Friday September 30th 2016

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Understanding detox

Here, we review the purpose of detox and how it can help people in addiction recover.y Then, we invite your questions about detox or how to withdraw from alcohol safely (or from drugs) at the end.

What is detox?

Interrupting the addiction cycle, whether to alcohol or other drugs, is crucial to establishing long-term recovery. For some, the consequences of their substance problem—emotional pain, legal or health problems, employment issues, etc.—cause them to seek help before their physical dependency reaches the stage where withdrawal becomes a potential medical problem. Others will face the challenge of quitting while experiencing symptoms that are at best extremely uncomfortable and at worst painful and possibly life-threatening.

Why is detox so important?

Detox fulfills two functions. First, it isolates the user from proximity to alcohol or drugs, thereby making way for successful withdrawal. Second, it ensures safety and attempts to minimize discomfort during the withdrawal process.

Medical supervision can be critical in anticipating and handling seizures, dehydration, and other symptoms. Are you at risk of severe alcohol withdrawal?  Staff can assess your risk.  Without medical help, death rates for severe alcohol withdrawal and delirium tremens have historically been as high as twenty percent; intervention and treatment greatly reduce mortality rates. Additionally, alcoholics may have co-existing health problems such as cardiovascular issues, cirrhosis of the liver, or pancreatitis. Comorbidity presents among drug addicts as well: hepatitis, HIV, as well as concurrent mental disorders may have to be considered and managed during treatment.

The importance of drug and alcohol detox

Alcohol withdrawals, following continuous and heavy consumption, can include

  • seizures
  • hallucinations
  • trembling
  • disorientation
  • motor-skill impairment
  • memory and cognitive problems
  • possible delirium tremens

Alcohol withdrawal symptoms treatment includes benzodiazepines (typically Valium, Ativan, or Librium). These can be useful with opiate withdrawals as well, although drugs like Suboxone and Methadone can also be employed. These latter drugs are not part of a detox regimen so much as replacement drugs that subvert the craving for opiates; however, they too can trigger dependency.

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Drug withdrawals share most of these and, depending on the drug, can also include hyperactivity, severe cramping, and nausea, among other symptoms. Common to withdrawal from both alcohol and drugs is an intense desire to alleviate the symptoms with a resumption of use. Along with drugs to treat withdrawal, detox can require intravenous fluid replacement as well as a vitamin regimen, particularly vitamin B1 (thiamine).

Stages of detox

There are three defined stages to the detox process: evaluation, stabilization, and guiding the patient into treatment. Evaluation determines which substances are to be treated for and what other factors—such as co-occurring disorders, mental/behavioral issues, etc.—need to be considered. Stabilization involves medical treatment for safety and minimalization of discomfort during the withdrawal cycle. The final stage addresses the psychological aspects of addiction—now that the withdrawal crisis is past, can the patient be persuaded to submit to rehabilitation through treatment? Otherwise, the odds are high that the patient will resume consumption and require detox again.

PAWS drives relapse

Post-acute-withdrawal symptoms (PAWS) occur in seventy-five to ninety percent of substance abusers, depending on the class of substance involved, and can last from months to years. PAWS is the primary driver of relapse after detox, as its symptoms—including extreme mood swings, anxiety, panic attacks, insomnia, and anhedonia (inability to feel pleasure from anything besides resumption of the substance in question)—are overwhelming to the patient, and the addictive mind is still programmed to seek relief by the quickest method possible. One primary purpose of treatment is to assist the addict or alcoholic in understanding and acknowledging the probability of PAWS, and to provide tools for responding appropriately.

Photo credit: Patricksmercy

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About Tracy Smith

Tracy Smith covers topics within the drug addiction niche being a recovering addict herself. She is thankful to have found treatment for her substance abuse that helped her become sober.

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