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Detoxification from addictive substances is, in a clinical setting, referred to as medical detox, or medically managed withdrawal. This process involves medical oversight while a person stops taking the addictive substance and goes through withdrawal, with help from doctors, therapists and other professionals. This process often involves prescriptions for medications that ease the physical and psychological symptoms of withdrawal, which helps to keep the person focused on the therapeutic recovery process and avoid relapse.
However, medical detox by itself is not the same thing as a rehabilitation program, which can take place on an inpatient or outpatient basis. Detox is one stage of the treatment process, but it is not considered an effective treatment on its own. People who struggle with addictions need help uncovering the reasons for their addictions – what led to the initial substance abuse and what contributes to the ongoing addiction. A full rehabilitation plan that addresses all aspects of the person’s life is the best course of action to fully overcome an addiction.
Some rehabilitation programs require potential clients to detox before they enter the program, while others help their clients detox while in their care. Sometimes, people begin detox after being hospitalized and are then encouraged to continue into a rehabilitation program; in other cases, individuals will begin treatment in a rehabilitation program that includes medical detox.
During detox, the first stage in the larger process of rehabilitation, the individual stops taking all addictive substances. Since the body has become accustomed to the presence of the substance in question, removing it sends the body into withdrawal. If prescription medications can help ease some of the physical or emotional symptoms of withdrawal, medical professionals can prescribe those and monitor the person to make sure the prescriptions are effective. Therapists also often help the person manage the psychological aspects of withdrawal, including anxiety and cravings.
Withdrawal from alcohol or drugs begins after the last dose is ingested, typically within 24-48 hours, depending on the substance. When the body becomes dependent on an addictive substance, the brain and other organ systems rely on certain doses to feel “normal” or good; however, as the substance leaves the body, the body and mind react in its absence. Some withdrawal symptoms are mild and can be managed with distractions or engaging in other activities. Other symptoms can be incredibly uncomfortable and even dangerous, which is why medical oversight during detox is important.
Mild physical withdrawal symptoms include:
Psychological symptoms include:
More serious withdrawal symptoms include:
The worst physical symptoms, like nausea or pain, can last about 7-10 days. After symptoms peak, they begin to subside over the following days. In some cases, certain mild symptoms may linger for weeks or even months.
In some cases, people who struggle with addiction have become so physically dependent on the addictive substance that drug replacement therapy is useful. This is especially true for opioid drugs, like heroin or fentanyl. During detox and rehabilitation, the individual may receive methadone or buprenorphine, and then taper off that substance over time until the body no longer needs any opioids.
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Prescription medications are often used in the process of medical detox. These help to ease withdrawal symptoms so the person is less likely to relapse to substance use, and they mitigate the severity of withdrawal symptoms. With a doctor monitoring each prescription and the 24-hour supervision provided in most medical detox programs, the person is less likely to abuse the prescriptions.
No single approach to detox works for everyone, and this is in part because of the number of addictive substances that exist. Each addictive substance can cause different clusters of withdrawal symptoms, so one medication does not ease withdrawal symptoms for everyone. While certain medications are approved by the FDA to be used in treatment for addiction to specific drugs, other medications are used to treat specific withdrawal symptoms. Medications can include drug replacement therapies to taper the individual off opiates, anti-seizure medications, anti-nausea medications, antidepressants, and anti-anxiety medications.
Here are a few common medications and their applications in medical detox:
The detox process takes different amounts of time for different people, though in most cases, it takes 5-10 days. The specific timeline depends on individual factors, including the amount of the substance ingested, the length of time the person struggled with addiction, the person’s physical makeup, and what type of drug the person abused.
Regardless of how long withdrawal takes, it is a step that has to be taken when overcoming addiction. Medical oversight keeps the detox process safe and comfortable. Just detoxing from a drug is not the same as overcoming addiction, and it is very important to complete comprehensive addiction treatmentafter detox.
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