Some Important Considerations Regarding Medical Detoxing from Opioids
People seeking to break the vicious cycle of addiction to opioids (including prescription medications, such as oxycodone and fentanyl, or morphine, heroin, etc.) may derive great benefit from medical opiate detoxing, as an initial step forward in the recovery process. However, it should be noted detoxing is widely considered to be just that: an initial step.
According to the National Institute on Drug Abuse (NIDA), “medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and can, for some, pave the way for effective long-term addiction treatment. (However, it) is only the first stage of addiction treatment and patients should be encouraged to continue drug treatment following detoxification.”
That being said, when reviewing one’s choices about where to undergo medical detox for opioids, it would be wise to look to the standards established by government-credentialed addiction researchers and professionals. The National Center for Biotechnology Information (NCBI) states, “the detoxification process consists of the following three sequential and essential components: evaluation, stabilization, and fostering patient readiness for and entry into treatment.”
They note that “a detoxification process that does not incorporate all three critical components is considered incomplete and inadequate by the consensus panel.”
Many medical detox protocols utilize “short-term” substitution of one of a relatively small number of pharmaceuticals for a person’s addictive substance. In 1981, the FDA (U.S. Food and Drug Administration) approved the use of buprenorphine, as an alternative to its predecessor, methadone, for the treatment of opioid addiction. A few years later (in 1984), naltrexone received FDA approval, adding another clinically-studied alternative to the medical treatment of addiction. (Additional details and research on these three drugs can be found at the NIDA website: https://www.drugabuse.gov/news-events/science-highlight/study-highlights-effectiveness-methadone-buprenorphine.)
Since research has shown stopping opioid use abruptly and on one’s own (‘going cold-turkey’) can put the person seeking recovery at risk, utilizing some form of medical detox treatment offers a much safer alternative, helping the person stabilize, so that moving forward with substance abuse treatment can begin with greater effectiveness.
It should be noted that, according to the Drug Addiction Treatment Act (DATA) of 2000, which focuses on treatment allowed for opioid dependence, doctors may treat recovering addicts either as outpatients or in a residential treatment center. However, any medicines used must be FDA approved and the treating physician must have a U.S. (Drug Enforcement Administration) license to legally prescribe medical detox therapies to patients.
Continuing on after medical detoxing with a planned treatment program has been widely observed as a critical component in establishing long-term recovery. Indeed, whether or not a person’s medical detox is worthy of being considered “successful” has a great deal to do with their entering and completing a treatment plan that addresses their specific substance abuse disorder, post-detox.
For anyone considering medical detox to start themselves along the path forward to treatment for a substance abuse disorder involving opioids, the bottom line can be summed up by quoting the authors of a detox research study (Kertesz, et al): “Successfully linking detoxification with substance abuse treatment reduces the ‘revolving door’ phenomenon of repeated withdrawals, saves money in the medium and long run, and delivers the sound and humane level of care patients need.”
 Kertesz S G, Horton N J, Friedmann P D, Saitz R, Samet J H. Slowing the revolving door: Stabilization programs reduce homeless persons’ substance use after detoxification. Journal of Substance Abuse Treatment. 2003