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) 233-1111
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

2264 Green Hill Road
Sebastopol, CA 95472
(916) 488-8123
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Bayside Marin

718 4th Street
San Rafael, CA 94901
(888) 484-1042
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Belmont Behavioral Hospital

4200 Monument Road
Philadelphia, PA 19131
(215) 877-2000
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Eating Disorders
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Beloit Comprehensive Treatment Center

2240 Prairie Avenue
Beloit, WI 53511
(608) 361-7200
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Blue Ridge Mountain Recovery Center

1380 Howell Bridge Road
Ball Ground, GA 30107
(888) 724-1793
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Bowling Green Brandywine

1375 Newark Road
Kennett Square, PA 19348
(888) 307-6237
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Burkwood Treatment Center

615 Old Mill Road
Hudson, WI 54016
(866) 666-2118
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Camp Recovery Center

3192 Glen Canyon Road
Scotts Valley, CA 95066
(877) 557-6237
Levels of Care
  • Residential
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Cascade Behavioral Health

12844 Military Road South
Tukwila, WA 98168
(206) 244-0180
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 S. IH-35
Belton, TX 76513
(866) 543-7779
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

202 Cove Forge Road
Williamsburg, PA 16693
(855) 648-4598
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Cross Creek Hospital

8402 Cross Park Dr.
Austin, TX 78754
(512) 215-3900
Levels of Care
  • Inpatient
  • Detox
Treatment
  • Mental Health
  • Trauma / PTSD
Communities Served
  • Children
  • Adolescents / Teens
  • Adults
Facility

Delta Medical Center

3000 Getwell Road
Memphis, TN 38118
(901) 369-8100
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 Rehab

3076 Myrtledale Road
Calistoga, CA 94515
(877) 356-5763
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Green Bay Comprehensive Treatment Center

2979 Allied Street
Unit C
Green Bay, WI 54304
(920) 337-6740
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Greenleaf Hospital

2209 Pineview Drive
Valdosta, GA 31602
(229) 247-4357
Levels of Care
  • Inpatient
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Harbor Oaks Hospital

35031 23 Mile Road
New Baltimore, MI 48047
(586) 725-5777
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization 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) 569-2153
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 Road
Shickshinny, PA 18655
(570) 864-8615
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Keystone Treatment Center

1010 E. 2nd Street
Canton, SD 57013
(877) 762-3740
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 Parkway South
Norcross, GA 30092
(678) 713-2600
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Life Center of Galax

112 Painter Street
Galax, VA 24333
(877) 762-3747
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Life Healing Center

25 Vista Point Road
Santa Fe, NM 87508
(866) 806-7214
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Longleaf Hospital

44 Versailles Blvd.
Alexandria, LA 71303
(318) 445-5111
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) 250-2512
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Mirror Lake Recovery Center

999 Girl Scout Road
Burns, TN 37029
(866) 836-8125
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Mount Regis Center

405 Kimball Avenue
Salem, VA 24153
(540) 389-4761
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • 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) 438-7640
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

North Tampa Behavioral Health

29910 SR 56
Wesley Chapel, FL 33543
(813) 922-3300
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 System

5602 Caito Drive
Indianapolis, IN 46226
(317) 544-4340
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 Avenue
Riverside, CA 92506
(800) 992-0901
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 Drive
Fort Myers, FL 33908
(239) 985-2700
Levels of Care
  • Inpatient
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Pocono Mountain Recovery Center

3437 Route 715
Henryville, PA 18332
(570) 864-8615
Levels of Care
  • Residential
  • PHP (Partial Hospitalization Program)
  • IOP (Intensive Outpatient Program)
  • Sober & Transitional Living
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

Racine Comprehensive Treatment Center

5735 Durand Avenue
Suite A
Racine, WI 53406
(262) 598-1392
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

Rebound Behavioral Health

134 E. Rebound Road
Lancaster, SC 29720
(803) 313-3700
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 Eighth Street
Wichita Falls, TX 76301
(940) 322-3171
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 Drive
Riverdale, GA 30274
(770) 991-8500
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 Lane
Ada, OK 74820
(580) 436-3600
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, Puerto Rico 926
(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 Parkway
Henderson, NV 89052
(702) 646-5000
Levels of Care
  • Inpatient
  • PHP (Partial Hospitalization Program)
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adolescents / Teens
  • Adults
Facility

Sober Living by the Sea

2800 Lafayette Road
Newport Beach, CA 92663
(866) 323-5609
Levels of Care
  • Residential
  • Outpatient
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Sonora Behavioral Health

6050 North Corona Road
Tucson, AZ 85704
(520) 469-8700
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 Landing of Newport Beach

4711 Seashore Drive
Newport Beach, CA 92663
(877) 235-6134
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) 202-0102
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

2800 Lafayette Drive
Newport Beach, CA 92663
(888) 471-0435
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 North Thompson Lane
Murfreesboro, TN 37129
(615) 867-1111
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
(877) 762-3758
Levels of Care
  • IOP (Intensive Outpatient Program)
  • Outpatient
  • Detox
Treatment
  • Substance Abuse
  • Trauma / PTSD
Communities Served
  • Adults
Facility

Vantage Point of Northwest Arkansas

4253 Crossover Road
Fayetteville, AR 72703
(479) 521-5731
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 North University Avenue
Lafayette, LA 70507
(800) 821-2567
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) 549-6600
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

West Milwaukee Comprehensive Treatment Center

1610 Miller Park Way
West Milwaukee, WI 53214
(414) 672-3801
Levels of Care
  • Outpatient
  • Detox
Treatment
  • Methadone & Suboxone Maintenance
Communities Served
  • Adults
Facility

White Deer Run - Allenwood

360 White Deer Run Road
Allenwood, PA 17810
(877) 907-6237
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

White Deer Run - Blue Mountain

8284 Leaser Road
Kempton, PA 19529
(855) 268-2708
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
Communities Served
  • Adults
Facility

White Deer Run - Lancaster

53-55 N. West End Avenue
Lancaster, PA 17603
(855) 265-2307
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

White Deer Run - Lebanon

3030 Chestnut St.
Lebanon, PA 17042
(855) 264-1452
Levels of Care
  • Residential
  • IOP (Intensive Outpatient Program)
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

White Deer Run - Lehigh

1620 Riverside Drive
Bethlehem, PA 18016
(855) 550-9940
Levels of Care
  • Residential
  • Detox
Treatment
  • Mental Health
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
  • Trauma / PTSD
Communities Served
  • Adults
Facility

White Deer Run - York

106 Davies Dr.
York, PA 17402
(855) 260-7469
Levels of Care
  • Residential
  • Detox
Treatment
  • Substance Abuse
  • Dual Diagnosis / Co-Occurring
Communities Served
  • Adults
Facility

Wilmington Treatment Center

2520 Troy Drive
Wilmington, NC 28401
(877) 762-3750
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

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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