Medical detoxification eliminates drugs, alcohol, and any toxins from the body when a person is being treated for acute intoxication with the end goal being sobriety. This procedure helps ensure the person in substance abuse recovery is physically and mentally stable before moving to a less-supervised level of care.
Withdrawal symptoms vary from person to person, but the whole process really is determined by the severity of someone’s addiction. Withdrawal makes detox difficult to deal with, and those who proceed without medical intervention commonly relapse.
To detox in the care of medical and addiction treatment professionals affords the client a better chance of maintaining sobriety and avoiding relapse. Detox medications make this process easier to manage.
Why Use Medication During Detox?
Using drugs to combat drug abuse? It may seem as though this is fighting fire with fire, and it is, but it has a proven track record of success. Medication-assisted treatment (MAT) during detox is not only positive for a more comfortable detox but safer as well. The medications address some of the worst symptoms associated and minimize their effects.
Withdrawal is not just unpleasant, but at its worst, it can be dangerous. These medications allow for a more predictable outcome and a way to manage the symptoms more effectively and take away some of the life-threatening outcomes out of the equation.
The Food and Drug Administration (FDA) has approved various medications meant for the medical detox process that treat prescription opioids down to over-the-counter supplements. Detox medications are often administered to negate withdrawal symptoms that are common in most substances such as:
- Muscle pains
- Vomiting
- Insomnia
- Anxiety
- Diarrhea
- Nausea
- Depression
- Drug cravings
Detox medications also wean the client off the substance they have become dependent on. This is done by tapering down the dosage slowly as opposed to quitting cold turkey, which is when substance use is abruptly stopped. Cold turkey brings an increase of life-threatening symptoms or seizures. People who do this also increase their risk of relapse and overdose.
What Medications are Used in Detox?
Over-the-counter medicines have proven to be effective in dealing with certain ailments attributed to addiction. For example, Dramamine is used to deal with nausea, Tylenol is used for aches and pains, and natural supplements such as melatonin treats insomnia.
Since detox differs depending on the drugs consumed, antidepressants may be used to deal with depression and suicidal thoughts.
Detox Medications for Opioids
The opioid crisis seems to worsen each day with the never-ending stories of deaths by overdose and families begging for answers. With the advancement of treatment, abusing prescriptions drugs such as Percocet or stronger illicit drugs like heroin, the detox process is seldom a life-threatening experience.
While it may not be life-threatening, that does not mean withdrawal isn’t uncomfortable. The symptoms one may experience through detox could very well lead them right back to abusing drugs. In most cases, it is the fear of being sick that drives individuals from seeking help. If an individual did not adhere to the advice of medical detox, they could expect symptoms from opioid withdrawal such as:
- Exhaustion
- Restlessness
- Agitation and mood swings
- Fever and chills
- Flu-like symptoms
- A runny nose
- Rapid or irregular heartbeat
- Difficulty concentrating
- High blood pressure
- Tremors
- Uncontrollable crying
Not all opioids will affect the client the same. For example, withdrawing from codeine may not be as severe as withdrawing from OxyContin or heroin, so not all the symptoms could be experienced. But even going through it mildly can detract from the objective of sobriety. Something as mild as vomiting or diarrhea, however, can lead to dehydration, which could be dangerous.
The detox medications that medical professional administer are actually weaker opioids to help the patient cope with cravings, curb the sickness, and making weaning a lot easier. The withdrawals from these are more tolerable, and the client surely would sacrifice the strong symptoms for weaker ones. Here is a list of the common opioid detox medications:
Methadone
Methadone is a synthetic, narcotic analgesic that is used in heroin addiction treatment. The drug shares the same characteristics and effects of morphine, but methadone has a gradual onset of action that prevents users from getting high and experiencing euphoric effects.
Methadone is medically useful because it can remain in the body anywhere from 15 hours to 55 hours. This depends on the dosage, but when treating heroin withdrawals, it helps by taking up space in the opioid receptors. The primary objective of methadone is the replacement of opioids the person had been consuming and then following that by lowering the dose of methadone steadily. Since methadone does not provide a high, there will not be the cravings when a person weans off it.
