Drug abuse can take a serious toll on a family’s overall mental health. Fights can tear apart the strongest relationships, and it’s not uncommon for family members to blame one another for the difficulties they face. The person with the addiction might be at the center of all of this suffering, and that person might also have serious medical conditions to contend with, all due to the addiction. In a study in the Journal of Substance Abuse, for example, researchers found that people with addictions were 6.7 times more likely to be hospitalized than people who didn’t have addictions. It’s clear that this is a deadly problem, and it’s clear that people with addictions really need to get help in order to speed their own healing, as well as the healing of their families. Enrolling in a detox program is an excellent way to get started.
The Role of Detox
Drugs and alcohol can cause persistent changes inside the brain that can lead to dysfunction when those drugs are no longer available to the cells that once used them. These deprived cells can misfire and cause physical distress, mental upset or both when the drugs are gone, and this misery can lead people back into their drug-using habits. Some can even endure terrible medical complications when they try to withdraw without help. Detox is designed to smooth the path, allowing people to make that transition safely. With the help of a program like this, people can see the process through to the end, where they might have been more likely to relapse or become quite ill when they attempted to get sober on their own. The process is important, but according to the National Institute on Drug Abuse, detox without followup therapy isn’t considered a form of treatment for addiction. When people are sober, all of the thoughts, habits and opinions that led to the addiction are still in place, and unless they’re dealt with, the substance use might quickly recur.
Detox Setting Choices
Drug detox is designed to last as long as it might take for a person to safely withdraw from a specific substance of abuse. Drug detoxification can take place in inpatient settings, and according to the National Survey of Substance Abuse Treatment Facilities, about 6.5 percent of inpatient treatment facilities and 4.8 percent of hospitals provide this kind of care. In a program like this, people have around-the-clock medical supervision that can help them to avoid serious complications caused by withdrawal, and people also have a safe and sober place in which to recover from their addictions, so they won’t be tempted to relapse. But, not everyone who has an addiction needs to go through withdrawal in an environment like this.
Some people detox at home or at a friend’s home instead. As long as these people have a sober friend with them at all times, who can step up and step in if something goes wrong, this can be a safe strategy to follow.
It can be hard for families to know where they should place the person they love, or whether they should keep the person home for detox, but medical experts can weigh in on this issue and provide needed help. According to the Substance Abuse and Mental Health Services Administration, medical experts assess these factors when determining an appropriate setting for detox:
- The person’s intoxication level at the moment
- Underlying medical or mental health issues that might need monitoring
- The person’s willingness to change and get sober
- The potential for relapse
- The environment in which the person might detox
In this model, people of sound health, who are willing to change and who have loving families to care for them, might be able to detox at home. Other people might need more intense help. Medical professionals can provide this kind of assessment, helping families to make the right choice for the person they love.
Some of the cellular changes caused by addictions are best treated with the help of medications. In some cases, these medications attach to the same receptors used by the addictive drugs, and while these replacements don’t cause a euphoric high, they can fool the brain into thinking it has access to the drugs it feels are necessary. In a way, these medications are easing the transition between intoxication and sobriety, allowing people to skip the intense discomfort and pain that an addiction can cause.
Sometimes, the medications do more than just provide comfort. In some cases, replacement medications are absolutely necessary. Very sedating benzodiazepine drugs, for example, can cause such diminished activity inside the brain that seizures can take hold when people try to stop their drug use. In detox programs for these drugs, doctors provide replacement medications on a tapering dose, allowing the brain to adjust slowly so no seizures take hold. The same approach can be useful for people who were once addicted to alcohol. With this kind of monitoring, people can get sober without losing their lives in the process.
In an inpatient facility, this kind of help is provided by medical staff that’s always present and always available. It can be handled on an outpatient basis, however, as long as people continue to go to their appointments on a regular basis. In each appointment, medical staff can monitor the person for negative reactions and supply medication as needed.
The physical discomfort that detox can cause can sometimes be alleviated with basic comfort care, including:
- Bland foods
- Cool baths
- Plenty of water and juice
- Mild exercise
- Soft, clean sheets
- Dark, quiet rooms
These are the sorts of attributes found in some homes, but detox facilities often have all of these components pulled together well in advance, and they can provide care that is seamless and comforting. People don’t need to make their own meals or change their own sheets in a facility like this. They can just relax, and that might also be helpful.
