the patient. This is because outpatient detox allows patients the opportunity to use the drug outside the detox clinic or to otherwise hurt themselves.
Individuals receiving outpatient detox are also more likely to cancel appointments and fail to complete detoxification. Conversely, inpatient detox facilities provide around-the-clock medical care and supervision to ensure that the patient isn’t in danger. This can prevent depressed patients from committing suicide.
Patients should discuss the specifics of their situation with their medical and therapeutic team in order to choose the best type of detox for their needs.
Methods of Drug Detox
Depending upon the drug, people might have different options in drug detox methods. No one method is right for everyone. Rather, the drug of choice, the dose taken at the time the patient starts detox, how long the person has been using that drug, and whether the patient is using other drugs will determine the most appropriate type of detox. Different detox approaches include:
- “Cold-Turkey” detox
- Short-term medicated detox
- Long-term medicated detox
A “cold turkey” detox means stopping use of all drugs and substances with nothing more than medical supervision to aid you in case of an emergency. There’s no pharmacological assistance, and patients experience the full brunt of the withdrawal symptoms for as long they last. For some drugs, these can be quite intense and last for a couple of weeks or longer. For other drugs, cold turkey detox isn’t as physically difficult.
Patients who opt for medical detox stop taking all substances, including alcohol. But as they experience withdrawal symptoms, a short-term medication plan for this detox stage might have them take certain medications for a limited period of time to ease discomfort.
For example, someone who has a hard time sleeping might be prescribed a non-addictive sleep medication. Someone who experiences bone aches or muscle pains may be offered a pain reliever. Medical personnel who give patients these medications are standing by to make sure that they have what they need to get through the discomfort of detox as quickly as possible.
Those detoxing from alcohol are commonly given benzodiazepines on a regular schedule or as symptoms arise. These drugs can treat or prevent seizures and delirium and aren’t dangerous to take. These medications aren’t to be taken long-term, but due to their cross-tolerance with alcohol, they can help the patient to safely detox from alcohol.
To treat use of opioid drugs such as heroin and prescription painkillers, patients might have the option to take longer-term medications. For example, the patient and their provider might decide on using methadone or the drug combination buprenorphine and naloxone (Suboxone) to stop the person in detox from experiencing the brunt of the withdrawal symptoms. Over time, they’ll often get to lower the dose of the medication until they’re drug-free.
No matter what type of drug detox the patient chooses, it’s important that it’s done under the supervision of a medical professional and that there’s follow up with psychotherapeutic substance abuse treatment.
At-Home Drug Detox
It’s a common question among those who want to find the quickest, easiest way to recovery: Is it possible to go through drug detox at home?
The short answer is “yes,” it’s possible. But there are three reasons it’s not always the wisest choice:
- It may not be safe.
- It doesn’t always work.
- Professional detox, in many cases, is safer, more comfortable and effective.
When a person builds up a physical dependence upon a drug or alcohol, their body comes to expect that they’ll continually maintain a certain supply of the substance in their blood stream. Their body adjusts its production of certain chemicals accordingly. Should the person abruptly stop supplying that substance, withdrawal symptoms will begin. Depending upon the drug, the existence of underlying medical conditions (of which the person might not even be aware), the dose they’re taking when they discontinue the drug, and other drugs the person uses regularly, the detox experience can be medically dangerous, even deadly.
Drug Detox Kits
Drug detox kits are available for a wide range of prices and are based on different philosophies. Some require users to take a handful of supplements each day for months, each one more costly than the last. Others require users to change everything about their lifestyle or conform to a certain set of religious standards.
Though the details of each are different, they have a few things in common:
- They’re impersonal.
- They’re ineffective.
- They’re unsafe.
Drug Detox Kits Are Dangerous
Drug detox kits aren’t safe because they don’t take into consideration the patient’s personal needs. If the user has a co-occurring mental health disorder or an active dependence upon a very high dose of an addictive drug – or multiple drugs – there’s no medical care available to come to that person’s aid in the event of a complication. Should the patient relapse, the risk of overdose will always be a factor (and potentially elevated, if tolerance has subsided). In any of these scenarios, there would be no one there to help them in the face of any unexpected dangerous developments.
Drug Detox Kits Aren’t a Complete Treatment Program
Psychotherapy is a key component of addiction treatment. Detox is just the first step, and it’s a relatively minor one. Stopping the use of a drug will only be a short-term experience if the patient doesn’t follow up with treatment that helps them learn how to live without turning to drugs and alcohol for solace, entertainment, and other purposes.
