“Imagine trying to live without air. Now imagine something worse.” ~Amy Reed, author of Clean When a person has finally decided to get help for a substance abuse problem, the first step that most addiction experts recommend is that they go through a medically-assisted detox. This ISN’T recovery – this is getting ready to begin recovery.
What Is a Medical Detox, Exactly?
Drug or alcohol detoxification is a period of abstinence so the intoxicating substance can leave the body. The main goal of a detox is to largely free the person from the physical compulsion to drink or use. When the abused substance of choice is discontinued, the person will experience a number of uncomfortable withdrawal symptoms, including:
- Headache
- Nausea/vomiting/diarrhea
- Muscle cramps and aching
- Insomnia
- Irritability and mood swings
- Nightmares
- Anxiety
- Depression
- Tremors
- Strong drug cravings
Not only are these withdrawal symptoms harshly unpleasant, they can also trigger an immediate relapse, before recovery has even truly begun. The purpose of a MEDICAL detox is to safely manage the physical symptoms of withdrawal by making the patient as comfortable as possible, while at the same time providing a safe, drug-free environment. A medical detox can also include the use of certain prescription medications to reduce cravings and to ease the symptoms of withdrawal.
Where Does the Medical Detox Take Place?
A medical detoxification from alcoholism or drug addiction takes place under the close supervision of trained physicians and other medical staff members. Sometimes, it will take place in a separate facility that ONLY offers detoxification, while other times the rehab program will provide the supervision. The best alcohol and drug detox programs will provide around-the-clock, 24/7 medical supervision, but for those with less serious substance abuse issues, detoxification can sometimes occur on an outpatient basis – still under the supervision of a physician.
Why Do I Need Medical Detox – Why Can’t I Just Go “Cold Turkey”?
Going “cold Turkey” is NEVER recommended – the disease of addiction is characterized by changes within the substance abuser’s brain. Impulse control, rationality, and decision-making are all disrupted, making it HIGHLY – almost impossible – that a person will be able to just quit on their own. Furthermore, depending upon the abused substance of choice, abrupt cessation can be dangerous, even potentially fatal.
- Alcohol –Seizures, hallucinations, and delirium tremens (the “DTs”)
- Benzodiazepines –loss of reality and life-threatening seizures
Withdrawal from other addictions, while not particularly physically dangerous, can still be intensely uncomfortable and even painful. This is particularly true in the case of addictive opioids such as heroin or prescription painkillers. The “sick” feeling experienced during heroin withdrawal is what pushes many addicts in early recovery into a relapse. Medical supervision, compassionate support, and – when necessary – medication assistance can all aid greatly in getting the patient physically stable enough to be mentally clear enough to receive the message of recovery.
When I Am Physically Free of Drugs, Why Isn’t That ENOUGH?
Undergoing a drug or alcohol medical detox isn’t enough because long-term sobriety and abstinence is the REAL goal of recovery. By definition, detox is short-term, usually lasting no more than two weeks. Recovery, on the other hand, will take months, and in some cases, years. Certain aspects of recovery will require a lifetime of participation, if the disease is to be successfully managed. Even when the physical compulsion has been lessened, there is still the psychological compulsion. Addiction is a disease that is characterized by changes within the brain – decision-making, impulse control, rationality, etc. – and those changes are what controls the person’s behaviors. Complicating the matter is the fact that when a person has been abusing drugs or alcohol for a significant length of time, they lose the ability to feel pleasure – or even normal – without the presence of the intoxicating substance. Until the brain regulates itself during abstinence, that person is at extreme risk for relapse. To best combat the disease, addiction needs to be addressed on multiple levels, including:
- Educational – learning more about the disease and how to best manage it
- Emotional – uncovering any underlying issues or trauma that contributed to the disease’s development
- Mental – treating any co-occurring psychiatric disorders or conditions
- Behavioral – learning how to replace dysfunctional, self-destructive behaviors with positive, healthy ones
- Medical – the judicious use of prescription medication to stabilize moods, ease lingering withdrawal symptoms, and reduced drug cravings
- Reactionary – learning new positive coping skills and stress-reduction techniques
- Physical – including healthy exercise as part of recovery
- Familial – understanding the role that family history and/or dysfunctional or codependent relationships have played
- Nutritional – discovering how healthy eating habits can reduce cravings, protect against relapse, and repair some of the damage done by long-term substance abuse
- Social – learning how to recognize and avoid the people, places, and things that were part of an active drinking and drugging lifestyle
- Practical – assistance with educational needs, housing procurement, and employment coaching
- Relapse avoidance – practical strategies on how to prevent relapse, and even more importantly, how to move forward in the event of a relapse
- Alternative – strategies outside of the “mainstream” that have nonetheless proven to be beneficial – yoga, massage, meditation, art/poetry therapy, pet/equine therapy, etc.
- Fellowship – attendance of 12-Step peer support group meetings
- Aftercare – providing ongoing “tune-up” support whenever a person is feeling overwhelmed or tempted
Because addiction is a lifelong, incurable disease, perhaps it is the aftercare that is of most importance. Without constant vigilance, ANYONE – regardless of the length of their sobriety – can be in danger of a relapse. Recovering addicts and alcoholics who have access to professional support can get the help they need BEFORE a relapse occurs. Detox is a necessary first step, but it is just that – a FIRST step. Give yourself a real chance of successful, long-term sobriety by seeking out a recovery program that best works for you.