When people begin to realize that their substance use has become dangerously excessive, many attempt to do a seemingly simple thing—they attempt to detox from drugs and alcohol by trying to cut back or stop entirely, without knowing the underlying dangers of detox.
They are unlikely to be aware of it, but if they find they are unable to cut back or stop using, they are meeting the first two criteria of a substance use disorder as outlined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders, the tool used widely in the United States to diagnose mental disorders.
If they meet six or more of the eleven criteria, the substance use disorder is considered severe. In his 2016 report, the Surgeon General equated this level of severity with addiction. Trying to stop on your own at this stage is problematic as most people will have misused substances for quite some time.
“The physical symptoms of withdrawal can be very unpleasant and—for certain substances—even dangerous,” says Kacie Sasser, the senior director of medical services at Lakeview Health.
“While withdrawal from opiates is very painful and rarely life threatening, detoxing from alcohol and benzodiazepines without adequate medical supervision can be lethal. Withdrawal from alcohol and benzodiazepines can lead to devastating seizures or delirium tremens that would require medical attention.”
-Kacie Sasser, Senior Director of Medical Services at Lakeview Health
Lakeview Health offers a medical detox program in the in-house facility with around-the-clock supervision by the medical team. “We will make patients as comfortable as possible under the circumstances,” says Sasser. Detoxing at home by going “cold turkey” often fails because the withdrawal symptoms become too unbearable and the person will go back to using drugs or alcohol to alleviate the pain. “Typical withdrawal symptoms include sweating, nausea, vomiting, diarrhea, chills, anxiety, and tremors,” explains Sasser. “At Lakeview, the medical team provides medication therapy that can reduce those symptoms throughout the process.”
Following admission, Lakeview patients are first assessed by qualified physicians who look at all relevant symptoms and determine an appropriate treatment plan based on individual needs. “No detox is going to be completely pain-free, but you’re going to be as comfortable as you possibly can while your body is purged of toxins,” says Sasser. In the initial phase, the efficacy of the treatment is re-assessed on a daily basis.
Another reason why detoxing without the assistance of qualified addiction professionals frequently does not lead to sustained recovery is the failure to address the underlying reasons for the substance use. Addiction is a complex bio-psycho-social-spiritual disorder that requires treatment on multiple levels over a considerable time span. At Lakeview, detoxification is only the first step of a comprehensive treatment program.
In many cases, persistent use over many years has “rewired” the reward cycle of the brain. “Most patients with substance use disorder misused drugs and alcohol to numb their emotional pain, and they became accustomed to relying on substance use whenever they were upset, angry, afraid, or even happy,” says Ashley Harms, the manager of the alumni department at Lakeview Health. “Whenever they have those emotions, the conditioned brain will react with strong craving for the substance.” They become prisoners of the addiction cycle. In his book The Craving Mind, addiction psychiatrist Judson Brewer describes this habit loop as “Trigger. Behavior. Reward. Repeat.”
The underlying issues were masked by narcotics, and if they are not addressed in therapy the patient will continue to mask them. “Patients have to learn different ways of coping with the pain without the negative consequences,” says Harms. “They need to find their authentic selves, so they don’t have to reach for substances to feel better.”
Breaking the addiction cycle requires an integrative approach, including abstinence from substance use, therapies to address co-occurring conditions, and the development of healthy coping skills. “The treatment approach at Lakeview is abstinence-based because the real recovery work happens only in true sobriety,” says Sasser. “Therapy at Lakeview addresses the whole self of the patient, not just the substance use. Recovery is so much more than detoxification. Patients need a lot of professional support, and they won’t get that at home.”
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