In 2016, approximately 1 out of every 13 people in the United States needed treatment for substance abuse or addiction, the National Survey on Drug Use and Health (NSDUH) reports. One of the side effects of drug and alcohol addiction is physical dependence, which can mean difficult withdrawal symptoms when a person attempts to stop using the substance. Withdrawal symptoms can be both physically and emotionally intense, and even life-threatening in some cases. For this reason, detox programs are often a necessary first step in the recovery process.
Detox programs should be offered as part of a comprehensive addiction treatment program or at least as an option before entering into a program. Detox can help a person to become physically stable and ready for a complete treatment program.
An evaluation by trained substance abuse, medical, and/or mental health professionals can help determine what level of care is optimal for each individual and what type of program will be most beneficial to promote addiction recovery. Not all detox programs are exactly the same, and there are several factors to consider when selecting one.
Types of Detox Programs to Consider
The National Institute on Drug Abuse (NIDA) publishes that there are more than 14,500 dedicated drug treatment centers in the United States. There are a lot of choices when it comes to choosing an addiction treatment and detox program.
One of the first things to consider is what type of care is needed. There basically two main types of detox programs: inpatient and outpatient. Outpatient detox can also be referred to as ambulatory detox, which basically just means that a person can come and go during treatment and does not stay in a center around the clock. Inpatient detox usually lasts 7–10 days, and a person will reside in a monitored and specialized facility where they can be supervised and cared for 24/7. Inpatient detox can also be medically managed, called medical detox, which involves the use of medications to control and minimize significant withdrawal symptoms.
Outpatient detox may be most beneficial for people who do not struggle with a high level of physical drug dependence. This is generally for those who only suffer from mild to moderate withdrawal symptoms. Inpatient medical detox is optimal when a person battles intense withdrawal symptoms that may even become life-threatening.
Medical detox provides the highest level of care, as vital signs are monitored and stabilized as needed, and complications can be attended to on the spot. Withdrawal from opioid and benzodiazepine drugs, as well as alcohol, can involve difficult withdrawal symptoms. As a result, detox from these substances should not be attempted at home; medical detox is required.
There is a third type of detox program, known as rapid detox, which is often advertised as a fast, easy solution to opioid withdrawal. This type of program is not recommended, and the Centers for Disease Control and Prevention (CDC) warns that it can even be dangerous. Rapid detox programs put patients under sedation and attempt to flush the drugs out with medications. These programs are not widely accepted or endorsed by the medical community, and they can have potentially life-threatening outcomes.
Medical detox is the preferred standard of care. It provides maximum stability and promotes long-term recovery.
Elements of a Good Detox Program
As published by NIDA, addiction is a complex brain disease, and treatment programs should cater to each individual specifically. A detailed medical, mental health, and drug use history should be taken into consideration when determining the type and level of care that will be most beneficial for the individual entering detox.
Co-occurring mental health and medical disorders should be attended to during detox and addiction treatment, as the presence of an additional disorder can interfere with treatment, potentially complicating matters. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that nearly 8 million Americans struggled with both addiction and mental health disorder at the same time in 2014. Detox and addiction treatment programs must offer integrated care for co-occurring disorders to properly care for both disorders simultaneously. All treatment providers should work together when developing and implementing a treatment plan to ensure a cohesive approach.
Addiction treatment and detox methods should be based in scientific and relevant research in order to provide the highest quality and standard of care. Medications, supportive care, and behavioral therapy methods are all often components of a comprehensive addiction treatment program.
Staff members at a detox facility should be properly licensed in their fields, and the center should be as well. Each state will have certain requirements both for an addiction treatment center to operate and also for its staff members. State-run detox facilities may be low cost or free, but they also often have less availability and less privacy than a private detox center. While more amenities and heightened privacy often come at a higher cost, NIDA estimates that addiction treatment has a high return on investment, saving society around $12 for every $1 spent on treatment when taking into account criminal justice, workplace production, and healthcare costs.
Questions to Ask Before Selecting a Detox Program
Addiction is a personal disease that impacts entire families, and a detox program should be selected with care. Things to consider include level and type of care provided. Location is important. Is privacy and a secure, tucked-away location ideal, or would the family prefer a center closer to home?
Cost and family budget should be considered prior to selecting a program. Private rooms will cost more than shared rooms in an inpatient detox program; however, more privacy may be important for the healing process, depending on the individual. Priorities need to be agreed upon ahead of time.
Below are some questions to ask before deciding on a specific detox program.
- Is the care tailored to each individual? Good detox programs will assess an individual prior to admission to design an optimal care plan for them specifically. Each person is different and therefore requires a customized treatment plan.
- What is the client-to-patient ratio? Depending on the type of detox offered, this ratio can vary. For instance, outpatient detox does not require as many staff members and around-the-clock care; therefore, these programs may have higher ratios of clients to staff than medical detox programs should. Lower client-to-staff ratios mean more personal attention.
- Does the center have any special accreditations? While each center is required to meet the state licensing requirements and staff should be properly credentialed, facilities can also apply for and receive additional accreditations. The CARF (Commission on Accreditation of Rehabilitation Facilities) accreditation signifies that a facility meets a higher quality and standard of care on a nationally recognized level, for example.
- How secure is the facility? Detox centers should be comfortable and safe with security in place to ensure the wellbeing of everyone. Client safety and security should be a top priority.
- What types of amenities are offered? There are many different types of amenities offered at different facilities, such as yoga, mindfulness meditation, spa treatments, massage therapy, chiropractic care, hiking trails, and more. Often, these services and amenities may incur additional costs, but as adjunctive treatment methods, they can promote relaxation and enhance comfort during detox.
- Is insurance accepted? Health insurance often covers some of the costs of detox, and many programs accept insurance to cover at least a portion of the costs. A respected detox program will staff highly trained professionals who can help families navigate their insurance policy and also aid in budgeting for the cost of detox.
- What type of follow-up treatment or aftercare is provided? Detox should be considered a component of a complete addiction treatment program and not a standalone treatment. Many detox programs allow clients to move directly into an addiction treatment program following detox to provide a full continuum of care.
When choosing a detox program, families and individuals should seek out a facility that feels right to them. The center should be sensitive to the family’s needs and requirements, and make the individual feel welcome.
The whole goal of detox is to provide a calm, stable, secure, and supportive environment while allowing drugs and/or alcohol to safely process out of the body. Detox provides an opportunity for the brain to heal, and a conducive environment can go a long way in helping with this.