Outpatient Drug And Alcohol Detoxification Programs
Medically reviewed byDr. Alan Weiner, MD
March 22, 2018
An outpatient drug and alcohol detoxification program offers flexible options for individuals who desire to stay home while receiving their care. Outpatient detox permits patients to remain with family which can be a great source of comfort during this time. Certain drugs, such as alcohol, benzodiazepines, and opioids, however, form strong dependencies, which sometimes require inpatient, medically-supervised detoxification.
Selecting a detox program is a critical step in your recovery and not one you should take lightly. There are a lot of treatment options and program formats today. These choices can make choosing seem like a difficult task. You might wonder what makes outpatient and inpatient detox programs different.
At first glance, it could be tempting to think that outpatient treatment is a better choice. It most commonly lets you live at home while you receive treatment. This might seem ideal to some people. While it’s true that this format can help certain people overcome substance abuse and addiction, inpatient programs are quite often the better choice.
What Is Withdrawal?
When an addicted person significantly reduces their dosage or quits without a gradual taper, (“cold turkey”) their body experiences a harsh reaction called withdrawal. Symptoms of withdrawal vary per drug, but overall they are very uncomfortable and painful. These symptoms are predominantly physical, however a person could also experience adverse mental effects, such as anxiety or depression.
What Is The Purpose Of A Drug Or Alcohol Detox Program?
The primary aim of detox is to treat the physical addiction. Detox gives your body time to heal after the invasive effects of addiction. Addiction places a massive chemical burden on your body, and detoxing helps you to cleanse these toxins from your system. But as we’ve mentioned, withdrawal can be a very strenuous time, both physically and mentally.
To counter these effects certain medications will likely be used. These medications, termed pharmacotherapies, work to alleviate or significantly reduce withdrawal symptoms, including cravings.
But even with the support of medications, withdrawal can still be very difficult and overwhelming. This brings us to a reason why outpatient withdrawal may not be sufficient for everyone. Though it is possible to detox safely within an outpatient program, certain individuals need constant medical support, as is offered in an inpatient program.
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How Do I Select A Detox Program?
Before you select a program, whether it be outpatient or inpatient, you need to look at the way the addiction affects your life. We can help you to make this determination, but here’s some questions you can ask yourself to get started:
- What is the drug, or drugs, of abuse?
- How long has the addiction occurred for?
- How often is the substance used?
- How much of it is being consumed?
- Does the individual have a good support system of family and friends?
- Are there negative influences or triggers in the home or community which could prove problematic?
- Have you went through withdrawal before? This is important for those with an alcohol addiction, as severity may increase if this is the case.
- Do you plan on proceeding to treatment directly after detoxing?
- What financial resources and/or insurance coverage do you have available for treatment?
Considering these elements will actually help to inform your decision regarding the question of outpatient versus inpatient care. The form of program and type of facility you choose should be based on your unique situation.
Deciding If An Outpatient Or Inpatient Detox Program Is Best
What seems easier, more accessible, or shortest isn’t always your best option when it comes to something as important as battling for your sobriety. Even though it can seem convenient to enroll in an outpatient detoxification program, this level of care is not comprehensive enough for every person.
The temptation for relapse often runs higher in outpatient programs. Here are risk factors for relapse you may experience during an outpatient detox program:
- being around dysfunctional family dynamics
- exposure to triggers
- exposure to drug-abusing peers
- higher amounts of stress
- lack of supervised care
- proximity and access to the substance
A comprehensive inpatient detox program should insulate you from these worries.
Yes, you’re able to remain close to your family and friends during this time, and for many people this constant source of support and comfort can be a great asset. But for some people, this may not be as positive an influence as you might think.
If you come from a dysfunctional family, this exposure may actually be detrimental to your recovery. Remaining at home could subject you to maladaptive behaviors, emotions, and conversations. If you’ve struggled with issues of enabling or codependency with any of your family members, these issues may continue to aggravate the addictive mindset.
If you decide you’d like to pursue outpatient detox, let us do the legwork for you. We have access to and information on programs all across the United States. We can even contact your insurance provider to find out if and how your benefits cover detox.
Who Do Outpatient Programs Work Best For?
During treatment, from start to finish, there isn’t a set formula. Or at least there shouldn’t be. The best treatment protocols are customized to the individual’s needs. What best helps one person may not be the most effective treatment plan for another. This holds true for detox programs.
Here’s some common situations which may make outpatient treatment a more feasible option.
- A person has a mild to moderate addiction.
- Outpatient programs typically cost less, which makes them attractive options for individuals on a budget.
- People who are caregivers of older adults or parents of small children often choose these programs because they can’t get away.
- Individuals may have careers which won’t permit them an extended absence.
- An individual doesn’t plan on attending rehab after detoxing.
Keep in mind, paying out of pocket isn’t your only option to cover treatment costs. Contact us for more information regarding alternative payment options. And in regards to the latter two situations, in many cases detoxing will be so strenuous it may be hard to fulfill these responsibilities, so these shouldn’t be your defining criteria.
Do Certain Drugs Need Detox More Than Others?
