KEY TAKEAWAYS
Detox from prescription medication becomes necessary when, as a result of addiction, the individual is either:
Medical professionals usually carry out detoxification in either a hospital or a residential rehab.
Inpatient care has a 3-fold higher success rate compared to outpatient detoxification [1].
What Is Prescription Drug Detox?
Detoxification from prescription treatment means removing dependence on drugs either in a hospital, residential rehab, or at home.
Prescription medication detoxification works by ceasing intake of drugs, while managing withdrawal symptoms using medication.
When Is Prescription Drug Detox Necessary?
Indicators of prescription drug abuse include:
How Is Prescription Drug Detox Done?
Different approaches used during prescription detoxification are:
Which approach to use is decided by professionals who:
Where Prescription Detox Takes Place
Header | Unsupervised | Outpatient |
---|---|---|
Duration | Up to 90 days | 3-14 days |
Advantages | Unsafe practice | Able to |
Cost | Free (NHS) | Free (NHS) |
Risks | Hallucinations | Withdrawal |
Header | Private Detox | Hospital Detox |
---|---|---|
Duration | 14-28 days | Up to 60 days |
Advantages | Away from | 24-hour supervision |
Cost | £ | Free (NHS) |
Risks | Minimal | Minimal [2] |
Prescription Drug Detox & Medicine Prescribed In The Community
Prescription drug detoxification is typically set up in the community and either carried out in the community or a private treatment facility.
A private treatment provider will only detox when appropriate, meaning each clinic's medical professional must assess each client individually to decide whether detoxification is appropriate.
In most cases, a doctor in a private medical setting will only intervene upon prescribed medicine by an external doctor if:
Prescription Drug Detox vs "Cold Turkey"
Header | Prescription Drug Detox | “Cold Turkey” |
---|---|---|
Risks | Managed via individualised care plans | Not managed professionally; |
Side Effects | Controlled with detox medication | Seizures, psychosis and |
Timescales | 28 + days | Up to 6 months |
Long Term Outcomes |
Detoxing From Multiple Prescription Drugs Simultaneously
The complications involved in detoxification from multiple medications, as compared to one substance alone, are:
Here at Abbeycare, our clinicians routinely approach multiple prescription drug detoxification by completing a joint assessment that takes into account the clients':
Needs Prescription Drug Detox vs Wants Prescription Drug Detox
There is a difference between those who need to detox from all medications, and those who want to detox from all medications but should not.
Examples of those wanting prescription detoxification, but who do not need to, include:
Examples of those needing to detoxify from prescription medication, but who do not want to, include:
The requirement for prescription drug detoxification depends on whether active addiction is present.
Those who want to detox willingly may achieve better results due to:
Detoxing From Maintenance Medication
Special considerations are required when a client wishes to detox from a maintenance medication, such as:
Detoxification from maintenance medication must be endorsed by GPs or other medical professionals who prescribe maintenance medication.
Detoxification must also be communicated to the pharmacy providing medication.
When Detoxing From Prescription Drugs Is NOT Appropriate
During Pregnancy
While detoxification from prescription drugs during pregnancy is possible, detoxification from maintenance drugs, such as methadone or buprenorphine, can cause miscarriage or early labour [10].
Doctors may replace faster-acting benzodiazepines (diazepam and clorazepate) with longer-acting benzodiazepines (flurazepam or prazepam) to reduce harm to the baby [11].
Psychoactive Medications
Desire for detoxification may increase when the patient is feeling well as a result of taking medication in the correct prescribed dosage.
Instead of detox, doctors recommend switching the patient's current antipsychotic for one with fewer side effects (e.g., quetiapine or ziprasidone) [12].
Epilepsy In Benzodiazepine Withdrawal
Detoxification from benzodiazepines may not be appropriate when the patient suffers from pre-existing epilepsy, as benzodiazepines reduce epileptic seizures.
When a patient wishes to withdraw, doctors must give the patient another anti-seizure medication before withdrawal occurs [13].
Multi-Substance Abusers
It is not appropriate to attempt detoxification combined prescribed and illicit drug users from only prescribed drugs when:
Suicidal Ideation
Detoxification is inappropriate for those experiencing suicidal ideation as it may exacerbate symptoms of depression or anxiety and worsen suicidal thoughts [14].
Lack Of Supervision
When detoxing in the community, a lack of professional observation can mean detoxification is inappropriate, as:
Anti-Depressant Interactions
Warfarin
It is inappropriate to detox when taking Warfarin as ibuprofen and acetaminophen, commonly used during detox, increase bleeding in Warfarin users [21].
Chronic Underlying Pain
Detoxing is not appropriate when the patient is suffering from undiagnosed chronic pain as:
Personal Preference
Patients may wish to detox from all prescribed medication as a result of:
However, detoxing may not be appropriate if the patient needs medication to manage an ongoing condition (e.g. schizophrenia, bipolar, or borderline personality disorder).
Benzodiazepine Users
Benzodiazepine users may be unable to detox appropriately as benzodiazepine detoxification can take up to 18 months, and professional supervision may not be available for that timeframe [23].
Detoxing From Prescription Drugs vs Detoxing From Other Substances
Header | Prescription | Opioids | Stimulants |
---|---|---|---|
Detox | Up to 6 months | 28+ days | 2 weeks |
Severity Of | Insomnia, | Rhinorrhea, | Hallucinatio |
Dangers Of | Possibility of | Opioid | Post-acute |
Long Term | Reduction in | Regain | Reduction |
Header | Benzodiazepines | Alcohol |
---|---|---|
Detox | 28+ days | 7-10 days |
Severity Of | Panic attacks, | Delirium tremens, |
Dangers Of | Depersonalisation/ | Alcohol withdrawal |
Long Term | Improved cognitive | Preventing further liver damage and increasing life |
Prescription Drug Detox At Abbeycare
Here at Abbeycare, each client is assessed individually before admission to determine:
Abbeycare offers detox alone and as part of a complete rehab programme [32].