Duration of Drug Detox
A given period of drug detoxification will last as long as the withdrawal symptoms persist, and for as long as it takes for the patient to stabilize physically and mentally, according to the NIDA. In addition to stopping the abuse of addictive substances safely and supporting the patient through withdrawal symptoms, another goal of detox is to help prepare the patient physically and mentally for the work that lies ahead in therapy and counseling.
In some cases, antidepressant medications or antipsychotics might be necessary if there are co-occurring issues of depression or a mental health disorder. Depression is commonly seen in people who are addicted to stimulants such as cocaine or methamphetamines and opioids such as heroin or prescription painkillers. People suffering from psychiatric issues could benefit from antidepressants or antipsychotics in order to stabilize. Finding a stable dosage of these medications will help to prepare the patient to begin the process of working through other issues that might be driving or worsening their addiction issues.
It’s important to note that not every patient will successfully complete detox on the first try. In some cases, multiple attempts will be made before sobriety takes hold. Addiction is defined by relapse and is chronic by nature. There’s always hope even when relapse seems constant. The only way to create lasting change is to keep trying.
Medications Used for Drug Detox
Medications can be extremely effective in helping patients to safely stop abusing drugs and alcohol. They might address the changes in the brain that occur due to chronic drug abuse or help to mitigate cravings. In some cases, they might even mimic the action of the addictive drug in the brain and help patients to avoid the bulk of withdrawal symptoms. Research is ongoing in this area. There are even vaccines in development that might one day help people to avoid experiencing the addictive high that often triggers addiction.Not all substances of addiction have medications that are approved for use during the withdrawal process. But according to the National Institutes of Health, the following drugs might assist with detox:
Used for the treatment of opiate addiction, methadone is highly restricted and must be taken in the presence of a medical professional when it’s prescribed for the treatment of addiction. Patients must go to a methadone clinic daily to get their dose. Over time, as long as they remain drug-free and come in daily, they can earn “take-homes” or doses of medication to take at home so they don’t have to come in every day. Advantages of methadone maintenance are that it:
- Decreases drug cravings.
- Alleviates withdrawal symptoms.
- Has a long half-life, so its effects last anywhere from 24 to 36 hours.
- Doesn’t elicit euphoric effects.
While methadone is an effective treatment for opiate addiction, it has some disadvantages as well. These include:
- Its status as a Schedule 2 drug, which means it has a risk of diversion and abuse.
- Side effects similar to that of other opioids, including vomiting, nausea, excessive sweating, constipation, sexual dysfunction, itchy skin, and respiratory depression.
- Potential for physical and psychological dependence.
Methadone is the most commonly used medication for the treatment of opioid addiction. In 2011, more than 300,000 patients in opioid treatment programs were given methadone as part of a treatment plan. Up to one-fourth of opioid-addicted patients receive methadone maintenance.
Prescribed on its own or in combination with naloxone as Suboxone, buprenorphine is a partial opioid agonist drug approved for use in the treatment of opioid dependence and is available by prescription from doctors qualified to dispense the medication. There is some anecdotal evidence that buprenorphine may have antidepressant effects as well. According to the National Drug Intelligence Center, there’s a low chance for abuse of the drug among patients in recovery. Advantages to using buprenorphine to treat opioid addiction include that it:
- Can be distributed by a physician in places such as health departments, community hospitals, doctors’ offices, and correctional facilities, unlike methadone.
- Decreases cravings.
- Diminishes withdrawal symptoms.
- Has a ceiling effect, meaning the medication’s effects plateau at a certain dose in order to prevent overdose and abuse.
- Can be combined with naloxone, as with Suboxone, to decrease the risk of abuse.
As with methadone, there are a few disadvantages to taking buprenorphine for an opioid addiction. These include side effects similar to those of other opioids, such as:
- Sleep problems.
- Muscle cramps.
There’s also potential for diversion and abuse when buprenorphine is used in isolation (without naloxone added).
Naltrexone binds to opioid receptors in the brain and blocks the effects of opiate drugs that would otherwise make the user feel high. This effect deters individuals from relapsing because the drug no longer produces rewarding effects. Naltrexone has also been shown to be effective in alcohol detox. In both cases it can help to reduce cravings.
Some advantages for using naltrexone include that it:
- Is available as an extended-release injection that lasts for a month.
- Helps to prevent relapse.
- Doesn’t cause withdrawal symptoms with cessation of use.
A few disadvantages for using naltrexone are that it:
- Cannot be used if opioids are present in the body because it would send that user into acute opioid withdrawal.
