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Same Day Admission to a Detox Program

Last Updated: September 18, 2019

Quick admission to a detoxification program may reduce risks and could be lifesaving. Withdrawal from some substances can be deadly, and relapse may be life-threatening for some substances.1,2

Potential situations where quick admission to a detox program may help avert dangerous consequences (if a person is already experiencing significant symptoms or another emergency, call 911):

  • Patient is experiencing or is at risk of experiencing alcohol withdrawal. (Alcohol withdrawal can be lethal.1)
  • Patient is experiencing or is at risk of experiencing sedative-hypnotic withdrawal. (Sedative-hypnotic withdrawal, such as withdrawal from barbiturates or benzodiazepines, may be life-threatening.1,3)

Additionally, same day admission to a detox program might be beneficial if a patient is experiencing or is at risk of experiencing opioid withdrawal. Abstinence from opioids can decrease tolerance, so a smaller amount of opioids might cause an overdose in a relapse, which could be fatal.4 If an individual pursuing treatment warrants pharmacological treatment but maintenance treatment is impractical, is not indicated, or is turned down, then detoxification is indicated.1

Better results correlate with methadone or buprenorphine treatment that is ongoing than with medically supervised withdrawal. Relapse to opioid use will occur, research indicates, for the majority of individuals who have opioid use disorder and go through medically supervised withdrawal, though psychosocial strategies can be beneficial during and after. After an adequate amount of time without using opioids, injectable extended-release naltrexone can be used, which is better at lowering the likelihood of using opioids again than no medicine or placebo.5

The Detox Process

According to a consensus panel, there are three crucial elements in the detox process:1

“Evaluation”: This involves testing for substances of abuse, checking for co-occurring health problems (physical and psychological), assessing any health problems present, and evaluating the individual’s social circumstances.

“Stabilization”: This includes helping a person to get through any current state of intoxication and withdrawal. Medical and/or psychosocial interventions may be used. Also included is helping individuals become acquainted with their part in their treatment and their recovery as well as with what they should anticipate in the treatment environment.

“Fostering the patient’s entry into treatment”: This component includes, through emphasizing that continuing on with the whole treatment continuum is important, getting an individual ready to enter treatment. Patients with a history of repeatedly detoxing but not participating in substance abuse treatment after might be motivated to do so by signing a treatment contract early, once sufficiently stable.

These elements do not have to happen one at a time in practice.1

Intensity of Care

There are several factors to consider when determining the appropriate care for detoxification, for example:1

  • Admission to a hospital or another setting that provides round-the-clock medical care may generally be preferable for detox for sedative-hypnotic withdrawal, alcohol withdrawal, and opioid withdrawal.
  • It should be a suitable setting for any existing physical or mental health issues.

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Initial Evaluation in Detox

calling-for-treatment One thing to expect when being admitted to a detox program is an initial evaluation, which may include:1
  • Obtaining a substance abuse history: This may include questions about what substances the patient abused, how often the patient used them, what amount(s) the patient used, and how long it has been since the patient last used them.
  • Getting information on any prior detoxes and/or treatments for substance abuse: Whether the patient has gone through withdrawal before and, if so, how many times and what happened, ought to be part of this.
  • Laboratory tests: Determining blood alcohol content (BAC), checking breath alcohol levels, and/or urine drug screening may be part of the evaluation. Lab tests may also be used to assess nutritional status and to screen for health problems.
  • Physical assessment: Through a physical exam, the patient can be assessed for any health concerns.
  • Gathering a history concerning overall health: Questions may include inquiring if the patient has any mental health conditions, any physical health conditions, and/or any allergies, as well as if the patient has had any surgeries and/or has ever had seizures.
  • Assessing the person’s current living situation: Assessing living situation may include asking if the patient is homeless, stays in a shelter, or lives with others.
  • Evaluating risk of suicide or violence.

Other elements may also be included in an initial evaluation.1

Conclusions

Doctor hands writing on a clipboard.

Quick admission to a detox program may be helpful and possibly lifesaving in some circumstances. Assessing the patient, stabilizing the individual, and promoting treatment entrance for that individual are crucial elements of detox.1 Commonly, if detox is not followed by treatment, there will be a relapse.2 However, one detox goal is to promote treatment entrance and recovery.1

 

Sources:

  1. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment: A treatment improvement protocol TIP 45.
  2. National Institute on Drug Abuse. (2018). Treatment and recovery.
  3. Guina, J. & Merrill, B. (2018). Benzodiazepines II: Waking up on sedatives: Providing optimal care when inheriting benzodiazepine prescriptions in transfer patientsJournal of Clinical Medicine7(2), 20.
  4. Joudrey, P. J., Khan, M. R., Wang, E. A., Scheidell, J. D., Edelman, E. J., McInnes, D. K., & Fox, A. D. (2019). A conceptual model for understanding post-release opioid-related overdose riskAddiction Science & Clinical Practice14(1), 17.
  5. Substance Abuse and Mental Health Services Administration. (2018). Medications for opioid use disorder: For healthcare and addiction professionals, policymakers, patients, and families: Treatment Improvement Protocol TIP 63.
Last Updated on September 18, 2019
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About the editor
Sarah Hardey
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A Senior Web Content Editor for the American Addiction Centers. Sarah has worked with healthcare facilities across the country to create digital content for readers of all types.

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