Selecting a Detox Program: Must-Haves
When looking for a drug or alcohol addiction detox program, there are a few things that every potential client should ask about.
It’s essential that a good amount of research be done before a program is chosen. Addiction is a very serious mental illness and requires proper treatment; otherwise, relapse is likely.
It can be overwhelming at first. There are over 14,500 addiction treatment centers in the US alone. People in major metropolitan areas may be spoiled for choice. Those in rural areas may be tempted by local facilities that aren’t properly licensed. Individuals are also likely to be restricted by certain personal circumstances, not the least of which is finances. Not everyone will be able to afford treatment programs with all the frills, even if insurance can help cover the costs. Basic programs can, of course, still be very helpful. However, there are a few things that every treatment center should absolutely have. Some of these are necessary for insurance to even agree to cover the program. Always make sure to check directly with your insurance company to make sure you’re covered before entering treatment.
Must-haves in a an addiction treatment program include:
- Accreditation and licensing: These are two different things, and any medical treatment center should have both. Licensing comes from the states, and accreditation comes from medical organizations. You can look at the organization’s website to learn more about the type of treatment the center is likely to employ.
- Staff credentials: Not only the center, but the medical staff need to be licensed as well. Make sure all the doctors and counselors have proper credentials from accredited medical schools.
- Research-supported treatment methods: Find out what you can about a facility’s treatment methods and look up studies done on their effectiveness. Don’t attend programs that use debunked or unsupported tactics.
- Individualized treatment: Any good addiction treatment center treats its clients as individuals. Cookie-cutter programs don’t work for everyone because each person’s situation is different. Studies have shown that different methods work better for people of different genders, races, and socioeconomic statuses.
- A respectful and supportive setting: Clients who feel like they’ve been institutionalized are less likely to take an active role in their recovery and much more likely to relapse after the program is finished. Recovery should be about taking back control of one’s life, not feeling like a prisoner.
- Aftercare support: The completion of an addiction treatment program does not mean that the addiction has been cured. Cravings, temptations, triggers, and the general threat of relapse continue for the rest of an addicted person’s life. Aftercare programs are designed to keep people on track on a long-term basis. A decent program should at least help clients transition into these types of programs by providing information and connections.
- Insurance support: Addiction treatment can be very expensive without insurance. Fortunately, these services are considered to be standard for coverage, and some coverage is generally required for plans that fall under the Affordable Care Act. Facilities that don’t help you with insurance issues or that aren’t covered by insurance should likely be passed over as they may not be properly licensed. Most facilities will also offer payment plans to offset the financial burden of services that are not covered by insurance.
The most important thing to look for in any addiction treatment program is whether it feels right for you. This is your journey, and you should feel comfortable with the program you choose.
When investigating a detox program, it is important to understand a few basics about how these programs work.
What Is the Difference between Ambulatory and Medically Assisted Detox?
Ambulatory detox versus medically assisted detox is essentially a distinction between outpatient and inpatient detox. Ambulatory detox works well for people who have mild to moderate withdrawal symptoms, which can be managed with over-the-counter medications or small doses of prescription medications. Their symptoms are not life-threatening or uncomfortable, and they are not likely to lead to relapse.
In contrast, medically assisted detox works better for people who may develop life-threatening withdrawal symptoms without the oversight of doctors and nurses. It also works best for people who have struggled with addiction for a long time, who take large doses of intoxicating substances, or both. Opioid drugs do not have life-threatening withdrawal symptoms associated with them, but people who suffer from addiction to these drugs, especially to more potent drugs like OxyContin, heroin, fentanyl, or Opana, will find it more difficult to end their addiction without replacement medications like buprenorphine and then help tapering off these medications. Other drugs, like benzodiazepines or alcohol, can lead to life-threatening withdrawal symptoms like seizures. Medical oversight is very important in these instances.
Regardless of whether ambulatory detox or medically assisted detox works best, it is important to find a doctor who can appropriately evaluate withdrawal symptoms and set up a treatment plan. Individuals who attempt to go “cold turkey” on their own face significant health risks and a high relapse potential.
Are Rapid Detox Programs Valid Options?
