Why a Medically Managed Detox is Important
Some of you may be familiar with what withdrawal might look like if you’ve seen the movie, The Basketball Diaries starring Leonardo DiCaprio. In one of the scenes, Leonardo DiCaprio is experiencing withdrawal with no medical intervention and trying to go ‘cold turkey.’ He’s become addicted to Heroin and with the help of his friend Reggie he attempts to detox.
It’s true what you’ve seen in some movies or TV shows. Detox also referred to as withdrawal management, can be an uncomfortable and possibly dangerous if not executed properly. Detox is completed by patients that have severe dependence on alcohol or other drugs and need assistance getting rid of all these chemicals from the body. Not all detoxes are the same and can differ from person-to-person.
What is a Medical Detox?
According to research, a medically supervised detoxification treatment has always been seen as the “gold standard” and as a reasonable position to begin treatment. It’s important to clarify that medical detox will mitigate but does not always eliminate the discomfort.
At the EHN’s Bellwood Health Services, a medically managed detox is carried out because there are some serious health risks for clients coming off alcohol and or other drugs, such as seizures and other possibly life-threatening symptoms. At EHN, our detox includes the involvement of a medical doctor, a psychiatrist may be involved, a nurse, and support staff (counsellors).
According to Joshua Montgomery, Director of Nursing and Admissions at Bellwood Health Services, the process of a medically managed detox all depends on the substance. At Bellwood, the length of time a person is in detox can vary from three to ten days depending on whether the person has become addicted to opiates, alcohol or benzos. A thorough assessment using the Clinical Opiate Withdrawal Scale (COWS) or the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) to provide a framework to assess where the person is within their withdrawal and to determine what support the person requires and the medical attention needed.
Are There Risks Having a Non-Medically Supervised Detox?
Joshua Montgomery states that going through withdrawal can be dangerous, “People going through withdrawal without any medical supervision will experience withdrawal symptoms to a greater degree than a medical detox. Yes, it can be dangerous. There are various levels of care someone might need. I would advise against that and to speak to a healthcare professional to determine the best course of action to take. We don’t want to support someone with their medication that they are trying to get off of but I rather have them wait a few days to receive medical attention than trying to detox on their own if the circumstances doesn’t allow them to immediately access medical detox services. We want to promote a safe and healthy detox.”
What Happens After Detox?
Joshua Montgomery shares, “Some clients might need continued monitoring. We eventually begin to integrate a client into our program. We motivate them and give them the freedom to do what they are ready to do. We use placement criteria to assess and determine what’s the best course of treatment that the client needs. We want to meet the client where they’re at. We want to encourage them to choose recovery and support them through the process.”
If you know someone who requires detox (withdrawal management) there are many organizations, including Bellwood Health Services, that can provide this delicate service across Canada. Give us a call to learn about the range of services and treatment programs we offer for alcohol, drug and prescription pain addictions.
 McCabe, Susan EdD, RN, CS. Rapid Detox: Understanding New Treatment Approaches for the Addicted Patient. Perspectives in Psychiatric Care, Vol. 36, No. 4. October- December 2000.
The Facts, Effects and Dangers of Benzodiazepines
Benzodiazepine Abuse Epidemic
Benzodiazepines are a prescription medication that is commonly prescribed by a physician for individuals with legitimate medical conditions such as:
- Alcohol withdrawal
- Seizure control
- Muscle relaxation
- Inducing amnesia for uncomfortable procedures
Yet, individuals across North America are obtaining these prescription drugs illegally and therefore are abusing these drugs to obtain the side effects that one experiences using them.
There is a serious epidemic occurring in the United States and is quickly spreading into Canada. According to a recent report released in 2013 from the International Narcotics Control Board, Canada is now the second- largest per capita consumer of prescription opioids, behind the U.S.
As stated by Health Canada, “In 2012, about 1 million youth, aged 15-24 years, reported having used a psychoactive pharmaceutical in the past year.” As a result of this research, Health Canada is looking for ways to raise awareness among parents and youth about the health risks of marijuana and prescription drug abuse.
Serious prescription drug abuse is taking place in Canada. Many youth are taking drugs what they believe to be MDMA, Molly and other designer drugs but in fact are a concoction of illegal and unidentifiable ingredients.
Here is Bellwood’s first mini blog series entry on the various prescription drugs that are being abused by many Canadians of all ages:
What are benzodiazepines?
