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Opiate Detoxification Options: Community and At-Home

When you think of the process of detoxification of the body from an opiate in general, what comes to mind?

Do you see an addict in a hospital room hooked up to an IV with nurses checking in frequently?

Or do you imagine a brave soldier trying to kick the habit in their room curled up all by their lonesome with no medical help or attention, instead?

Many people tend to conjure up one of the two scenarios when thinking about detox from not just opiates, but any drug. There are many preconceived ideas about the process of cleansing your body floating around the anecdotal culture of society. But, what is the difference in the various methods if the results produced are the same in the end? It's simply a matter of comfort and safety with a side of enduring efficacy.

There actually are quite a few ways to safely detoxify from a drug habit! Sadly, they tend to not be as popular or well-known as the hospitalized addict or the addict going at it alone. It always helps to increase our arsenal of recovery resources, so let's look at the potentially less well-known routes of detoxification!

There is a technique commonly known as a "community detox". For many people this can prove to work wonders with their journey of detoxification. The details vary from area to area, but generally fall within the same bounds.

You've decided enough is enough and you're done with your nasty pain-pill addiction. You muster up the courage and ask around about how to get started, you settle on being as safe as humanly possible so you go to the hospital to check in for a safe and controlled detox. Only as you stand outside the hospital doors you are overcome with emotion and cannot make your feet carry you through the doors. Many thoughts can pervade your vision and in turn prevent you from ever even stepping into the building, foregone is the notion of detox by now. Thoughts such as inferiority, shame, lack of worth, esteem. I am sure anyone who has or had a drug habit can imagine the scope and feel of these sudden sentiments of self-degradation.

Now you're back where you started, maybe even worse off if you coped with the strange emotional battle you just lost via using. You just wish you could go somewhere private and not be in the public record or domain to do this whole process, but who can afford those "resort rehabs" anyway?

Then it is suggested you check into the accessibility of a community detoxification program in your area. This route provides the utmost privacy for the recovering patient, thereby removing and external feelings that only serve to detriment the recovery process.

But, wouldn't that be dangerous to do it outside of a medical setting though?!

Yes, it would. Thankfully you will still be provided for by a professional health care worker. The timeline is wildly individual, but the programs begin with seeing your new health care provider for the first three days in a row, at least. The frequency of the visits from then on depends on your progression and coping, which is taken into consideration by your provider before they set up a schedule of meetings. Some programs will have you meet in a more personal community clinic. More and more programs however, are offering the sessions in your very own home. Can't get much more comfortable than that, can you Malibu beachside rehab? Your health care worker is there the entire way, keeping a vigilant eye on your progress and medication (if used) to spot any signs of severe withdrawal symptoms. It is common for them to collaborate with your General Practitioner if they are included in the process and you permit it, of course.

What is the big deal anyways, why can't you just stop taking it and sleep it off like any other hangover? Because it isn't anything close to a hangover, just like alcoholism is nothing close to a hangover. The two terms don't cross-compute.

With alcohol, benzodiazepines and you guessed it, opiates, the cessation process has a propensity to get very dangerous and out-of-hand much too quickly and with aggression.

When opiates are abused long enough, it becomes more than a matter of willpower to stop. A pretty good rule-of-thumb is if you've used an opiate for more than just one month it is advisable to seek medical attention if you plan to stop. A big inherent issue with opiate abuse and even as prescribed use is the sheer speed at which a tolerance develops. Some sources would say that within a week or two is all it takes for the cycle of addiction blossoms. Just from the lucrative and rapidly progressing tolerance alone. This leads to addiction taking hold long before most people would even consider the thought of a habit, not to mention a full-blown addiction.

Okay, so what does that have to do with quitting and safety? A tolerance can be thought of as an ongoing transformation of your mind and body. That tolerance that lets you do more of whatever substance than all your buddies? It is an equally potent manifestation of how much more your body and mind very literally need said drug than your friends.

Here is where medical risks begin to come into the realm of possibilities. If you stop taking the amount of drugs your body has not just grown to like, but grown to require, there will obviously be some issues. Your body will not appreciate the sudden withholding of what it has substituted for many natural components of your brain (e.g. replacing the body's natural opiod pain-killing processes with the foreign opiate and neurotransmitters). In a nutshell the opiate becomes equated with dopamine and other neurotransmitters that regulate our very being. This in effect replaces your internal sense of joy, happiness, achievement, reward and every other positive result of neurotransmission in your brain with one singular entity, the opiate.

