How Do Detox Programs Ensure the Health and Safety of Their Clients?
Drug detox programs are meant to help people suffering from an addiction disorder get on the road to recovery.
They’re not meant to be a cure, as there is no cure for addiction, but rather a starting point on a journey that lasts a lifetime. Each program is different depending on the philosophies of the treatment center, the preferred treatment methods, and the type of addiction being treated.
In any detox program, the health, safety, and general wellbeing of clients should be paramount concerns.
Getting off an addictive drug, going through withdrawal, and participating in a rehabilitation program are all difficult processes, and it’s therefore essential for all clients to know without a doubt that they are in a safe place.
Many addiction specialists stress the idea that a lack of health and safety in people’s lives is one of the prime reasons that people abuse substances in the first place.
Any accredited treatment center will have a list of rules and policies designed to keep all clients safe and maintain their health for the duration of their stay. These can include:
Depending on the type of program, rules may be more or less strict.
- A minimum doctor-to-client ratio
- Strict rules against bringing intoxicating substances into the facility
- Rules for visiting family members
- Schedules for counseling, support group meetings, and activities
- Requirements for complete sobriety
- Requirements for participation in a 12-Step program
- Certain mandatory training programs
Inpatient vs. Outpatient
The actual detoxification process refers to the time period wherein the intoxicant is leaving the addicted individual’s system, and the body is returning to normal after months or years of being under the influence. This involves withdrawal symptoms, which can be very intense. People may go through this at home or at a treatment facility.
After this process, clients are usually encouraged to enter a comprehensive rehabilitation program. This greatly reduces the chances of relapse, which is very important, considering the fact that studies show a 40-60 percent chance of relapse in the case of alcohol and drug addiction.
Inpatient rehab programs are the more intensive variety when compared to outpatient programs. Clients stay in a facility 24 hours per day for a few weeks or months. They stay on the facility’s premises, and their contact with the outside world is limited. This may seem extreme, but it allows for full focus on recovery.
Outpatient programs are much more flexible. They allow people to return home each night and come in for treatment multiple times per week around their schedules. This way, clients can still work, attend school, or care for children while they get help. The downside to this is that they are much more likely to be exposed to temptation. Many of these programs require clients to be drug tested regularly to ensure treatment compliance.
Essentially, the choice between an inpatient or outpatient program should be made by the client, the client’s family, and the treatment team. One type of treatment may be more appropriate to the specific situation. Inpatient care is usually recommended for those with long-term or more severe addictions as well as those with co-occurring medical or mental health disorders.
Both types of programs typically encourage aftercare programs, such as therapy and continued support group meetings. Ongoing care is important as cravings and triggers to use can pop up at any time, even from unexpected sources.
Whether a detox program offers ambulatory programs or works with patients who need inpatient, high-level care, the security of each patient is deeply important. Here are some ways that detox programs care for patients and ensure their overall health and safety.
Can Detox Programs Prescribe Medication?
Detox programs come in five basic settings, according to the Substance Abuse and Mental Health Services Administration (SAMHSA):
- Outpatient/ambulatory treatment through a physician’s office
- Emergency department care
- Intensive outpatient or partial hospitalization treatment
- Acute inpatient care services
- Detox attached to an inpatient rehabilitation program
While these programs have different types of staff members associated with running the organization, each detox program has oversight from a medical professional, such as a physician, emergency room doctor, registered nurse, or mental health professional like a psychiatrist. These professionals can prescribe medication in several ways, ranging from medication replacement therapies like buprenorphine to antidepressants for co-occurring disorders to naloxone.
It is important for detox programs to have at least one staff member who can prescribe medicines, depending on the type of substance abuse being treated. For example, alcohol use disorder may be treated with benzodiazepines for a short time, to prevent seizures during withdrawal. Opioid detox treatment may involve a prescription for Suboxone, along with a physician-monitored taper to safely withdraw from opioids altogether. Detox programs specializing in the treatment of co-occurring disorders must have a psychiatrist available to fill prescriptions to treat depression, anxiety, schizophrenia, bipolar disorder, or other mental health conditions.