Benzodiazepines are a group of prescription medications used to produce sedation and muscle relaxation. Through their effect on the Central Nervous System, they have the ability to lower anxiety levels. They are milder than other tranquilizers and are commonly prescribed by medical doctors to treat anxiety, agitation, insomnia, muscle spasms and seizures.
Benzodiazepines are categorized as short-acting, intermediate and long-acting. Short and intermediate-acting benzodiazepines are usually used to treat insomnia while longer-acting ones are used in the treatment of anxiety and alcohol withdrawal.
Benzodiazepines have often been called the most widely prescribed group of drugs in the world and the biggest selling drugs in the history of medicine with worldwide sales in excess of $21 billion in 1999. An estimated 60% of users of tranquilizers and sleeping pills suffer a mixture of adverse effects and withdrawal after 2 – 4 weeks of use (including therapeutic dose levels) due to tolerance and addiction.
Commercial Names: Ativan, Halcion, Librium, Valium, and Xanax
Street Names: Candy, Downers, Benzos, Rowies, Sleeping pills, Tranks, Date Rape Drug, Club Drug
How are benzodiazepines used?
Benzodiazepines mostly come in the form of pills although they are also available through injection. When taken orally, benzodiazepines must first be metabolized by the liver in order to exert their effects. This method results in approximately 50% of the drug undergoing first-pass metabolism, which lessens its effect. Injection bypasses the metabolism and results in a stronger effect.
How do benzodiazepines make you feel?
The effect of benzodiazepines depends on many different factors such as a person’s height, weight and dosage. Some common immediate effects include a feeling of relaxation, drowsiness, decrease in energy levels, mental confusion, dizziness and short-term memory impairments.
Long-term users may experience further effects such as a lack of energy and interest in doing every day activities. They may feel irritable, nauseated, and have headaches and experience loss of libido. Long-term use of benzodiazepines may also lead to depression.
What are some possible side effects of benzodiazepines?
Side effects caused by benzodiazepines may include drowsiness, dizziness, upset stomach, blurred vision, headache, confusion, depression, euphoria, impaired coordination, changes in heart rate, hypotension, trembling, weakness, amnesia, grogginess, dreaming or nightmares, chest pain, and vision changes. Benzodiazepines share many common effects with alcohol and barbiturates.
What causes the effects?
Benzodiazepines act to prevent or inhibit neurons in the brain from firing neurotransmitters. This occurs because benzodiazepines increase the release of a chemical called GABA – the primary inhibitory neurotransmitter in the brain – which serves to inhibit the release of other neurotransmitters.
How long do the effects last?
Duration of the effects of benzodiazepines depends on whether they are short, intermediate or long acting. Short acting benzodiazepines have a half-life of less than 12 hours while long-acting ones have a half-life of 24 hours or more. However, duration of apparent effects is usually considerably less than that. For most benzodiazepines these effects wear off within a few hours. However, the drug can continue to exert subtle effects within the body, which becomes apparent through withdrawal-related side-effects.
Are benzodiazepines addictive?
It is very easy to become dependent on benzodiazepines in as little as four weeks. Dependence develops sooner in people who take higher doses of the drug. Abrupt discontinuation of the drug or a drastic reduction of dosage results in withdrawal symptoms. Some of the withdrawal symptoms may be identical to those for which the medication was originally prescribed. Most common withdrawal symptoms from discontinued use of the drug are increased anxiety, depression, autonomic instability, insomnia and sensory hypersensitivity.
Are benzodiazepines dangerous?
When used in prescribed dosages, benzodiazepines are relatively safe. Overdose of benzodiazepines rarely results in death; however, concurrent use with other drugs or alcohol can lead to death. Benzodiazepines are also highly addictive and rapid discontinuation of the drug can lead to convulsions and seizures.
Treatment for Benzodiazepine Addiction
A person with chronic abuse usually requires the assistance of a doctor or specific drug rehabilitation centre. Bellwood Health Services can help individuals recover through a specialized, comprehensive and client-centred treatment program for prescription drug addiction. Our recovery care is based on a medical and holistic treatment model – an ddiction treatment approach that addresses an individual’s physical, psychological, social and spiritual well-being. Our team of caring professionals works closely with the individual and the family to provide counselling and treatment to meet the individual’s needs.
A good starting point is to call and speak with one of Bellwood’s addiction specialists. They can help identify an individual’s specific needs, discuss options, and next steps to help stop the cycle of addiction in a safe manner.