Can You Detox through an Outpatient Program?
An outpatient detox center allows people to seek help at the facility during the day and return to the comfort of their own home at night. For many people, outpatient treatment is preferable to inpatient care. They can continue to work and keep up with familial responsibilities while getting the addiction treatment they need. These types of programs also tend to be more cost-effective as people don’t have to pay for 24-hour care.
What to Expect
Detox involves the body processing out substances of abuse. With medical detox, medical supervision is provided.
In outpatient detox programs, the team of professionals guiding treatment will come up with a personalized plan to meet each client’s specific needs. An individual’s entire medical history needs to be considered as well as their history with substance abuse and attempts at recovery.
Outpatient programs work best for people who have a stable and safe home life. If the person lives in an unsafe home environment or with people who abuse drugs or alcohol, inpatient treatment is a better choice.
If the person is dependent on alcohol, benzodiazepines, or opioids, inpatient detox is recommended since the risk of relapse is incredibly high with these drugs. In addition, withdrawal symptoms from alcohol and benzodiazepines can be life-threatening in some instances.
Medications may be prescribed to ease withdrawal symptoms and reduce cravings. In some instances, medications are used to replace the drug of abuse; clients are then slowly weaned off the maintenance medication over weeks or months.
For opioid detox, Suboxone is commonly prescribed. According to the Drug Enforcement Administration, in 2013, there were 16,000 doctors in the US permitted to prescribe Suboxone. The medication successfully activates the same part of the brain that’s triggered by opioid abuse, but it doesn’t produce the same high. The brain is satisfied, however, because it thinks it’s still getting the substance of abuse. This keeps withdrawal symptoms at bay, helping the individual to focus on therapy and reducing the likelihood of relapse.
Medications are also given to address specific withdrawal symptoms, such as anti-nausea medications for intestinal issues or over-the-counter painkillers to ease aches and pains. Alternative forms of pain and symptom management may also be provided during outpatient detox, such as balanced nutrition, adequate hydration, and massage therapy.
While the bulk of therapy takes place once the person has stabilized after withdrawal, some therapeutic meetings may begin during detox. Psychological support is a key component of this early stage of recovery. Without adequate support during detox, relapse is likely.
Clients will meet with counselors and support staff when they come to the clinic for outpatient detox. Ensuring the client has a strong support system at home in the form of friends and family will also be a critical part of the planning process at admission.
The Withdrawal Process
The length of the detox process and the specific symptoms experience depend on the individual as well as the substance of abuse. Someone who is withdrawing from alcohol will have a different experience than someone who is withdrawing from opioids. While individual differences, such as a person’s age, gender, metabolism, history of substance abuse, and physical and mental health status, will determine specifics of the withdrawal process, there are some things you can expect when withdrawing from certain substances of abuse.
- Marijuana withdrawal: The general symptoms are typically mild and resolve within a few days to two weeks. The person might feel anxious, tired, and irritable. Their appetite may be affected as well.
- Alcohol withdrawal: These symptoms can be severe and life-threatening, so medical detox is required. Nausea and vomiting are common. In addition, the person might experience an elevated heart rate, tremors, anxiety, and insomnia. Inpatient detox is generally recommended for alcohol withdrawal due to the potential severity of symptoms and the risk of developing delirium tremens.
- Opioid withdrawal: Opioid detox can be intense with symptoms such as excessive sweating, muscle cramps, hot flashes, chills, diarrhea, anxiety, and nausea. Individuals shouldn’t quit opioids cold turkey. As mentioned, medication-assisted treatment, such as buprenorphine, may be prescribed to ease the withdrawal process.
- Benzodiazepine withdrawal: Medical detox is required for benzodiazepine withdrawal due to the severity of symptoms. Usually, doctors prescribe a tapering process where the dosage of benzodiazepines is slowly lowered over a period of time until the person is eventually fully weaned off the drugs. Withdrawal symptoms include anxiety, irritability, muscle aches, poor concentrations, and insomnia. In some instances, life-threatening seizures can develop.
- Stimulant withdrawal: Withdrawal symptoms include increased fatigue, depression, sweating, muscle aches, and irritability. If psychiatric symptoms are severe, the individual will be referred to inpatient care. In both inpatient and outpatient stimulant detox, individuals are monitored for signs of depression.
Is an Outpatient Detox Program the Right Choice?
The supervising physician must determine if an outpatient detox program is appropriate. Again, those withdrawing from alcohol are not good candidates for outpatient detox. In most cases, those withdrawing from opioids and benzodiazepines will be recommended to inpatient detox; in all cases, those detoxing from these substances should be under medical supervision if outpatient detox is selected.
Research published by the Journal of Addiction found a correlation between increased relapse rates and outpatient opioid detox programs. Those in outpatient detox programs were more likely to encounter triggers to use opioids that led them back to opioid use. Since clients don’t reside at a facility during detox, temptations to return to opioid use are present and access to the drugs isn’t restricted. As a result, relapse is more likely with outpatient detox versus inpatient detox.
This doesn’t mean that outpatient detox can’t be successful. If someone has a strong support system, a safe home environment, and life responsibilities they can’t take a break from, outpatient detox may be the best choice. The key is to develop a plan of action before the process begins to limit access to substances of abuse as well as opportunities to encounter triggers.
How to Choose the Best Program
Once someone decides that an outpatient detox program is the best choice, they can start narrowing down their options. Here are the questions to ask about prospective treatment facilities:
- Does this program suit my needs? Different programs are tailored to address withdrawal from different substances of abuse. For example, a program may have the capacity to prescribe MAT during the detox process for certain substances.
- Do you feel comfortable? You should feel comfortable with the staff members and other clients in a detox center. You don’t need to surround yourself with people who like you, but you do need to feel that you can be yourself. Certain treatment programs cater to specific demographics, such as programs that specialize in LGBTQ individuals or young adults.
- Can you afford it? Many detox centers accept insurance, so make sure you choose one that will work with your provider. An outpatient program is often much cheaper than inpatient options, and many programs offer payment plans to finance the portion that insurance doesn’t cover.
- Do you have transportation? Choose a clinic you can easily get to every day. The recovery process has to be manageable for your lifestyle.
Set Yourself up for Success
Because clients retain control of their movements, an outpatient detox program allows people to be in charge of their own recovery. While there are more temptations with outpatient detox since clients live in the outside world, they also have the opportunity to put lessons learned into practice right away.
Again, support is critical. With the assistance of medical professionals in an outpatient detox program as well as a strong support system at home, individuals can successfully complete the withdrawal process and move on to addiction therapy.