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The Importance of Medical Detox Before Rehab

Asking or agreeing to go to treatment is a big first step in the road to recovery.

If you have never gone to drug or alcohol rehabilitation before, different ideas and preconceptions probably come to mind. You may think of what you have seen in movies or TV shows and pictures of people going through painful withdrawals. Many do not realize there are multiple stages in the treatment process, and one of the most important steps is medical detox.

Medical detox ensures comfort and safety and is often a requirement prior to the actual rehabilitation. Even if medical detox is not required before treatment, it may be a good idea.

What Is Medical Detox?

Medical detox is the process in which drugs or alcohol are safely removed from the body.[1] The procedure is most likely used in conjunction with medication to help the process be more comfortable. It is conducted in a medical facility with doctors and nurses on site 24/7. Many people avoid recovery and treatment because they are afraid of painful withdrawals. This is usually because they only have ever tried to abstain from their drug-of-choice on their own and have felt the full effects of withdrawal symptoms. It is important to know that withdrawal symptoms can be greatly reduced in medical detox. In addition to comfort, medical detox insures a safe and regulated end to substance abuse.

substances-most-often-responsible-for-detox-admissionsDetox from substances like alcohol and benzodiazepines can be a very dangerous withdrawal process and can lead to severe seizures and cardiac arrest. In a medical detox center, doctors will administer tapering medication to decrease the chances of the body having adverse reactions to an abrupt end to substance abuse. With both alcohol and benzodiazepines, another benzodiazepine will most likely be prescribed for anti-seizure purposed. The patient is brought off the drug slowly, as opposed to cold turkey, which decreases symptoms and increases safety. Other medications may be used to assist with sleep, anxiety, depression and even cravings.

Though opiate withdrawal is rarely life-threatening, attempting the process on one’s own can be extremely painful, and it may be very difficult to remain abstinent. In a medical detox scenario, just as in the case with alcohol or benzodiazepines, a taper is used. This taper, usually buprenorphine (Suboxone or Subutex), decreases symptoms of opiate withdrawal and cravings. There are many benefits of buprenorphine detox, and evidence suggests it has much higher success rates than those who quit on their own.[2]

In medical detox there is also the option of being prescribed Naltrexone[3] or Vivitrol. These drugs block opioid and pleasure receptors in the brain. They decrease cravings and also block the effects of opioids altogether. These drugs can also prevent overdose if one were to relapse.

How Detox Works

Doctor talking with patientMedical detox, depending on a person’s historical drug-use patterns, can last from 3-10 days. The first stage is an evaluation in which doctors will determine the length of detox and how much medication should be used. As the process begins, the medical detox regimen may be increased or decreased depending on the observed reactions of their body.

Medically-supervised detox can reveal further diagnoses unavailable to someone attempting to detox on their own. Blood tests are conducted and medical staff can determine if further medication may be needed. In active addiction, users put their body at significant risk for liver dysfunction or communicable diseases like HIV or Hepatitis C. In detox, diseases can be caught as early as possible, and a treatment plan can be created if problems such as these are discovered. Skipping a medically-assisted detox can allow diseases and viruses to go undetected and leading them to progress. Left untreated, liver dysfunction, HIV and Hepatitis C can be fatal.

After the detox process, a patient is ideally transferred to inpatient rehab. Some treatment centers have on-site detox capabilities. Detox centers also exist on their own, and one should be transferred to a treatment center after detox. One should always plan additional treatment following detox.

The Benefits

In addition to comfort and safety, medical detox increases the chance of successful recovery. Underlying medical issues can be addressed, both physical and mental. According to the National Alliance on Mental Illness (NAMI) up to 53% of those with a substance abuse disorder also have an additional, severe mental health disorder like major depression, Schizophrenia, Bipolar disorder, or borderline personality disorder. In medical detox doctors can evaluate a person mentally, and typically a therapist is assigned to each patient. Medical detox can make inpatient rehabilitation more effective because a personalized treatment plan can be made prior to inpatient or outpatient rehab. This will allow a person to get the most out of the treatment process.

It is important to know that many treatment centers require detox. According to NIDA, the following are the essential steps to successful addiction treatment:

  • Detox (the process by which the body rids itself of a drug)
  • Behavioral counseling
  • Medication (for opioid, tobacco, or alcohol addiction)
  • Evaluation and treatment for co-occurring mental health issues such as depression and anxiety
  • Long-term follow-up to prevent relapse[4]

Although there is significant evidence that detox is crucial, there is also equal evidence that detox alone is not enough. NIDA states that it is important to remember that detox is only the first step in the treatment process. Below is a chart made by NIDA showing the components of effective treatment. Notice the inclusion of medical services. Medical detox is not just a suggestion. It is almost always considered necessary for an effective treatment experience.

Components of Comprehensive Drug Addiction Treatment
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If you or someone you love is in need of detox and rehab, please call us at our 24 hour, toll-free helpline at 760.548.4032. We want to help you find the best treatment for your needs. We can answer any question you may have and even check your insurance benefits for you. Please call now.