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Outpatient Detox: Frequently Asked Questions

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Outpatient detox is an effective and affordable treatment option for some types of substance withdrawal. Outpatient detox at a doctor’s office, clinic, or addiction treatment center can help you or your loved one safely manage the difficult symptoms of withdrawal.

What is Outpatient Detox?

Seeking help for addiction.Outpatient detox programs help you eliminate drugs and alcohol from your body and achieve medical stabilization so you can then enter a comprehensive addiction treatment program. The goal is to provide daily supervision and evaluation, as well as any needed intervention to keep you safe during withdrawal. Withdrawal is a set of symptoms that emerge if you abruptly stop taking a substance to which you’ve developed physical dependence. The symptoms can be painful, uncomfortable, and sometimes even life-threatening. People may relapse during withdrawal in order to alleviate these distressing symptoms. Outpatient detox can provide a person with the support they need to detox comfortably.1

Outpatient detox programs provide patients with detox services during the day and allow them to return home at night; these programs can take place in a variety of different settings, ranging from intensive all-day programs to regularly-scheduled doctor’s appointments. Depending on the substance you are withdrawing from, your detox program may include medication management. In such cases, doctors will prescribe medications that help reduce cravings and treat uncomfortable withdrawal symptoms.

Detox is only the first step on the road to recovery. It helps you achieve a drug-free, stable state so that you can do the work necessary to overcome your addiction. After completing a detox program, you should continue on with a formal rehab program, where you can make lasting positive changes in your life.

What Settings are Available?

Outpatient detox can take place in a few different settings. Each of the possible settings offers varying levels of treatment and supervision.

Different levels and settings of detox.Common outpatient detox settings include:1

  • Doctor’s office: Many people seek help from a psychiatrist or other physician when withdrawing from drugs. While this option provides limited supervision, it allows access to prescription medications that can help reduce withdrawal symptoms.
  • Day hospital: Detox programs at day hospitals allow for much more supervision than the relatively brief check-ins at doctors’ offices. Nurses and other trained staff can manage medications and conduct group therapy sessions.
  • Community clinics: Community clinics allow people to attend the clinic on a daily basis in order to receive medication and detox support. These clinics offer group counseling sessions and case management programs.

Outpatient vs. Inpatient

Inpatient detox programs require that individuals reside at the detox facility for the duration of the program. These patients receive 24-hour support and monitoring throughout the withdrawal process. They tend to last from a few days to a couple weeks, depending on the substance or substances you’re addicted to and whether you’re receiving detox medications or not. Inpatient detox is not required for everyone, but people addicted to alcohol, sedatives, and opioids may want to consider this type of detox because of the sometimes risky and/or markedly unpleasant withdrawal syndromes associated with these substances.

Pros and cons of detox treatment options.Conversely, outpatient detox programs provide you with the freedom to attend detox treatment during the day and return home at night. You can schedule your sessions around work, school, or any other responsibilities you may have. Many people benefit from the flexibility of an outpatient program, but you will require reliable transportation to attend treatment each day. If you have a mild to moderate addiction and a strong support system in place, an outpatient program may be a solid recovery option for you.2

What Detox Medications are Used?

Depending on which substance you or your loved one is abusing, detox medications may be available. In these instances, medications can help reduce intense cravings. They can also help alleviate withdrawal symptoms.3

What does medicated detox feel like?Medications that may be provided during outpatient detox include:1

  • Benzodiazepines (alprazolam, Xanax, Valium): These medications help prevent or manage seizures in those withdrawing from alcohol or barbiturates.
  • Methadone: Methadone manages opioid cravings and withdrawal symptoms.
  • Suboxone: Suboxone, a combination medication, manages the symptoms of opioid withdrawal and reduces cravings.
  • Clonidine: Clonidine relieves autonomic arousal withdrawal symptoms, like rapid heart rate and high blood pressure.
  • Anti-nausea drugs.
  • Anti-diarrhea drugs.
  • Antipsychotics: These may be given to treat delirium, hallucinations, and severe anxiety.

Is it Necessary?

Detoxing in a medical setting.

