Recovery from drugs, alcohol, and other addictive substances typically starts with medical detoxification that takes place at a private treatment facility, hospital, or other settings. This process, also known as detox, serves several purposes. A primary one is to ensure that substance users are kept safe while drugs, alcohol, and other toxic substances are removed from their systems. In many cases, clinicians will use medications to aid the body in clearing the drugs and helping recovering users manage withdrawal symptoms that can range from mild to severe.
You can read more about the medical detox here, but in short, a person who enters a treatment facility for this procedure should be aware that:
The three main stages of medical detox treatment are:
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A detox plan that involves using drugs to help someone end their physical or psychological dependence on drugs may be confusing at first. However, medications approved by the U.S. Food and Drug Administration (FDA) for a medical detox program can help users manage uncomfortable and sometimes unpredictable withdrawal symptoms as they gain stability after substance use. Over-the-counter drugs such as Tylenol are also used during this period.
What a person experiences during substance withdrawal depend on a few factors, including the severity of the addiction, the frequency of use, the history of drug and alcohol use, and whether or not a person has a mental health disorder in addition to their substance abuse disorder. When both conditions are present, it is known as having co-occurring disorders or dual diagnosis.
Detox medications are commonly used to help people in withdrawal manage conditions such as:
Medical maintenance therapy is an important part of the process of slowly weaning someone off a substance. This means clinicians slowly reduce the dosage of the drug until it is safe for the person to stop using it. This process, known as tapering, is necessary for some drugs that are extremely dangerous to immediately quit all at once.
There are many others not listed above, and everyone will not experience the exact same symptoms. Withdrawal symptoms also vary according to which drugs were used. Listed below are detoxes for different drugs and the medications commonly used to treat withdrawal symptoms for that particular drug.
People in treatment for severe alcohol use disorders are commonly given medications to treat their chronic alcoholism and help them get through alcohol withdrawal syndrome (AWS). Medications are also used as a conditioning treatment to help people end their dependence on alcohol.
Symptoms that can occur during alcohol withdrawal include:
Here are detox medications commonly used during alcohol withdrawal syndrome.
Acamprosate (Campral). Acamprosate is used specifically to treat alcohol withdrawal symptoms during detox. It is typically administered after someone with alcoholism completes the detox process. It is used to help recovering alcohol users avoid relapse by stabilizing the part of the brain that is disrupted by triggers and drug cravings. How acamprosate helps balance out the brain’s chemistry and GABA levels (the neurotransmitter most affected by central nervous system depressant use) is not completely understood, but it has been proven to have some effectiveness. As with all medications, acamprosate should be handled with care because of its side effects, which include depression and suicidal thoughts.
Disulfiram (Antabuse). This prescription medication is found to be an effective therapy for people who have completed the detoxification process or are in the beginning stages of abstinence. Disulfiram may not stop or reduce the urge to consume alcohol, but it may support recovery clients who are motivated to stop drinking. The medical detox process must take place first before disulfiram therapy begins.
Naltrexone. The medication was first developed for the treatment of opioid addiction. But, since 1994, it has been used to treat people with alcohol use disorders (AUDs). It has been found to be effective in reducing the rewarding effects of alcohol and the desire for it. As explained by WebMD, Naltrexone works in the brain to block the effects of opioids (such as sensations of well-being and pain relief) and lowers one’s desire to drink or helps them drink less alcohol if they do drink.
Naltrexone is different from disulfiram (Antabuse) in that it doesn’t make people sick if they take it with alcohol. That means they can drink alcoholic beverages while taking this medication, but it might not be as effective for people who need a stronger deterrent to stop drinking.
Benzodiazepines. Benzodiazepines (benzos for short) may be given to recovering drinkers to help ease their discomfort while undergoing detox. Benzodiazepines are used to treat alcohol withdrawal symptoms because they reduce anxiety, block seizures, and help improve recovering alcohol users’ sleep. The type of benzo used will depend on the person’s situation. Commonly used benzos in alcohol withdrawal treatment include Ativan (lorazepam); Valium (diazepam); Librium (chlordiazepoxide); and Serax (oxazepam).
Detoxing from chronic opiate/opioid use is rarely life-threatening. Still, for many people, it can still be a difficult process with some uncomfortable and sometimes painful withdrawal symptoms. In addition to the previously mentioned common symptoms of drug and alcohol withdrawal, symptoms can include:
Detox medications that are commonly used to treat opioid dependence tend to be weaker forms of opioids that help keep drug cravings at bay and wean the user off heroin and other stronger heroin. Opioid detox medications include:
Methadone – Methadone, a Schedule II narcotic, is an opioid pain reliever used to ease opiate withdrawal symptoms for people who are undergoing a medical detox and those who are using it as a part of a maintenance program. The medication is used to treat pain and addiction to other opiates during the detoxification process, but it doesn’t supply the high that comes with other drugs. Methadone blocks pain relievers from interacting with the brain. This helps reduce the cravings that accompany withdrawal symptoms.
The National Institute on Drug Abuse says methadone is more effective when it is used in behavioral treatment. “Research has shown that methadone maintenance is more effective when it includes individual and/or group counseling, with even better outcomes when patients are provided with, or referred to, other needed medical/psychiatric, psychological, and social services (e.g., employment or family services),” it writes.