How Do Detox Programs Coordinate with My Doctor?
With an increasing understanding of the disease of addiction and more effective medical treatments to help people overcome substance use disorders, it is becoming more important for primary care physicians like doctors or registered nurses to coordinate with detox programs and rehabilitation programs to support ongoing sobriety.
People who struggle with addiction and receive help to overcome this condition are likely to have other issues that require attention from specialists in the community; these could include increased risk of chronic health problems or the development of chronic health issues. Sometimes, chronic issues like tough-to-treat pain, liver conditions, consistent infections like tuberculosis or pneumonia, high blood pressure, and heart disease can indicate an underlying substance abuse problem, so the physician’s diagnosis and treatment is the first line in getting help. The physician should communicate their findings to any detox program their patient attends, so healthcare can be managed safely while the individual detoxes from their substance of abuse.
A primary care physician should coordinate with detox programs about medications their patient takes that might be medically necessary or that may interact with drugs used in detox treatments. This reduces the risk of relapse and helps to prevent health problems.
Once the person completes detox and a rehabilitation program, their primary care physician can coordinate with these programs and provide ongoing support to maintain the patient’s health and sobriety. This includes wellness calls and doctors’ visits, screening for health problems and relapse, referrals to professionals for other treatment such as mental health treatment, and much more.
What Is the Protocol if a Medical Emergency Happens?
SAMHSA’s federal guidelines for opioid detox treatment offers a good understanding of how medical emergencies should be handled in any drug or alcohol detox program.
- The facility will display emergency contact information for doctors, medical technicians, hospitals, or others who provide emergency medical treatment. Staff should be trained to call 911 for medical emergencies.
- A process for providing assistance to patients experiencing a medical emergency outside regular treatment hours must be developed, and staff must be trained in this procedure.
- Part of the process must be coordinating with emergency medical providers regarding the individual’s treatment plan in the detox program, including any medications they may be taking and their stage in the program.
- People entering detox programs must receive identification cards, so information can be quickly provided to emergency medical responders and ER doctors.
- Emergency contact information for relatives, guardians, or close friends of the patient must be on file, on the card, and up to date.
Are Detox Patients Offered Privacy?
Yes, although this type of privacy may not mean a private room. Some inpatient detox programs offer those entering treatment the option of living in a private room while others have shared rooms; however, when talking about detox privacy, what is most important is the privacy of medical records.
SAMHSA has issued guidance on privacy for substance abuse and mental health treatment and associated records in accordance with the Health Insurance and Portability and Accountability Act of 1996, aka HIPAA. People undergoing any kind of medical treatment, including behavioral counseling, mental health treatment, substance abuse detox and rehabilitation, and more, can choose to disclose their records or not. Hospitals, physicians, and treatment facilities must ask the patient before these records can be transferred, so the individual may consent to their continued use in treatment or not. This is a vital aspect of protecting patient privacy from those who may misuse this information. Any safe, supportive detox program will follow these guidelines.
What Licenses or Certifications Do Programs Need to Have?
Each state has different regulations on licensing and certification for detox treatment programs. Some have laws stating that program certification is voluntary. Other states require licensing of rehabilitation and detox professionals but not the programs they are part of. Programs offering inpatient services may be more regulated than those that offer outpatient services. For example, Nevada requirements to receive licensing to run a drug or alcohol treatment facility include inspections from the fire marshal, criminal background checks for employees, a kitchen, and medical labs.
There are also voluntary professional societies, such as the American Society of Addiction Medicine (ASAM), that require their members to meet more rigorous standards, compared to state or federal guidelines. If a detox program does not list licenses and certifications in their literature or on their website, ask about them. Additionally, finding a detox program through a state-level health and human services department can narrow the list to those with state licensing.