The idea of using drugs to cover up the effects of withdrawal from other drugs seems redundant. It may seem as though we are fighting fire with fire, but that is precisely the case. Medication-assisted treatment (MAT) during detox is not just designed to allow the client to feel comfortable, but the reality is that it is much safer. The medications are designed to address and treat some of the worst symptoms and minimize the effects. Many avoid stopping drugs like heroin because of the serious side effects, and having drugs to treat symptoms at your disposal takes the fear out of the detox process.
Withdrawal is viewed as unpleasant, but it is much more than that; it can be downright dangerous. These medications allow for a more predictable outcome and manage the symptoms more effectively to take away the life-threatening aspects of withdrawal.
The U.S. Food and Drug Administration (FDA) has approved several different medications that were created for medical detox that treat prescription opioids down to over-the-counter supplements. Detox medications are administered to negate withdrawal symptoms that are common in most substances such as:
Detox medications also wean the client off the substance they have become addicted to. It is done by slowly tapering the dosage as opposed to abrupt cessation. The method, known as “cold-turkey,” brings an added risk of life-threatening symptoms or seizures — those who go cold-turkey increase their odds of relapse, which can lead to an overdose.
Over-the-counter medicines have proven to be effective in treating specific ailments attributed to addiction. For example, the medication Dramamine is useful to treat nausea, while Tylenol can be used for aches and pains, while natural supplements such as melatonin treat insomnia. The detox process will be different based on the type of drugs used and from person to person, and anti-depressants can also be utilized to combat depression and suicidal thoughts.
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While opioid detox is not necessarily life-threatening, that doesn’t indicate the discomfort that will be experienced during withdrawal. The symptoms are often so severe that it will lead back to drug-seeking habits, and in some cases, it could push someone to use a stronger opioid than they were initially using, which can lead to an overdose. The fear of being sick drives individuals from seeking help. If you do not attend detox for opioid withdrawal, you can expect some of these symptoms:
All withdrawals are not equal, and someone stopping codeine will not experience the same adverse effects as someone coming off heroin. Even mild withdrawals can detract from the objective of attaining sobriety. The detox medication that professionals administer is weaker opioids to cope with the cravings, curb the sickness, and simplify the weaning process. It makes withdrawal symptoms more tolerant, and the client will have an easier time transitioning to sobriety.
Methadone is a synthetic, narcotic analgesic that is used in heroin addiction treatment. The drug shares the same characteristics as morphine, but the substance has a gradual onset of action that prevents users from getting intoxicated and experiencing euphoria.
Methadone is medically useful due it its long-half life and can remain in the body from 15 to 55 hours. The length of time in your system will vary based on dose, but when treating heroin withdrawal, it helps by taking up space in the opioid receptors. Methadone’s objective is the replacement of opioids the person had been consuming and then following that by lowering the dose of methadone slowly and methodically. Since methadone does not provide euphoria, there will not be cravings when someone weans off.
Methadone has a long history of effectiveness when used with counseling, but is a controversial means of treatment because of its abuse potential. It must be carefully monitored when used during detox, but its proven history of success is why it remains an option.
It is often seen as the last case scenario depending on the severity of someone’s addiction.
Buprenorphine shares similarities to morphine, but the difference is that buprenorphine is a partial opioid antagonist, which is defined as something much weaker than a full agonist opioid. The potential for abuse is even less than methadone.
In short, it works similarly to methadone by taking up space in the opioids receptors to decrease the withdrawal symptoms. It blocks the euphoric effects associated with opioids for up to 24 hours.
Although the risk for addiction is less likely, there still are individuals who abuse the drug, and it does hold some risk of dependency. It should be monitored closely by those who administer the substance.
Suboxone is a brand version of buprenorphine and naloxone. Naloxone, also known as Narcan, is much too strong to be used on its own, but it is considered a full opioid antagonist, which negates the effects of opioids entirely. The reason it is not used alone is that it triggers immediate and intense withdrawal symptoms. The purpose of suboxone is to combine the most useful parts of the two drugs to create a reversal medication that cannot be abused.
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Benzodiazepines, alcohol, and barbiturates are all classified as central nervous system (CNS) depressants; abrupt cessation of these substances can lead to dangerous, and potentially life-threatening symptoms. These risks mean medical detox must be considered when getting on the path toward sobriety. Not only is medical intervention the safest way, but it will alleviate the dangerous symptoms of withdrawal. Some of the most common withdrawal symptoms from alcohol, benzos, and barbiturates include:
Benzos are often used in treating dependence on alcohol as well as other benzos. In cases of alcohol, Valium is used to sedate and ease anxiety as an anticonvulsant. It carries a low risk for adverse interactions with the former user. As with most drugs, it is most useful to taper off as opposed to quitting all at once. By doing so, it allows the central nervous system to regain functions slowly as opposed to all at once. It is a sensory overload for the brain to stop at once; doing this slowly must be done in a controlled environment because of the risk of abuse and addiction.
The process of detoxing for stimulants is different than the other drugs on this list. The reason for this is that stimulants are psychological and mood-based, and they carry the same effects as heroin or opioids.
Stimulants affect dopamine, which is the brain chemical responsible for regulating emotions, cognitions, and feelings of pleasure. Common stimulant withdrawal symptoms are depression, anxiety, insomnia, but more several withdrawal symptoms may include:
There are no medications specifically designed to treat stimulant withdrawal, but a majority of detox centers will provide anti-depressants, muscle relaxers, and modafinil, which treats sleep disorders among other medications.
Kleber, H. D. (2007, December). Pharmacologic treatments for opioid dependence: Detoxification and maintenance options. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202507/
Hartney, E. (n.d.). What Are the Risks of Quitting Substance Use Cold Turkey? Retrieved from https://www.verywellmind.com/what-are-the-risks-of-quitting-cold-turkey-21813
Methadone. (n.d.). Retrieved from http://www.cesar.umd.edu/cesar/drugs/methadone.asp
Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from https://medlineplus.gov/ency/article/000949.htm
National Institute on Drug Abuse. (n.d.). Pharmacotherapies. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies