Doc Talk: All About Detoxification By: Dr. Jason Powers Title: Chief Medical Officer, The Right Step and Spirit Lodge Info: Among the first doctors certified by the American Board of Addiction Medicine (ABAM). H Magazine Texas’ “Top Doc” in Addiction Medicine, 2007-2009. 2008 winner of Sierra Tucson’s Gratitude for Giving, Compassion Award. Dr. Powers, The Right Step Chief Medical Officer, has worked in addiction recovery for eight years and has helped The Right Step’s inpatient detoxification program reach out to, and reform, hundreds of addicts over the years. We asked him to share some information on detoxification for addiction victims and their loved ones.
Detoxification – The Basics
“Not all addicts require detoxification,” Dr. Powers says at the beginning of the interview. “Mostly, it’s required for [addiction to] alcohol and sedatives.” Detoxification from prescription benzodiazepines (“benzos”) such as Xanax®, Klonopin®, and Valium® can be fatal, according to the doctor. Detoxification from opiates may not be as life-threatening, but Dr. Powers calls it a “horribly wretched” experience. Most insurance companies cover the detoxification process because it can be life-threatening, as well as, a necessary first step on the road to recovery. Insurance companies know that if someone can get and stay sober it will reduce the company’s future costs considerably. However, some insurance companies do not cover opiate detoxification. Dr. Powers still feels that it can be an important step in the recovery process that should not be missed. The Right Step’s opiate detoxification program can provide aid and comfort to the patient during the unpleasant process. While detoxification can be a long process, depending on the substances in question, the primary segment people think of as “detox” is, in fact, the period of acute withdrawal.
The symptoms of acute withdrawal vary from drug to drug, as does the duration of the withdrawal. “The initial stages are the opposite of whatever the drug does to the person,” says Dr. Powers. “If it’s a sedative, like alcohol or anxiety medicines, the person’s going to feel anxious.” Alcohol detoxification may take three to five days, while opiates and benzos may take five to seven days or longer. It is important that adolescent alcohol and benzodiazepine addicts go through the detoxification process, which bears subtle differences from an adult’s, but, is generally similar in effect. The Right Step stands apart from other detoxification facilities because of the medical staff’s one-on-one attention to every patient. “Most [other facilities] are about the same,” because medical indications for detoxification are fairly clear. “I’d say the main thing that sets [The Right Step] apart is our attention to each individual and to detail.”
The second phase of a thorough detoxification program is called P.A.W.S.: Post-Acute Withdrawal Syndrome. After acute withdrawal ends, a The Right Step patient is enrolled in a treatment program that will carry them through the difficulties of P.A.W.S. “[Patients] might have pockets of time that can be misconstrued as acute withdrawal, but they are part of a normal healing process. As patients struggle to regain full control over their minds and bodies, they may feel hopeless, or like they are suffering from mental illnesses such as ADD, Generalized Anxiety Disorder, and others. The Right Step’s program provides hope by referencing those further along the path to recovery, as well as oversight by a caring and experienced medical staff. Detoxification is an important part of the recovery process for many, but Dr. Powers is quick to caution addicted people and their families that it is not the end of that process. “If someone is sick enough that they need crisis stabilization in terms of detoxification, then he/she needs treatment that follows,” he says. “What breaks my heart is when people come in or do detox somewhere else and they think it’s sufficient. They go right back with the same coping skills as before, and most of the time it’s disastrous.” Remember: Referring someone in need is a gift of compassion. For more information on admission to The Right Step, please click here.