Detoxification is the process by which an individual seeks to overcome alcoholism or drug addiction while under the treatment of experienced addiction medicine physicians. The patient may reside in a rehabilitative facility or a hospital or be treated as an outpatient. People who are addicted to alcohol or drugs should not attempt to stop taking alcohol or drugs on their own, because their withdrawal symptoms may be very severe (such as hallucinations, delusions, high fevers), and even fatal. About 10 percent of all substance abuse treatment facilities in the United States (including inpatient and outpatient facilities) offer some form of detoxification treatment.

The time that is required for the detoxification process varies according to the drug to which the person is addicted, the degree of addiction, and other factors, but generally, detoxification takes at least several weeks. However, some physicians offer ultrarapid detoxification, in which the individual undergoes detoxification while under anesthesia. This process is very controversial, and it is extremely costly. It must be performed in a hospital.

Individuals who are addicted to alcohol cannot readily stop drinking if and when they decide to do so (although they and their loved ones may believe that they can). However, medications and therapy may help achieve this goal.

Medications that can be used In the past and often in the present, Disulfiram (Antabuse) has been used to detoxify alcoholic patients on an outpatient basis. Disulfiram is used as an aversive form of therapy. When it is taken, if patients subsequently consume any amount of alcohol, even an extremely low amount, as with cooking sherry, they become extremely nauseous and vomit copiously. Even the alcohol in a shaving lotion can induce the severe vomiting response. Often patients actively resist taking disulfiram because of this extreme side effect. Experts disagree about the efficacy of this drug, although many treatment centers continue to use it.

Other drugs that have been successfully used to treat individuals for alcoholism are Acamprosate (Campral) and naltrexone (Revia). Sometimes a combination of drugs is used to detoxify patients with alcoholism.

Some experts believe that only inpatient rehabilitation for alcoholism is effective, while others believe in outpatient treatment combined with a twelve-step group, such as Alcoholics Anonymous. Many experts believe that a combination of therapies, such as medication, psychotherapy, and a support group, is the most effective means in helping patients to stop drinking.

References:

O'Connor, Patrick G., M.D. "Methods of Detoxification and Their Role in Treating Patients with Opioid Dependence." Journal of the American Medical Association 294, no. 8 (August 24/31, 2005): 961-963.

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