Detoxification

Detoxification is a process through which the body uses the liver to rid itself of dangerous and harmful substances. Withdrawal is a carefully supervised treatment process which includes using closely monitored medication to maintain the stability of the patient while the body detoxifies itself.

Withdrawal Symptoms

When any addictive drug, such as alcohol or a barbiturate, is used regularly over a period of time, the body adjusts to the drug's effects, thus 'working around" the drug. Once this adjustment takes place, any drop in the body's level of the drug will eventually cause withdrawal symptoms.

Total elimination of the drug is not necessary to cause withdrawal symptoms. Simply cutting back on use may bring on symptoms of withdrawal. By having an early morning drink to ease the "shakes," a person is, in fact, treating early withdrawal symptoms. Severity of withdrawal has much more to do with how long and how regularly the addictive drug has been used than the amount used. Unfortunately, we have no way to accurately predict who will experience severe withdrawal and who will not.

To control withdrawal symptoms, special medications are given for a very short time - generally 24 to 48 hours for most addictive drugs. These medications help the body get through the most dangerous period. They take the place of the drug while the body detoxifies it- self and adjusts to living without it. Untreated withdrawal, however, can some- times result in severe illness or even death. Untreated withdrawal is dangerous business.

Alcohol

Alcohol withdrawal produces four major withdrawal syndromes, or groups of symptoms. However, while they are discussed separately here, in real life these syndromes blend together. The most common syndrome begins with a "trembling" feeling, often called "the shakes." The shakes may worsen to include other symptoms, such as a fast heartbeat, fever, high blood pressure, a flushed or red- colored face, short temper, and sleeping difficulties.

Hallucinations, seeing or hearing things that aren't real, mark the second major alcohol withdrawal syndrome. The third syndrome, seizures, commonly known as "rum fits," involves loss of body control, muscle spasms, and loss of consciousness.

Delerium tremens (DT) is the most serious symptom of alcohol withdrawal. Early with- drawal symptoms worsen markedly, and often fearful hallucinations appear. Once begun, the DT process is nearly impossible to reverse, and can prove fatal.

Barbiturate Sedatives

These chemicals, which include such drugs as Seconal and Nembutal, produce withdrawal symptoms much like those of alcohol. In addition, they may cause nausea, vomiting, panic, weakness, and diarrhea. Close supervision during withdrawal is advised.

Nonbarbiturate Sedatives

These chemicals, which include the benzodiazepines, commonly known by such trade names as Valium, Librium, Seraz, and Ativan, are central nervous system depressants.

Both barbiturate and nonbarbiturate sedatives produce a remarkably similar and potentially severe withdrawal pattern. The reaction has been termed the "general depressant withdrawal syndrome." Symptoms may range from minor anxiety to seizures and delirium. The main difference among them involves the onset of symptoms. For example, drugs that are excreted faster, such as meprobamate, produce symptoms sooner than those that are excreted more slowly. Withdrawal can be life-threatening, and requires close medical supervision.

Stimulants

Central nervous system stimulants such as amphetamines, nicotine, and caffeine, and hallucinogens such as LSD and marijuana, cause no significant level of physical addiction and seldom require detoxification. However, their continued regular use often brings about strong psychological dependence.

Opiates

Those withdrawing from heroin, morphine, or other opiates often experience restlessness, shakiness, irritability, vomiting, diarrhea, muscle and bone pain, stomach cramps, rapid heartbeat, and high blood pressure. Severity depends on the rate at which they are eliminated from the body.

Withdrawal under Medical Supervision

Withdrawal carried out under the careful supervision of trained medical personnel can and should be quick, safe, and as painless as possible. The withdrawal symptoms can be largely controlled or entirely eliminated.

Good medical care begins with a complete history and physical examination of the patient. Medication for managing the withdrawal symptoms is prescribed in gradually decreasing amounts for patients who are physically addicted to alcohol or other drugs, and is ended according to the needs of each person.

All patients are watched throughout the withdrawal process by staff who are specially trained in the treatment of addictions.

The goal in treating the withdrawal syndrome is to provide just enough medication to control symptoms without causing too much sleepiness or other side effects.

Giving up any addictive drug can be tough

No person should be alone. Hospitalization should be sought if there is any possibility of problems. At every step along the way, reassurance and support playa most important role.

Because alcohol and other drug dependency affects every area of the patient's life, and because successful recovery involves significant lifestyle changes, detoxification and withdrawal are just the first steps in the recovery process. Once physical withdrawal is completed, an inpatient rehabilitation program or intensive out- patient program, a halfway house, or community services may provide ongoing treatment and support.