Understanding Detox for Addiction Treatment

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Facility
Levels of Care
Treatment
Communities Served
Facility

Acadiana Addiction Center

156 Choctaw Rd
Sunset, LA 70584
(337) 284-4047
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Azure Acres Treatment Center

2264 Green Hill Rd
Sebastopol, CA 95472
(707) 284-0361
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Bayside Marin Treatment Center

718 4th St
San Rafael, CA 94901
(415) 233-9865
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Beloit Comprehensive Treatment Center

2240 Prairie Ave
Beloit, WI 53511
(608) 713-6090
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Blue Ridge Mountain Recovery Center

255 Depot St Suite 200
Ball Ground, GA 30107
(678) 515-9867
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Bowling Green Brandywine Treatment Center

1375 Newark Rd
Kennett Square, PA 19348
(610) 347-5608
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Cascade Behavioral Health Hospital

12844 Military Rd S
Tukwila, WA 98168
(206) 745-4473
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Cedar Crest Hospital & Residential Treatment Center

3500 Interstate 35 Frontage Rd
Belton, TX 76513
(254) 781-3217
Levels of Care
  • Inpatient
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Cove Forge Behavioral Health Center

202 Cove Forge Rd
Williamsburg, PA 16693
(814) 554-0149
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Crestwyn Behavioral Health Hospital

9485 Crestwyn Hills Dr
Memphis, TN 38125
(901) 457-5667
Levels of Care
  • Inpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Cross Creek Hospital

8402 Cross Park Dr
Austin, TX 78754
(512) 549-8021
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Delta Med Center

3000 Getwell Rd
Memphis, TN 38118
(901) 881-1303
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
  • Pain Management
Communities Served
  • Adults
Facility

Duffy's Napa Valley Rehab

3076 Myrtledale Rd
Calistoga, CA 94515
(707) 709-8099
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Green Bay Comprehensive Treatment Center

2979 Allied St
Unit C
Green Bay, WI 54304
(920) 827-4025
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Greenleaf Behavioral Health Hospital

2209 Pineview Dr
Valdosta, GA 31602
(229) 588-8215
Levels of Care
  • Inpatient
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Harbor Oaks Hospital

35031 23 Mile Rd
New Baltimore, MI 48047
(586) 684-4870
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Highland Ridge Hospital

7309 S 180 W
Midvale, UT 84047
(801) 845-9544
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Huntington Creek Recovery Center

890 Bethel Hill Rd
Shickshinny, PA 18655
(570) 991-6256
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Keystone Treatment Center

1010 E 2nd St
Canton, SD 57013
(605) 519-2077
Levels of Care
  • Residential
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Pain Management
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Lakeview Behavioral Health

1 Technology Pkwy S
Norcross, GA 30092
(770) 766-7006
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Life Center of Galax

112 Painter St
Galax, VA 24333
(276) 522-0406
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Life Healing Center

25 Vista Point Rd
Santa Fe, NM 87508
5053226881
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Longleaf Hospital

44 Versailles Blvd
Alexandria, LA 71303
(318) 562-4988
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Madison West Comprehensive Treatment Center

151 E. Badger Road
Suite A
Madison, WI 53713
(608) 729-8723
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Mirror Lake Recovery Center

999 Girl Scout Rd
Burns, TN 37029
(615) 913-8493
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Mount Regis Center

125 Knotbreak Rd
Salem, VA 24153
(540) 212-6079
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

New Perspectives at White Deer Run

3030 Chestnut St
Lebanon, PA 17042
(717) 454-2486
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

North Florida Comprehensive Treatment Center

6639 Southpoint Pkwy
Suite 108
Jacksonville, FL 32216
(904) 674-8664
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

North Tampa Behavioral Health Hospital

29910 SR-56
Wesley Chapel, FL 33543
(813) 452-4597
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Options Behavioral Health Hospital

5602 Caito Dr
Indianapolis, IN 46226
(317) 942-3102
Levels of Care
  • Inpatient
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Pacific Grove Hospital

5900 Brockton Ave
Riverside, CA 92506
(951) 330-3649
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Park Royal Hospital

9241 Park Royal Dr
Fort Myers, FL 33908
(239) 204-2131
Levels of Care
  • Inpatient
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Pocono Mountain Recovery Center

