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Detox centers concentrate on treating the withdrawal syndrome associated with the use of alcohol or certain drugs. The term medical detox is no longer used by major organizations like the World Health Organization (WHO), the American Psychiatric Association (APA), and the American Society of Addiction Medicine (ASAM). Instead, these organizations refer to the process as withdrawal management.
Detox or withdrawal management programshelp clients control withdrawal symptoms as they attempt to remain abstinent from drugs or alcohol; initiate formal substance use disorder treatment, such as therapy, support group participation, and other forms of support; and provide medical management for any other co-occurring issues, such as depression. For many individuals, placement in a detox center is often a result of convenience; they simply attend the closest facility to them or the one recommended by a referring treatment provider. There are, however, numerous factors one should consider before choosing a facility that is designed to help with withdrawal.
The initial consideration should be whether or not one should enter the facility as an inpatient or attempt to receive treatment as an outpatient. Often, this will depend on the extent of insurance coverage the individual has, and insurance companies will often approve the use of inpatient withdrawal management programs if the referring physician can demonstrate the medical necessity of inpatient treatment compared to outpatient treatment.
Medical necessity refers to the notion that the proposed treatment is necessary and better suited to the needs of the individual than some alternative intervention.
Medical necessity is often established by physicians who wish to place individuals into inpatient withdrawal management programs by explaining that the withdrawal process can result in significant physical or emotional harm if the person is not monitored around the clock or that placement in some other outpatient program will most likely lead to relapse. Other co-occurring issues, such as a severe psychiatric disorder, suicidality, a severe abusive environment, etc., can also determine the need for inpatient treatment. An individual who has undergone numerous attempts at recovery followed by relapses would also be a strong candidate for inpatient detox.
On the other hand, some individuals may find that they would prefer an outpatient detox program. These individuals may wish to maintain active participation in their employment or family life, or the withdrawal syndrome they are expected to experience is not deemed to be potentially dangerous. Anyone considering inpatient versus outpatient withdrawal management should discuss the situation thoroughly with their physician and other treatment providers to determine the option that best fits their needs.
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An individual contemplating admission to a withdrawal management or medical detox program cannot realistically determine if a particular program meets their needs if they have not outlined their situation and their needs and expectations of treatment. Again, this is an issue that should be discussed with one’s treatment providers. The first step in finding a detox program that satisfies one’s needs is to actually identify the major areas that one wishes to have addressed during this phase of the treatment.
After defining treatment goals and expectations, it is time to find an appropriate facility. Some of the following considerations can help one determine if the particular program will be sufficient to help them meet their goals: