Drug Detox
Some drugs require prescribed medication to safely stop and come off that drug. For example, anyone taking an illegal substance that is opioid based who has developed a drug addiction or drug disorder will require a GP to prescribe what is known as a controlled drug to counter the effects of withdrawal. Subutex – also known as buprenorphine – is a good example of this. It is commonly used as a detox medication to help someone to stop using heroin. It can also be used to assist withdrawal from a codeine dependency. As it is a controlled drug it cannot be medically prescribed for someone to self-administer as a home detox and therefore has to be administered within the safe and monitored environment of a residential addiction treatment unit or drug rehab.
The opiate detox usually takes 10 – 14 days to complete. The local drug and alcohol team, and there is one in every county within the UK, are very short of funds and the ability for them to get anyone into a residential drug treatment unit could take many months. What they tend to offer are the availability of bottled water, a needle exchange and methadone for the person with the heroin or opiate disorder, which is meant to be a heroin replacement and is a man made opioid. It effectively reduces withdrawal symptoms and is usually prescribed long term. However it is addictive in itself and, once on it, in order to to stop using it there will also need to be a supervised residential detox.
The alternative is a very slow reduction with an agreed goal to finally stop the dose. This is usually not successful as, way before the reduction time to stop taking methadone is reached, withdrawal from the reduction in dose has kicked in. As a result, the individual will revert back to a higher dose of the drug to maintain a degree of normality of functioning.
Alcohol detox
Alcohol is also regarded as a drug, in fact medically it is known as a Psychotropic Central nervous system depressant. Other drugs, such as Marijuana or Cannabis and Cocaine, all share the same trait of slowing the activity of the brain. Because it is legal to buy almost anywhere and now even unbelievably in petrol stations, people’s perception of it as being a dangerous potentially addictive drug are flawed. For anyone who is alcohol dependant or who has an alcohol disorder to suddenly stop drinking alcohol will potentially result in that individual suffering withdrawal symptoms such as shaking, tremors, nausea and vomiting. On day 2 they could potentially start to hallucinate followed by dangerous seizures around day 3. So again, prescribed medication by a GP is essential to safely stop drinking alcohol if the body has come to expect a daily intake.
The medication usually prescribed is Librium, the initial amount being gradually reduced typically over 7 – 10 days. However, it is often the case that the GP will be unable to prescribe sufficient for the amount of alcohol the body has come to depend on (because the detox medication can also be dangerous if taken in too high a dose). Therefore to get a safe and comfortable alcohol detox quickly, then the immediate option is to be admitted into residential alcohol treatment in an addictions rehab unit or alcohol clinic.
Does a detox cure addiction?
Anyone with a drug addiction or drug disorder can be treated, although options for immediate help are very limited. Part of the process to overcome any form of withdrawal requires a supervised medicated detox within a residential addiction treatment environment. However, a drug detox alone is not enough. It may mean that physically there is no reason to use a substance again. However, psychologically the obsession and need will still be there calling the person back to use the drug again. A detox within the safe environment of an addictions rehab is just the first step of getting someone back in control of their life.
Certain drugs are safe to stop using without medication to assist with withdrawal symptoms. For example, there is no detox medication attributable to a Cocaine detox and it is medically recognised by the NHS that anyone with a Cocaine Addiction can safely just stop using it. This is exactly the same as with a Cannabis addiction – there is no medicated cannabis detox. That is not to negate the effect of psychological withdrawal. It is still difficult to ‘just stop’ even if it is safe to do so. Being in a safe environment with no access to cocaine or cannabis will assist here.
Addiction therapy
Prescribed detox medication is extremely effective and allows people to engage in a daily structured therapy programme. The type of therapy used is usually Cognitive Behavioural Therapy (CBT). This involves looking at realistic and repeated unrealistic behaviour. Residential addiction treatment offers a safe environment in which to do this. Whilst there it is important for the individual to understand and accept the changes that need to be made to their thinking and behaviour so that they are less likely to relapse when they return home.
A residential drug rehab will usually have qualified professionals who themselves are in Recovery from their own addictions. They can be inspirational in terms of offering an example of how it is possible to get well and to get a life back free from addiction. They demonstrate that addiction can be treated successfully. 95% of residential addiction rehabs or drug clinics have a modality based on the 12 Steps of AA with the wording being adapted for other addictions and support groups (such as Narcotics Anonymous, Cocaine Anonymous and Gamblers Anonymous). Following residential addiction treatment regular attendance at these support groups is critical to anyone’s ongoing support or Recovery.
Relapse after drug rehab
However good the therapy, ultimate success in terms of getting an addict permanently clean will depend on their desire to stay clean. Unfortunately some people complete 28 days’ residential addiction treatment and then at some stage, usually within the first 6 months of going home, have a relapse. A relapse is not something that just happens. It is usually planned and starts with a reverse back to addictive thinking. It may be that the individual stops attending ongoing aftercare support groups from when they were in treatment, they might stop attending AA, NA or CA, or they may start to mix with people who are drinking alcohol or using drugs thinking they will be all right with that. Usually it is simply stopping doing the simple things they have been recommended to do and thinking that they will now be all right. They forget how bad it was before they stopped the last time.
A drug relapse can be very dangerous. The body’s tolerance to the drug will no longer be as it was and using a similar amount will hit it hard. For example, a relapse on heroin can lead to extreme sleepiness, unconsciousness or even for breathing to stop, and death. It is very easy to overdose following a period of clean time. Whatever the drug being taken before treatment , with a relapse it is common to be using more of that drug than before within about 3 weeks of the relapse starting.
It is important to get back on track as soon after a relapse as possible and it important to make contact with the addiction rehab or detox clinic for support, as soon as possible. No one will judge anyone that has had a relapse but it is important to realise that in all our many years experience, we have never met anyone who has admitted that they relapsed and enjoyed it. Therefore, the sooner that help is sought to get back on the road to Recovery the better, as by not sharing the situation the matter will just worsen.
‘Cure’ for addiction – the vital ingredients
In summary, a medicated detox if applicable, a residential addiction programme of structured therapy and an understanding of the 12 Step programme with ongoing support from Aftercare from the addiction rehab or alcohol clinic, together with regular attendance at support groups, has proven to be the combination that has been extremely successful in anyone being able to maintain a life free from their old addictive thinking and behaviour.