Are there Outpatient Drug Detox Centers?
There are a lot of reasons outpatient drug detox centers exist, today. Beginning with the changing patterns of substance abuse and the detoxification needs accompanying them, the changing concepts of treating addiction as a disease have led to many improvements in the strategies used in outpatient drug detox treatments.
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What is an Outpatient Drug Detox Center?
Traditionally, there has been an assumption that certain treatment could only be delivered in a particular setting and people who sought drug detox services expected to remain in a drug detox center for several days, but, these assumptions, according to the Substance Abuse and Mental Health Services (SAMHSA), “may not be applicable or valuable to patients. Clinical judgment and consideration of the patient’s particular situation are required for appropriate detoxification and treatment.”
Because the choice of a treatment setting and intensity of treatment (level of care) are so important, new methods have been devised by the American Society of Addiction Medicine (ASAM) to match patients with the appropriate settings and levels of care. Accordingly, outpatient drug detox centers provide a level of care without extended onsite monitoring which can be delivered in a variety of settings allowing the individual to be treated with the least restrictive care that interferes with their civil rights and freedom to participate in society.
This means that outpatient drug detox centers can provide detox services where the individual can remain at home and continue working or performing other obligations in society without having to give up those activities while they are receiving the treatment.
How Do Outpatient Drug Detox Centers Work?
Outpatient drug detox may be delivered in an office setting, healthcare center, addiction treatment facility, or in the patient’s home by trained and qualified clinicians who can provide medically supervised evaluations, detoxification, and referral services according to a predetermined schedule of sessions.
The patient may spend one or two days at a facility receiving medications to assist with the acute withdrawals and be able to return home with medications after reasonable safety measures have been planned. Depending on their withdrawal potential and conditions; and the policies and procedures of the outpatient drug detox center, some patients may return home immediately with a schedule of ongoing detox treatment session plans.
During the ongoing sessions, the patient’s progress will be determined, medications administered and evaluated for the effectiveness, use, and safety along with any take home or prescribed medications, and they will receive counseling, referrals, and other services to promote ongoing recovery and treatment. The sessions may be scheduled daily, several times a week, or weekly with a gradual reduction in medications over a set period of time.
Who Benefits from Outpatient Drug Detox Center Treatments?
A successful detox involves the components of evaluation, stabilization, and fostering a patient’s entry into treatment. Outpatient drug detox centers work well for those individuals who have:
- A readiness for change
- A positive, safe, and supportive living environment
- A will to be compliant with the detox treatment procedures, policies, and management of medications
- Based on their physical and psychological health conditions, relapse or continued drug abuse problems, a safe withdrawal and stabilization potential
- Ongoing commitments regarding family, work, or social obligations
“As treatment regimens have become more sophisticated and polydrug abuse more common, detoxification has evolved into a compassionate science.”
It is important for substance abuse treatment providers to foster the patient’s recovery in the most effective manner by keeping them engaged in the process and treating them with the similar compassion afforded to patients suffering from other chronic diseases. Patients are often treated with medications to ease the discomfort of withdrawals from the drugs under this concept.
Medically supervised detoxification is considered an effective clinical protocol that helps to facilitate the patients into treatment and recovery. Retention in treatment, engagement in treatment processes, and comfort are some of the most beneficial aspects of medication assisted therapies and a primary service of many outpatient drug detox centers.
Medications for Opioid Addiction
For the treatment of opioid addiction, the most common medications used in an outpatient drug detox program are buprenorphine, methadone, and naltrexone. Buprenorphine and methadone reduce cravings and withdrawals for illicit opioids up to 24 to 36 hours or more, while blocking their effects to deter abuse. At appropriate doses, these medications do not produce euphoria and sedation like other opioids allowing the patients physiological processes to rebalance with improved function abilities.
Naltrexone is an antagonist drug that precipitates sudden opioid withdrawals and requires admission into a facility that can monitor the process and immediately respond to any complications. Vivitrol is an extended release injectable medication containing naltrexone that may be used to prevent relapse, but, it is recommended for use only after opioid detoxification, unless otherwise determined by the physician.
Medications for Alcohol Dependence
Vivitrol is also used to treat alcohol dependence. Campral, a generic brand of Acamprosate, can help to restore more normalized brain activity in people who have drunk excessively, although it does not prevent withdrawals. To help with anxiety, tremors, and insomnia, benzodiazepines such as Librium or Klonopin may be used.
Medications for Other Substances
For benzodiazepine and stimulant addictions, there are no standard medications to help alleviate withdrawals. The drug detox center may prescribe Clonidine, to lower blood pressure and help to calm individuals or use a mild benzodiazepine during the acute withdrawal stage.