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Opioid Addiction And Dependence Drug Detoxification

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Rapid Detox – Opioid Addiction Treatment – Rapid Drug Detox – Opiate Addiction Treatment

At Ken Seeley Rehab, our drug detox program helps people suffering from drug addiction recover and become sober. Individuals with co-occurring disorders will learn to manage and cope with their conditions through customized treatment plans and therapy techniques.

Relapse prevention and aftercare programs will help you or a loved one prevent relapse and live a sober lifestyle free from addiction. You are not alone! Contact us today to learn more about our drug detox program, and how we can help you get on the road to recovery.

Medications Used In Opiate Detox

Doctors often prescribe medications during the detox process. These medications help treat the long-term issues associated with Opiate withdrawal, such as drug cravings. Over time, a doctor will gradually taper down the dosage of these medications until the patient recovers from acute withdrawal symptoms. Medications may continue to be prescribed while the patient is continuing treatment in an inpatient rehab center.

Addiction Center is not affiliated with any insurance.

Here are some of the most common medications used during opiate detox:

  • Clonidine

    Clonidine is often prescribed to suppress withdrawal symptoms and treat high blood pressure. It is especially useful in reducing symptoms of anxiety and stress. It is available as an oral tablet or patch that is worn on the skin. Clonidine does not cause the euphoric feelings commonly associated with Opioid painkillers. As a result, the drug also has little potential for abuse and physical dependence. This makes it easier to discontinue the use of the drug once withdrawal symptoms subside.

  • Methadone

    Methadone was once widely used medication in detox settings, but has largely been replaced by Buprenorphine. It is typically prescribed to help patients ease off of the drug they originally became dependent on. As a long-acting opioid, methadone is most effective as a long-term treatment method for patients struggling with chronic opiate addiction.

  • Treatment Of Opiate Dependence

    Treatment for opiate dependence initially involves a phase of assessment and stabilisation using opioid substitution therapy and engagement with services. Following this, ongoing treatment can be broadly categorised as either harm reduction or abstinence oriented. Early access to medication is a key factor in engagement, but developing a strong therapeutic alliance is thought to be more important for long-term recovery .

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    The Opioid System: An Overview

    The opioid system in the brain is the main target for both endogenous and exogenous opioids . Good effects from other substances of misuse, such as alcohol and amphetamines, have been shown to be associated with increases in endogenous opioids in the brain . There are three main types of opioid receptor mu , kappa and delta which are responsible for the range of effects of both exogenous and endogenous opioids .

    TABLE 1 Opioid receptor effects

    The mu-opioid receptor is found in various brain regions involved in the reward circuitry, including the ventral tegmental area and ventral striatum. It is thought that effects elicited by this receptor are responsible for the misuse potential and reinforcing properties of opioids. The nucleus accumbens within the ventral striatum receives input from dopaminergic cell bodies in the ventral tegmental area via the mesolimbic pathway, while inhibitory gamma-aminobutyric acid neurons project from the nucleus accumbens to the ventral palladium via the striatopallidial pathway . Opioids produce their effects in the ventral striatum directly by binding to MOR in the ventral striatum or indirectly by binding to MOR on inhibitory GABA neurons, both of which increase dopaminergic neuronal firing.

    BOX 2 DSM-5 and ICD-11 diagnostic criteria relating to substance use

    Both the DSM and ICD have released revised versions in the past decade: DSM-5 and ICD-11 .

    BOX 3 Common signs/symptoms of opioid withdrawal

    Subjective

    Updates On Group Therapy

    9 Ways to Detox from Opiates

    Addicts Anonymous is credited with having developed the mutual self-help group counselling approach . Group therapy is imperative during recovery in a detoxification centre especially after withdrawal and when stabilization has gained effect. Group therapy has gained recommendation as one of the most important maintenance strategies in rehabilitation centres. In the detoxification facility and subject to evaluation of the particular clinical case, group therapy kicks off the long process of rebuilding self-esteem. This therapy brings about the discipline associated with group dynamics, intensive short-term dynamic psychotherapy, cognitive-behavioural and psychodynamic approaches . These aspects assist in strengthening the patientsâ will to get off drug addiction and to improve their prospects for success in therapy programs after leaving the detoxification facility.

