Your ability to overcome an alcohol or drug addiction starts with carefully selecting a detox clinic that best meets your needs. A national survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that more than 24.6 million Americans engaged in illicit drug use at least once in the last 30 days.1 Many of them have become addicted to their drug of choice and need detox treatment at some point. When evaluating programs, among the factors to consider are program quality, staff training, and their ability to cater to your specific needs.
What Settings Can I Get It In?
The type of treatment setting you choose can positively impact your journey toward long-term sobriety. People vary in their response to detox, so multiple types of treatment settings are available to meet differing needs. The primary types of treatment settings are distinguished by the intensity of services provided: 2,3
- Physician’s Office: Some patients begin their detox process in their primary care provider’s office. When this happens, it is important for the practitioner to determine if it’s safe for them to go through detox on an outpatient basis. Outpatient detox treatment may be as effective as inpatient treatment in certain instances, such as when the patient’s withdrawal symptoms are mild and there is low risk for medical complications.
- Outpatient Treatment/Ambulatory Detox: This type of treatment offers regularly scheduled detox sessions in an office or clinic setting while you continue to live at home and engage in your daily activities. It is conducted by trained clinicians who provide medically supervised support that is tailored to your symptoms. Ideal participants for outpatient treatment are not at risk of severe withdrawal and have a stable and drug-free home life.
- Urgent Care or Emergency Department: Emergency departments and urgent care facilities can provide very short-term detox services to those in acute need. People typically go to the emergency department in a time of crisis, and they may go to an urgent care facility when they do not have or want to wait to see a primary physician. These options are not considered to be a complete solution because they don’t offer adequate psychosocial support that can be important in the detox process, and you may be referred to a more appropriate setting once your acute symptoms are stabilized.
- Medically Monitored Inpatient Treatment: In this setting, patients are provided around-the-clock care by doctors, nurses, and other medical professionals in a controlled environment. Since this treatment is costlier than others, it is typically focused on ensuring the patient is medically stable and then facilitating entry into other appropriate residential or outpatient treatment. Medically assisted detox involves the supervised administration of medications to help combat the withdrawal symptoms that often accompany quitting drugs or alcohol. Medications are prescribed by a trained medical doctor who supervises the detox process and monitors your vital signs. The type of treatment medications you might receive varies depending on the type of substance you’re dependent on.
- Intensive Outpatient (IOP) and Partial Hospitalization (PHP): These programs offer organized outpatient services that typically work closely with medical partners who can provide clinical care for all levels of detox. PHPs and IOPs are more intensive (as their names suggest) than standard outpatient detox, but present a less intensive option to inpatient detox.
There are several assessment factors that medical professionals will consider when deciding which type of detox setting is best for you:3
- Are you currently intoxicated or experiencing withdrawal symptoms?
- Do you have any pre-existing medical complications that may impact treatment?
- Do you have any behavioral, cognitive, or emotional disorders?
- Are you ready to make a lifestyle change?
- What is your relapse potential?
- Does your environment at home or work help or impede treatment efforts?
Generally speaking, inpatient detox is a good choice for people with pre-existing medical conditions or a history of repeated relapse. It is also a safer choice for those who are at risk of experiencing severe or complicated withdrawal or who are addicted to multiple substances. Outpatient treatment is more appropriate for people at low risk for severe withdrawal symptoms and who have a strong social support network.
What Are Good Detox Programs Like?
The best detox programs foster a commitment to sobriety and provide you with a foundation to benefit from ongoing substance abuse treatment.
Other hallmarks of effective detox programs include:4,5
- Services are available immediately. Substance abusers are often reluctant to seek help for their disorders—they may procrastinate and lose motivation, so it is imperative that a detox program have immediate resources to accommodate someone ready to get help. The inability to begin treatment right away often gives people time to rethink their decision or abandon the idea altogether.
