When most people think of detox it can conjure up images of yoga mats, smoothies and sweat lodges. It invokes thoughts of someone cleansing themselves from a toxic substance. In a medical sense, however, it is the process of giving medical treatment to someone in order to remove the effects of poisoning from drugs or alcohol. There are different approaches to detoxification dependant on the substance of misuse. A detox program is designed to support and guide you through the withdrawal process and ease the symptoms as well as care for any medical and health issues.
When using a mind-altering chemical over a period of time the body and brain get used to having that substance in your system. The feedback systems that are present in the body change in order to compensate for the effects of this substance. Through this process, individuals can gain a tolerance for the effects of a substance and therefore need to take more of the substance to get the same effect.
Through this tolerance and increased usage, a dependency can occur. This means that when individuals attempt to stop taking the substance, they experience withdrawal effects. These withdrawal effects differ dependant on the substance used but can be very uncomfortable and in some cases life-threatening.
An example of this dependence and subsequent withdrawal can be described when looking at alcohol dependence. Alcohol has a depressive effect on your system. Brain function slows down and this affects the way the nervous system sends messages around the body. The body works harder to keep the brain in a more awake state and to keep the nervous system communicating effectively. If alcohol is then suddenly stopped the brain stays in this hyperalert state which causes the withdrawal symptoms.
These symptoms include anxiety, shaking hands, headache, nausea, vomiting, insomnia, sweating and potential hallucinations.
When in alcohol withdrawal, the individual can also experience seizures, which can have serious consequences. The effects of withdrawal on the brain can be significant, another consequence being delirium tremens also called the DTs where people can experience vivid hallucinations and delusions. As alcoholism is a disease of the brain this is hardly surprising.
Dependency describes a process where due to the body needing higher doses of a substance to get the same effect, the body systems come to depend on having the substance in the system to keep things functioning normally. This is the key difference between abuse and dependency. When someone is dependent, they experience uncomfortable symptoms when they stop taking the substance, they have become addicted to. Therefore, in order to stop taking the substance medical assistance is needed such as alcohol detox. Often a substitute drug that works on the same receptors of the brain is used is used to be able to enable this withdrawal process safely.
The words “abuse” and “dependence” describe a destructive relationship to alcohol or drugs. In fact, health professionals and addiction specialists make a distinction between abusing a substance and becoming dependent on it.
Often in popular culture and present in a lot of the population’s perceptions, drug and alcohol use is seen to be caused by individuals not having the willpower to stop using. In fact, people try to go “cold turkey” in order to stop using. This could have significant medical complications and can even put an individual’s life at risk.
In order to stop taking a substance that you have become addicted to; medical help is often required. It is important to recognise that addiction is a disease of the brain. If people could just choose to give up on their own, they would. Even faced with extreme consequences both socially and physically, making the changes can seem impossible. There are complicated mechanisms hard at work inside the brain of someone caught in an alcohol addiction, which can make this process very difficult.
A detox program is designed to provide support and to guide through the withdrawal process. It is designed to ease symptoms and to provide care for any medical and mental issues.
There is a distinction between fixed-dose detoxification regimes and symptom-based detox regimes. A fixed-dose regime is written at the point of assessment by the prescriber. The prescriber will ask the client how much of the drug/alcohol they have been using and then write a detox regime based on that information.
The main issue with this approach is it doesn’t consider how much people under or overreport their use. An individual can sometimes over report in order to be prescribed more of the substitute drug in the misguided belief that this will make the detox easier for them.
But in fact, the vast majority under report their usage. This is linked with the shame and guilt that people feel around their substance misuse. Also, people can be in denial around their usage, if they have been keeping to a narrative in order to hide their shame, then it can become difficult for the individual to accept this narrative isn’t accurate.
A symptom-based detox is a detox that is monitored by medical professionals. The detox dose and rates are informed by the symptoms that the client is experiencing. The client is closely monitored for withdrawal symptoms and the dose of medication is prescribed to meet the individual’s needs.
The benefits of this approach are that the client is receiving the amount of medication necessary. This prevents over-sedation from too much medication or discomfort from not receiving enough. When clients only have a limited time to engage in the necessary therapeutic work, the advantages of this style of detox is significant. This also is recommended by the NICE guidelines as best practice care. The medical team at Lovelong house take the symptom-based detox approach to care.
For more information on Lovelong Detox Packages, please contact us for a free assessment and further information.
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