3437 PA-715
Henryville, PA 18332
(570) 580-4833
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Sober & Transitional Living
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Racine Comprehensive Treatment Center

5735 Durand Ave
Suite A
Racine, WI 53406
(262) 355-4579
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Rebound Behavioral Health Hospital

134 E Rebound Rd
Lancaster, SC 29720
(803) 810-0995
Levels of Care
  • Inpatient
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Red River Hospital

1505 8th St
Wichita Falls, TX 76301
(940) 341-2464
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Riverwoods Behavioral Health System

223 Medical Center Dr
Riverdale, GA 30274
(770) 766-3367
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Rolling Hills Hospital

1000 Rolling Hills Ln
Ada, OK 74820
(580) 279-6642
Levels of Care
  • Inpatient
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

San Juan Capestrano Hospital

State Road 877 km 1.6
Camino Las Lomas
Rio Piedras, PR 00926
(787) 760-0222
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Seven Hills Hospital

3021 W Horizon Ridge Pkwy
Henderson, NV 89052
(702) 919-6182
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Sober Living by the Sea

2800 Lafayette Ave
Newport Beach, CA 92663
(949) 612-2210
Levels of Care
  • Residential
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Sonora Behavioral Health Hospital

6050 North Corona Rd
Tucson, AZ 85704
(520) 214-0211
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Sunrise Recovery Ranch

6690 Limonite Frontage Road
Riverside, CA 92509
(877) 543-4261
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

The Camp Recovery Center

3192 Glen Canyon Rd
Scotts Valley, CA 95066
(831) 269-5578
Levels of Care
  • Residential
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adolescents / Teens
  • Adults
Facility

The Landing of Newport Beach

4711 Seashore Dr
Newport Beach, CA 92663
(949) 612-2128
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

The Refuge - A Healing Place

14835 SE 85th St
Ocklawaha, FL 32179
(844) 214-8796
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

The Rose

6111 Seashore Dr
Newport Beach, CA 92663
(949) 612-2086
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Timberline Knolls

40 Timberline Drive
Lemont, IL 60439
(877) 706-5922
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
  • Eating Disorders
Communities Served
  • Adolescents / Teens
  • Adults
Facility

TrustPoint Hospital

1009 N Thompson Ln
Murfreesboro, TN 37129
(615) 203-8239
Levels of Care
  • Inpatient
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Twelve Oaks Recovery Center

2068 Healthcare Avenue
Navarre, FL 32566
(850) 378-3034
Levels of Care
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Valley Behavioral Health System

10301 Mayo Dr
Barling, AR 72923
(479) 310-8194
Levels of Care
  • Inpatient
  • Residential
  • IOP (Intensive Outpatient Program)
  • Therapeutic Day School
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Vantage Point Behavioral Health Hospital

4253 N Crossover Rd
Fayetteville, AR 72703
(479) 310-8197
Levels of Care
  • Inpatient
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Vermilion Behavioral Health Systems

2520 N University Ave
Lafayette, LA 70507
(337) 806-8934
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Waukesha Comprehensive Treatment Center

2422 N. Grandview Blvd.
Waukesha, WI 53188
(262) 293-5438
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

West Milwaukee Comprehensive Treatment Center

1610 Miller Pkwy
West Milwaukee, WI 53214
(414) 939-7556
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

White Deer Run of Allenwood

360 White Deer Run Rd
Allenwood, PA 17810
(570) 980-2475
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

White Deer Run of Blue Mountain

8284 Leaser Rd
Kempton, PA 19529
(610) 756-1487
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

White Deer Run of Lancaster

53 N West End Ave
Lancaster, PA 17603
(717) 869-0408
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

White Deer Run of Lehigh

1620 Riverside Dr
Bethlehem, PA 18016
(484) 895-1486
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

White Deer Run of York

106 Davies Dr
York, PA 17402
(717) 802-8181
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Wilmington Treatment Center

2520 Troy Dr
Wilmington, NC 28401
(910) 758-2023
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults

History of Detoxification Treatment

In the past, patients who found themselves addicted to drugs or alcohol were doomed to unspeakable suffering as they tried to achieve abstinence. A few fortunate patients underwent drug detox at clinics and hospitals, where doctors could prescribe a handful of medications that eased the misery of withdrawal – but even these medications were only partially successful. Most patients were left to their own devices and the agony of a “cold turkey” detox (so called because of the symptoms of chills and gooseflesh that accompanied opioid and alcohol withdrawal). Those addicted patients who were unable to endure withdrawal often returned to drugs to obtain relief. Few made it through the detox process. Some even died.

Today, doctors who treat addiction no longer inflict cold turkey detox on patients. It’s ineffective, and it’s inhumane. Now doctors have new medications such as the newly approved opioid detox medication buprenorphine (Suboxone) to help patients through the detoxification process safely and comfortably. Proper detox makes it much more likely that addicts will seek treatment at an earlier stage of their illness, and will transition from treatment to long-term sobriety with greater confidence.

Addicts, like all patients, deserve treatment that best serves their needs and not ill-informed and tired ideologies about moral failings and bad choices. Combined with the traditional wisdom of twelve-step recovery, the medications available today to doctors who treat addicts paint a bright future for the treatment addiction. Patients who repeatedly failed treatment in the past are now reporting that for the first time in their lives they feel hope.

Length of Detoxification

Because detoxification often entails a more intensive level of care than other types of AOD treatment, there is a practical value in defining a period during which a person is “in detoxification.” There is no simple way to do this. Usually, the detoxification period is defined as the period during which the patient receives detoxification medications.

Another way of defining the detoxification period is by measuring the duration of withdrawal signs or symptoms. However, the duration of these symptoms may be difficult to determine in a correctly medicated patient because symptoms of withdrawal are largely suppressed by the medication. Chapter 3 describes the typical lengths of regimens for withdrawal.

The Role of Detoxification in AOD Abuse Treatment

For many AOD-dependent patients, detoxification is the beginning phase of treatment. It can entail more than a period of physical readjustment. It can also be a time when patients begin to make the psychological readjustments necessary for ongoing treatment. Offering detoxification alone, without followup to an appropriate level of care, is an inadequate use of limited resources. People who have severe problems that predate their AOD dependence or addiction — such as family disintegration, lack of job skills, illiteracy, or psychiatric disorders — may continue to have these problems after detoxification unless specific services are available to help them deal with these factors (Gerstein and Harwood, 1990).

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Immediate Goals of Detoxification

To provide a safe withdrawal from the drug(s) of dependence and enable the patient to become drug free. Many risks are associated with withdrawal, some influenced by the setting. For persons who are severely dependent on alcohol, abrupt, unsupervised cessation of drinking may result in delirium tremens or death. Other sedative-hypnotics may produce life-threatening withdrawal syndromes. Withdrawal from opioids produces severe discomfort, but is not generally life threatening. However, risks to the patient and society are not limited to the severity of the patient’s physical disturbance, particularly when the detoxification is conducted in an outpatient setting. Outpatients experiencing withdrawal symptoms may self-medicate with street drugs. The resulting interaction between prescribed medication and street drugs may result in an overdose. Less severe side effects include sedation or a drop in blood pressure.

To provide withdrawal that is humane and protects the patient’s dignity. A caring staff, a supportive environment, sensitivity to cultural issues, confidentiality, and the selection of appropriate detoxification medication (if needed) are all important to providing humane withdrawal.

To prepare the patient for ongoing treatment of his or her AOD dependence. During detoxification, patients may form therapeutic relationships with treatment staff or other patients, and may become aware of alternatives to an AOD-abusing lifestyle. Detoxification is an opportunity to offer patients information and to motivate them for longer term treatment.

Repeated Detoxification

Alling discussed detoxification and treatment in a text published in 1992:

Those not familiar with the chronic nature of addictive disorders often characterize detoxification programs as ‘revolving doors’ through which patients come and go in an endless cycle, and which have little or no impact on the recovery process. Although it is true that many people undergo detoxification more than once — and some do so many times — the assumption that little or no progress has been made is often false. (Alling, 1992)

Alling(1992) described a pattern in individuals who return for several detoxification episodes, observing that young people with a history of AOD dependence of short duration (a year or less) “often are unrealistically optimistic about being able to remain drug free following detoxification.” When recently AOD-dependent persons return after several months for repeat detoxification, it is usually with a more realistic expectation about what is needed to remain free from AODs. Individuals who subsequently relapse and return for detoxification a third time may have an even clearer understanding of what is required to sustain recovery (Alling, 1992).

