Detox

Detoxification: Drugs, Alcohol, and Synthetics 

By The Fix staff 01/21/15

Detoxification: Drugs, Alcohol, and Synthetics 

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Detox

Substance and alcohol use disorders can damage the relationships, responsibilities, and nearly every aspect of the life of someone suffering from the grasp of addiction. When you or a loved one has made the decision to get clean from addiction, the process begins with detoxification.

Detoxification, or detox, is the process by which a person overcomes the presence of a mind-altering substance in the body and enters a state in which the influence of drugs or substances does not have any current symptoms. Ultimately, detoxification describes a period of forced withdrawal in order to overcome the power of substances over a person. However, each detoxification process will include withdrawal symptoms, which may require medical supervision. Depending on the severity of the dependency, some detoxification may be achieved successfully at home in nontraditional care settings, but careful observance must be maintained.

Detoxification primarily occurs following the use of either drugs or alcohol. While each detoxification process will have similar withdrawal symptoms, the exact method of treating the specific substance use disorder varies. Furthermore, the use of synthetic compounds may require a drug detox. Due to the constantly changing laws surround synthetic drugs, the last section will be devoted solely to their detoxification process.

According to the National Institute on Drug Abuse, several principles define an effective treatment strategy for substance abuse, which include the following factors:

  • Acknowledgement of substance use disorder that affects both the mind and body.
  • Unique treatment for each type of addiction
  • Treatment should be available at all times
  • Treatment must address all health concerns of the person
  • A person seeking treatment must stay in treatment for enough time to fully recover
  • A person receiving treatment must attend counseling sessions
  • Medications should be used during the course of treatment of substance abuse or alcohol use disorders
  • The treatment plan for each person must be continually redressed and adapted to meet the needs of the person
  • Acknowledge of the presence of mental health disorders in most of those using substances or alcohol to cope with stressors
  • Detoxification does not result in a totally successful attempt at sobriety as it only remains the first initial phase of recovery
  • Treatment options should address the potentially risky behavior that occurred as a result of the use of varying substances

Drug Detox

Although many drugs have the potential to cause minor withdrawal symptoms, the use of opiates possesses the most intense drug detox process. Opiates include heroin, codeine, oxycontin, dilaudid, and methadone. In addition, this class of drugs includes morphine and minor painkillers, and approximately 9% of the population has abused opiates at some point in their lives.

Symptoms

The most common, early symptoms of detoxification and withdrawal from drugs include agitation, anxiety, muscle pains, increased tear production, difficulty sleeping, dripping or runny nose, perspiration, and fatigue. Other symptoms occur later in the withdrawal process and include abdominal cramps, diarrhea, dilated pupils, chills, nausea, and vomiting.

Treatment During Drug Detox

At the beginning of treatment, a licensed medical practitioner will perform a variety of tests to check your blood chemistry, organ function, and your complete blood count (CBC). These tests can identify dangerous risk factors or health considerations to monitor during the detoxification process. For example, low levels of medications for the treatment of cardiovascular or endocrine diseases can influence the amount of medications given to treat the withdrawal symptoms.

In addition to receiving medication assistance to treat the symptoms of withdrawal during detox, you will begin receiving supportive care and treatment. Supportive care includes a host of behavioral therapies geared toward the management of your symptoms and condition.

The FDA has only approved medications for the treatment of drug detox for opioids and tobacco; however, researchers continue working in the hopes of finding a medication to treat the withdrawal symptoms of stimulants, cannabis, and other drugs. Fortunately, physicians have the ability to prescribe medications to treat the changes in affect and behavior associated with detox from these other classes of drugs.

Methadone, buprenorphine, and naltrexone are effective medications for treating withdrawal from opioids. These medications bind to the same receptor sites as opioids, which essentially trick the brain into thinking that the person has engaged in drug use once more. This relieves the cravings. However, naltrexone blocks the effects of heroin and opioids from the binding sites and should not be administered to people currently in the detoxification process.

