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Detox is an essential part of substance abuse treatment, but it is not typically effective enough on its own, since it doesn’t address the underlying issues driving drug or alcohol abuse. Once detox is complete, many people are still at risk for relapse, which is why rehab is the crucial next step in the recovery process.
What is Detox & How Can it Help?
Addiction is a complex and progressive condition characterized by chronic substance abuse regardless of negative effects.1 After abruptly stopping the use of a drug, such as benzodiazepines, cocaine, heroin or alcohol, a person can experience unpleasant and, in some cases, potentially dangerous withdrawal symptoms. These withdrawal symptoms can make it difficult to quit using drugs and alcohol, as the user might relapse in an effort to alleviate the distressing symptoms.
Detox refers to a set of interventions that manage drug withdrawal symptoms and ensure comfort and safety. It typically serves as an individual’s first point of contact with substance abuse treatment but is not a substitute for comprehensive addiction treatment. Not all detox programs are the same—some utilize a medical approach, known as “medical detox,” while others are nonmedical and are referred to as “social detox.”2 Detox also occurs in various settings, such as in a hospital, as part of an addiction treatment program, in an inpatient detox facility, or in an outpatient detox center.
Evaluation: Testing is conducted to determine what kind of substances the person has been using. This helps the medical team decide what interventions are best. The assessment also includes information about the person’s medical, social, and psychological history. The evaluation serves as the foundation for the initial treatment plan.
Stabilization: The person is stabilized through the use of various interventions, depending on whether the detox program is medical or social in nature. Medical detox programs are likely to utilize medications and medical care to help the person achieve this state. Social detox programs instead rely on psychological and emotional support while the person withdraws form the substance. No matter which detox model is used, the aim is to achieve a drug-free, stable state.
Fostering transition to treatment: Since detox is just the first step towards sobriety, the detox treatment team will prepare the patient to transition into an addiction treatment program that can provide them with the therapy and counseling they need to remain sober.
Professional detoxification programs provide effective interventions to help people with addiction manage and overcome the initial challenges associated with stopping drug use, such as withdrawal symptoms and cravings. It can keep someone safe who is attempting to quit alcohol or sedatives, like barbiturates or benzodiazepines, since these withdrawal symptoms can be fatal. Medical detox can also increase the comfort of someone withdrawing from opioids, since these withdrawal symptoms can be rather painful and crippling. Detox rids toxins from your system; however, it does not address the problems or behaviors that led to substance abuse in the first place.
Detox, by itself, has limited effectiveness when it comes to helping a person achieve long-term sobriety. This is because detox doesn’t address any underlying or co-occurring mental health issues. That is why it is important to continue seeking help for your addiction by participating in a professional addiction treatment program. These programs help you address the problems that initially led to your drug or alcohol abuse, develop new coping skills to deal with cravings and triggers, and seek appropriate social support from family and friends.5
Studies have found that people who have follow-up care after detox experience better recovery outcomes. One study looked at data from five states and found that patients who participated in addiction treatment within 2 weeks after completion of detox were less likely to be readmitted to drug detox than those who didn’t receive follow-up treatment. This research suggests that rehab helps maintain abstinent for longer.6
What Does Rehab Entail?
Rehab can help you make positive changes that will prepare you for a life of sobriety. It helps you build the skills you need to live drug-free and avoid relapse.
The first step of rehab involves an intake evaluation. This assessment is typically performed by a substance abuse professional. During the assessment, screening tools will be used to help the clinician understand the nature of your addiction and how it affects your life. This information will be used to create your individualized treatment plan.7
Rehab varies depending on what type of program and treatment setting you’re in. There are also varying levels of treatment intensiveness.
Here are the most common types of rehab programs:4
Inpatient: Someone participating in an inpatient rehab program will receive 24-hour medical care and supervision. Interventions often consist of individual therapy, group counseling, family therapy, peer support meetings, and medication, if applicable.
Residential: These programs also provide around-the-clock treatment, but immediate access to medical services may be somewhat limited. Peer support is a major facet of a residential program.
Partial hospitalization: Partial hospitalization is a very structured outpatient program that is ideal for people with severe addictions who still wish to live at home. Partial hospitalization programs can last for several hours per day, every day of the week. Patients receive a combination of nonmedical and medical services.
Intensive outpatient: This type of treatment takes place in a community setting, such as at a clinic or addiction treatment center. Contrary to partial hospitalization, patients in intensive outpatient programs do not typically receive medical care. This type of treatment usually consists of 6 to 9 hours of therapy per week.
Standard outpatient: Traditional outpatient treatment is ideal for someone who has a job or attends school and who also has extensive social support at home. It is also more appropriate for someone who has a mild to moderate addiction. With this type of treatment, the person visits the treatment center or clinic to receive therapy for a few hours per week. It is the least intensive of the outpatient treatment program options.
Luxury rehab: These programs provide upscale amenities for those who want a more private or high-end treatment program. Many of these programs cater to celebrities and other well-known, affluent clients. In addition to drug and alcohol treatment, you’ll find things like plush bedding, gourmet chefs, private beaches, tennis courts, and gorgeous settings at these types of rehabs.
Holistic rehab: A holistic rehab is focused on treating the whole person. Comprehensive treatment plans are often used to treat the entire body. Things like yoga, meditation, acupuncture, and tai chi are commonly found in holistic-orientated treatment programs.
Executive rehab: These tend to be very private rehabs geared towards high-level executives. They offer a discreet environment for professionals that would like to continue working while in rehab. Some amenities include high-speed internet, private work rooms, and phone access. The surroundings are high-class and include things like golf simulators and luxury accommodations.11
No matter which setting you choose, you should receive treatment based on a customized plan for your needs. This plan will likely include a combination of therapies and treatments designed to meet your specific needs.
Individual drug counseling: This focuses on rectifying maladaptive behaviors, such as drug use. Therapists assist patients in building healthy coping skills to use when they experience cravings or triggers. Counselors also focus on addressing any co-occurring psychiatric problems that may have influenced substance abuse.
Group counseling: A substance abuse professional facilitates a group therapy session, in which patients can practice sober social skills and drug refusal skills.
Family therapy: A therapist facilitates a counseling session in which the patient and their family members learn healthy communication skills, as well as boundary-setting.
Drug education programs or classes: These classes provide the person with information about drugs and the harms associated with using them.
Peer support or 12-step meetings: Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are 2 of the most well-known peer support programs. They may be integrated into the treatment program.
Medication-assisted treatment (MAT): Medications, such as methadone and Suboxone, may be used in combination with counseling to improve treatment outcomes. MAT is typically associated with opioid addiction, although some medications are available to treat alcoholism.
Benefits of Substance Abuse Treatment
There are a variety of benefits of continuing with treatment after detox. Treatment can help you:13
Develop the skills necessary to avoid relapse.
Learn how to change negative thoughts and behaviors that lead to drug use.
Reach goals related to abstinence.
Build a secure and sober support network.
Learn how to cope with environmental triggers that lead to relapse.
Identify and address issues that might underlie substance abuse, such as mental health problems.
Rebuild relationships that were damaged as a result of drug or alcohol abuse.
Research has consistently shown that rehab is more likely to be useful when it is longer-term. In fact, most people that are addicted to drugs or alcohol require at least 3 months of rehab to stop using. Generally, the longer the length of treatment, the better the outcome.8 The first step in regaining control of your life is detox. After that, your treatment team can help you transition into a comprehensive addiction treatment program, which can help you build a strong foundation for recovery.