During certain expected and predictable phases of recovery, addicted persons are at increased risk of relapse. However, relapse can occur at any point in recovery. Thus, relapse prevention is a legitimate area for patient education, and the relapsed patient is appropriate for clinical treatment. Treatment services designed precisely for this stage of the disease may facilitate the individual’s return to abstinence.

Issues in Postdetoxification Treatment

Few addicted persons enter detoxification or seek further treatment with the idea of maintaining lifelong abstinence. They may still believe they can control their abuse of AODs. Some persons enter detoxification and other treatment to satisfy the demands of their families, employers, or the courts. They may be motivated to seek treatment because attempts to relieve pressure through other means have proved futile. Clinicians should consider patient motivation when deciding upon appropriate treatment placement.

Families suffer severe consequences from the AOD abuse of their loved ones. The consequences may include obvious problems such as lost income, domestic violence, or divorce. Less obvious consequences may also occur, such as issues concerning trust and children’s mirroring maladaptive ways to deal with problems encountered in everyday living. Addiction is a family disease because of the seriousness of its effects on family members and family functioning. Just as the person who abuses AODs needs support, education, and counseling, so too does the family. It is appropriate and important for treatment providers to engage the family in treatment as early as possible, even while the individual is undergoing detoxification.

Effects of AOD Exposure and Withdrawal

Tolerance and Physical Dependence

Continued exposure to AODs induces adaptive changes in an individual’s brain cells and neural functioning. The changes vary depending on the drug of abuse and are not completely understood. The term “neuroadaptation” is often used to refer to these changes. One result of neuroadaptation is drug tolerance; that is, increasing the amounts of the drug that are required to produce the same effect. A second consequence of neuroadaptation is physical dependence; the brain cells require the drug in order to function.

Drug Withdrawal

Sudden removal of alcohol or another drug of abuse from the system of a person who is physically dependent produces either an abstinence or withdrawal syndrome. The abstinence syndrome for each drug follows a predictable time course and has predictable signs and symptoms. Signs are defined by Webster’s Medical Dictionary as “objective evidence of disease especially as observed and interpreted by the physician rather than by the patient or lay observer.” Symptoms are defined in the same text as “subjective evidence of disease or physical disturbance observed by the patient.”


There are three immediate goals of detoxification:

  • To provide a safe withdrawal from the drug(s) of dependence and enable the patient to become drug free
  • To provide withdrawal that is humane and protects the patient’s dignity
  • To prepare the patient for ongoing treatment of his or her AOD dependence

The signs and symptoms of drug withdrawal are usually the reverse of the direct pharmacological effects of the drug. Heroin use commonly produces elevation of mood (euphoria), a decrease in anxiety, insensitivity to pain (analgesia), and a decrease in the activity of the large intestine, often causing constipation. Heroin withdrawal, on the other hand, produces an unpleasant mood (dysphoria), pain, anxiety, and overactivity of the large intestine, often resulting in diarrhea. Alcohol usually reduces anxiety and causes sedation; large quantities may produce sleep, coma, or even death by respiratory depression. In a person who is physically dependent, cessation of alcohol use produces anxiety, insomnia, hallucinations, and seizures.

For short-acting drugs such as alcohol and heroin, the most severe signs and symptoms of withdrawal usually begin within hours of the individual’s last use. With a long-acting drug or medication, such as diazepam (Valium), withdrawal symptoms may not begin for several days and usually reach peak intensity after 5 to 10 days. The most severe drug-withdrawal symptoms, during the initial stages of detoxification, constitute the acute abstinence syndrome. The adjective “acute” distinguishes the syndrome from a “chronic” or protracted abstinence syndrome, in which signs and symptoms of withdrawal may continue for weeks to months after cessation of use (Martin and Jasinski, 1969).

Protracted abstinence syndrome is the subject of considerable controversy. Providers often find it difficult to distinguish symptoms caused by drug withdrawal from those caused by a patient’s underlying mental disorder, if one is present. The signs and symptoms of protracted withdrawal are not as predictable as those of acute withdrawal. Some patients may be predisposed to a protracted withdrawal. Acute withdrawal syndromes produce measurable signs that researchers can study in animals under controlled laboratory conditions; protracted withdrawal in patients, by contrast, is often confined to distress symptoms that cannot be studied in animals.

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