Some facilities utilize techniques that are considered part of Eastern or alternative medicine traditions. For example, in a study conducted in China, researchers measured the effectiveness of Qigong in people undergoing heroin detox. The people in this study were asked to perform the rhythmic and repeated movements of this ancient form of exercise on a daily basis, and when the study was concluded, the researchers found that the people who got this therapy performed better in detox than those who didn’t have the intervention. Their symptoms were mild and tolerable, where others still had severe symptoms. Studies like this have motivated many facilities to incorporate movement-based therapies like yoga or alternative therapies like acupuncture into their detox programs, and some people really do find them useful.
Going through detox can be physically distressing, but it can also be an incredibly emotional experience. Many people have said things and done things while under the influence that they might not have even considered while they were sober, but the memories of those instances have been kept in check with the use of drugs. When those substances are removed and all the memories come flooding back once more, the pain can be intolerable, and feelings of guilt can be hard to tolerate. Similarly, some people lean on addictive drugs in order to help them deal with prior trauma or abuse, and these people may have no idea how to handle these issues without the help of drugs. People like this may be tempted to return to drug use, just to make the pain go away.
In an inpatient facility, therapists can provide the support and understanding that can help clients to understand their past and why they might need to change for the future. At home, family members may not have this kind of therapeutic background, but they can still listen, provide support and express their love. They can also help the person to stay motivated to enroll in addiction care by reminding the people they love that therapy for addiction is designed to soothe just the kind of pain the people are feeling right now, in their most vulnerable moments.
Research suggests that people who get addiction care immediately following detox relapse less often when compared to people who delay that followup care or skip it altogether. In fact, The Partnership at Drugfree.org reports that people who got addiction therapy within 30 days of detoxification took 40 percent longer to relapse, and some didn’t relapse at all. It’s clear that detox seems to prime people for success in therapy, and that the benefits seem to fade a little bit with time. Perhaps the urgency fails or perhaps people just find it too hard to maintain on their own without help. By ensuring that people enroll in drug addiction therapy right away, families can capitalize on the gains the person has made and ensure that the treatment and the healing keeps moving forward.
Inpatient programs may help to smooth this process by facilitating enrollment in therapy. The person might be able to just walk down the hall to start therapy, or the person might be physically escorted to the new treatment program. It’s more difficult to do this in outpatient care, but families can make appointments for the people they love and they can also escort them to their appointments. This kind of outside help is vital in ensuring that people get the care they need in order to make lasting changes.
Studies suggest that the week following detox is the most vulnerable for people who are fighting an addiction. In fact, according to a study in the British Journal of Psychiatry, most people who relapsed to opiate use did so within a week of leaving their treatment programs. The risk of relapse might persist much longer than a week, however, and some people always feel a little niggling urge to take the drugs they were once addicted to. Therapy can help these feelings to fade, and the longer the person stays in recovery, the more good and sober memories are built and the more sober skills are strengthened. In time, the addiction really can be controlled, but detox and rehab are vital.
At Futures of Palm Beach, we provide customized care for people who have addictions, and we have a separate program for people who have both addictions and eating disorders. Some of our clients have benefitted from inpatient care, as they’re allowed a respite from their difficult lives while in our care, but we’ve seen others who have fared better in the company of their families while participating in outpatient care. It’s a personal decision, and we work hard to help families to make the right choice for their own situations. If you’d like to know more about how treatment works or you’re struggling with your own questions regarding addiction detox care, please call us. We have counselors available who are happy to talk with you about your questions and provide you with the answers you’re looking for.
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What is CARF? — The Commission on Accreditation of Rehabilitation Facilities (CARF) is a nonprofit and independent accreditor of health and human services.
What Does CARF Do? — CARF helps treatment centers achieve internationally recognized standards by working with them to improve the quality and value of their services.
The Accreditation Process — CARF conducts an on-site survey to evaluate the business and service standards of a facility. Then a facility must submit a Quality Improvement Plan (QIP) to address areas of improvement.