Addiction rehab: what can I expect if I need an alcohol detox or detox from drugs?
At The Haynes Clinic, we are often asked the format a detox takes and how long it takes to be detoxed. The initial concern is usually about being detoxed and not about the much-needed help with the psychological obsession nor with how long should a person be in residential rehab treatment.
A detox is a necessary part of addiction rehabilitation treatment but is not the part that will help us change our thinking and behaviour – that part would be a daily structured programme of therapy. Basically, a detox is where someone is given prescribed medication over a clear set period of time to help come off alcohol or a drug in a safe manner and that counters the effects of withdrawal.
Alcohol detox
Possibly the most common detox would be for alcohol. Legislation has changed and now it would be extremely rare for a GP to offer a prescription for a home detox. This is because they are restricted with the amount that can be prescribed and it is normally quite a low dose. Therefore, people will go into withdrawal and to compensate their feelings will drink alcohol in conjunction with the prescribed medication, which can be very dangerous.
What we have noticed though, at The Haynes Clinic, is the number of people with an alcohol addiction that have been prescribed anti-depressants following a consultation with their GP. This medication does not work when alcohol is being consumed and generally will make people feel even more depressed as they think their mood should be lifting and it isn’t.
Hospitals have also changed their policy and will generally not offer a medicated detox but will usually just hydrate someone for 24 hours and then discharge them from treatment. Every county has a local Drug and Alcohol team, but they are vastly underfunded and are not able to offer people immediate help in the form of an alcohol detox. Therefore, people’s options are greatly reduced and generally there is only the option of private residential rehab that can offer immediate help.
Cost can now become the restricting factor and we hear from a lot of people who have tried to simply cut back and reduce their alcohol consumption a little each day to see if that will work. Generally speaking, it just doesn’t work, and people are again just delaying what is the inevitable. It is also very dangerous as the body can react very violently from a reduction or just stopping taking the amount of alcohol that it is used to daily having. The most common reaction is a seizure on or before day 3, which can have a detrimental and potentially permanent impact on the brain.
An alcohol detox starts when the individual has been admitted into residential treatment by the doctor attached to the alcohol clinic or alcohol rehab. The doctor will prescribe a Benzodiazepine, either Librium or Diazepam for a period of usually around 7- 10 days. The dosage starts high on day one and will slowly reduce down to zero on the last day.
For anyone with a high daily alcohol consumption then what is termed PRN can also be prescribed. This stands for Pro Re Nata and where the normal dose of medication, to start with, is taken four times a day, PRN can be extra doses for those suffering with more extreme symptoms of withdrawal. It translates as ‘As Needed’.
Anyone undertaking an alcohol detox should be initially observed for any adverse reactions to the medication. It is important to ensure that the medication is sufficient for people to not feel the effects of alcohol withdrawal but is not too much that it impairs their normal daily functions. Anyone undertaking an alcohol detox would normally be able to commence group therapy within the first 24 hours. It is also possible that you may be prescribed Zopiclone for the first six days as this acts as an aid to restart the natural sleep pattern. In some alcohol rehab clinics, Pabrinex may also be prescribed, this is a series of a single daily injections of vitamins over three days to aid the liver to start recovering.
Heroin detox or any opiate, such as Codeine, detox
A heroin detox will take up to two weeks to complete, and the detox drug prescribed is usually Subutex or Buprenorphine. At The Haynes Clinic we will often get people who are being admitted for a heroin detox who may have also been prescribed Methadone by their local drug and alcohol team.
Heroin and methadone can be detoxed at the same time, but some clinics will not offer a detox if the methadone is of a high dose and therefore it is best to check what restrictions the clinic may impose and to be totally honest before being admitted. The opiate detox is commenced just at the point that the individual is starting to go into withdrawal, which is usually 6 to 12 hours from the time that they last used. Usually, a small dose is initially given and if tolerated then the dose is gradually increased within the first 24 hours.
Subutex comes in tablet form and has to be put under the tongue and allowed to dissolve or it will not work as well. Then, from day one the medication is stabilised then reduced down over the scheduled number of days. Withdrawal effects can include headaches, stomach pains, constipation, nausea, back pain and sweating. Subutex, in itself, is a controlled drug and as such is usually kept in a locked cabinet within the locked room that is set aside to store medications.
It is extremely dangerous for anyone who has had a heroin detox to relapse. The body has had time away from the drug and to reintroduce it can lead to a fatal overdose.
Cocaine detox
Basically, there is no medication used for detox off Cocaine. Therefore, the NHS will not offer any help. It is deemed safe to simply stop using it.
In fact, the danger in using Cocaine is the effect it has on our heart and will create a “racing heart.” This can lead to a heart attack or stroke and also regular use can lead to depressive episodes and feelings of paranoia. Usually though, alcohol consumption and Cocaine use go hand in hand, so anyone having a medicated alcohol detox will benefit from not having such extreme cravings for using Cocaine.
Benzodiazepine detox
A benzodiazepine such as Valium or Diazepam, potentially has the longest detox which would be completely dependent on the dosage that is being taken on a daily basis. The diazepam detox consists of a reducing regime and could potentially take as much as up to 6 weeks (or longer) to complete within a residential drug rehab or addiction clinic.
Generally speaking, the success of this detox is due to the individual being within a safe and controlled environment which in turn seriously reduces the risk of relapsing back to a higher daily dose which can easily happen when it is attempted within a home environment.
