NIDA, or National Institute on Drug Abuse, defines detox as removal of all toxic and drug-related substances from a person’s organism as well as dealing with the symptoms of withdrawal at the same time.
In a more general sense detox is necessary for a person’s organism in order to function properly. All cells are able to detoxify themselves; however, the most essential organ in this network is the liver. It takes most of the detoxifying work on itself.
The liver deals with toxins in the form of water- and fat-soluble molecules; the former of which are washed out with the urine and are pretty easy to get rid of, while the latter tend to hide in fat cells and take far longer time to leave and are harder to get rid of.
One of the drawbacks of overweight is the excess of fat in the body and internal organs (this alone is fraught with various health-related conditions); however, with the impact of toxins added the risk increases.
Phases of Detoxification
The process of detoxification consists of three major stages. Phase I presupposes that toxins are eliminated by phase I enzymes and develop as metabolites in the result. The most common phase I enzyme is cytochrome P-450s.
The aforementioned enzymes have got two major functions in the process of detoxification – they make toxins more water-soluble and they cause the molecule transformation that results in the appearance of a less toxic molecule. As a result, they are easier eliminated through the blood and then urine system.
Phase II is noted by its most known enzyme – glutathione (GSH) transferase. Its function is obvious – it transfers GSH molecule onto the toxin and by doing so, makes the latter even more soluble and easier to remove from the system. There are also a number of other molecules that serve in a similar way – they bind to a toxic molecule and make it more water-soluble. Among them are amino acids, sulphates as well as glucuronic acid. Excessive toxic exposure can cause deficit of GSH due to the fact that all its stores will go to the detoxifying process.
Phase III means that toxins are eliminated from cells. This is the stage when all the metabolites and products that appeared on the previous stages are transferred to blood stream and removed.
Detoxification is the first stage of drug or alcohol dependence or addiction treatment. This stage is usually closely related with a medical treatment program and is meant to cover two major objectives – 1) to eliminate all drug toxins from a person’s organism, 2) alleviate the period of withdrawal.
Drug detox programs vary a lot as rehab centers and their programs do. All of them are very individualized and are offered with specific addiction as well as health state of a person in mind.
Detox is usually comes first in all of these programs. It is a physiological process that can be experienced in a pretty different way by each person. There is a list of factors that should be taken into consideration when detoxification is considered.
- The type of a drug used;
- Common daily dose;
- Any other drugs used recently;
- Any mental health disorders (dual diagnosis);
- Any health conditions in medical history;
- The history of medications’ therapy (any);
- Individual physiology of a given person.
Withdrawal is as closely connected with detox process as one can imagine. As it has already been mentioned, detoxification is meant to help to live through withdrawal period easier; however, the length as well as severity of this stage correlate with individual state of health of a person as well as the drug in question; the same can be said about medications chosen to help.
There are several withdrawal symptoms common for all drugs; however, it is not necessarily that all of them will occur in the course of the treatment. Most common are:
- Various cravings – first of all for the substance itself;
- Sleeping problems;
With the beginning of a detox process, it is likely that withdrawal symptoms show up in the following 24-48 hours. However, the term also depends on the drug in question – with some you can expect withdrawal as early as 10 hours after the last dose. The initial detox period is the most intense and severe for a person – withdrawal is the harshest; after some time it is easier to handle.
Most frequently withdrawal symptoms can be expected closer to the time when the next dose was supposed to take place. Physical withdrawal climax is usually within the first several days; then symptoms tend to subside and fade. However, psychological symptoms are likely to stay for months; and this is the hardest and trying part when a person is at risk to relapse.
Drug detox can be short-term, where you get basic help and emergency care for the period when withdrawal is the hardest; it can also be an all-included program with all the services and options individually tailored to a patient’s needs. Taking into consideration individual health and mental conditions, any underlying issues and risks, all detox options can be divided into the following groups:
- Natural Drug Detox. This option presupposes that a person quits drugs “cold turkey”. Which actually means that a person stops taking a drug and overcomes its addiction or dependency on their own but under the supervision of medical professionals. One of the hardest challenges of this method is that an onset of withdrawal symptoms has to be endured just as it is; and an organism has both to cleanse itself from a drug and tolerate the symptoms that come with the deficit of the substance an organism got used to. In a great number of cases the sensation is too hard to bear and a person relapses.
- Medical Drug Detox presupposes all the same things; however, the stage of withdrawal is easier to overcome due to the use of drugs that create the impression of restored substance deficit in the system, but they do not cause dependence or addiction.
Among such medications are synthetic opiates, e.gg methadone and buprenorphine – they are frequently used in the process of heroin withdrawal as well as withdrawal from Vicodin and OxyContin and etc. These medically approved drugs serve to support the impression of substance intake, however, in much smaller dosages, until the time they are no longer needed. This is a much easier way to tolerate withdrawal; however, there is a risk of developing medical drug dependence – as many do.
- Medical care: First stage of any drug detox program is related to medical assessment and evaluation. Not every person on drugs requires hospitalization; however, all of them need to be made sure that they can go through detox process without any additional complications.
- Therapeutic support: As long as detox means withdrawal, and withdrawal first starts with physical sensations, it is essential to have all the range of therapeutic options at disposal. Any therapy that can be used for the benefit of the treatment should be available and accessed.
- Regular assessments: Detox process usually takes a while – in some cases up to several weeks; and regular assessments are essential here as they allow understanding how a person’s organism deals with and handles the challenge. They are also necessary to identify any needs that might occur.
- Aftercare support, treatment, or referrals: Detox might be initial, primary part of drug addiction treatment program; however, treatment does not stop there, of course. It is in no way sufficient measure to help a person recover completely.