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What has medically assisted detoxification and how does it work?

Detoxication is but one part of the process of entering sobriety and is essentially one of the easiest parts also.

Medically assisted reductions are rarely complicated and, can be commenced quickly and safely when managed by a team of expert workers.

Detoxification allows the body to be cleared of alcohol and substances by using a substitute medication. Once detoxification has been completed, this will allow counsellors and other professionals to start the process of psychological work.

Below is an outline of information on each possible detoxification.

Alcohol Detoxification

Problems during medicated alcohol detoxification are extremely rare and highly unlikely to occur.This is because such an in-depth assessment process will take place prior to you commencing one.

Medication is likely to be used.

Diazepam (Valium), Chlordiazepoxide (Librium), Lorazepam, Oxazepam are most commonly used to aid in the detoxification process.

Possible side effects during a medically assisted detoxification include:-  drowsiness, tiredness, unsteadiness, poor muscle coordination, forgetfulness headache, dizziness, low blood pressure, stomach upsets, skin rashes, problems with your eyesight, changes in the level of sexual desire, inability to pass urine/holding of urine in the bladder.

To aid with these side effects the following drugs can be prescribed. Zopiclone to support sleep patterns. Vitamin B strong compound and Thiamine to support the loss of vital nutrients to the body. Carbamazepine to support DT’s or the shakes. Metoclopramide to help with sickness and stomach cramps.

Duration of detoxication 8-12 days.

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Opiate Detoxification

Before undertaking an opiate reduction plan, please tell an expert of your medical history. Especially include brain disorders (such as head injury, tumour, seizures, etc.), breathing problems (such as sleep-apnoea, chronic obstructive pulmonary disease – COPD, etc.), kidney disease, liver disease, mental/mood disorders (such as confusion, depression, suicidal thoughts), stomach/intestinal problems (such as blockage, constipation, diarrhoea due to infection, paralytic ileus, etc), difficulty urinating (such as due to an enlarged prostate) disease of the pancreas (pancreatitis), gallbladder disease.

Medication likely to be used

Methadone, Buprenorphine or known as Subutex, Naltrexone, Lofexidine, Zopiclone to aid with sleep, Vitamin B strong compound and Thiamine, as a nutrient supplement.

Possible side effects during a medically assisted detoxification include; Nausea, vomiting, constipation, light-headedness, dizziness, dry mouth, drowsiness, or sweating may occur. Some of these side effects may decrease after you have been using this medication for a while. If any of these effects persist or worsen, tell the Doctor or pharmacist promptly.

To prevent constipation, eat a diet adequate in fibre, drink plenty of water, and exercise. Consult your pharmacist for help in selecting a laxative (such as a stimulant type with stool softener).

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tear production
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Later symptoms of withdrawal include:

  • Abdominal cramping
  • Diarrhoea
  • Dilated pupils
  • Goose-bumps
  • Nausea
  • Vomiting

Opiate withdrawal reactions are very uncomfortable but are not life-threatening. Symptoms usually start within twelve hours of last heroin usage and within thirty hours of last methadone exposure if you have been using methadone for an extended period.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Duration of detoxication process 5-16 days

When a person stops using stimulants, they will normally experience a series of unpleasant withdrawal symptoms, but none are life-threatening. Often, the physical and mental effects that present during withdrawal mirror a near-opposite of the substance’s primary effects.

This means that most stimulants, which would normally provide a feeling of elevated mood and energy levels, have a withdrawal period characterized by the opposite feelings of depression, low energy, and lethargy.

Most people who are entering stimulant withdrawal, will not produce life-threatening effects, but it can be problematic to cope with emotionally and physically.

Symptoms may begin immediately following the last use of the substance.

In some cases, the longer-lasting symptoms may still present up to months afterwards, which is why it is highly recommended that professional help, coincides with detoxification.

Stimulants withdrawal symptoms:

Instantly (within 6-12 hrs) after a person stops using, feelings of anxiety, sadness, agitation, and intense cravings for the drug.

The initial phase (24hrs -1 week) the user can feel both mental and physical withdrawal, depressive symptoms, insomnia and exhaustion.

The duration of effects will vary on the stimulant. For example, cocaine’s depressive symptoms usually lessen within a few hours, whereas methamphetamine users may experience depressive symptoms lasting for a much longer period.

One associated risk during stimulant withdrawal can be intense depression, which can lead to suicidal ideation. Having skilled workers such as a doctor or therapists can make the difference for a person when they’re struggling with harmful thoughts.

Medication likely used during detoxification.

