Medicated Detox: Is It the Right Choice for You?

January 5, 2016
Diagnostics of Mental HealthThere is no one single path to take when it comes to breaking free from an active and debilitating substance abuse or addiction problem.
Each person’s situation is unique, so it’s important to take some time to familiarize yourself with the options and talk to a substance abuse treatment professional in order to identify the best choice for you.

Depending upon your drug of choice and a few other factors – like the medications you are currently taking or co-occurring disorders you may be facing – there may be a medication option. The medications vary widely, but may be able to:

  • Diminish the experience of withdrawal symptoms
  • Reduce cravings
  • Create a physical response to relapse

In general, the intent of medication use is to make the detox process as simple as it can be. While there are not medications available for the treatment of detox from all substances of abuse, and medications may not be appropriate for some people even if they are available, medications may be able to mitigate the risk of relapse during the first few months of recovery and enable the person to build a strong foundation in early recovery.

Drugs of Abuse

pillsMedications have been approved for detox purposes only in the treatment of addiction to certain substances of abuse.
For example, for those who struggle with withdrawal symptoms related to alcohol addiction, medications including diazepam, lorazepam, chlordiazepoxide, and phenobarbital have been approved for treatment, though some are used primarily in an inpatient detox setting. Other medications, like Antabuse, cause a person in recovery to vomit if alcohol is ingested, thus deterring relapse, and still others are designed to mitigate cravings that can make it difficult to focus on making progress in recovery.

Dependence upon opiate drugs like heroin and opiate painkillers (e.g., oxycodone- and hydrocodone-based medications) are most commonly treated with methadone, Subutex/Suboxone, and Vivitrol. These medications bond to opiate receptors in the brain, making it easier for the person to stop using the drug of choice, thereby reducing the risk of detox and relapse. Depending upon the dose of the opiate drug of choice at the time of cessation of use, any one of the above medications may be most appropriate.
Even if there are not specific medications designed to treat the withdrawal symptoms associated with a certain drug of abuse, there may still be medications that can help to quell specific withdrawal symptoms (e.g., non-addictive medications to treat insomnia or antidepressants to treat associated depression symptoms). Individuals considering medication as an option should discuss all avenues of treatment with their treatment team.

Medication Can Help

man-with-doctorThe real work of recovery is not necessarily getting through the withdrawal symptoms associated with detox. Though treatment for physical dependence is key and must be done safely and effectively, long-term recovery requires dedication to therapy, in one-on-one sessions and in groups, for months if not years. Medication can help to empower the long-term process of recovery by:

  • Helping to stabilize the client in recovery as quickly as possible
  • Increasing the safety of detox
  • Improving the ability of the client to avoid relapse
  • Helping the client to focus more fully on addressing co-occurring mental health issues and aspects of psychological addiction

Medication has proven so effective that about 100 jails and prisons are giving Vivitrol to inmates who have a history of struggling with opiate addiction as they leave the facilities, according to The Boston Globe.

The injection that lasts for up to a month blocks the “high” experienced when the person takes an opiate drug or drinks alcohol, increasing the ability to stay sober and avoid relapse as well as the behaviors that often occur while under the influence.

The 30-day relapse prevention medication also gives people time to connect with the right resources for long-term recovery, empowering them to get started rebuilding their lives without succumbing to relapse.

Dr. Barbara Herbert is the president of the Massachusetts chapter of the American Society of Addiction Medicine (ASAM). She points out that: “Its [Vivitrol’s] reputation on the street is that it’s a silver bullet. But there is no way to heal from addiction without doing the psychological work of recovery.”

Determining the Right Path for You

For some people, it’s a no-brainer: If medication is available and safe to take in their personal situations, they are going to take it. For others, the choice isn’t as clear. Medications can be expensive, and in the case of methadone, a real hassle. Federal regulations require that people taking methadone for the purposes of opiate addiction treatment show up in person every morning at a methadone clinic in order to receive their doses. They must also attend case management meetings and group therapy sessions, and they must continue to come in daily for as long as they continue taking the medication.

Additionally, many people prefer to end their physical dependence upon all substances once and for all. The quickest way to be free of any drug dependence is to undergo detox without any maintenance medications at all – under the supervision of substance abuse treatment professionals – using non-addictive medications to address specific symptoms as needed.

The path that is right for you is a choice you must make together with a medical and psychiatric treatment professional who is an expert in substance abuse treatment and who takes the time to get to know your history with drugs and alcohol. Personalized care is the key to success, and early treatment is recommended.

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