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    What Is Opiate Withdrawal

    Opiates, or opiate painkillers, encompass a number of prescription drugs such as Codeine, Dilaudid and Tramadol. Individuals who take these drugs in larger doses, or for longer periods than initially prescribed, have a high risk of forming a physical dependence.

    A person who becomes physically dependent on opioid painkillers will feel a need to continue using the drugs in order to function normally. If they quit taking the drug cold turkey, they will experience various uncomfortable symptoms as the body tries to adjust without the substance.

    Withdrawal occurs when a person suddenly stops using a drug, or significantly reduces the amount they were taking. The symptoms of withdrawal depend on a number of factors, including the type of painkiller being abused, the persons established tolerance to the drug the length of their addiction, whether they abused multiple substances, and their mental and medical history. Most symptoms of withdrawal are flu-like, such as fever, sweating and vomiting.

    Common Questions About Rehab

    Trying to quit painkillers cold turkey is difficult and dangerous to do on your own. It is highly recommended to seek the help of medical detox staff in order to overcome opioids safely and effectively.

    Break free from addiction.

    Those Lost To Overdose

    Many more celebrities, including actors Heath Ledger and Corey Monteith and singer Prince, also struggled with opioid use disorderbut sadly lost their lives in the battle. But despite all their differences, these celebritieslike anyone else living with drug dependencyshare many things in common, including a history of multiple failed attempts at rehab and recovery.

    Failed detox attempt does not suggest a moral failure of the celebrities, nor anyone else whos been in and out of drug treatment programs before. Instead, its meant to highlight some critical questions that arent adequately addressed in the fight against opioids.

    Why is the failure of opioid use disorder treatment so familiar even among individuals who are blessed with plenty of financial resources to help them? Why do so many people leave intensive rehab only to, eventually, use again and place themselves at dire risk of accidental overdose and death? After all, if drug dependency were indeed a chronic disease, like many people argue, wouldnt medical treatment be sufficient to address the issue?

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    Randomization And The Sampling Method

    Data for total of100 opiate dependents will be randomly selected from the Centre patient files going back 6 months. It is also costs less to do a randomized sample, and despite this, the results obtained are usually an accurate reflection of the situation in the population. All patient records with either the CIWS or COWS forms filled out will be extracted from the centre database, checked to see which patient and withdrawal medication classification they belong to and listed as part of the project-sampling frame. If the number exceeds the quota of 200, systematic sampling will be carried out to arrive at a final list of patient records. One hundred was chosen as an ideal figure for the project because it would provide for effective data collection and at the same time ensure that the information can be applied in the general detoxification practice.

    Conflict Of Interest Statement

    What causes opioid addiction, and why is it so tough to combat? – Mike Davis

    The author DM is an inventor on issued patents pertaining to the active metabolite of ibogaine. She is a founder and shareholder in a Florida corporation, DemeRx, Inc., which is advancing clinical trials of ibogaine and noribogaine for opioid detoxification and maintenance therapy, among other indications. The author conducted offshore ibogaine research and development studies with government approval in St. Kitts, West Indies.

    The other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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    What Causes People To Become Addicted To Drugs

    When someone uses drugs, the brain becomes naturally stimulated with neurotransmitters such as dopamine. We all have different DNA, and the way drugs and other substances metabolize in our bodies is just as unique.

    Therefore, the chemistry within the brain becomes forever changed, and over time, the body produces less and less dopamine and other neurotransmitters, and it begins to become more addicted to the drug of choice. Professional help is the best path to take to recover from the cycle of addiction.

    Contingency Management For Opioid Treatment

    Contingency management denotes a therapeutic option for drug abuse and psychological issues. Few doctors, though, are aware of this approach or how it is used to treat a variety of client habits.

    Contingency management is a sort of behavioral treatment in which people strive or are rewarded when they show signs of successful behavior modification.

