Medical detox and addiction treatment are essential healthcare services in California and all over the country. The opioid crisis has increased the rates of addiction and overdose in the state, and the COVID-19 epidemic has had a significant impact on people with substance use disorders. Around 8% of Californians have a substance use disorder, and only 10% of people that meet the criteria for a SUD ever receive treatment. Medical detox is an important intervention for someone with a severe substance use disorder. It may allow someone to achieve the first steps toward lasting sobriety as safely as possible. Learn more about addiction treatment and medical detox in California. 

What is Medical Detox?

Medical detox is an approach to substance use disorder treatment that’s designed to address withdrawal and other medical needs that are associated with chemical dependence and cessation. As a level of care in treatment, it’s called medically managed intensive inpatient treatment. Detox involves 24-hour care from medical and clinical professionals. Medical management means that doctors and healthcare professionals may prescribe medications to help treat symptoms or avoid complications. The medical care that you receive will depend on your needs and the severity of your withdrawal symptoms. 

Some people may need to be tapered off of the drug slowly or given medications that can help alleviate withdrawal symptoms. For instance, alcohol withdrawal is sometimes treated with a benzodiazepine to help prevent severe and dangerous symptoms. In other cases, you may only need to be treated with medications that can help with specific symptoms and increase your comfort. For instance, opioids can cause diarrhea, which can be treated with over-the-counter or prescription medications. 

In medical detox, you may also go through therapy with clinicians that are intended to address some of the issues that may come with substance use problems like mental and behavioral health issues. You may sit down with a therapist and address issues like anxiety, depression, past trauma, eating disorders, and other issues that can feed into a substance use disorder. While the main concern of medical detox is your physical safety and medical treatment, detox centers will also address the root of your addiction. Clinical treatment may continue through other levels of care after detox. 

Is Medication-Assisted Treatment Part of Medical Detox?

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Medication-assisted treatment (MAT) involves the use of certain medications to help replace a person’s dependence on illicit drugs. In most cases, MAT refers to the use of opioid medications or partial opioid agonists to treat opioid use disorders. MAT is an evidence-based approach that uses opioid drugs like methadone or buprenorphine to replace illicit drugs like heroin. These medications typically cause more mild side effects and don’t lead to significant intoxication. This allows opioid-dependent people to spend less time seeking drugs, intoxicated or recovering from their effects. 

MAT is usually not used in traditional medical detox programs. However, you may go through medical detox at the end of a round of MAT when you want to get off of the medication. However, MAT usually ends after a long tapering process. There are some situations in which medications may be used to alleviate withdrawal symptoms, particularly when it comes to alcohol withdrawal. Since alcohol and other depressants like benzodiazepines can cause life-threatening withdrawal symptoms, certain benzodiazepine medications may be used in the course of detox to help taper.  

Is Medical Detox Really Necessary?

Medical detox is an important level of care for many people that have substance use disorders, but it’s not the only approach in addiction treatment, and it may not be necessary in every case. However, many people start their treatment journey in medical detox. When you first enter a substance use treatment program, you’ll go through an assessment process that’s designed to determine the right level of care for your needs. You may meet with medical and clinical professionals to form a treatment plan that’s personalized to your needs. 

During this assessment, treatment professionals may use the ASAM Criteria, a set of important factors to consider in addiction treatment that was outlined by the American Society of Addiction Medicine. The criteria examine things like your acute withdrawal potential, biomedical conditions, and psychological conditions to determine the ideal level of care for your needs. If you’re found to have high-level needs, you may need medical detox or inpatient treatment. 

Clinicians may also use what’s called a biopsychosocial assessment to examine all of your areas of need in treatment. Biological, psychological, and social issues need to be addressed for treatment to be effective. If it’s found that you have significant medical needs, treatment professionals may recommend medical detox.

Of course, before you enter a medical detox program, you’ll go through a medical assessment with a doctor. Your potential for withdrawal is a major factor in your need for detox, but you may also have other needs that should be addressed early in treatment that could be revealed by an examination with a doctor.

There are also several other issues that may mean detox is necessary. Whether or not you need medical detox will depend on several factors, including:

  • The severity of your chemical dependency. If you’ve used a drug in high doses for a long time without breaks in between, you’re more likely to experience more severe withdrawal symptoms. If you’ve only taken a drug for a few weeks and you’ve just started noticing signs of tolerance and dependence, you may be able to taper at home with a doctor’s help and advice. 
  • The specific kind of drug you’re dependent on. There are several drugs that can cause substance use problems that don’t cause severe or life-threatening withdrawal symptoms. Drugs like marijuana, nicotine, and psychedelics can cause substance use issues that may require treatment and therapy to address them effectively, but they aren’t likely to cause dangerous symptoms during withdrawal. Other drugs, like alcohol and depressants, can cause life-threatening withdrawal symptoms that have to be treated and monitored by medical professionals. 
  • Other medical needs. If you have medical needs that could be worsened or complicated by a medical condition, you may need to go through medical detox. Medical treatment and monitoring can help with other conditions and complications alongside withdrawal symptoms. 
  • The severity of your addiction. Addiction is related to chemical dependence and withdrawal, but it’s a distinct issue. Addiction is a disease that affects your reward center and causes powerful compulsions to continue using a drug even if you’re experiencing consequences to your health or relationships. If you’re addicted to a drug, getting through the withdrawal phase without relapse may be difficult. Uncomfortable withdrawal and cravings may make a relapse likely. 

If you’re concerned that you have a substance use issue, but you’re not sure if you need medical detox, don’t quit cold turkey before speaking to a doctor or addiction treatment professionals.

Where Does Detox Fit in the Continuum of Care?

The continuum of care refers to the multiple levels of multidisciplinary care in addiction treatment. There are four major levels of care on the continuum, with several more specific levels between them. When you enter a treatment program, the ASAM Criteria may be used to find the best level of care for you. As you progress or regress, you may move on to another level that’s more appropriate for you. In many cases, you will move on to less intensive care as you advance in your treatment plan. 

Medical detox is the highest level of care on the continuum and involves the most hands-on treatment from medical and clinical professionals. As inpatient treatment with medically managed care, it’s the best place for people with high-level needs. Medical detox is an important first step for many people that seek addiction treatment. But if you have a moderate to severe substance use disorder, detox may not be enough to lead you to lasting change and sobriety. Addiction is known as a chronic disease that affects the reward center of the brain. Learning to cope with cravings and situations that could lead to compulsions to use takes time. 

According to the National Institute on Drug Abuse, three months is the ideal minimum duration for addiction treatment. When you complete detox, you may move onto another level of care that’s appropriate for your current needs. You may meet with a therapist to help determine what your next step is. If you have medical needs that need to be monitored around the clock, you may continue to an inpatient or residential treatment program. 

Inpatient treatment involves medically monitored treatment, which offers medical oversight, but less hands-on care from medical professionals. Residential services may involve 24-hour access to care, monitoring, and accountability, but you’ll have more autonomy day-to-day. If you can live by yourself safely, without significant risk to your sobriety, you may move on to a partial hospitalization program with 20 or more hours of services per week, intensive outpatient treatment with nine hours or more per week, or outpatient treatment with fewer than nine hours of treatment per week.

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