Detox Options 

Recovery always begins with getting the drugs out of our system, and getting the brain back to normal in terms of functioning. There are many ways to do this; none are simple, most are quite unpleasant, some are frankly dangerous. Following is a brief overview of the three main options currently available for detoxification- getting the drugs out of the brain, and allowing the brain to heal and return to more normal functioning.

"SOCIAL” OR UNAIDED DETOX- “GOING COLD TURKEY”

“Social Detox” basically means doing nothing- just quitting and waiting for something to happen while being “talked through” the very unpleasant detox experience by a community of supporters who’ve been through it before. But unfortunately, “Something” almost always does happen. The drug-adapted brain is very unhappy when the drugs it now depends upon simply to feel “normal” are suddenly removed.

The opposite effect of the drug in question will now be seen. If we’re dealing with a depressant, such as alcohol or valium, the result will be brain hyperactivity; a depressed brain unleashed in a storm of autonomic hyperactivity including brain seizures, tremulousness, extreme anxiety, and fever. For stimulants such as speed or cocaine, the result will be the opposite of stimulation and euphoria- deep depression and dysphoria, and especially in the case of methamphetamine, prolonged periods of sleep and ravenous hunger, sometimes lasting for several days.

With opiates, we see the opposite of euphoria and well-being; the opiate withdrawal syndrome (“dope sickness”) is best described as feeling horrendously miserable and is characterized by yawning, bone and joint pain, cold sweats and “goose flesh”, diarrhea, and an indescribable horrible feeling unique to that class of drugs. You wish you would die, but you don’t.

Alcohol withdrawal-the DT’s, or “delirium tremens”- can be quite dangerous and people die from it. Other specific drug withdrawal syndromes may just be very unpleasant, if not horrible.

In summary, going “cold turkey” is not fun. The overwhelming desire to end the misery of withdrawal by having a drink or fix is what makes this method of detox so very ineffective. The only addicts who will be successful in going “cold turkey” are those in jail or on a desert island when their drug or alcohol supply runs out, and there's NO WAY they can get their hands on any drug. And God have mercy on them!!!

Going Cold Turkey is bound for failure. Social detox is pretty much that, and does not take advantage of modern medical options that make detox both safer and less uncomfortable. It’s miserable and can be dangerous. Our recommendation: Don’t do it.

MEDICALLY-ASSISTED DETOX

Medically-assisted detox is the most common technique of drug and alcohol detox currently in use. Simply described, the central concept here is a slow, calculated, medically assisted weaning process while the drug-adapted brain gets used to the absence of drug.

Back in the "olden days", and before the availability of prescription medications, alcoholics in withdrawal were given a beer or a shot of whisky- or what ever it took, to “calm down the nerves”. Additional shots were given periodically over the ensuing days to manage the severe tremulousness, hallucinations, and to prevent withdrawal seizures. Simple, but it worked. Crucial to this process was MEDICAL OVERSIGHT, where control of the alcohol given to the withdrawing alcoholic was controlled by another person, and NOT by the alcoholic. Self-detox does not work.

Today, a host of medications are available to substitute for the drug in question, and are used for medically-assisted detox. Examples include methadone, suboxone, benzodiazepines, and a host of others. Regardless of drug or medication used, the concept there is the same; gradual, supervised weaning of a safer substitute drug over a matter of days rather than suddenly. The drugs and medication used for a given addict will depend upon the drug or drugs of addiction.

The problem with medically-assisted detox is that the brain is still not “normal” fully healed at the end of a 3-7 day medically-assisted detox. Full normalization takes yet more weeks, months, even years for optimal outcome. Sometimes damage remains permanently.

Medically-Assisted Detox is much safer than cold turkey, and it IS humane- but it has inherent limitations. TRIAD offers traditional medically-assisted detox options, and in particular for alcohol, where benzodiazepines (Valium, Ativan, others) are the mainstay of therapy. Medical detox for alcohol may be a good option for alcoholics whose level of physiologic dependence is moderate to light.

BRAIN RESTORATION THERAPIES FOR ADDICTION: NTR™ AND PROMETA™

NTR™ or Neurotransmitter Restoration Treatment, and Prometa™ (Hythiam, Inc.) are two recently-available medical treatments for addiction that go well beyond simply easing the speed and discomfort of withdrawal. Keep in mind that the drug-adapted brain has been bathed in drugs continually for months or years; the brain has changed and it does not function normally. Under normal circumstances it take months or years for those changes to revert to it's original healthy, pre-drug state or close to it.

NTR™ and Prometa™ both stimulate the brain cells and synapses to much more quickly revert to normal. This process is what is referred to as "brain restoration" treatment. They differ in how they accomplish this brain repair process, but they each appear to lead to a similar end result. Both techniques do the following:
o Ease the discomfort of withdrawal
o Speed up return of normal brain function
o Decrease or eliminate drug cravings.
All three benefits must be considered HUGE.