Alcohol, benzodiazepines (benzos), and opioids, including heroin and prescription painkillers, can form powerful dependencies. The stronger the dependency, the more acute the withdrawal symptoms, and the greater the necessity for specialized medical care. Should a person quit these cold turkey, they will begin to feel ill in way which can become quite unbearable.
Individuals who are attempting to quit alcohol or benzos may face a more dire concern. Withdrawal from these drugs can be not only intolerable, but it may also be deadly. The severe seizures and delirium tremens which result in these circumstances require prompt and expert medical care. The risk of this is higher for a person who has been using for a long period of time.
Is An Inpatient Medical Detox More Appropriate For Certain People?
If you have a moderate to severe addiction to these drugs, or an addiction to more than one drug, please consider an inpatient medical detox. If symptoms of acute withdrawal become too severe, unaided, a person might relapse to avoid further symptoms. This happens during outpatient detox programs far too often.
Once a person is within the comfort of their own home, it becomes easier to make this detrimental choice. This is because the level of accountability and knowledge you have at the ready is far more limited than what you’d receive in an inpatient programs. Additionally, when you’re living at home, in the back of your mind you know that you can make a call or take a drive to find, and use, the substance.
Choosing an inpatient program can be a life-saving decision. Here, should withdrawal progress to life-threatening extremes, you’ll have immediate medical support. If you’re alone at home, or with family members who panic or don’t understand what’s going on, you won’t receive the care as quickly as you need. In these situations every minute matters.
A National Institutes on Health (NIH) article comments on the importance of this for individuals who have an alcohol addiction: “Outpatient detoxification is not safe for alcoholics at risk for potentially life-threatening complications of withdrawal, such as delirium tremens, or those with associated medical conditions such as pancreatitis, gastrointestinal bleeding, or cirrhosis.”
Further, they caution that outpatient detox isn’t a suitable option for patients who:
- Are suicidal
- Are homicidal
- Are “in adverse or disruptive family or job situations”
- Cannot travel to the facility as required
If you have a co-occurring disorder (a mental illness accompanying the addiction), an outpatient program might not always be equipped to address both needs.
What Happens During An Outpatient Detox Program?
While most people choose to live at home during outpatient programs, some individuals may opt to live in a sober living home. Outpatient detoxes are offered through hospitals and rehab facilities.
To receive outpatient care, a patient must typically travel to the facility daily, either during the day or in the evening. Certain clinics don’t offer these services on weekends. Some outpatient programs combine day hospital programs into the detoxification regime.
Prior to treatment commencing, you must undergo an initial screening and assessment. This should include a full health and medical history and a physical exam. These findings help the facility to tailor the detox program to your needs. Laboratory tests may be ordered at this time as well.
The exact detox protocol will be adapted to a person’s health and medical history. For example, if a person has any co-occurring disorders they may require certain medications or greater emotional support.
What Medications Are Used During Detox?
When you first arrive, detox will be initiated. This will include a thorough explanation of the process and medications, any risks, and special precautions you should keep in mind. At this point, should you require medications, the first dose will be administered.
Here’s some medications commonly used to detox:
- Chlordiazepoxide (Librium)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Oxazepam (Serax)
Other medications may include:
- Atenolol (Tenormin)
- Carbamazepine (Tegretol)
- Clonidine (Catapres)
- Gabapentin (Neurontin)
- Haloperidol (Haldol)
- Oxcarbazepine (Trileptal)
- Valproic acid (Depakene)
- Certain antihypertensive agents
- Medications for insomnia
- Medications for anxiety and depression
- Buprenorphine based medications (Suboxone, Subutex, and Zubsolv)
- Medications for anxiety and depression
- Medications for insomnia
- Depending on the drug of abuse and severity of addiction, you may be required to take doses while you’re at home.
How Long Are Outpatient Detox Programs?
Program length can vary, and is dependent on the drug of abuse and severity of addiction. Many outpatient programs may offer three, five, or seven day detoxes. At first glance, this may seem ideal, after all, won’t these permit you to be back at it within a week or less?
A vast majority of addicted individuals need more time than this, and any less may leave person still in the midst of withdrawal, and with a limited chance of success. Detoxing may take upwards of two weeks for some individuals.
Because of the assessment and education which occurs at your first session, the first will likely be longer than the others. The following sessions may be anywhere from 15 to 30 minutes or more. If you’re taking part in a day hospital program, sessions may be several hours.
Rehab Should Follow Detox For The Best Treatment Outcomes
Detox shouldn’t be viewed as a final destination. Detoxing is only the first step within effective and long-lasting treatment. For the best results you should continue your treatment with drug rehab. Selecting a facility which offers rehab can make this transition much easier on you, in a way which can enhance your success and decrease your stress.
According to the National Institute on Drug Abuse, “medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use.” While detox treats the physical addiction, drug rehab treats the psychological one. Without this dual approach, many people fail to obtain a sober state or relapse when they do.
Locate An Outpatient Program Near You Today
If you feel that any of these concerns are making it difficult for you to choose the detox program you need, don’t give up. The staff at RehabCenter.net is highly trained and up to date on all the best resources. Together we can design an individualized treatment program, including detox and rehab.Article Sources
American Family Physician - Alcohol Withdrawal Syndrome
American Family Physician - Management of Withdrawal Syndromes and Relapse Prevention in Drug and Alcohol Dependence