Opiate Detoxification Program

What all is involved in opiate detoxification? Whether you are dealing with heroin or prescription opiates the process is often the same. It is very important to note that there is a distinct difference between medical stabilization of someone with opiate dependence and a complete detoxification. The definition of detoxify is; to remove a harmful substance (as a poison or toxin) or the effect of such from, let’s say the body. Now, this can be argued as to ones beliefs of a partial agonist like buprenorphine (the opiate agonist in Suboxone and Subutex) being a harmful substance and therefore the removal of it, et cetera. For purposes here we will consider detox to be the removal of all opiates, opioids, and opiate agonists to include; methadone and buprenorphine.

The process of detoxification is theoretically very simple. The body, having an increase in dopamine agonists (i.e. heroin, prescription opiates, buprenorphine, methadone, et cetera) has a physiological adaptation to this in a number of ways. There is an increase in receptor site density at dopamine receptors and other systems and chemicals as the body adapts to the increased dopamine and dopamine agonist levels. While usage continues the body functions normally, of course we should also consider the tolerance increases and need for higher amounts of these chemicals, but we will not go into great detail there. When the amount of dopamine and dopamine agonists decrease the body can no longer function normally and there is a compromise of homeostasis in a multitude of systems.

Because of the many changes, adaptation back to normal state is a gradual process but the withdrawal symptoms experienced most severely at the beginning can be stabilized. Many places use methadone, Subutex or Suboxone to accomplish this. Suboxone tends to be the most preferred method currently because of its added chemical naloxone which limits the threat of abuse. The duration of this process depends on the individuals responses to treatment in the outpatient setting but often follows a rigid timeline when done residentially. There is typically a stabilization period on the partial agonist used and then a gradual taper until the medication is completely removed from the treatment. Throughout this process other medications are often prescribed to treat any symptoms associated with the gradual taper and therefore minor withdrawal symptoms. Ideally this is done in conjunction with psychiatric care, individual therapy, group therapy, and family therapy. As each facility may vary in their detox protocol it is advisable that you inquire for information specific to the clinic. Detoxification alone has not shown to be very effective for long-term increases in quality of life or sobriety. It is advised that an individual combine this with other therapies for greater effectiveness.

www.midwestinstituteforaddiction.org