Medical Detox vs. Medication-Assisted Detox
The Substance Abuse and Mental Health Administration (SAMHSA) reports that each year, at least 15.4% of the American populace struggles with a substance abuse disorder. According to the National Institute on Drug Abuse (NIDA), around 20.4 million Americans were diagnosed with a substance abuse disorder in 2021, and of that number, only 10.3% received any kind of treatment.
In 2019, NIDA said almost 71,000 Americans died of drug-related overdoses. To make matters worse, the National Center for Drug Abuse Statistics says there is an observed 3.8% increase in drug use each year. Combined with the staggering death toll, these statistics are perhaps the best argument for the importance of medically assisted detox.
What is a Medical Detox?
Medical detoxification, or medical detox for short, is the process of physiologically or medicinally removing toxic substances from the human body. The natural process of detoxification is typically done by the liver. In instances of alcohol or substance abuse however, the toxicity may be too much for the liver to flush out alone, particularly if the person has not stopped taking alcohol or substances. The medical detox phase necessarily needs to include completely stopping the person from taking alcohol or any kind of substance before the substances in the body are flushed out.
The medical detox phase also necessarily includes the period of drug or alcohol withdrawal, which is intended to return the person’s system to homeostasis after long-term use of an addictive substance. This is because prolonged substance abuse is known to alter the chemical balance of the body after some time.
Depending upon several factors, including the type of substance taken, the person’s natural threshold, and inherent genetic predisposition, medical detox would usually last anywhere from five days to up to a week. Patients that need to undergo a medical detox have to be thoroughly screened to know several specific things. This is so that the clinicians would know if any adverse reactions could come up during the actual detox process. A standard detox program will usually come with the following:
- A physical and mental health assessment
- Care and supervision by a medical team
- Treatment for withdrawal symptoms (Medications)
- Nutritional support
- Treatment for any medical issues that arise
What Is Medication-assisted Treatment?
As the name might suggest, medication-assisted treatment (MAT) is a process that involves the use of medication to help a person through withdrawal. It particularly helps in dealing with specific difficult elements of detox such as withdrawal symptoms and adverse reactions that come during detox. The medication is necessary because the withdrawal symptoms are not only immensely uncomfortable at times, but there are also instances when they could become outright debilitating or even life-threatening.
There are many substances that are extremely difficult to quit because apart from the agonizing withdrawal symptoms, they could also produce cravings and urges that are almost impossible to resist. These intense urges and cravings are mostly only managed through the use of medications that help dull these sensations. Before this approach, people unable to resist the urge to take substances once more or become hysterical while going through withdrawal symptoms had to be restrained. This is particularly true for the people who had the misfortune of having seizures during withdrawal, as their bodies had become used to the presence of substances in their bloodstream and are not reacting to its absence.
Medication-assisted treatment is only done within the confines of a rehabilitation center and detox drugs are administered only by medical specialists trained in the process. This process is also done alongside counseling and behavioral therapy. This is mainly because this period is characterized by persistent confusion, great discomfort and even pain, and overpowering urges to take substances once more.
MAT is also strictly done only in rehab centers because people who have a dependency issue tend to substitute one dependence with another, and there is also the risk that the detox medications used might promote a new kind of dependence. This is particularly seen in the behavior of some people going through detox, where the mere act of taking a substance, whether it be orally or intravenously, produces a placebo effect, as the patient goes through the familiar motions of addiction.
What are the Categories of Substance Abuse Treatment?
The three main forms of substance abuse treatment are:
Detoxification
This phase is where the entire process of recovery begins. This is where the patient is taken to a facility to undergo medical detox where they end the use of alcohol or drugs and flush out whatever toxins there are in the person’s body. This phase is highly important to stop the damage being done by the substances to the body.
This phase is characterized by great discomfort, pain, and mental distress. These things are primarily because the body is seeking to readjust to not having alcohol or drugs in the system, and also largely due to the fact that the body has already suffered damage from the substance abuse.
Medication-assisted Therapies
There are many instances where the usual treatments done in medical detox are not enough and there is a need for medications during detox. This is particularly true for those who find it next to impossible to deal with not being able to take alcohol or drugs anymore. There are many cases of people previously hooked on painkillers who simply went out of their minds when they began to feel the sensation of pain once more now that painkillers are no longer clouding their senses.
In other instances, people suffer highly distressing symptoms such as seizures and unbearable pain. To mitigate these symptoms, medication is used to ease the agony felt by the patient. Meciation-assisted treatment has even proven to be quite effective in helping reduce the instance of relapses in many people, as they permanently lose interest in taking substances.
