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Detox Medication

Medical Detox Treatment

Detoxification, or detox, is a procedure during which any drugs and alcohol, as well as the toxins associated with them, are flushed from someone’s system to treat acute intoxication and attempt to mitigate the physical and psychological damage caused by long-term chronic substance abuse.

In medical detox treatment, whether it is done through an inpatient or outpatient treatment program, there will be at least some level of medical support and monitoring. This includes the administration of medication as part of medication addiction treatment and medical maintenance therapy to keep the individual in detox both stable and in the least amount of discomfort possible.

Medical detox teams are also tasked with dealing with any kind of health complications that can happen during detox, whether this is due to withdrawal symptoms or other reasons relating to the individual’s overall physical or mental health.

The three stages involved in the process of medical detox treatment are as follows:

This first stage is where the medical detox team will screen for co-occurring disorders, carry out a general physical and psychological exam, measure the level of drugs or alcohol in the bloodstream, and more. This information will be used to determine the best course of treatment for meeting their client’s needs.

This stage takes place during the withdrawal phase of detox when the person undergoing detox is experiencing the worst of the symptoms associated with stopping the use of drugs or alcohol. In this context, stabilization means what it sounds, keeping the client stable as well as minimizing the pain, cravings, or discomfort that these symptoms can cause, and monitoring for more dangerous symptoms like seizures.

In this final stage, the physical aspects of detox are basically complete, and is mostly centered around helping to prepare for posts-detox addiction recovery treatment by providing information and resources for the most effective way to go about moving forward with ongoing care.

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SEEKING ADDICTION HELP FOR YOURSELF OR A LOVED ONE? GET IN TOUCH WITH A TREATMENT SPECIALIST. WE ARE AVAILABLE 24-7.

Why Use Medication in Detox?

Admittedly, the idea of using drugs in a process that is meant to remove them from someone’s body can seem counterintuitive or even possibly harmful. But, as we previously mentioned, detox medication is incredibly useful and is generally used to prevent harm, particularly when it comes to handling withdrawal symptoms, which are often very unpredictable, depending on the substance in question, if there is a co-occurring disorder present, and also the severity of the addiction.

There is a wide range of different medications that have been officially approved by the U.S. Food and Drug Administration for therapeutic use during the process of detox, including prescription opioids down to over-the-counter medications like ibuprofen. Detox medications are generally administered to help those experiencing very common, uncomfortable withdrawal symptoms that include:

  • Anxiety
  • Insomnia
  • Depression
  • Diarrhea
  • Nausea
  • Vomiting
  • Muscle pains

Detox medications are also employed as a key part of medical maintenance therapy, which is the process of weaning someone off of a substance they have become dependent on by slowly reducing their dosage over time until it is deemed safe for them to stop using altogether.

This is generally referred to as a tapering schedule and is absolutely necessary for certain substances that are dangerous to try and immediately quit cold turkey, such as benzodiazepines and other central nervous system depressants that can cause delirium, seizures, and other life-threatening symptoms when not stopped via a tapering schedule. Medication used in medical maintenance therapy can also help to subdue drug cravings and make the tapering process less of an ordeal.

Detox Medications for Opioids

Opioids, from prescription drugs like OxyContin to illicit ones like heroin, currently take center stage in the overdose epidemic that covers the United States. Undergoing detox from opioids is almost never a life-threatening experience, but is still usually very uncomfortable, with difficult and sometimes painful withdrawal symptoms.

These symptoms include the previously listed common side effects of drug and alcohol withdrawal along with:

  • Strong cravings
  • Irregular heart rate
  • Mood swings
  • Fever
  • Chills
  • Exhaustion
  • Restlessness

In combination, these symptoms can often border on intolerable, and occasionally be dangerous in the instance of certain flu-like symptoms such as diarrhea, vomiting, and sweating, which can lead to severe dehydration. This could become serious if the person in withdrawal is not being monitored by a detox staff.

The detox medications most commonly used in opioid detox treatment are actually other, substantially weaker opioids. These are used during medical maintenance therapy to help lessen drug cravings and slowly wean someone off of stronger, more dangerous opioids. Some of these opioid detox medications include:

Methadone has long been one of the go-to medications when it comes to opioid dependence. Methadone is a long-acting opioid whose half-life can be anywhere between 15 and 55 hours, depending on the amount administered. The amount of time it spends taking up space in the brain’s opioid receptors is, in part, why it is so useful in tapering therapy.

Tapering with methadone involves administering carefully monitored amounts of methadone to relieve cravings and withdrawal symptoms, replacing the much shorter-acting opioids like heroin and taking up space in the body and brain’s opioid receptors. The goal is to have methadone replace the opioid that someone has become dependent on and, once that has been accomplished, lower the dosage of methadone with the eventual outcome of sobriety.

Methadone has been proven to be clinically effective when paired with counseling and behavioral therapy and has been in use for many years. However, its use is still a bit controversial since methadone does have active addictive potential, and so its administration must be strictly monitored by a medical professional. Generally, a doctor will try other detox medication first before turning to methadone.

