Opiates and opioids are analgesic drugs that are most often used for pain management. The only opiates are heroin, morphine and codeine. Many narcotic pain medications are opioids, and include such drugs as:
The only illicit opiate is heroin. Opiates are extremely addictive and potentially harmful drugs. Individuals who abuse opiates are at a severely increased risk of developing an addiction to them, and once that happens, a trap is set for life, until such time that the addict is ready to accept help by first going through opiate detox, and following with an addiction treatment program.
Once an addiction has formed and an addict tries to stop using opiates, withdrawal symptoms can occur within 12 hours after the last dose. Withdrawal symptoms can vary from a mild discomfort to severe pain. Opiate withdrawal symptoms can include:
- High fever
- Muscle pain and spasms
- Intense cravings
- Severe agitation
- Cold sweats
- Goose bumps
These symptoms are not life threatening but can be extremely uncomfortable and seem unbearable for an opiate addict going through withdrawal. These symptoms can last up to a week and sometimes longer, depending on the individual, and the severity of his or addiction. The psychological withdrawal symptoms, such as intense cravings make it so that overcoming the urge to go back to using opiates is overwhelming for most addicts. When the withdrawal symptoms peak, most opiate addicts who are attempting to detox on their own find the cravings insurmountable and the motivation to continue with the detox gone, thereby resorting to use of opiates once again to find relief from withdrawal. It is for this reason, a detox facility is recommended for opiate detox, as within the walls of a detox center, there is no access to drugs, and addicts have supportive individuals who provide encouragement to get through the detox, and medications can be given to reduce the withdrawal symptoms.
According to United States Department of Health and Human Services, there are three steps in a drug detoxification process:
Before a detoxification program begins the patient’s blood is tested to identify the amount and types of drugs present in the body. The patient’s mental and behavioral issues are also evaluated.
This is the actual detoxification process that may or may not use medical assistance, depending on the individual’s health and possible complications resulting from co-occurring ailments. The patient is also informed on what to expect during treatment and given the details of the recovery process.
- Guiding Patients into Treatment
This is the last step of the detoxification process and where the patient begins the recovery process. Once the physical dependency to the drug has ended the patient needs to address the psychological aspects of the addiction. This stage is best addressed by enrolling in a drug treatment facility.
As with any detoxification program, the main goal is to minimize the symptoms of withdrawal from opiates, thereby decreasing the chance of relapse. John Saunders and Junkie Yang stated in Clinical Protocols for Detoxification that
“Detoxification can occur in multiple settings. There are home detoxification programs, ambulatory, hospital settings and treatment facilities. The amount of supervision each program provides will vary form low supervision to intensive supervision. Each program will also vary in the type of detoxification program they provide; whether they provide sedation regimes, supportive care or medical treatment. The type of program chosen will depend on the severity of the drug addiction and the likely withdrawal symptoms the patient will encounter.”
Detoxification settings are classified as:
- Drug Treatment Facility
Home detoxification occurs in the patient’s home with the assistance and supervision of a health care professional. Typically, the addict’s general practitioner is in charge of the detox program and will prescribe the required medication to help ease the withdrawal symptoms. A health care professional or registered nurse will make home visits to the individual to monitor the progress and administer any medication that might be needed.
Home detoxification is only recommended when the detox is anticipated to be without complications and where a low level of sedation is required. Home detoxification has limited supportive and medical care. The addict needs to have a stable home environment and to be motivated to overcome his or her addiction. If the withdrawal symptoms are too intense to be treated at home he or she should immediately seek alternative treatment or enter a drug treatment facility.
Ambulatory detoxification occurs on an outpatient basis through a local hospital or clinic. In order for an ambulatory detoxification program to be successful the addict needs to be self-caring and have reliable transportation. He or she will need to visit the hospital or clinic on a daily basis to receive medication and medical care. This type of detoxification program works best for those who have never had a history with addiction, and not severely dependent on the drug. If the withdrawal symptoms cannot be controlled through the daily visits to the hospital the addict should immediately enter into a drug treatment facility to complete the opiate detox process.
Detoxification can also take place in a hospital setting, where the addict is admitted and the medical staff helps manage and supervise the detoxification process. This type of setting is best suited for those who have a more severe drug addiction and/or failed to complete a home detoxification or ambulatory program. A hospital setting will have varying degrees of supportive care and can prescribe a wide range of medications to help ease the withdrawal symptoms.
Drug Treatment Facility
A drug treatment facility has a trained medical staff that will supervise and manage the detoxification process. This setting will assist addicts with the most severe withdrawal symptoms, and can treat any complications that may occur during the detox process.
There is a high level of supportive care and a wide range of medications can be prescribed to help ease the withdrawal symptoms. Those who are severely dependent on opiates and who have previously experienced complications with detox are highly encouraged to pursue detox in a drug treatment or detox facility.
Opiate Detox is Not the End of Addiction Recovery
No one approach to detoxification is guaranteed to be best for all addicts. A detoxification program does not address the psychological dependency, social factors or any behavioral issues that occur with a drug addiction. Detox is not a cure for drug addiction. For an opiate addict to fully recover from his or her addiction, a comprehensive drug rehab plan must follow the completion of any detox process in order to get to the root cause of his or her addiction and destructive behaviors. Counseling and therapy are crucial in the rehab process and will help addicts to understand their addiction and give them the foundation, empowerment, and tools they need to stay sober, and maintain their recovery. In order to be in recovery from addiction, every aspect of the process must be completed, from detox to addiction treatment, and the life-long adjustments to maintain sobriety.