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    How Long Does The Process Take

    The withdrawal timeline varies from drug to drug and even within drug classes. Generally, the emergence and resolution of withdrawal symptoms are impacted by the half-life of the substance , the mode of administration, the frequency of use, and the average dose used.1 While you might feel symptoms right away for some drugs, others will not produce immediate withdrawal symptoms: 1

    • For stimulant drugs, withdrawal symptoms typically appear within a few hours to a couple days after the last dose.
    • Sedative withdrawal symptoms may appear as quickly as a few hours after or as delayed as several days following last use. For someone who is addicted to Xanax, withdrawal symptoms may appear within 6-8 hours of the last dose and improve by the 4th or 5th day. Meanwhile, Valium may produce withdrawal symptoms a full week after the most recent dose and may not resolve for 3-4 weeks.
    • For opioid drugs, such as heroin and painkillers, symptoms typically emerge within 6-12 hours after the most recent dose and subside within 5-7 days.
    • Long-acting opioid drugs, such as methadone, may have a longer and more delayed timeline, with symptoms appearing 2-4 days after the last dose and taking longer to dissipate entirely.
    • Alcohol withdrawal symptoms tend to emerge within a few hours to several days after quitting or reducing consumption.

    Contributing Factors Of Clients That Have Returned For Detoxification After Relapse

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    Limited evidence exists on the evaluation of predictors, moderators and to a lesser extent the community settings exist. Factors influencing the relapse time include the wearing out that is occasioned by the lifestyle adopted by the patient in a bid to prevent further damage to the functioning of the body . The precipitation of life events that is responsible for governing the tendency to distribute the durations taken in each relapse cycle. These factors have major implications in the eventual control of relapses depending on the way they are handled by the physicians. To ensure or minimize the occurrence of relapses in the patients, it is usually advisable to apply motivational techniques that enhances or lengthens the period of abstinence among the patients. The kind or type of motivation significantly decides whether the behaviour wills be replicated or the patient will observe the period of abstinence. Mann, Charuvastar and Murthy observed that motivation and wear out offer contradicting input thereby resulting in the formation of competing risk distribution cycle.

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    Inclusion And Exclusion Criteria

    Individuals participated in a 12-day inpatient study to determine the safety and open-label efficacy of ibogaine as a pharmacological treatment for managing withdrawal symptoms. The study was conducted in a 12-bed freestanding facility in St. Kitts, West Indies. The treatment program had a planned duration of 12 days and stated goals of: safe physical detoxification from opioids or cocaine, motivational counseling, and referral to aftercare programs and community support groups . Subjects were self-referred for inpatient detoxification and met inclusion/exclusion criteria. All participants signed an informed consent at program entry to allow medical record review of study results for submission to the Food and Drug Administration . Retrospective chart review of patient records was conducted under University of Miami Institutional Review Board approval . All individuals were subjected to a physicians review of the history and physical examination, clinical laboratory results and electrocardiograms for inclusion in the study. The results of the electrocardiogram and clinical laboratory testing were within predetermined normal limits at program entry. Exclusion criteria included histories of stroke, epilepsy and axis I psychotic disorders, cardiovascular and liver pathology, and HIV/AIDS.

    Risks And Dangers Of Opioid Detox

    Opioid withdrawal can be very uncomfortable. Without clinical support, this could result in a person relapsing to their opioid use, to stave off withdrawal.

    Detoxing at home, for instance, is strongly discouraged for people with opioid dependence, due to potential health dangers and an inability to manage medical complications should they arise.

    Dangers of opioid detox include:

    • severe dehydration: This can occur through excessive vomiting, diarrhea, and inadequate intake of fluids during withdrawal.
    • drug relapse: Relapsing back into drug use can return people to a vicious cycle of wanting to get off opioids but feeling unable to.
    • overdose: Detoxing from opioids carries a risk for overdose, due to the fact that detoxing reduces a persons tolerance for opioid drugs.

    The safest way to stop using opioids and overcome an addiction is to seek professional help through a detox facility or an inpatient treatment center that offers detox services.