- Can produce some uncomfortable side effects, such as muscle or joint paint, nervousness, diarrhea, vomiting, headache, and fatigue.
- Is not safe for patients with liver damage to use.
This drug is prescribed when there are long-lasting withdrawal symptoms associated with drug and alcohol detox such as insomnia, restlessness, and anxiety. Advantages of acamprosate include that it:
- Helps normalize brain activity.
- Decreases cravings for alcohol.
- Can be taken by those with liver damage.
- Doesn’t have potential for abuse or dependence.
Disadvantages of acamprosate are that it:
- Has side effects including muscle weakness, nausea, stomach cramps, dizziness, headache, and itchiness.
- Shouldn’t be taken by people who have kidney problems.
A few studies comparing acamprosate treatment with a placebo revealed that 27% of patients receiving acamprosate were able to obtain and maintain abstinence for one year, while only 13% of patients receiving the placebo were able to do the same. Furthermore, acamprosate decreased drinking frequency in the patients who weren’t fully abstinent.
This drug might be prescribed to patients after alcohol detox when they’re stabilized and attending addiction treatment but are concerned about relapse. Disulfiram works by eliciting several negative effects when the individual drinks alcohol while taking it. These effects include:
- Flushing of the face.
- Blurred vision.
Once the patient experiences these unwanted side effects, they’ll likely be deterred from drinking alcohol while on the medication. A few other advantages of disulfiram treatment include that it:
- Discourages drinking behaviors due to unpleasant physiological effects.
- Is a successful tool for motivated patients.
- Can be used before entering situations that might trigger unwanted behavior, such as a party.
There are some disadvantages of disulfiram treatment. These include that it:
- Doesn’t decrease cravings for alcohol.
- Doesn’t normalize brain function.
- May not be effective if patient isn’t motivated to stop drinking.
- Can have severe side effects if excessive alcohol is simultaneously ingested, including liver damage, damage to peripheral nerves, delirium, and psychosis.
- Shouldn’t be used in patients who have liver damage.
Drug Detox: First Step to Recovery
Detox alone isn’t a complete treatment for addiction to any drug, including alcohol. In many cases, pre-existing psychological issues due to sexual trauma, grief, violent attack, and major life changes such as divorce or loss of employment can increase the chances of addictive behavior when drinking or abusing other drugs. These issues must be addressed in therapy once the withdrawal symptoms have passed and the drug toxins are no longer in the body.
According to Principles of Drug Addiction Treatment published by the NIDA, effective therapies include:
- Personal therapy. Here the real work on underlying issues will occur.
- Family therapy. Family members can make or break effectiveness of treatment. Therapy that addresses problems at home will increase the chances of success.
- Medical services. For chronic illnesses and/or co-occurring disorders, proper medical care can help patients avoid self-medication with drugs and alcohol.
- Educational classes. Learning the effects of drugs and alcohol on the brain and body can help patients to avoid relapse.
- Relapse prevention. Creating an actionable plan to implement when faced with temptation will increase the chances of avoiding relapse.
- Life skills classes. Learning how to function and keep up with normal responsibilities people struggling with addiction to feel more in control and less likely to turn to drugs and alcohol.
Benefits of a Drug Rehab Program
A drug or alcohol addiction treatment program can offer many benefits, including:
- Psychiatric care. Many people suffering from a substance addiction also have mental health issues. A quality program will have experience in treating mental health disorders such as depression, anxiety, bipolar disorder, and schizophrenia.
- Individualized treatment plans. Upon entering the program, the severity of the patient’s addiction will be evaluated, as well as any co-occurring mental or physical conditions. This evaluation will allow the treatment team to create a recovery plan that caters to the patient and their specific needs.
- Medicine maintenance. You can receive continuous pharmacological interventions in order to address any problematic symptoms while receiving treatment.
- Aftercare planning. Once the patient completes their private program, the recovery team will devise a plan for them to continue ongoing treatment. This plan could involve recovery programs including 12-step programs, sober living homes, outpatient treatment, partial hospitalization, individual therapy, and support groups.
- Individual therapy. Patients can work one-on-one with a therapist to address the underlying influences of their addiction and to develop coping skills.
- Group counseling. Patients can develop sober social skills while sharing their experiences related to addiction with a group of peers who are also struggling with addiction.
- Drug education classes. Patients will learn how alcohol and drugs affect the mind and body in the short and long terms, as well as further complications.
- Life skills classes. These classes are designed to help the person in recovery become self-sufficient when they complete the treatment program by providing them with the daily skills they need.
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