Alcohol and drug detoxification and rehabilitation is a medically supervised process of helping individuals through the withdrawal from an abused substance.
In situations where individuals have developed a physiological dependency on drugs of abuse such as alcohol, benzodiazepines, and opiates, a sudden withdrawal of the drug of abuse can lead to life-threatening symptoms. In these cases, medically supervised withdrawal is recommended. This process is sometimes referred to as a detoxification (detox) program and can last for a few days (alcohol or heroin) to a few weeks (benzodiazepines). The individual does not need to be hospitalized or confined for the entire period, but does require some clinical supervision to monitor use of medications and possible side-effects from either the medications or the substance withdrawal. Some individuals may be admitted to a hospital or a specialized alcohol detoxification unit for the first few days of treatment, while others may be treated on an outpatient basis.
Treatment during the acute, or detoxification, phase requires close observation for at least 72 to 96 hours for the emergence of withdrawal symptoms. About one-third to one-half of individuals need medication therapy in the acute phase. This may include the use of benzodiazepines to decrease tremors and reduce or prevent increased blood pressure and heart rate, plus medications as needed for other symptoms, such as diarrhea or muscle aches. Folic acid, thiamin, and vitamin B12 are used to replenish vitamin deficiencies
In the outpatient treatment of individuals with mild to moderate alcohol withdrawal symptoms, a suitable option to a benzodiazepine is carbamazepine. Other medications including haloperidol, beta blockers, clonidine, and phenytoin may be used in addition to a benzodiazepine if indicated. Some research suggests that administering mirtazapine in addition to the standard treatment protocol helps the detoxification process by reducing physical and mental discomfort.
Treatment in the first month of abstinence and early remission phases may include education on physical, emotional, and mental aspects of addiction and recovery, identification of stressors and stress management skills, improvement of coping skills, assertiveness training, and relaxation training. A narcotic antagonist such as naltrexone, which diminishes the effects of alcohol, or the drug disulfiram, which causes an individual to be intolerant of alcohol, can be used to help some individuals remain abstinent. Although not yet approved by the FDA, the use of acamprosate, sometimes in combination with cognitive behavior therapy, for the treatment of alcohol addiction has proved very promising in clinical trials.
In addition to professional treatment, many individuals are referred to self-help groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). The long-term support that self-help groups provide can be crucial in preventing relapse. An alternative to AA is Rational Recovery, a self-help group based on cognitive rather than spiritual principles. |
Source: Medical Disability Advisor