Anyone with a drug or alcohol addiction can benefit from outpatient detox; however, outpatient detox is not necessarily the best treatment option for some people. For example, some substances have more severe withdrawal syndromes than others, creating a higher risk for complications. Inpatient detox would be a more appropriate option for these people, as 24-hour medical support is crucial to keep them safe.1

Substances associated with dangerous withdrawal symptoms (and for which you should probably seek inpatient detox) include:4

  • Alcohol: Alcohol withdrawal can cause uncomfortable symptoms, such as anxiety, elevated heartrate, and gastrointestinal problems. Although rare, it can also cause life-threatening symptoms, such as seizures, hallucinations, and delirium tremens.
  • Benzodiazepines: Benzodiazepine withdrawal has been known to cause seizures and delirium tremens.
  • Barbiturates: Withdrawing from barbiturates can be dangerous, possibly resulting in grand mal seizures, delirium tremens, psychosis, and hallucinations.

Ideally, the people who can benefit from outpatient detox are those who do not have a severe addiction and are addicted to a substance that doesn’t have a life-threatening withdrawal syndrome, such as marijuana, ecstasy, hallucinogens, cocaine, amphetamines, and crystal meth.1 Another important factor to consider before choosing outpatient detox is the support system at home.2 Inpatient detox programs allow people to remove themselves from an environment of temptation. People in outpatient programs should have a strong support system at home and friends or family members willing to help them maintain sobriety.

If you plan on participating in an outpatient rehab program, consider the following questions:

  • Is my home free of alcohol and drugs?
  • Is there someone there to help me if a medical emergency occurs?
  • Do I have reliable transportation to get to my medical appointments?
  • Are my friends and family committed to my sobriety?

Potential Complications

It is important to consider the risk of complications before enrolling in an outpatient detox program. Inpatient clinics offer 24-hour medical support for those who have a high risk of experiencing complicated withdrawal.

People who may be ill-suited for outpatient detox include people with any of the following conditions:1

  • Polydrug abuse
  • Dual diagnosis, or co-occurring addiction and mental health condition
  • A history of severe withdrawal symptoms
  • Serious physical health conditions
  • Severe depression
  • Suicidal ideation or past suicide attempts
  • Pregnancy

Does Much Does it Cost?

Cost of addiction treatment.Outpatient detox programs are more affordable than inpatient programs, but they do not always come cheap.

The price of an outpatient treatment program will depend on a number of factors, such as:

  • Location.
  • Intensity of the program (how many hours per day, days per week).
  • Duration of the program.
  • How much your insurance plan will cover.
  • Services offered.

Inpatient treatment programs can be as much as $600 to $1,000 per day, but that’s because you are paying for 24-hour supervision, plus room and board.5 Since outpatient programs do not have these requirements, they will on average cost less than their inpatient detox counterparts.

Insurance Coverage & Payment Plans

If you have insurance, it is likely that you’ll receive at least partial coverage for substance abuse services, including detox. Depending on your plan, the entirety of detox may even be covered. It all depends on your individual plan, deductible, and other factors. Call your insurance company to learn more about your specific coverage.

Programs that accept insurance.

If you don’t have insurance, don’t worry.

Many detox programs offer payment plans or sliding scales for those who are unable to pay for the full price of treatment. There are also grants and scholarships available.

What Happens Afterwards?

Detox is only the first step on the continuum of addiction treatment care. Sobriety is extremely difficult to maintain without formal addiction treatment. To have the best chance of long-term recovery, you will need to find a comprehensive addiction treatment program.6 Fortunately, there are many types of programs to choose from.

Common settings for comprehensive addiction treatment include:

  • Inpatient: These provide intensive around-the-clock treatment, allowing you to dedicate yourself completely to recovery. Programs typically last several weeks, but stays can be shorter or longer if necessary. These comprehensive programs offer a combination of group, individual, and family therapy sessions, as well as medication management (if applicable) and other structured activities.
  • Intensive outpatient programs (IOPs): These outpatient programs typically require a commitment of 6-9 hours per week of counseling and other substance abuse treatment services.
  • Partial hospitalization programs (PHPs): These are the most intensive of the outpatient program varieties, with treatment from both medical and nonmedical staff members for many hours each day.
  • Standard outpatient: Patients receive counseling and other services for a couple hours per week in a clinic or office setting.

Sources

  1. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment (Treatment Improvement Protocol (TIP) Series, No. 45.).
  2. Hayashida M. An Overview Of Outpatient and Inpatient Detoxification.
  3. The National Institute on Drug Abuse. (2014). Drugs, Brains, and Behavior: The Science of Drug Addiction.
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  5. American Addiction Centers. (2017).
  6. Center for Substance Abuse Treatment. (2006). Chapter 1: Overview, Essential Concepts, and Definitions in Detoxification; Detoxification and Substance Abuse Treatment (Treatment Improvement Protocol (TIP) Series, No. 45.).

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