Antidepressants may be prescribed to aid with low moods. Use of these medications will generally be reserved until after the acute withdrawal phase has passed.

Sedatives or anti-anxiety medication may be used, in the short term, to help with the anxiety associated with withdrawal.

A short course of antipsychotic medication may be used if any signs of psychosis emerge during the recovery period.

Once detox is completed, a client can start engaging in therapy sessions, both in a group and one-on-one. Therapy will help recovering users, learn how to deal with cravings, resist relapse, and find new activities without stimulants.

Over the Counter/ Prescription Medication Detoxification

Sleeping pills can be both physically and psychologically addictive. Those that abuse sleeping pills or any over the counter medication can easily become dependent on these drugs—sometimes addiction can be developed within a few weeks.

A dependency on the counter medication can be difficult to stop because the user’s body will become dependent on them to function. If they quit taking sleeping pills, they’ll experience withdrawal as their body tries to readjust.

Withdrawal symptoms from over the counter and sleeping pills can be powerful. Some symptoms can be life-threatening if left untreated by a medical specialist. During medical detox, specialists will monitor the withdrawals to check vital signs and address any health concerns that may occur.

For example, excessive vomiting or diarrhoea (common over the counter medication withdrawal symptoms) can lead to dehydration. In some cases, the doctor might suggest the administration of intravenous (IV) fluids to help balance electrolytes and give the body a replenishment of lost nutrition.

Medical detox is not only the safest way but the most effective for someone to detox from sleeping pills or any other addictive drug available from over the counter.

Common sleeping pill and over the counter medication withdrawal symptoms include:

GHB & Ketamine Detoxication

Withdrawal symptoms from ketamine are largely psychological in nature. Heavy dependent users have experienced physical withdrawal symptoms, but these have not been scientifically proven. Psychological withdrawal symptoms can be dangerous. The most dangerous is depression, which can lead to an increased suicide risk.

Withdrawal from ketamine could last anywhere from 72 hours to several weeks. It is not commonly life-threatening, however, can be uncomfortable. How long it lasts is determined by the number of drugs in the addict’s body, tolerance levels, length of dependency, and if they’ve also been using other illicit substances.

The most common ketamine withdrawal symptoms are:

Withdrawing from GHB, can result in severe withdrawal symptoms, medically supervised detoxification is characteristically advised by all addiction specialists. Withdrawal from GHB is common in cases of severe dependence, and most detoxification stays are between 7 to 14 days.

One of the aspects of GHB withdrawal treatment could involve the use of other drugs to help alleviate the symptoms of withdrawal. Benzodiazepines are commonly used, particularly to help sedate anyone exhibiting substantial agitation or psychotic symptoms. Due to the nature of these drugs used for detoxification also being addictive, they should only ever be used under medical supervision.

Other drugs to support detoxification are anticonvulsants and antihypertensive medications sometimes used during GHB withdrawal treatment. As these drugs have very little or no addictive nature, they are stereotypically favoured over benzodiazepines. However, even though they are not addictive, they should also only be used under the supervision of trained medical professionals.

Cannabis

An intense craving for marijuana is the most common marijuana withdrawal symptoms. Irritability, anxiety, and restlessness may occur during marijuana withdrawal. The severity of these withdrawal symptoms will depend on the length of time a person has been on the drug. Some people may not even have any marijuana withdrawal symptoms when they quit using it.

The most common symptoms include:

While some can safely detox from marijuana off their own back, it is proven that the best outcome is under supervision with a doctor, as they’re able to prescribe medications to help reduce withdrawal symptoms.

For example, metoclopramide or promethazine will help with nausea and vomiting. Headaches or muscle aches can be alleviated with paracetamol or ibuprofen. It is always important to get a consultation with addiction specialists about how to best treat withdrawal symptoms.

The duration of withdrawal from marijuana can be different for everyone. For most dependent marijuana users, withdrawal symptoms can start on the first day after quitting and peak within 48 to 72 hours. Symptoms generally last no longer than two to three weeks and dissipate over time with professional support.

About Author

Nicholas Conn

Nicholas Conn

Nicholas Conn is a leading industry addiction expert who runs the UK’s largest addiction advisory service and is regularly featured in the national press, radio and TV. He is the founder and CEO of a drug and alcohol rehab center called Help4addiction, which was founded in 2015. He has been clean himself since 2009 and has worked in the Addiction and Rehab Industry for over a decade. Nick is dedicated to helping others recover and get treatment for drug and alcohol abuse. In 2013, he released a book ‘The Thin White’ line that is available on Amazon.

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