- Multiple types of detox services are available. There is no single universally effective detox process. So rather than using a one-dimensional approach, the best programs offer a variety of services and interventions to optimize the odds of successful detox, including medical interventions, individual therapy, group therapy, and relapse-prevention therapy.
- Staff are properly trained and certified. Doctors, nurses, and support staff who provide detox care should possess the specialty training required to treat substance abusers. Certification is recommended to facilitate treatment results, including a Certified Addiction Specialist (CAS) who must receive specialized training and pass a written examination. All National Certified Addiction Counselor (NCAC) candidates must meet minimum education requirements and complete at least 3 years of supervised experience as a Substance Abuse Counselor. This type of certification is offered by the Association for Addiction Professionals (NAADAC).6,7
- The facility uses evidence-based treatment protocols. Research supports the effectiveness of evidence-based treatment programs, especially when combined with behavioral treatment interventions. Programs that employ experimental procedures and practices typically lack longevity and scientifically proven effectiveness, so they are usually not supported by insurance providers. When evaluating detox programs, be sure to inquire about treatment methods and their effectiveness.
- There is a strong focus on securing high-quality aftercare. A well-planned aftercare plan is the cornerstone of long-term success for a detox program; failure to develop one can reverse the progress made during detox. And while detoxification is a vital first step toward sobriety, long-term recovery is best pursued through programs that involve a comprehensive approach that emphasizes continuing care.5 Effective detox programs usually include the following prior to completion: a formal assessment; a referral to a drug addiction treatment specialist; and discussion of the proposed course of treatment with you and your support network.
- The facility has been inspected and accredited. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) conducts inspections of healthcare facilities in the United States and requires detox centers to adhere to stringent operational standards and safety guidelines to receive accreditation. As you evaluate centers, ask to see evidence of their recent industry accreditations and certifications.
- Industry reputation. In addition to seeking accreditation from regulatory organizations, top treatment centers conduct their own regular internal audits. Before you commit to a program, ask for references, check online review sites, and seek feedback from your primary care provider or another healthcare professional you know and trust.
What Else Should I Consider?
After deciding on a type of treatment and the most appropriate setting, consider these other factors:
- Special needs. Many people enter detox with problems that accompany their substance abuse disorder, which can affect treatment outcomes and should always be considered during the treatment planning process. Examples of additional conditions that those with addiction may have include:
- Vocational difficulties.
- Relationship challenges.
- Physical health complications.
- Dental health problems.
- Legal concerns.
- Mental health issues, such as depression, anxiety, or personality disorders.
- The location of the facility. A detox program’s location should be considered for several reasons. Parents of adolescents who need detox often prefer programs that are within driving distance of their homes for easy visitation. Conversely, remote locations can separate people from some of the negative influences that contributed to their substance abuse in the first place.
- Personal preferences. Some people seek a detox environment that closely aligns with their values or preferences, such as preferring to receive care in a gender-specific environment or one that focuses on faith-based treatment.
- Type of drug addiction. Consider whether the facility has expertise in treating people with addictions to your drug(s) of choice.
- Your age. The detox needs of people who abuse substances vary with age. This is especially true for adolescents who sometimes abuse different substances than adults and who often lack the self-awareness that accompanies adulthood. Additionally, parents seeking detox for their adolescent children typically prefer a highly supervised environment.
- Comfort and compatibility with staff. One of the most important variables to consider is trust. If you do not feel comfortable during detox treatment, your likelihood for success is reduced. Staff who are empathic yet firm can help build a relationship of trust, which, in turn, enables you to focus on achieving recovery.
- National Institute on Drug Abuse. (2015). Nationwide Trends.
- National Center for Biotechnology Information (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
- National Center for Biotechnology Information. (2006). Treatment Improvement Protocol (TIP) Serie, No. 45.
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
- National Institute on Drug Abuse. (2016). Understanding Drug Abuse and Addiction: What Science Says.
- American Academy of Healthcare Providers in the Addictive Disorders. (2017). Certification.
- Association for Addiction Professionals. (2017). Certification.