Does Drug Detox Include Therapy?

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In the scope of addiction treatment, people can find in a detox program both medical intervention and a starting point for their recovery journey. This journey may continue to include medical help, but treatment outside of detox will rely heavily on therapy.

Does Drug Detox Include Therapy?

If you are beginning the addiction recovery process, then you may be facing the need for inpatient detoxification to address withdrawal symptoms.

A drug and alcohol detox program offers many medical interventions to help clients get through uncomfortable and sometimes serious withdrawal symptoms.

This may include the use of medications such as buprenorphine, naltrexone, methadone, and others, which may also help with drug cravings.

Finally, a detox program acts as a bridge from detox to addiction treatment in either a residential or outpatient setting offering behavioral therapy and other treatment options.

Does Drug Detox Include Therapy?

Medical detox includes supervision during the detox process and the use of medications to address symptoms of withdrawal and related health complications. Medications can also address cravings and make them manageable.

While most drug detox programs do not provide behavioral therapy, it is essential that detox centers act as a bridge to inpatient or outpatient drug abuse treatment programs.

Behavioral therapy and related interventions are what the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends for long-term recovery.

The Drug Detox Process

In its recommendations for drug and alcohol detoxification, SAMHSA names three necessary components: evaluation, stabilization, and preparation for entry into treatment.

A quality detox program for drug withdrawal acknowledges that some clients may have trouble seeing that addiction recovery encompasses more than getting through withdrawal.

This is why the third component, preparing clients for a long-term treatment plan, is essential during a detox program.

Medical Care For Withdrawal

Medical detox programs address drug withdrawal through 24/7 monitoring and the use of medications to treat or prevent uncomfortable, serious, or even life-threatening symptoms.

These methods stabilize the client, preparing them for entry into a substance abuse treatment program.

Opiate And Opioid Withdrawal

Detoxification support during opioid withdrawal is often critical, as withdrawal from heroin, prescription opioids, or synthetic opioids like fentanyl can be life-threatening at times.

Medications used during opioid withdrawal, such as methadone, buprenorphine, or naltrexone, can help control withdrawal symptoms that can lead to dangerous conditions such as dehydration.

Following detox, the use of a specific medication may carry over into medication-assisted treatment (MAT), which also involves behavioral therapy for addressing the root causes of addiction.

Some inpatient and outpatient treatment centers offer opioid detox services prior to a treatment program, which typically includes MAT services, providing a full continuum of care.

Alcohol Withdrawal

Alcohol detox provides monitoring for the sometimes severe, even life-threatening symptoms of alcohol withdrawal, such as delirium tremens (DTs) or seizures.

These symptoms are typically associated with severe alcohol addictions or prolonged, heavy alcohol use.

Symptomatic care for alcohol withdrawal may include the use of benzodiazepines to help with anxiety, agitation, and sleeplessness. Other medications may include anticonvulsants for seizures.

Medications that may be used to help during or following alcohol withdrawal include naltrexone, acamprosate, disulfiram, and others.

Paving The Way For Long-Term Addiction Treatment

Once a person no longer has drugs or alcohol in their system and is medically stable, they are ready for the third and final component of detoxification: an introduction to addiction treatment.

One key way that addiction is recognized and diagnosed is through a person’s behaviors related to drug use. Behavioral therapy aims to change these behaviors related to substance abuse.

SAMSHA recommends therapeutic intervention early in the recovery process, i.e., at the detox stage, as a way of helping clients more easily transition to a treatment program.

People’s needs during recovery may also include peer support, MAT, relapse prevention, life skills education, and more.

Behavioral Therapy Interventions

SAMHSA recommends cognitive behavioral interventions as part of effective strategies for initiating patients into long-term treatment.

Therapeutic interventions that may be started during detox include:

  • cognitive behavioral therapy
  • dialectical behavior therapy
  • motivational interviewing

Cognitive Behavioral Therapy (CBT)

CBT is a foundational treatment modality for drug and alcohol addiction and is a mainstay in many treatment programs.

CBT for substance use disorder is founded on three principles:

  • substance use disorder is, in part, the product of unhelpful thought patterns
  • substance use disorder is, in part, the product of unhealthy behaviors
  • people have the ability to overcome substance use disorder by changing unhealthy thought patterns and behaviors

This form of talk therapy helps clients identify unhelpful beliefs and behaviors and replace them with positive, helpful ones.

Dialectical Behavior Therapy (DBT)

DBT is also broadly used for drug addiction treatment as well as co-occurring mental health disorders.

This form of talk therapy is based on CBT, but DBT is often best suited for people who have difficulty managing their emotions.

“Dialectic” describes bringing two opposite ideas together. In addiction treatment and other therapy settings, this typically refers to acceptance and change.

Motivational Interviewing (MI)

MI is designed to help clients find intrinsic motivation to pursue sobriety by resolving ambivalent beliefs that might prohibit them from taking action.

Four principles for counselors or therapists offering MI include:

  • expressing empathy for their clients
  • supporting their self-efficacy
  • rolling with resistance
  • developing discrepancy

By focusing on these principles, therapists help their clients recognize their own motivation to stop using drugs, which can be critical in recovery.

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