What Protocols are used during Detox?


Whatever your thoughts on detoxing may be, when it comes to using professional help there has to be a framework of protocols.

The first thing you should notice when interviewing a drug or alcohol rehab center is how clear and concise their protocols are.

Ask yourself whether they answer your questions with confidence and clarity. Remember that your well-being is not something that should hang in the balance.

In light of this, we at The Recovery Way always make sure our clients are completely informed.

What protocols are used during detox?

The Principals of Detoxification

  • Detoxing alone cannot be considered a cure or effective treatment for drug dependency.
  • The process of administrating medicine or implementing other detoxing procedures will be based on protocols of safety and efficacy.
  • In case the procedure or medication hasn’t been established as safe the client will be informed and advised.
  • The client’s access to medication during detox will be controlled as precisely as possible.
  • Withdrawal symptoms will be handled on an individual basis.
  • If possible, medication with sustaining effects should substitute short-acting drugs.
  • Predicting the intensity of withdrawal is simply not possible.
  • Treatment shouldn’t be limited to medicine and all means of support should be incorporated.
  • After detoxification is successful immediate follow-up treatment should follow.

The above mentioned principals are the guidelines for detox protocol.

Alcohol Detoxification

In most cases a medical setting can be used for alcohol detoxification, given there is ample information regarding the client’s medical history and condition. Predicting when mild withdrawal symptoms will become more severe is difficult because it differs from person to person.

For some a grand mal seizure can be the first sign of symptoms.

Treatment includes

  • Librium
  • Klonopin
  • Tranxene
  • Valium

These drugs are used because they have a higher chance of avoiding seizures, typical symptoms and episodes of delirium. For clients with liver disease Serax and Ativan will be used.

Currently there are three methods for treating alcohol withdrawal namely:

  • Gradual or tapering doses
  • Symptom-triggered therapy
  • Loading dose

The psychological aspect of the withdrawal should also be a crucial factor because distinguishing between symptoms and psychological issues can be difficult. Therefore a detailed assessment has to be done both mentally and physically before, during and after the detoxing stage.

Opiate Detoxification

Opiate withdrawal symptoms are very similar to those of alcohol, but there is a difference between the time they start to surface and how long the symptoms continue.

Opiate detox treatment varies between two fundamental medications called Catapres and Methadone; the latter can be used in short and long term depending on the client’s specific needs.

Short term regulations are based on 30 days and the client is not allowed to take the medication home. Long term is based on a time period of 30 to 180 days and it follows a set of requirements.

Additional medication includes LAAM, Buprenorphine and Dextropropoxyphene. Once again the same care has to be taken regarding physical and mental examinations.

Stimulants Detoxification

Currently the suggested treatment for stimulants (Cocaine, Crack, Methamphetamine and Amphetamines) is a mild phenobarbital sedation to encourage sleep and ease the client’s distress.

Chloral hydrate can also be used.

Within 2 to 3 days of abstinence symptoms of exhaustion occur.

The client will be dysphoric and somnolent for at least 24 hours and seeing as cocaine abuse typically goes with other substances the client might be dependent on other drugs.

Benzodiazepine and Sedative-Hypnotics Detoxification

Judgment from the physician is critical in the withdrawal process. If the symptoms aren’t diagnosed correctly treatment can make the situation worse. There are two categories of treatment depending on the level of dosage that was abused.

High level dosage treatment

On this level the physician can choose between a gradual reduction of dependency or a phenobarbital substitution.

The latter is generally chosen because the former comes with a complicated guideline as to the habits of the client.

Phenobarbital substitution is regarded as a long-acting medication and has shown great results for gradual withdrawing.

Low Level Dosage Treatment

In this case decisions are based on the symptoms of the client and the danger of seizures is relatively small. However, strict observations should be made because severe withdrawal will heavily depend on a strong psychological approach.

Substances that don’t require Medication

Marijuana

The only visible symptoms come in the form of irritability and a loss of sleep for a few nights. In such cases a supportive environment is the best answer during detoxification.

Nicotine

In essence the client is encouraged to stop smoking and nicotine substitutions are used like patches, gum and nasal spray. In very rare cases are medicine a part of the detoxification.

Hallucinogens

LSD, Ecstasy, PCP, DMT and MDA don’t produce any symptoms within the withdrawal period and don’t require any medication. Once again a supportive environment is the best treatment.

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