Substance abuse detoxification

No medications used in substance abuse detoxification can prevent all side effects. 

In this chapter, we will focus primarily on treatments for the substance use disorders. However, because detoxification during a substance-induced withdrawal is often the first step in treating a substance use disorder, we will discuss withdrawal states to some extent. The substance use disorders include both substance abuse and the more serious substance dependence. Substance abuse consists of a pattern of misuse that causes recurring problems in at least one aspect of life. This can be a failure to fulfill responsibilities at home or work, reckless use of the substance such as drunken driving, repeated substance-related arrests, and ongoing substance use despite resulting problems in family relationships. See Table 6.1 for the diagnostic criteria for substance abuse. 

It is in this context, in which psychosocial treatments have been mobilized and an appropriate treatment setting has been chosen, that medications can be helpful. The use of psychiatric medications to treat substance use in isolation, apart from such a comprehensive treatment plan, sends the wrong message. The substance abuser typically already leans too heavily on substances to either escape or solve problems. We can quickly succumb to the temptation to join in this dependence on substances to resolve all problems. However, in the context of a comprehensive treatment plan, the substance abuser can benefit from psychiatric medication without unduly seeing it as a panacea. Just like the psychosocial treatments, the use of psychiatric medications should be tailored to the individual s specific treatment needs as well. This includes both medications to treat the substance use disorder by detoxification or craving reduction and medications to treat comorbid psychiatric and medical conditions that may be underlying much of the incentive for continued drug use. 

Banbery J, Wolff K Raistrick D (2000). Dihydrocodeine a useful tool in the detoxification of methadone-maintained patients. Journal of Substance Abuse Treatment, 19, 301-5... 

As piperazine abuse has been recognized only recently, specific detoxification, addiction, and rehabilitation programs have not yet been developed, nor are success rates known for specific treatments. Presumably, treatment protocols will follow general principles of other substance abuse programs and will include psychological counseling. 

Kleber HD. Detoxification from narcotics. In Lowinson L, Ruiz P, editors. Substance Abuse. Baltimore Williams and Wilkins, 1981 317. 

The treatment of inhalant abuse faces some serious problems. Some substance abuse clinics often do not even know how to treat inhalant abusers. It is shocking that in spite of the fact that inhalant abuse is a widespread problem, inhalant abusers are often faced with having nowhere to turn to for help. Since inhalant abuse often arises in episodic events in communities, towns facing major problems with youth abuse often find that there is nowhere to accommodate the abusers for treatment and no nearby treatment facilities that can handle detoxification specific to inhalant abuse. Some communities have faced these problems by setting up their own treatment facilities, but this takes time and money. Indeed, with time being critical for treatment of abusers who need it, the lack of adequate treatment... 

Several controlled studies appear to support the use of certain herbal preparations in rational detoxification treatment programs. Exhibit 3 displays findings of selected studies on natural products with apparent efficacy in treating syndromes of substance abuse, withdrawal or addiction. 

Once detoxification is complete, the drug abuser can start the rehabilitation and long-term recovery process with a clear head. Research shows that detoxification alone is not an effective treatment, and addicts who leave rehab immediately after detox with no further counseling or interventions soon abuse methaqualone or another mind-altering substance again. 

Detoxification Of Poisonous Substances. A healthy liver has at its disposal many chemical reactions for the detoxification of poisonous substances. These reactions rely on the presence of enzymes whose activity depends in part on the level of dietary protein, and in part on the need to detoxify substances such as alcohol and various drugs. Therefore, protein-deficient persons may have heightened susceptibility to the undesirable side effects of certain medications. Chronic abuse of alcohol may also impair liver function since it may promote fatty degeneration. In addition to protein, other nutrients which promote liver function are the B-com-plex vitamins, methionine, choline, and lecithin. 

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