Treatment for Other Health Conditions During Drug Detox

If you have another mental health disorder, such as an anxiety disorder, bipolar disorder, depression, schizophrenia, it would be a pointless endeavor to treat anxiety of withdrawal when the underlying cause of the substance use disorder may have been a person wanting to obtain treatment for a mental health disorder. Furthermore, the effects of drugs on the body may diminish the body's ability to function appropriately. Liver and kidney function may be impaired, and maintaining an adequate level of hydration can be difficult due to severe nausea, vomiting, and diarrhea accompanying many drug detox processes.

Alcohol Detox

Alcohol detox remains one of the most important aspects of recovering from alcohol dependency or alcoholism. According to the Diagnostic and Statistical Manual of Mental Health Fifth Edition, alcohol use disorders and alcoholism have been reclassified into a single affliction that addresses the problems created by binge or heavy drinking practices.

Entering detox for alcohol dependency often requires medical oversight in order to treat the accompanying symptoms of withdrawal from alcohol, including body tremors, changes in cognitive function, agitation, confusion, decreased ability to focus, extensive periods of deep sleep, delirium, excitement, fear, anxiety, hallucinations, rapid mood changes, restlessness, overly sensitive sensory perception, and fatigue. Most often, symptoms begin within 48 to 96 hours following the last drink; however, they may take up to a full week before they appear. Furthermore, some people going through detox may begin to experience severe feelings of aggression or suicidal thoughts and actions.

Medication Treatment

The FDA has currently approved three medications for the treatment of alcohol withdrawal during and after detoxification: naltrexone, acamprosate, and disulfiram. A fourth medication, topiraramate, has been under development, but the FDA has yet to announce a decision regarding its use.

Naltrexone functions in the same manner as the treatment of opioids as it blocks the euphoric effects from the consumption of alcohol. It lowers the chances of relapse and cravings for alcohol.

Acamprosate reduces the minor symptoms of withdrawal, such as insomnia, anxiety, restlessness, and the general feelings of discomfort associated with alcohol withdrawal and detoxification.

Disulfiram blocks the metabolism of alcohol and results in abdominal cramping, vomiting, nausea, and flushing in a manner consistent with the principles of taste aversion when drinking alcohol. You may have heard of disulfiram by the alternative name, "Antabuse."

Delirium Tremens is a severe form of alcohol withdrawal that occurs following severe alcohol dependency. However, DTs may occur after long-term use of alcohol heavily without the need for undergoing alcohol withdrawal. A licensed medical practitioner will make the determination whether a sedated state through benzodiazepine medications will be needed in order to survive the stage of alcohol dependency treatment where DTs are present.

Antipsychotic medications may be used to treat psychotic symptoms following withdrawal from alcohol. Psychotic symptoms include extreme paranoia, delusions, or hallucinations. Furthermore, antidepressants and anti-anxiety medications may be required.

Treatment of Other Health Conditions Starts During Detox

When entering the initial phase of detox and substance abuse treatment, including alcohol use disorder, a person suffering from the disorder will need to have any other health conditions addressed as well. Unfortunately, some people may have long-term damage as a result of alcohol dependency. This can include arrhythmias, seizures, injury from accidents, and self-inflicted injuries. An arrhythmia is an irregular heart beat that occurs as a result of substance abuse, genetic factors, or other illnesses.

Although the primary concerns during detox for drug or alcohol abuse revolve around the treatment of withdrawal symptoms, each person must begin attending behavioral therapy to address the adverse thought processes supporting the addiction. Some of the common behavioral therapies utilized for substance and alcohol abuse include cognitive behavioral therapy, multidimensional family therapy, motivational interviewing, and motivational incentives. For some, detoxification for alcohol and drugs may be the result of a court order, intervention outcome, or a personal desire to attain sobriety. However, every detox process will be unique to the needs of the person suffering at the hands of addiction, so you may still need to consult with a licensed professional for more information on what to expect during your detox or the detox of a family member or friend.

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