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Prescription Drug Detox Centers

man holding a prescription pill and glass of waterPrescription drug abuse is a growing concern in the United States. In fact, the U.S. Department of Health and Human Services has called opioid abuse (a phenomenon that encompasses prescription painkiller misuse) an epidemic.1 Prescription drugs—whether they are opioids, sedatives, or stimulants—can treat many conditions, but they can also be very addictive. Once someone starts abusing them, it can be very difficult to quit, and the process of quitting becomes even more challenging due to unpleasant withdrawal symptoms.

The withdrawal symptoms for different prescription drugs can range in severity, but they may be fatal in some cases. Treatment at a prescription drug detox center may help reduce the risks of withdrawal and ensure a person’s safety and comfort. After someone completes detox, they should continue with some type of formal drug treatment to help them maintain abstinence and cement their newfound sobriety.

Painkillers

Prescription painkillers help reduce a person’s perception of pain. However, if people use prescription painkillers incorrectly or on a long-term basis, they can develop physical dependence, which means their bodies adapt to the presence of the drug. The development of significant physical dependence often accompanies the onset of addiction. Many people also develop addictions to these medications because they can produce feelings of euphoria.14

The most commonly abused of all prescription medications are opioid painkillers—a group of drugs that includes:5

  • Fentanyl.
  • Hydrocodone, a component of brand-name drugs such as Vicodin.
  • Oxycodone, a component of brand-name drugs such as OxyContin or Percocet.

When people who are dependent on or addicted to painkillers stop using, they may develop withdrawal symptoms. Painkiller withdrawal symptoms can vary by drug and by a person’s physical and psychological makeup, but often include:3

  • Agitation.
  • Anxiety.
  • Muscle aches and pains.
  • Insomnia.
  • Teary eyes.
  • Runny nose.
  • Sweating.
  • Abdominal cramps.
  • Vomiting.
  • Diarrhea.

People who relapse after a period of abstinence may be at increased risk of overdose.

The withdrawal timeline varies by drug and individual, but symptoms often begin within a few hours of last use. Acute painkiller withdrawal symptoms usually last 4-10 days in the case of short-acting opioids, such as heroin or codeine, or 10-20 days for long-acting opioids, such as methadone. Some people may experience prolonged withdrawal symptoms that can include strong cravings and feelings of reduced well-being for up to 6 months.6

Withdrawal symptoms alone are not usually lethal. But some of the complications associated with these symptoms can be fatal. For example, people who relapse after a period of abstinence may be at increased risk of overdose because their bodies lose tolerance to the drug.6 In addition, people who experience vomiting or diarrhea can develop complications such as dehydration or lung infection secondary to aspiration of gastric contents.3

Benzodiazepines/Sedatives

sad woman lying in bed looking at benzodiazepine pillsBenzodiazepines are controlled substances that are often used to treat anxiety, panic disorder, and muscle spasms. But they are also used for conditions such as seizures or convulsive disorders, as well as during the alcohol detoxification process.8 They can produce pleasant feelings of calm and relaxation.

Some of the more commonly prescribed benzodiazepines include:8

  • Alprazolam, sold under the brand name Xanax.
  • Clonazepam, also known as Klonopin.
  • Diazepam, sold as Valium.
  • Lorazepam, also known as Ativan.

Users can quickly develop dependence on these drugs when they use them repeatedly. The severity of dependence is influenced greatly by the average dose used, and the frequency of use, as well as the full duration of use. When they stop taking the drug, they may experience benzodiazepine withdrawal symptoms, such as:8

  • Anxiety.
  • Increased heart rate.
  • Increased blood pressure.
  • Insomnia.
  • Seizures.

Withdrawal affects everyone differently, and the timeline for withdrawal varies by drug. For short-term benzodiazepines such as Xanax, people may develop acute benzodiazepine withdrawal symptoms within 2 days of their last use, with symptoms lasting for 2-4 weeks or longer. For longer-acting benzodiazepines such as Valium, symptoms may not begin for 2-7 days and continue for 2-8 weeks or longer.6 Some people may experience prolonged withdrawal symptoms such as anxiety, depression, and insomnia for several months.8

Some of the risks of withdrawal can include seizures or a condition known as delirium tremens, which involves symptoms such as hallucinations, tremors, anxiety, and confusion.8

Stimulants

Stimulants are prescribed to treat certain mental health conditions, such as ADHD (attention-deficit hyperactivity disorder) and narcolepsy (a type of sleep disorder). When used correctly, these drugs are usually safe. However, some people can develop dependence and addiction, especially when the drugs are abused. For example, people might abuse stimulants to get high or remain awake, such as when they are cramming for exams.9

Commonly abused prescription stimulant drugs include:5

  • Amphetamines, such as Adderall, Dexedrine, and Vyvanse.
  • Methylphenidate, such as Concerta or Ritalin.

Stimulant withdrawal symptoms can include:5,10

  • Depression.
  • Cravings.
  • Fatigue.
  • Sleep disturbances.
  • Chills.
  • Weight loss.
  • Anxiety.
  • Memory problems.

Withdrawal symptoms usually develop within a few hours to a few days after the last use. 10 Symptoms may last for a few days to a few weeks.11

Although stimulant withdrawal symptoms alone are not usually life-threatening, some people may suffer from suicidal thoughts and actions or violent behavior. Further complications from stimulant withdrawal can include intense cravings, severe depression, or self-medication with other drugs, such as alcohol, benzodiazepines, or opioids.

How Detox Centers Can Help

Nurse assisting patient in detox centerEngaging in a professional detox program may decrease a person’s risk of relapse and help them complete the withdrawal process.

The benefits of professional detox centers include:

  • Being equipped to attend to a person’s needs during withdrawal, providing continuous monitoring, and ensuring a person’s safety.
  • Providing medication for withdrawal symptoms.
  • Treating any mental or physical health complications.
  • Offering referrals to treatment programs after someone has completed detox so that they can continue their recovery.

The level of care and intensity of detox clinics can vary based on the level of a person’s addiction and dependence. People with severe addictions or who otherwise have been abusing prescription drugs for a prolonged period of time should consider detox treatment in a hospital, standalone detox center, or inpatient facility. These people may have a higher risk of more serious withdrawal symptoms and will benefit from supervision and medical detox management.

People with less severe addictions, who do not suffer from any physical or mental health issues, and who have a strong support system may benefit from detox on an outpatient basis or through assistance from their doctor.

After Detox

Regardless of the method or setting of detox a person selects, those addicted to prescription drugs will benefit from treatment in a recovery program after they have completed detox. Recovery programs include both residential rehabs and outpatient substance abuse treatment.

Recovery programs provide a number of benefits, such as:12

  • Helping people build skills to resist the urge to use.
  • Helping people develop improved problem-solving skills.
  • Helping people learn to repair relationships that may have suffered because of their drug abuse.
  • Helping them return to work or their regular daily activities.
  • Helping them address mental health problems.

Detoxing at Home

People might sometimes feel a bit resistant to professional detox because of the costs, or because they feel they can manage their withdrawal alone. But they might not be aware of the risks associated with quitting cold turkey or detoxing at home.

Some of these risks can include:12

  • Relapse. Addiction is a chronic disease, and without proper support, they might be tempted to start using again.12
  • Overdose. Someone who does suffer a relapse may resume using the previously prescribed dose. However, after a period of abstinence, tolerance decreases and the risk of overdose increases.6
  • A lack of immediate access to medical care. If a person suffers from complications while detoxing at home, such as depression or seizures, they won’t have immediate access to the medical care available in detox centers.
  • A lack of support and guidance to help a person address the issues that led to their addiction. Without awareness of the cause behind the addiction, a person may have a higher risk of relapse in the future. Professional treatment, especially behavioral therapy, can help one work through issues and increase their ability to function without drugs.

Sources

  1. U.S. Department of Health and Human Services. (2017). About the Epidemic.
  2. National Institute on Drug Abuse. (2016). Abuse of Prescription (Rx) Drugs Affects Young Adults Most.
  3. U.S. National Library of Medicine. (2016). MedlinePlus, Opiate and opioid withdrawal.
  4. National Institute on Drug Abuse. (2016). Misuse of Prescription Drugs: Summary.
  5. National Institute on Drug Abuse. (2016). Commonly Abused Drugs Charts.
  6. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings: 4. Withdrawal Management. Geneva, Switzerland: World Health Organization.
  7. National Alliance of Advocates for Buprenorphine Treatment. What it is like to be addicted.
  8. Longo, L. and Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61(7), 2121-2128.
  9. National Institute on Drug Abuse (for Teens). (2017). Prescription Stimulant Medications (Amphetamines).
  10. Center for Substance Abuse Treatment. (2001). Quick Guide for Clinicians Based on TIP 33: Treatment for Stimulant Use Disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration
  11. Australian Government Department of Health. (2004). The amphetamine withdrawal syndrome.
  12. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
  13. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. 2. Settings, Levels of Care, and Patient Placement. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  14. National Institute on Drug Abuse. (2016). Which classes of prescription drugs are commonly misused?

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