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    The Above Policy Is Based On The Following References:

  • American Society of Addiction Medicine. Public policy statement on opioid antagonist agent detoxification under sedation or anesthesia . J Addictive Dis. 2000 19:109-112.
  • Badenoch J. A death following ultra-rapid opiate detoxification: The General Medical Council adjudicates on a commercialized detoxification. Addiction. 2002 97:475-477.
  • Blum JM, Biel SS, Hilliard PE, Jutkiewicz EM. Preoperative ultra-rapid opiate detoxification for the treatment of post-operative surgical pain. Med Hypotheses. 2015 84:529-531.
  • California Technology Assessment Forum . Rapid and ultrarapid opiate detoxification. Technology Assessment. San Francisco, CA: CTAF June 12, 2002.
  • Camarasa X, Khazaal Y, Besson J, Zullino DF. Naltrexone-assisted rapid methadone discontinuation: A pilot study. Eur Addict Res. 2007 13:20-24.
  • Canadian Agency for Drugs and Technologies in Health . Rapid and ultra-rapid detoxification in adults with opioid addiction: A review of clinical and cost-effectiveness, safety, and guidelines. CADTH Rapid Response Reports. Ottawa, ON: CADTH January 2016.
  • Fontaine E, Godfroid IO, Guillaume R. Ultra-rapid detoxification of opiate dependent patients: Review of the literature, critiques and proposition for an experimental protocol. Encephale. 2001 27:187-193.
  • Forozeshfard M, Hosseinzadeh Zoroufchi B, Saberi Zafarghandi MB, et al. Six-month follow-up study of ultrarapid opiate detoxification with naltrexone. Int J High Risk Behav Addict. 2014 3:e20944.
  • Evaluation Tools For Detoxification Program

    Opioid Withdrawal: What It’s Like to Detox from Opiates | MedCircle

    Evaluation tools have proved imperative in the determination of the treatment outcome especially in the detoxification program. According to Ritcher, Eikelmann & Berger , a short form has proved effective in the monitoring of the health status and in the eventual evaluation of the treatment outcomes in the drug addicts. These findings were obtained from a study conducted in North Western Germany. The evaluation relied mainly on a pre and post assessment of patients who had undergone several detoxification referrals to one of the largest psychiatrist centre in Northwestern Germany. 79 males and 21 females who had a history of abusing different drugs were included in the study. The SF-36 form was provided immediately on admission and was retained until discharge time to ascertain the recorded changes that were largely based on self perceived health status by the patients.

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    Is Ultra Rapid Detox Safe

    Ultra rapid detox, which touts an ability to ease the process of opioid withdrawal, is a controversial method that can produce dangerous outcomes.

    Someone who undergoes rapid detox is placed under general anesthesia and is administered medication to initiate the withdrawal process. Under anesthesia, the individual theoretically wont experience the full spectrum of painful symptoms associated with withdrawal. Rapid detox can seem appealing to those who are apprehensive about enduring these symptoms.7

    However, one problem with this method is that the length of withdrawal is different for each person and is complicated by the combination of medications administered. For this reason, many people wake up still in the throes of withdrawal, experiencing intense symptoms for days after the procedure.8

    Some patients may fail to disclose preexisting health issues during medical and psychiatric screenings in order to be approved for rapid detox, which can have dire consequences.

    Researchers have posited that there is no evidence in support of anesthesia-assisted detox for the management of opioid withdrawal. Further, there are many risks associated with undergoing rapid detox. These risks include:7

    • Exacerbation of mental health problems, such as bipolar disorder, panic attacks, and depression.
    • Metabolic complications of diabetes.
    • Fluid accumulation in the lungs.

    Ost Dose And Treatment Length

    Guidance on the optimal length of maintenance OST has still not been standardised and remains person specific. In the UK a duration of months is emphasised by the Department of Health guidelines . However, in the USA guidance from the National Institute on Drug Abuse suggests that 12 months of methadone maintenance should be considered a minimum, and some patients may require years of treatment . In practice, many people remain on OST for many months or even years and have multiple episodes of OST of such duration. In one meta-analysis 51% of the cohorts studied had been receiving methadone treatment for 2 years or more .

    Although studies conducted in the 1990s indicated that increased length of OST is associated with favourable outcomes, the effects of chronic opioid exposure on physical health perhaps were less considered. In a longitudinal study of opioid and other drug users, the most common cause of death in the opioid users was cardiovascular incident , particularly in those aged over 55 years. This was interestingly higher than for users of central nervous system stimulants . Methadone and opioid painkillers have been associated with sleep-related problems such as sleep-disordered breathing, central sleep apnoea and obstructive sleep apnoea, all of which contribute to lethal disorders of breathing during sleep . Chronic opioid analgesia use has also been associated with wakeful ataxic breathing, and again increasing age appears to be a risk factor .

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