It has been said that the first step of any long process is the most difficult. That might be especially true when it comes to addiction. People who simply have no idea what recovery might look like or how it might start might be filled with concern about what might happen to them. They might have particular concerns about medical detox. After all, this is the recovery step that comes first, and potentially, it could be a step that causes a little discomfort.
Thankfully, medical detox is relatively easy to understand. In fact, the medical detox process can be broken down into a series of steps that almost anyone could understand.
Step 1: Know the rules.
Medical detox facilities might all be designed to do the same thing, but every facility will have different rules regarding what people can bring with them for care. Some allow hair products that contain alcohol, for example, while others ban those substances. All luggage is checked on arrival, and it can be upsetting to have items tossed by the intake staff. Knowing what is allowed, and not allowed, can help people to avoid that upset.
Similarly, some medical detox facilities like people to be in active withdrawal when they arrive for treatment. These facilities expect to see withdrawal signs when people arrive, such as:
- Minor shaking
Other facilities are not so strict about withdrawal, and they want their clients to be healthy and happy when they arrive for care. Knowing the rules can make all the difference, in terms of getting off on the right foot in treatment.
Note: Certain substances of abuse, such as alcohol and benzodiazepines, can cause life-threatening withdrawal symptoms. Those with addictions should never attempt to stop taking these substances on their own without medical supervision.
Step 2: Time the last hit.
Many medical detox facilities use medications to help people move through the process without experiencing overwhelming discomfort. The amount of medications people might need is deeply dependent on their last dose of drugs.
For example, the National Highway Safety Administration says that heroin’s effects can last for 4-6 hours, but the rate is deeply dependent on the method people used to take heroin. Shooting the drug is different than sniffing it. Similarly, different drugs come with different active times, and they may need different replacement medications.
Before enrolling in rehab, people should take note of the last hit they took and the method by which they took it. That is information the team will need in order to pull together an appropriate treatment program.
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Step 3: Prepare to answer questions.
Addictions are often surrounded by secrecy. People who have addictions may have an entire suite of skills devoted to avoiding questions and hiding their drug use. These are skills honed over many years of use, and they may be responsible for keeping an addiction hidden.
When people enroll in medical detox, they need to put those skills aside. The team will need straight answers to questions involving:
- Drugs taken frequently
- Drugs taken occasionally
- Dosage frequency
- Drug sources
When the interview involving drug use is complete, the team might ask questions concerning the person’s mental health and history of disease. Again, these can seem like intrusive questions and it can be tempting to lie, but the team really does need to know the scope of the problems the person is facing. Asking questions is an important way to get that information.
Step 4: Be prepared for drug tests.
Interviews about drug use can tell doctors a great deal about a person’s substance abuse habits, but some questions may remain. Some people metabolize drugs at a different rate than others, and some people might blur the truth about drug use. Relying on interviews alone is not ideal, so many programs also incorporate urine and blood tests into the intake process.
Tests for drugs can be remarkably sensitive. In fact, Forensic Fluids Laboratories suggests that tests of blood, urine, or saliva can detect most drugs for 1-4 days after they are used. That means these tests can uncover the issues people might desperately want to keep hidden. That means these tests can help doctors get the data they need to help people get well.
Step 5: Surrender to the symptoms.
The goal of a medical detox program is to help people move through the withdrawal process in a safe and controlled manner. That means these programs help to ensure that people can get sober without losing their lives, but these programs do not guarantee a total lack of discomfort. In fact, mild discomfort is very much part of the program.
According to the National Institute on Drug Abuse, clinicians use a withdrawal scale to supervise the withdrawal process. They look for the presence and severity of common withdrawal signs, which might include:
- GI symptoms
- Fast pulse
- Sweating or chills
- Pinned pupils
- Bone aches
- Runny nose
People with severe symptoms might need medications to soothe their distress, but people with moderate or mild symptoms might benefit from a less intense form of therapy.
Step 6: Take your medications.
If withdrawal symptoms are severe, clinicians might provide a medication that can deliver relief. The medications given are deeply dependent on the drugs the person is accustomed to taking. According to an overview in Medscape, substitute medications typically have some sort of cross-tolerance with the substance the person took on an addictive basis. That means the medications are similar to, but not exactly the same as, the drugs the person once took on a regular basis.
In the beginning of a withdrawal process, the dose of replacement drugs might be large, just as the dose of addictive drugs the person once took was probably large. As the process moves forward, those doses get smaller and smaller.
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Step 7: Use supplemental programs.
People who enroll in medical detox programs do not simply sit in a room and take medications all day long. They are encouraged to get up, get moving, and get well. Often, programs have a suite of supplemental activities that can help with healing on a physical and spiritual level.
For example, some programs offer instruction in yoga. People who enroll can take gentle classes in which they bend, stretch, and breathe. They can learn to calm their muscles and minds with this technique, and it can be quite relaxing.
Other medical detox programs offer complementary therapy techniques, such as massage and acupuncture, to ease the discomfort of drug withdrawal. These are nonpharmacological techniques that could appeal to people who do not want to take several drugs as they heal, and they could be quite helpful.
As people take advantage of these programs, they should think about how their bodies have been changed by drugs. For example, a study in the journal Drug and Alcohol Dependence took people addicted to cocaine through a 23-day sleep study test, and the researchers found that sleep disturbances were common. As people recover from a cocaine addiction, they may find that their sleep improves. It is a subtle change, but it indicates healing. It could be a motivating factor that keeps people in treatment.
Step 8: Repeat, as long as necessary.
Medical detox programs work best when people stay committed to the work and refuse to drop out. In a study published in the Journal of Psychoactive Drugs, researchers found that people dropped out of care due to patient perception, particularly concerning control. People resisted the idea of rules and regulations, so they dropped out of care.
People who are tempted to drop out too soon would do well to remember why they have enrolled. They would be wise to keep recovery in mind.
Step 9: Head to rehab.
Once a person reaches a level of recovery stability, where they are not taking replacement medications to control withdrawal symptoms and they feel clearheaded enough to participate in conversations about addiction, it is time to leave the medical detox facility behind and enroll in rehab. A rehab program allows the fragile sobriety earned in detox to become a matter of habit and persistence. With the right rehab program, people can get better for life.
According to NIDA, the goal of a rehab program is to return people to a productive level of functioning, both at home and in the community. Teams can accomplish that through counseling, support groups, and more. Medical detox providers believe in the efficacy of rehab, and they may supervise the transition from detox to rehab.
Medical detox is a process. It can be all too easy for people with addictions to claim that the work is too hard, too long, or both. It is important to remember the risks involved with an ongoing addiction. As the Daily Beast points out, those risks can include overdose. Every year, as many as 22 percent of people will suffer with a “near miss” overdose. Thousands more will die.
Medical detox is a key step people can take to prevent those overdoses. Following this plan is, put plainly, the best way to get better. Those who do it will see the results.