We often get asked – what is the detox available for X substance, if I go into treatment.
Well, there’s no simple answer to this, as the detox available in any addiction rehab clinic will depend of course on what the medical folks in that centre decide.
But we’ve gathered together some of the more common approaches below, all in one place, so that we can help you and use it as a resource to turn to, when the question gets asked:)
The picture changes of course if we’re talking about multi-substance abuse, and those tend to be done more on a personalised, individual basis.
But in our experience, here’s what we believe are the most commonplace approaches to detox in a residential treatment centre like rehab.
Of course it should go without saying that none of this is medical advice – always consult your doctor in the first instance if you’re thinking about treatment.
There’s no fixed detox for cocaine, as far as we’ve observed from the folks we know who’ve entered treatment. Usually the approach is just to deal with cocaine withdrawal symptoms as they come up, individually, they’ll be different for different folks. If struggling badly with depression or anxiety, the facility may be willing to prescribe an anti-depressant, or something to help with sleep, but not always. Most centres approach cocaine addiction as a psych addiction as opposed to a physical dependence.
Ask the centre about the detox options before committing to anything. In particular, if you have strong preferences either way, ask to speak to prescribing staff before admission. This can be especially useful if you have co-occurring psych issues, or a history of multi substance dependence.
In the public programs, this is a long one usually. Some programs are 1 year+, depending on the level of the physical addiction, so expect a much longer timescale for detox than other substances. We’ve seen facilities taper the detox for this simply using the substance itself, over time. Again this will depend on co-occurring psych issues, especially, since most will experience anxiety in withdrawal from (e.g.) diazepam and any underlying or pre-existing anxiety could be exaggerated under these consitions.
A particularly important one to get supervised help with.
Most programs will offer an opiate MAT for this (Medically assisted therapy) such as Suboxone, Subutex, etc. For straight heroin detoxes, friends have told me this usually works well, assuming it’s with an appropriate tapering that’s comfortable and managed. One slightly less comfortable version we’ve heard used is Lofexidine, to simply manage symptoms etc without any opiate substitution.
At low levels this can still work well, but regular users will typically opt for an opiate replacement detox to increase comfort during treatment.
Most tell us that Methadone is more difficult to detox from, than the substance itself (the substance they started on). Nevertheless, detoxing from methadone is possible, although the higher levels can require much longer periods of detox.
Risks of overdose increase if you’re detoxed from a high amount of methadone, then relapse after treatment – so this is a requirement to get this done properly, in a supervised setting.
Higher doses (typically more than 40mls daily) will usually be carried out by more specialists teams and aren’t always available widely, depending on where you are in the world.
From our experience in most cases Methadone itself is used to reduce intake daily in a step-wise, reducing taper, and at later stages the more traditional MATs are also used in some cases, e.g. Subutex, Suboxone, etc.
What most people how’ve never been in addiction don’t realise is that, most of the time, drug addicts are actually not seeking a high.
They’re just looking to feel ok again, to temper the withdrawals.
Most people caught in substance abuse are well intended individuals, with decent education.
In fact I’ve seen some former executives, stock brokers, and even doctors fall to the opiate addiction epidemic we’re currently witnessing in the world, and especially in the US.
These are not hopeless people.
But in addiction, it can seem hopeless if live is constantly lived on the edge of withdrawal.
The physical and emotional toll of withdrawal is so difficult, that it compels drug addicts to use to escape the pain.
And when the pain is this bad, who can blame them?
In the end, over and above the physical addiction and withdrawal, most in addiction are truly running from a different kind of pain:
– The pain of realising, and taking responsibility for – the fallout consequences incurred by years of drug abuse
– The pain of facing up to the hurt and anguish caused to family members
– The hurt and shame of seeing the impact on their children
There is no amount of heroin, crack, cocaine, or any other substance that can alleviate these sorts of emotional withdrawal symptoms, without proper therapeutic work and care.
Some get addicted initially – increasingly – via prescription pain medication. This in itself is an epidemic and one that seems almost impossible to resolve.
Others addicted to drugs after an initial experience with social peers or negative influences from family.
Sadly, some learn growing up, that addiction and drugs are “how we cope”, or “what we do when life is tough”.
It’s difficult to break these sorts of associations to addiction and substances, later in life, without comprehensive therapy and significant personal work.
But it’s possible.
It requires a huge amount of self-awareness from exceptional insights, and dedication to recovery for the long term – but it’s possible.
There are millions in recovery all over the world. How did they do it?
Go visit your local NA or CA meeting, and find the oldest person in the room, who’s been clean the longest. How did they do it?
The answer is usualy along the lines: with a lot of help.
If we’re to stay truly clean in the longer term, we can’t be expected to deal with everything alone, especially in the early days of the journey.
Becoming clean is a journey of learning how to be a different (better) person – the changes you need to make to be consistently clean and abstinent from drugs, will subtlely begin to mould you and your personality in a different way.
To become clean you’ll need to connect more, with other people – the right people.
You’ll need to get a structure back in life, and get the basics in place.
The daily routine you need to maintain, will benefit your recovery, as you learn that instead of boring, having a structure in life enables you to enjoy all elements of it, in equal measure.
The employment you seek will improve your recovery journey as you discover self-esteem once again, and feel positive about the ability to contribute to something positive again.
Your family life, when clean and sober, will benefit your recovery as you relearn where your heart is.
The changes you need to make in your relationship, will benefit your recovery, as you learn to more tactfully navigate the nuances of relating and communicating with others.
…and little by little, by learning recovery, you re-find your life, vision, and purpose.
This is where we’re all headed on this journey beyond drug addiction, I like to believe… what about you?
Hey there! Thanks for stopping by, and a warm welcome to wmttlc!
In the coming days and months we’ll be developing an addiction recovery resource site – like no other.
Primarily we’ll be condensing the best of our knowledge about addiction, alcoholism and substance abuse recovery, in to a resource guide. More than a directory, but less than a radio station (it takes work to get all that content!)
We’ll be canvassing a host of topic experts on 12 steps, recovery as a single person, smart .v. spiritual recovery, beliefs about addiction, enabling, anchors and associations in addiction, and recovery communities even if you live in remote locations. And that’s just for starters.
If you’re actively in recovery personally, or know someone who is, our hope is that you’ll be able to use the site as a bookmarked form of support, when you need it.
So, bring it on! Lots going on behind the scenes here, and we’ll write again soon.
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