For decades science has been searching for a truly effective treatment for the physiologic (medical) aspects of drug addition. We have now found it in NTR™ and Prometa™. Brain restoration treatment for addiction is revolutionary and is bound to change the entire approach to treatment of drug and alcohol addiction.

SUBOXONE DETOX FOR OPIATES

A special form of medically-assisted detox solely for opiate addiction uses a wonderful newer drug, Suboxone™, which is a trade name for buprenorphine and which also contains a small amount of the opiate blocker, Narcan, for safety and street diversion avoidance purposes. Suboxone has largely replaced methadone as the drug of choice for detoxing heroin and prescription pain medication addicts.

Suboxone™ may be used either for full detox, ie, to wean the addict completely off all opiates, or for so-called “maintenance” or substitution therapy. While it is FDA-approved for detox only, fact is that it has become widely used “off-label” for its powerful and effective cravings-reduction properties.

Detoxing off opiates with Suboxone™ has been described by many as “coming down with a gentle parachute ride”, as opposed to a thunderous and prolonged, painful crash when going “cold turkey” - or even when using methadone as a detox aid by substituting it and then gradually weaning off completely over 3-5 days. Suboxone™ is a god-send for many opiate addicts and has revolutionized opiate detox.

Another nice advantage for Suboxone™ is that it can be provided in a convenient doctor’s office outpatient setting, as opposed to methadone. Methadone is still highly controlled by the DEA for use in addicts, and must be obtained in a licensed methadone clinic when being used as a maintenance drug. Suboxone™ is unique in having essentially no euphoric effects, and street diversion is limited to those who wish to obtain it primarily for self-detoxification purposes. But as with any drug, addicts have TRIED to get high on it and to abuse it, usually with great frustration since nothing happens, at least no euphoria. On the contrary, Suboxone™ leaves the addict with a clear mind, and does not affect judgment, thinking, or cognitive function.

A relative downside for Suboxone™ is that, by comparison to methadone, it is quite expensive, and must be obtained by a specially-credentialed physician who is trained and authorized to prescribe it. TRIAD offers Suboxone™ detox, both as an outpatient, and in a residential setting for those whose tolerance levels are extremely high and who are at risk for “precipitated withdrawal” due to it’s inherent opiate blocking properties, the only major adverse reaction that can happen with Suboxone™. For the latter reason (precipitated withdrawal), it is imperative that Suboxone™ be administered by a skilled physician whose judgment is keen as to how to use it and best avoid precipitated withdrawal.


WHICH DETOX IS RIGHT FOR ME??

First, don’t even think about going “cold turkey”. Not only is it unpleasant (miserable!), but it can be dangerous as well. Alcohol withdrawal is the worst; delirium tremens (“DT’s”) has a mortality rate of up to 20% even today when seen in its full-blown presentation. This having been said, a well-run social detox setting may be adequate for those alcoholics or addicts whose active use is remote, or whose drug tolerance levels are low. Stimulant addicts (cocaine; methamphetamine) may also do well in social detox, since the accompanying withdrawal syndrome often does not require adjunctive medications.

The real choice (including opiate addicts) really comes down to making a determination between medically-assisted detox and brain restoration: NTR™ or Prometa™ These differ only in the types of medications or substances used to invoke the “repair phase” in the brain’s cells and neuroreceptors.

AS noted above, brain restoration accomplishes 3 key things: 1) Reduces or eliminates drug cravings 2) Speeds up return of more normal brain function (cognition), and 3) Markedly eases the discomfort of the withdrawal phase (detox). There is no better way to begin the long road to recovery than brain restoration; it allows for much earlier cognitive interaction during rehab treatment. And without the constant obsession of drug cravings it’s much easier to focus on other things besides using drugs.

For many, medically-assisted detox may make the most sense, especially if it’s the first attempt to get clean and sober, and if the addict’s “drug load” (physiologic drug tolerance) is moderate to light. It is more affordable and many insurances pay for drug and alcohol detox as a covered benefit. Today there are many medications, specifically including Suboxone™ for opiate detox, that make removing drugs and alcohol from the system more bearable. The key after that is STAYING clean and sober.

NTR™ and Prometa™are especially well-suited for chronically-relapsing alcoholics and drug addicts who have tried just about everything else that is available, and have failed the usual “detox and rehab” route on several occasions.

Brain restoration is very new on the scene; it is expensive, however. Most insurances do not yet cover the cost. Reason for the latter is that both of these exciting and more definitive addiction therapies are very new techniques, and studies showing unequivocal benefit have not yet been completed and published. Many such studies are underway, and early results are very promising. It would be reasonable to expect that many insurances will begin to cover the cost of NTR™ and Prometa™in coming years as positive clinical studies weigh in.


CALL US AT 877.653.4431

TRIAD Treatment Center specializes in offering a wide variety of drug and alcohol detoxification options and brain restoration therapies. We are on the cutting edge of drug and alcohol detox, and our NTR™ and Prometa™ brain restoration therapies are likely to become standard of care in the very near future as the first step in the addiction recovery process.

Call us today at 877.653.4431 to speak to our Intake Coordinator, and see what’s right for you.