Rapid detox typically means a medication-induced, sedation-based detox process from opioid drugs. It is also sometimes called ultra-rapid detox. The process involves sedating the individual, sometimes even inducing a medical coma, and then injecting them with small doses of naltrexone, which actively removes opioids from those receptors. The body flushes the opioids out normally, but there are no intoxicating effects while the body metabolizes these drugs. In theory, the sedation also prevents the person from experiencing withdrawal symptoms. The procedure lasts around four hours total, but the person must remain hospitalized for one or two days following rapid detox.
This process sounds too good to be true, and it is. Rapid detox is not a standardized procedure. Although hospitals perform this type of procedure, and there is a general outline governing the process, there is little regulation or oversight from addiction specialists. There is also no proof that withdrawal symptoms are gone when the person wakes up; this assumption is based on a general understanding of how the body metabolizes opioid drugs. Although the patient does not feel withdrawal symptoms consciously, some symptoms like rapid heart rate and increased blood pressure still occur, and this can cause physical harm while under anesthesia or trigger underlying cardiovascular conditions. This may lead to death.
Rapid detox has shown no evidence of effectively preventing relapse, but it is more expensive and more physically harmful than traditional detox methods. There is no evidence that people who undergo rapid detox completely avoid withdrawal symptoms, and in fact, many people experience withdrawal after waking up from anesthesia. Working with doctors and nurses through medication management and tapering offers better social support and recovery resources compared to rapid detox. There is no silver bullet to end an addiction, including rapid detox, and the risks of the procedure outweigh any potential benefits.
Are Visitors Typically Allowed during Detox?
Different facilities have different policies regarding visitors. Some allow pre-approved visitors, usually family members or close friends, for a small window of a couple hours each day. Other detox facilities allow family only during designated visitor days, generally once or twice per week. Some facilities do not allow visitors at all, whether these visitors are family members or not.
The detox process generally lasts 1-2 weeks. A person who requires medically assisted detox at an inpatient treatment facility should be able to contact their loved ones in some way, typically over the phone or through email. In-person visits may be more restricted or not allowed at all because it is such a short period of time before the person advances to a rehabilitation program.
Detox can be a tough experience for family members as well because their loved one may look worse during the first few days as withdrawal symptoms set in. Worry and anxiety in the family may make it harder for members to appropriately support their loved ones during treatment, which is another reason many facilities do not allow visitors during detox or limit visits accordingly.
Are Wellness Amenities Important?
As holistic treatments and wellness begin to permeate all areas of medical treatment, the concepts underlying complementary healthcare are entering rehabilitation medicine. Complementary medicine covers a wide range of health-supporting options, from vitamin and mineral supplements to regular massages or acupuncture to meditation mindfulness and even chakra opening, chanting, yoga, tai chi, and more. However, complementary treatments are typically viewed as amenities.
Some people may find these options indispensable when they care for their health, and there is some scientific basis that simple exercise, gentle touch, and improved nutrition bolster additional medical treatments. Still, the primary treatment – in this case, detox with help from medical professionals – must be the focus of the treatment. Anything supporting the process might benefit the patient, but it is not necessary.
Wellness amenities, like spas, hiking trails, guided meditation, restive landscape views, and more, may improve the detox and rehabilitation experience for many. However, as amenities, they have costs associated with them.
Overcoming an addiction to an intoxicating substance starts with detox, which requires assistance from physicians who have experience in rehabilitation medicine. This is the only part of detox that is necessary. However, it is important to find a program that will monitor patients individually because everyone has unique needs.
What Is an Appropriate Staff-to-Patient Ratio?
With a wide range of detox and rehabilitation programs available at dozens of different price points, it is understandable that the ratio of staff to patients will vary. High-end, private, and luxury detox and rehabilitation facilities may have lots of staff members with very few patients; free or low-cost clinics, which rely on government or nonprofit resources, will have more patients with fewer staff members.
However, programs with fewer staff members treating more patients can still provide quality treatment. Ambulatory or outpatient detox programs, for example, work with patients who require less oversight in general, so they can work with more patients overall. Medically assisted detox programs often have patients who require 24/7 care and supervision, so they should have more staff members available to help their patients.
Still, having a reasonable patient-to-staff ratio is important for people who need individual attention during detox. A reasonable workload for one registered nurse could be between 10 and 15 patients. The registered nurse should have two certified nursing assistants available, especially when there are more patients. Some states require programs to have a ratio of eight patients to one staff member. When seeking a detox program, ask about the average staff-to-patient ratio to assess if the appropriate level of medical oversight is available.