Medically supervised withdrawal from a drug, also referred to as detoxification, is the first step in substance abuse treatment programs and it involves the removal of these toxic products from the bloodstream.
An indicator of addiction to a substance is the onset of withdrawal symptoms when trying to remove the drugs from the body. These can range from mild to severe in nature, and there are situations that can be life-threatening depending on the drug used as well as the level of dependency and the method of intake.
Withdrawal symptoms can be both psychological and physical and abruptly stopping the offending drug is usually not suggested. Therefore, medically assisted detoxification is recommended to prevent patients from experiencing unwanted withdrawal effects.
Medically Assisted Withdrawal
Medically assisted detoxification is accomplished in a controlled facility that is supervised by healthcare professionals 24 hours a day, 7 days a week. Some patients may need to be weaned down from the drugs they are using in order to slowly get the product in their system down to nothing, and others may require being prescribed other medications in order to manage withdrawal symptoms and cravings.
The patients most likely to require medically assisted withdrawal include those who are addicted to drugs such as:
- Prescription opioids
- Heroin
- Alcohol
- Benzodiazepines
Prescription Opioids and Heroin
Prescription opioid addiction is a public health emergency currently in the United States with over 40 Americans dying from opioid overdoses every day in the country. In 2012 alone, over 2 million Americans over the age of 12 were addicted to these medications and another near 500,000 people were addicted to heroin. Heroin is also an opioid but an illegal one.
Opioid addiction needs to be managed medically since withdrawing from these drugs causes uncomfortable symptoms and signs such as:
- Excessive sweating with intermittent chills
- Nausea and/or vomiting
- Generalized muscle aches and pains
- Restlessness
- Agitation
- Sleeping disturbances
- Depression
- Irritability
- Anxiety
Patients addicted to prescription opioids are usually managed by gradually reducing the dose of the drug until it has worked out completely from their bodies. Heroin is managed differently in that methadone is dispensed to these patients to take over the effects caused by the drug. The methadone is then gradually tapered down until it can be stopped.
Medications such as buprenorphine and buprenorphine combined with naloxone are also used to help treat opioid addiction and dependency.
Alcohol
Suddenly stopping the intake of alcohol in someone who has a severe dependency on this product can be life-threatening.
A condition known as delirium tremens (DT) can develop as a result of alcohol withdrawal and may present with the following symptoms and signs:
- Agitation
- Fevers
- Confusion
- Hallucinations
- Seizures
In order to avoid these severe conditions, medically assisted withdrawal from alcohol is often necessary and entails the use of medications such as benzodiazepines. Mineral and vitamin supplementation may also be prescribed to replace those lost as a result of excessive alcohol use.
Benzodiazepines
These drugs do have their place in treating anxiety and sleep disorders but there are patients who become dependent on them and need help to remove them from their system.
Benzodiazepine withdrawal is performed in a similar fashion to that of opioid withdrawal in that the dosage of the medication is tapered down until it is completely metabolized by the body and completely removed from the patient’s bloodstream.
Patients addicted to short-acting benzodiazepines are prescribed longer-acting ones during medically managed withdrawal in order to reduce the chance of potential side effects.