Despite its therapeutic effects, methadone is habit-forming, even when taken at regular doses and dangerous when misused. It is addictive as well, so users are advised to be cautious when using it. It has been reported that ending physical and psychological dependence on the drug is hard. The detox process for it alone can take at least a month or more. And, some users struggle to achieve and maintain mental and emotional clarity, normal sleep schedules and more after battling a methadone addiction.
Buprenorphine. This opioid drug, which is similar to heroin, allows people who use heroin to safely wean off it. It also prevents or reduces the severity of withdrawal symptoms. It is a “partial opioid agonist,” which means it is weaker and not able to produce the same high as stronger opioids and opiates such as heroin. This drug also helps reduce heroin cravings. Buprenorphine comes in tablet form and is placed under the tongue to dissolve, which takes three to seven minutes to dissolve. It then enters the bloodstream. Care must be used with this drug as it is habit-forming and addictive like methadone.
Suboxone. Also known as Subutex, Suboxone is a strip medication that is a combination of buprenorphine and naloxone, a full opioid antagonist. This just means the medication negates the effects of heroin and other full agonists and can switch off opioid receptors in the brain. It is dissolved under the tongue when taken as directed. Similar to methadone, suboxone is a depressant used to limit cravings and withdrawal symptoms in heroin addicts. The drug is a strip that dissolves underneath the tongue. Suboxone is habit-forming and should be used with care. Naloxone is a useful overdose reversal drug, but it also is high-risk to prescribe it by itself for people in recovery. Combining it with buprenorphine can help make it less addictive than buprenorphine by itself.
Benzodiazepine withdrawal is characterized by uncomfortable or painful symptoms. Among those symptoms are:
Commonly used medications for benzodiazepine detox include:
Buspirone (BuSpar). This medication treats generalized anxiety disorder and affects brain chemicals that be unbalanced in people who have anxiety, according to Drugs.com. It is used to treat fear, tension irritability, dizziness, pounding heartbeat, and other physical symptoms of anxiety. It can be taken by mouth two or three times a day, according to WebMD. It is given to help recovering benzo users to think clearly, relax and go about their daily routine without anxiety.
Flumazenil. This medication is typically used to treat the side effects of benzodiazepine overdose, but it also can be used during the detox phase of benzo withdrawal. The drug works by affecting GABA receptors in the brain and blocking the effects of benzodiazepines. This drug may also be given in emergencies to counteract the symptoms of benzo overdose.
Acamprosate (Campral). Acamprosate, which is used to treat alcohol withdrawal symptoms during detox (see above under “Medications for Alcohol Detox), also can be used to treat clients with benzo withdrawal. The medication has been used to help recovering benzo users with anxiety, sleepiness, agitation, and other symptoms.
Stimulants mostly affect the brain’s dopamine levels. Dopamine is the chemical responsible for regulating our moods and emotions. Because of this, stimulant withdrawal symptoms are largely psychological rather than physical. People in stimulant withdrawal may experience:
These medications help users with addiction to cocaine, methamphetamine (crystal meth), and prescription drugs for Attention-deficit/hyperactivity disorder (ADHD), such as Adderall.
Modafinil. Modafinil is a potent stimulant prescribed to treat excessive fatigue or sleepiness commonly associated with narcolepsy, obstructive sleep apnea, shift work disorder, and other daytime sleep disorders. It is prescribed in detox for recovering stimulant users because it helps keep them awake, but it isn’t as potent as amphetamine or other stimulants. As an off-label medication, which means when it’s used in a way other than intended, it can help people increase their concentration.
Antidepressants. Medications used to ease depression may help some detox clients who have gotten through the acute phase of their stimulant withdrawal and may exhibit mental health conditions after the stimulant use has ended.
Antipsychotics. Clinicians may administer antipsychotic medications if they see symptoms or signs of psychosis in clients who are recovering from stimulant abuse.
All medications used during the medical detox process should be cleared by a doctor or medical staff who are aware of the client’s condition, situation, and treatment plan. This includes all medications, whether they are prescription or sold over-the-counter at retail stores or pharmacies.
The short answer? No. Quitting drugs and alcohol abruptly on your own, particularly when use occurred frequently for long periods is not recommended. It is not viewed as safe, and the risks involved include organ failure and relapse, which can end in overdose. Withdrawing from addictive substances without medical help can be uncomfortable and painful, but typically not life-threatening. However, abrupt interruptions that trigger a withdrawal can worsen other underlying health conditions that users may not be aware of, which can result in unexpected complications. It is safer to detox with a professional at your side.
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Medical News Today. Signs of alcohol withdrawal syndrome. (Juky 5, 2018) DePietro, CRT, Marcin, J. MD Retrieved from from https://www.medicalnewstoday.com/articles/322373.php
U.S. National Library of Medicine. Acamprosate. (May 15, 2016) Retrieved from from https://medlineplus.gov/druginfo/meds/a604028.html
WebMD. (n.d.) “Naltrexone HCL.” WebMD. Retrieved April 18, 2018 at from https://www.webmd.com/drugs/2/drug-7399/naltrexone-oral/details
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