Methadone has a long history of being effective when used with counseling therapy but is a controversial method due to its own potential for abuse. It must be carefully monitored when used during detox, but its proven history of success is why it remains a viable option. This is a last case scenario option depending on the severity of the person’s addiction.
Buprenorphine
Buprenorphine is an opioid with similar chemical structures to methadone, but the major difference between the two is buprenorphine is known as a “partial opioid antagonist,” which is defined as something much weaker than a “full agonist” opioid. Simply put, this medication has a smaller potential of becoming addicted to it.
In part, it works in the same way as methadone, which is by taking up space in the opioid receptors to decrease the intensity of substance cravings. This blocks the euphoric effects that are known from the opioid high, and a dose typically lasts for up to 24 hours.
Although the drug itself is weaker and carries less risk for addiction, it can still be abused and does hold some risk for dependency.
Suboxone
Lastly, Suboxone is the brand version of buprenorphine and naloxone. Naloxone is also known as Narcan, the life-saving drug first responders and medical professionals use to help someone come back from an overdose. Naloxone is a “full opioid antagonist” which negates the effects of opioids as a whole.
Narcan is too strong to use on its own during detox because it triggers immediate and intense withdrawal symptoms. The purpose of Suboxone is to combine the most effective parts of the two drugs to create a reversal medication that cannot be abused.
Detox Medications for Depressants
Benzodiazepines, alcohol, and barbiturates are all classified as central nervous system depressants; sudden cessation of these particular substances can lead to dangerous, and potentially life-threatening withdrawal symptoms.
These risks mean a medical detox should be highly considered when getting on the path to sobriety. Medical supervision will not only be the safe way, but it will help alleviate the worst symptoms of depressant withdrawals. Some of the more common withdrawal symptoms of alcohol and benzodiazepines include:
- Panic attacks
- Migraines
- Hallucinations
- Severe insomnia
- Suicidal behavior
- Seizures
- Delirium tremens (DTs)
- Psychosis
- Disassociation
- Memory loss
- Uncontrollable crying
- Tremors
- High blood pressure
- Increased heart rate
- Vivid nightmares
Suddenly stopping drugs such as benzodiazepines can have dangerous consequences. Those with no history of seizures can go into withdrawal-induced grand mal seizures as a result of halting use due to the hyperactive shock the system goes through.
Alcohol delirium tremens brings a whole set of severe effects attributed to stopping. It really is a matter of life and death in this situation, and the detox medications given during treatment will help with the discomfort and save the person from death.
Commonly used medications for this could be antidepressants to help with the suicidal tendencies, and melatonin to assist with insomnia. In a situation where seizures are likely, other medications will be given such as:
Benzodiazepines
In a twist as with opioids, benzos are often used in treating dependence on alcohol as well as other benzos. In cases of alcohol, medications such as Valium will be used to sedate and ease anxiety as an anticonvulsant. This carries a very low risk for any negative interactions with the former user.
In the case of benzos, it is most effective by tapering off as opposed to quitting all at once. By doing so, it allows the central nervous system to start regaining functions slowly as opposed to all at once.
It is a sensory overload for the brain to stop at once; doing so slowly is more beneficial. This has to be done in a very controlled fashion because of its high risk for abuse and addiction.
Detox Medications for Stimulants
The process for detoxing from stimulants differs from the other drugs mentioned on this list. The reason for this is stimulants are psychological and mood-based, and so they do not carry the same effects as heroin or opioids.
Stimulants affect dopamine, the brain chemical responsible for regulating emotions, cognition, and feelings of pleasure. Common stimulant withdrawal symptoms are depression, anxiety, insomnia, but more severe withdrawal symptoms include:
- Impaired cognition
- Suicidal behavior
- Difficulty concentrating
- Migraines
- Impaired memory
- Disassociation
- Emotional numbness
- Vivid nightmares
- Extreme fatigue
- Agitation and mood swings
There are no medications specifically tailored to treat stimulant withdrawal, but most detox centers will offer antidepressants, muscle relaxers, and modafinil which treats sleep disorders among other medications.