Cognitive and Behavioral Therapies
A person who is on the road to recovery necessarily needs to have a goal or destination that does not include staying in the rehab facility or taking medication just to arrest their urge to take alcohol or drugs again. This is where cognitive and behavioral therapy comes in. A therapist will assess the patient to determine what situations or triggers produce the urge to take substances, and then prescribe what particular form of psychotherapy would work best for the particular case.
Therapy is important in the recovery process because being in the real world once more outside of the rehabilitation facility will expose the patient to the stressors and situations that might cause enough stress to make them take alcohol or drugs once more. A large part of therapy is focused on helping the patient develop specific responses to the stressors and situations that could push them back to old habits.
What are the Withdrawal Symptoms that People Experience During Medical Detox?
Withdrawal symptoms experienced during medical detox would typically depend on some factors, such as the type of substance taken, the duration with which it was taken, if it was taken with anything else, and the quantity that was taken. The severity and manifestation of withdrawal symptoms may also vary greatly depending on the person as well. There are people who have a higher threshold for pain and discomfort, and these people are usually only bothered by the most severe of symptoms, while others with a lower threshold could agonize over the simplest and least painful of symptoms.
Those who undergo medical detox could experience some or even all of the symptoms that are associated with the substance they are detoxing from, which is why there is a need to work with trained specialists when undergoing a medical detox and not try to do it at home.
Alcohol
Alcohol is one of the most common substances that people abuse. It is also one of the earliest substances that people are exposed to, with adolescents still in school already getting initiated into its use, and then the habit is carried over into the adult years. Alcohol abuse comes with the following symptoms:
- Profuse sweating
- Nausea
- Vomiting
- Tachycardia (abnormally fast heart rate)
- Insomnia
- Tremors and tics
- Anxiety
- Restlessness
- Hallucinations
- Increased chance of grand mal seizures
There are also some more severe symptoms, and these are associated with delirium tremens syndrome, which is characterized by severe seizures. These symptoms include:
- Extreme agitation
- Fever
- Vivid and lasting hallucinations
- Severe confusion or disorientation
- Seizures
Opiates
The National Institute on Drug Abuse (NIDA) revealed that in 2020, at least two million Americans are addicted to opioids, and nearly a hundred people die due to opioid overdose every day. Withdrawal symptoms from opioid addiction include:
- Muscle pain
- Runny nose
- Teary eyes
- Profuse sweating
- Insomnia
- Diarrhea
- Nausea
- Vomiting
- Severe melancholy akin to depression
- Dilated pupils
- Vision problems
Benzodiazepines
The National Surveys on Drug Use and Health (NSDUH) released data showing that from 2015 to 2016, at least 30.5 million Americans used benzodiazepines. Of this figure, at least 2.1% eventually developed a dependence on it. The dangers of using benzodiazepines come from its side effects which include memory and reasoning impairment, attention deficits, persistent drowsiness, uncoordinated motor actions, confusion, and hallucinations of varying severity. Withdrawal symptoms include:
- Abdominal cramping
- Anxiety
- Blurred vision
- Inability to focus or concentrate
- Dizziness
- Headaches
- Increased sensory sensitivity
- Loss of libido
- Loss of appetite
- Nausea
- Mild to moderate depression
- Panic attacks
- Restlessness
- Vivid nightmares
- Disrupted sleep patterns
- Sore tongue
- Lingering metallic taste in the mouth
- Tinnitus (persistent ringing in the ears)
- Profuse sweating
- Tachycardia (abnormally fast heart rate)
- Vomiting
- Weight loss
- Confusion
- Memory loss
- Seizures
Stimulants
According to the National Institute on Drug Abuse (NIDA), in 2021 alone, at least 2.5 million Americans abused methamphetamines, while another 2.5 million are reportedly addicted to Adderall, another stimulant. In 2021, at least 32,537 people died from stimulant-related overdose cases, primarily involving methamphetamine. Withdrawal symptoms include:
- Tremors and twitches
- Anxiety
- Chills
- Dehydration
- Impaired senses
- Slurred or slowed speech
- Slowed movement
- Impaired reaction time
- Impaired cognition
- Bradycardia (slowed heart rate)
- Increased irritability
- Hallucinations
- Paranoia
- Fatigue
- Depression
- Fluctuating appetite
- Fluctuating weight
- Impaired memory
- Unexplained body aches
- Vivid dreams or nightmares
- Insomnia or hypersomnia
Path to Recovery Can Help You with Medical Detox and Medication-assisted Treatment
The first step is usually the most difficult in any journey, and this also applies to the journey to recovery. No one knows this more than the people at Path to Recovery, where we make it our business to know how best to help people achieve a full and lasting recovery from substance abuse. We believe that everyone deserves the best treatment available, and this is our mindset when we help people recover. We can help you too. Talk to us now.