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Pros and Cons of Inpatient Detox

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There are several pros and cons of inpatient detox. Inpatient detox offers 24-hour care and a structured environment that separates you from your drug-using environment. However, inpatient programs tend to be more expensive than outpatient due to room and board.

Pros and cons of detox treatment options.Substance addiction is a complex condition with numerous medical, physical, and social components which can affect the course of treatment and recovery. In many instances, the first stage of treatment for addiction is detoxification. Professional detox programs help people safely and comfortably withdraw from drugs or alcohol while providing or arranging for treatment for any co-occurring medical or psychiatric issues.1

There are many detox options, and different programs will vary in both level of intensity and treatment setting. Inpatient programs able to provide around-the-clock detox treatment and supervision rank among the most intensive of all detox options. While many people prefer this highly-structured environment, others may prefer outpatient, which allows them to live at home while continuing working or attending school. In order to discern whether inpatient detox is right for you, you’ll want to weigh the pros and the cons.

What is an Inpatient Program?

Evaluating your options.

Inpatient detox programs provide around the clock supervision for someone who needs to safely withdraw from drugs and/or alcohol. Detox usually lasts anywhere from a few days to several weeks, depending on the substance, the severity of the addiction, and the individual’s mental and physical health. The primary goal of detox is to manage withdrawal symptoms as people move toward a stable, drug-free state. In addition, inpatient detox programs can provide treatment for any co-occurring physical or mental health conditions which may worsen when a person is going through withdrawal.1

There are two main types of inpatient detox: social and medical.

Social detox is a type of program that provides room and board, social support, and limited medical oversight. Facilities with limited medical oversight must have a set procedure they follow in the event of medical complications or emergencies. This means that they must refer patients to a proper medical setting that can adequately intervene before being returned to the social detox setting. Social detox is not advisable for everyone. It’s important that you receive an evaluation from a doctor before entering a social detox program. A doctor can determine your risk of experiencing a complicated withdrawal and refer you to the appropriate level of care.2

In some cases, medical detox is a safer option. Doctors and nurses are available around-the-clock to provide onsite supervision, care, and monitoring. During medical detox you receive medications to relieve withdrawal symptoms.2

Medical detox is appropriate if you:2

  • Are addicted to alcohol, sedatives, or opioids.
  • Have had previous withdrawal experiences.
  • Are currently in active withdrawal.
  • Are currently intoxicated.
  • Have a co-occurring medical and/or psychiatric disorder.
  • Have a history of seizures or delirium tremens.

Some specific forms of substance dependence have established medications that are effective in reducing associated withdrawal symptoms and cravings. During medical detox from alcohol, for example, you may be given benzodiazepines, which have a similar mechanism of action on the brain’s GABA neurotransmitter system. Through their inhibitory actions in the brain, benzodiazepines can help to prevent severe complications, such as seizures, and they will be gradually tapered off over the detox period. Other medications, such as methadone and Suboxone, may be used to manage opioid detox.2 Not every abused substance has a medication specifically approved to manage an accompanying withdrawal syndrome, but other supportive medications can be administered to help treat various symptoms and address co-occurring disorders.

Regardless of whether you enter a social or medical detox program, there are definite advantages to receiving 24-hour care in an inpatient facility.

What Are the Advantages?

Getting assessed before enrolling into a program.Inpatient detox is not necessary in all cases of detox and withdrawal, particularly if your addiction issues are relatively mild and/or uncomplicated—e.g., you have good overall mental and physical health, less severe physiological dependence, and strong supports at home. However, if your doctor determines that you need inpatient detox based upon your substance abuse history and other factors, you should be aware that there are some distinct advantages to an inpatient detox, which include:1

  • 24-hour oversight and supervision.
  • Easier access to medical and mental health services.
  • Removal from a drug-using environment that may tempt you to relapse.
  • Increased ability to receive acute medical interventions in the event of dangerous withdrawal symptoms.

While these advantages are important to consider when exploring your options for detox, it should be noted that there may be some cons, though most of these are relatively easy to manage if you do need an inpatient detox program.

Are there Disadvantages?

Your doctor and other medical professionals who assess your individual case will help determine the appropriate type of detox for your situation. In some cases, inpatient detox may be needed for you to safely and successfully detox from substances, despite your preferences for treatment setting. Treatment in an inpatient setting may introduce certain challenges, however the advantages of an inpatient detox may far outweigh the disadvantages, which can include:1

  • High cost compared to outpatient detox.
  • Possible overdependence on 24-hour staff presence.
  • Inability to care for family or work at your job while receiving inpatient detox services.

The most important factor when considering a detox program is your safety, regardless of the possible disadvantages involved. If you are in need of inpatient detox, these cons can be managed, such as finding ways to pay for an inpatient program, or making arrangements with your job or school to take the days off you need. You may also arrange for someone to help care for your family while you get the help you need to withdraw safely.

Determining the Appropriate Level of Detox

There is no way to determine an appropriate level of detox for your situation simply by reading about detox options. Speak with your doctor if you believe you are dealing with an addiction and would like to seek help. Your doctor can provide the appropriate assessment to determine which type of detox is best for your situation.

Some of the factors your doctor will assess include:2

  • General health history.
  • Your vital signs, such as temperature, blood pressure, and pulse.
  • Severity of addiction.
  • Addiction to multiple substances.
  • Underlying mental health disorders.
  • Co-occurring medical conditions.
  • Social support availability.
  • Financial and living situation.
  • Violence and suicide risk.
  • Previous attempts at detox and recovery.

Getting consulted before enrolling into a detox program.If you are addicted to alcohol, sedatives, or more than one substance, an inpatient detox program may be the safest option for you. Inpatient is often recommended for someone addicted to an opioid, such as heroin or prescription painkillers, as well.2 Furthermore, if you have a history of depression or suicidal thoughts, your emotional well-being and safety are strong considerations for your doctor when making a decision to recommend inpatient detox.

If you are struggling with addiction, reach out and talk to your doctor, therapist, or other addiction treatment specialist to get help. Their professional evaluations will help best determine the level of care you need based on many factors. Do not let your worries or uncertainties about the type of detox treatment you may need stop you from reaching out for assistance.

Sources

  1. Hayashida, M. (1998). An overview of outpatient and inpatient detoxification. Alcohol health and research world22, 44-46.
  2. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. 

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