Buprenorphine is another opioid that is used in the same way and for the same reasons as methadone. But unlike methadone, buprenorphine is a “partial opioid agonist,” which means that unlike other opioids that may be “full agonists,” buprenorphine is much weaker. This means that it is unable to produce the euphoria and other symptoms of an opioid high that people get from other, more powerful opioids.

So instead of getting someone high, buprenorphine does what methadone does, namely, takes up space in the brain’s opioid receptors to both weaken withdrawal symptoms and cravings as well as keep other opioids out. This generally lasts for about 24 hours per dose. While it is weaker than methadone, it does also possess the potential for abuse and dependency, and so the use of buprenorphine must also be carefully monitored.

Suboxone is the brand name medication that is a combination of buprenorphine and a different drug called naloxone. Unlike methadone and buprenorphine, naloxone is a “full opioid antagonist,” which means that it works against the effects of full opioid agonists and essentially deactivates the opioid receptors in the brain.

Because of this effect, naloxone is an extremely effective overdose reversal drug but is too strong to be prescribed on its own for someone in detox, as there are risks of triggering sudden, dangerously intense withdrawal symptoms. So instead, naloxone is combined with buprenorphine to create a detox medication that is meant to be less addictive than buprenorphine and less dangerous than naloxone.  

Like naloxone, naltrexone is also an opioid antagonist, blocking out the effects of other opioids by binding to the brain’s opioid receptors without activating them. Also like naloxone, naltrexone is generally used to treat and reverse opioid overdoses, but it also can be used during addiction and detox treatment with the goal of slowly reducing opioid cravings.

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  • Detox Medications for Depressants

    Alcohol, benzodiazepines, and barbiturates are all substances that fall under the classification of central nervous system depressants, which have among the most severe and potentially dangerous withdrawals of any kind of substance. Attempting to suddenly stop taking depressants after regular long-term abuse can give someone’s nervous system an intense shock and cause, on top of the previously mentioned common withdrawal symptoms:

    • Panic attacks
    • Hallucinations
    • Suicidal thoughts and behavior
    • Seizures
    • Severe insomnia
    • Psychosis
    • Delirium tremens
    • Migraines

    And, specifically in the case of benzodiazepines, someone can experience what is known as benzodiazepine withdrawal syndrome. This is when the symptoms of withdrawal become even more intense and unpredictable, and can make the withdrawal period itself last much longer than it typically would.

    Detox medications can quite literally mean the difference between life and death when it comes to detoxing from central nervous system depressants. Common detox medications for depressants include:

    Acamprosate is a drug that is used to treat the symptoms of alcohol withdrawal during alcohol detox. Acamprosate helps to balance out the disrupted GABA levels in the brain. GABA is the neurotransmitter that regulates feelings of relaxation and sedation and is most affected by central nervous system depressant abuse. However, while it has proven to be effective at this, common side effects of acamprosate use include depression and suicidal thoughts, so it should always be used carefully and with caution.

    Much like opioids, even though benzodiazepine abuse can have extremely serious health consequences, these drugs can still prove helpful during detox for both other benzos and alcohol. Benzodiazepines can be used in tapering schedules much like methadone is, but, also like methadone, requires the same strict levels of dosage control in order to avoid the danger of replacing one addiction with another.

    Disulfiram is a drug that is typically sold under the name Antabuse and works by changing how the body breaks down alcohol, producing an extremely negative bodily reaction when someone drinks any alcohol. This reaction can include migraines, heart palpitations, and nausea.

    The idea of using disulfiram as a detox medication is that it can be used to rewire the brain of someone who is dependent on alcohol by creating a new, negative association that would substantially reduce the urge to drink. Unfortunately, because it is such an unpleasant drug, many people in detox are unwilling to take it, so it is not typically considered very effective.

    Detox Medications for Stimulants

    Unlike the other substances on this list, stimulant withdrawal symptoms are largely psychological and mood-based instead of physical. This is because stimulants mainly act on the neurotransmitter dopamine, which is responsible for controlling and regulating emotions and mood. The symptoms of stimulant withdrawal typically include:

    • Anxiety
    • Agitation
    • Muscle pain
    • Exhaustion
    • Insomnia
    • Difficulty concentrating
    • Impaired cognitive abilities
    • Depression
    • Suicidal thoughts
    • Mood swings
    • Migraines
    • Inability to feel pleasure

    The handful of physical symptoms are usually treated via over-the-counter medications, but the psychological symptoms will most likely require stronger forms of detox medications, most commonly:

    Again, much like methadone, modafinil is a medication that works in the same way as stimulants like cocaine in that it blocks the reuptake of dopamine, but at a significantly weaker level. This works to both treat the sleep disorders that often appear during stimulant withdrawal as well as ease stimulant cravings.

    RECOVERY STARTS WITH DETOX AT THE PALM BEACH INSTITUTE

    If you or a loved one is currently struggling with a substance use disorder and is ready to take the first step towards recovery, The Palm Beach Institute will help you make it happen. Starting with detox to ongoing treatment and beyond, we provide the full continuum of care to help you beat addiction and take your life back.

    Call (855)-960-5456 now to speak with an addiction specialist about our treatment programs and how to best meet your needs, or contact us online for more information.