In a traditional addiction recovery program, the addicted person is asked to talk, think and work on their addiction problem. The addict might be asked to go to counseling sessions, participate in group meetings and discuss the condition with family members. To eradicate bad influences and habits, addicts might need to make new friends, change jobs and move to new homes. All of these steps take an incredible amount of work and focus, and the addict must have a clear head and firm resolve in order to tackle this work.
People who are addicted to drugs and alcohol simply can’t do the hard work of recovery while the chemicals are still coursing through their systems. In fact, many structured recovery programs won’t allow addicted people to participate until they can prove, through urine or blood tests, that they do not have chemicals in their system. Going through a detoxification program is one way that addicted people can clean their systems and prepare their bodies for the later stages of recovery.
History of Detoxification Programs
In the 1940s and 1950s, addicted people were placed in hospitals and mental health institutions for detoxification. They were rarely given medical therapies to help ease the process along. At this time, people believed that addiction was a form of moral failure; by encouraging the addicted person to truly feel the pangs of withdrawal, they would feel punished and it would firm up their resolve to stay clear of drugs and alcohol in the future. Many old films and television shows portray addicts in straightjackets, sweating and screaming their way through withdrawal symptoms while doctors and nurses hover nearby, taking notes. This was simply seen as the proper way to clean the system and force the addict into a new way of life.
It may sound barbaric, but the method isn’t without its supporters. As some addiction therapists are quick to point out, some substances cause withdrawal symptoms that are merely uncomfortable without being life-threatening. For example:
Heroin withdrawal can cause diarrhea, nausea, and itching, painful skin. These symptoms can be severe but they tend to dissipate within two weeks.
Hydrocodone withdrawal can lead to disturbed sleep, excitability and diarrhea that can persist for up to two weeks.
Alcohol withdrawal symptoms include shaking, sweating and hallucinations. These symptoms tend to abate within days.
That doesn’t mean, however, that all forms of withdrawal are not life-threatening. People who have abused alcohol for a long period of time can experience severe and life-threatening withdrawal symptoms, including seizures and hallucinations. Placing a severe alcoholic into a facility to undergo withdrawal without medical management is not just cruel; it can lead to death.
In addition, some people who abuse substances such as heroin or cocaine experience such crushing symptoms that when their resolve to kick the habit is at its lowest point, they take substances again just to make the pain stop. They may simply walk out of inpatient treatment programs and look for drugs to take. As a 2011 study in The Journal of Addiction Medicine suggests, treating addicts without medications to help them cope with withdrawal symptoms leads to such high dropout rates that most doctors won’t even consider it. By providing medications to ease symptoms, doctors can help addicts stay motivated and enrolled in a treatment program.
Modern Detox Programs
After a successful intervention, an addicted person is asked to enroll in a formal detoxification program. This detox can take place at a clinic, hospital or addiction treatment facility. When the patient is enrolled, he or she is asked to describe what drugs he or she was taking and how many alcoholic drinks he or she consumed in one day. The patient must be completely honest here so caregivers can get a firm idea of what sort of withdrawal symptoms the patient is likely to face. This helps them determine what medication might be needed to treat those symptoms.
It goes without saying that the patient isn’t allowed to use any substances during the stay, unless those medications are prescribed by doctors. For example, recovering alcoholics might be given tranquilizers such as diazepam or lorazepam to reduce cravings, and they might be given benzodiazepines to prevent seizures. People addicted to opiate medications like Vicodin or heroin might be given an opiate-blocking medication like Naltrexone. This medication can keep the body from picking up signals from opiates still present in the blood, and it can dramatically reduce the amount of time it takes for the body to stop feeling the drug’s effects.
Forms of Detoxification
Modern detoxification programs can take anywhere from two days to several months. The programs can vary dramatically from facility to facility. This is just a short list of the detoxification options available in facilities today:
Slow taper. Here, the patient is given a synthetic form of the substance he or she is addicted to in smaller and smaller doses each day. The withdrawal symptoms may be mild, as the body doesn’t experience a sudden shock.
Rapid detoxification. A large dose of Naltrexone is given, immediately halting the body’s ability to pick up the drugs in the system. This shocks the patient’s system into withdrawal and then medications are given to control the withdrawal symptoms.
Rapid detoxification in steps. Rather than being given one large bolt of Naltrexone, the patient begins with a small dose and that dose is slowly increased until the system is clean. The withdrawal symptoms may be slightly milder in this approach.
Ultra-rapid detoxification. In this method, the patient is placed under general anesthesia and is given a high dose of Naltrexone. The patient stays under anesthesia while the withdrawal symptoms come and go, and may awaken feeling clean and sober.
In today’s quick-fix society, the idea of an ultra-rapid detoxification seems particularly appealing. The patient can emerge from the program in just a few hours, and not experience the pain and discomfort so often associated with withdrawal. News stories in Wired and other national outlets have covered this phenomenon, reporting that the idea is becoming more and more popular. Experts aren’t quite certain that the method is effective, however, and many studies are underway to determine how the method stands up compared to more traditional detoxification practices.
Detoxification programs that combine a short course of medications with a longer course of sustenance medications may be an effective way to combat addiction. After all, some substances cause months of withdrawal symptoms and giving a recovering addict just a few days of medications may not provide enough assistance. One study published in the journal European Psychiatry in 2011 found that heroin addicts who were given medications for six months were 38.6 percent likely to be clean one year after they were admitted into rehab. This is a remarkably high success rate of rehab for this particularly addictive drug.
Is Detox Enough on Its Own?
Most experts agree that detoxification programs alone don’t supply the sort of tools an addict will need to stay clean. A 2010 study in European Psychiatry found that people who completed a detoxification program didn’t live any longer than people who did not complete the program. Families who hope a detoxification program will save the addict’s life might need to do more to help ensure that the addict succeeds in recovery. Detoxification simply clears out the blood, but it doesn’t deal with the underlying conditions that cause the addiction in the first place.
Addicted people may still have a chemical dependency on the drug that calls out to them from time to time. Addicted people may also have friends, coworkers and other social ties that lure them back into drug use. That’s why most experts suggest that addiction counseling sessions begin right after detoxification programs are complete. A study published in the American Journal of Drug and Alcohol Abuse in 2009 makes this distinction quite clear. One group of participants completed a five-day treatment program. The other participants completed a 30-day treatment program. The group receiving 30 days of treatment was much more likely to stay clear of drugs and alcohol, as shown in their urine screenings.
Achieving Long-Term Sobriety
Detoxification programs can help people clear the drugs and alcohol from their systems, so they can clear their heads and get prepared to do the work they’ll need to do to stay sober for the rest of their lives. That being said, detoxification programs are only effective if they’re followed up with some other form of therapy. Some withdrawal symptoms simply don’t go away in just a few days or weeks, and some people haven’t developed the coping skills that allow them to deal with the stresses of modern life without the use of drugs and alcohol.
In addition, the stronger ties the people have when they enter a treatment program, the better they’ll do in a treatment program. As the study in European Psychologypointed out, people with strong family ties, higher incomes and good jobs were more likely to stay clean months after detoxification was complete. As cliché as it might sound, people really do need “something to live for” if they are to complete the hard work of rehabilitation. Detoxification programs can’t supply that motivation but rehabilitation programs might be able to assist. Here, the recovering addict can repair broken ties and make new friends, as well as gain tools and skills that could make employment more likely.