Your body will go straight into shock if you stop taking the drug suddenly and totally. It can also go into shock if the down titration isn't calculated properly and too steep of a decrease. This is where medical professionals come in more than valuable to the experience, for they can monitor and help fight or reverse the ill-effects that can be nullified to vastly improve the comfort of the process. Not to say it is comfortable at all, even then.

Okay, how does detox actually work then? It seems to work the same, just different settings, right?

Basically. Depending on your drug of choice and amount being used habitually your health professional will develop a regimen and a timeline to go along with it.

As an example of the individualistic nature of detoxifying, let us take a look at heroin. It is widely suggested not to cold turkey quit heroin due to the health complications it could potentially lead to. The method generally involves the patient to begin to take something along the lines of methadone or more recently buprenorphine (brand name Subtex) or a drug marketed as Suboxone, which is buprenorphine with the additive naloxone all in one mechanism of delivery.

Whatever medicine is deemed appropriate will be administered to the patient and the idea is to gradually wean the dosages down until they're negligible and thus freeing one from the clutches of the heroin addiction!

That principle and process applies to detoxification from any opiate, not just heroin. The process is said to take anywhere from 12 to 36 days depending on the time required to safely titrate down the dose. It is very much just a replacing a street drug or illicit drug with a controlled one that provokes the same response from our body. Then that new controlled addiction is lowered until the desired effects are present, in theory at least.

Withdrawals are the physical and psychological symptoms of your body getting very upset with you taking away its self-imposed crutch. The overall experience of withdrawals can be eased or at least given aid if proper preparation and monitoring is present. Using heroin as an example once again, anywhere from 6 to 12 hours is all it takes for withdrawals to start rearing its head and creeping into your very soul.

The symptoms of this immediate onset withdrawal are akin to the flu and other bodily illnesses of the like. Only it is the most horrid case of the flu you will ever feel. It induces real pain and real dangers.

This is exactly what is trying to be avoided via a detoxification regimen that is monitored by a health professional! The initial discomfort, dysphoria and outright pain are often only tolerated for a few days or perhaps week. The true danger and lethality of heroin/opiate detoxification comes from an unfortunate relapse in the middle to latter end of the initial withdrawals. All of that pain you feel is your body recalibrating itself and trying to get back to a state of homeostasis. In a way, every bit of pain you feel during that time is a bit of your tolerance and dependency that is dying off.

When people who are far into their withdrawal, just simply cannot tolerate it anymore and relapse death is common. Due to the now lowered tolerance as compared to it when the detox began. Even if it is only a few days' time; that rapid tolerance we mentioned earlier works both ways.

Thankfully there are plenty of medicines that have been proven to effectively relieve different aspects of withdrawal symptoms. Medicines such as Lofexidine block the neurotransmitter found to be responsible for a good deal of the withdrawal symptoms. Along with a non-addictive anti-inflammatory (Naproxen, Diclofenac, Brufen etc) and an anti-diarrheal drug to reduce the cramps and intestinal issues associated with your body readjusting to normalcy.

We have gone over a lot of very powerful resources we have today that can be deployed against addiction in the name of cessation. However, ultimately it lies solely in the person whether or not they will become a recovered addict or relapse and go back to their starting point. Medicine alone cannot magically take everything away and put everything back where it's supposed to be in your body.

AFTER detoxifying there are usually still residual effects to be had for days and weeks. It is during this time that your brain can now begin to rewire and repair since your body is more or less taken care of. It takes time and sometimes a lot of time for the delicate neurological processes to be renewed. During that time it is reported to be difficult to feel joy or any pleasure. The emotional damage is beheld in all of its glory. But, there is an inherent motivation to be found in the uncomfortable emotional recovery. It is the last big hurdle standing between you and freedom. Make it through the most hopeless feeling part and you can make it. Therapy, diet, support groups, healthy environment, all of these things and many more are just as important to recovering and staying recovered as the Suboxone or Methadone was back in the beginning.

If you are honest enough with yourself to admit that you fear a potential relapse it may be worth looking into Naltrexone. After detoxifying, that is. It is a tablet taken daily and blocks the receptors in your brain that bind with opiates for three days after the dose. The blocking of the receptors provides a safety net of sorts to prevent or at least marginalize the effects of a relapse. If taking Naltrexone correctly and you slip up in a relapse, you won't feel anything from the substance you relapsed into (as long as it is an opiate of course). Even if you use quite a bit it would at best produce withdrawal symptoms. If you are determined and try to override the medicine and free the receptors, you will quite simply end up overdosing and in dire need of medical attention. Keep in mind that Naloxone will not work if you are taking Naltrexone. They both work towards the same purpose, but not interchangeably and that can be a deadly bit of information if it isn't known to the health care provider(s).
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