Opioid detox can be very scary.
The feeling you get when you can’t get your fix or run out of money probably comes to mind. This alone can scare people away getting clean.
Opioid withdrawal when quitting cold turkey can be excruciating, and even unbearable.
Luckily there are many options that may make the detox process far less painful than you probably think.
There are Methadone clinics, suboxone clinics and doctors, and inpatient detox centers. All of these are different and have different approaches. With today’s opioid epidemic, many different forms of treatment are being tested.
There are non-narcotic detox drugs, maintenance drugs, and tapering drugs. If you have not gotten clean before you may not know what the difference between these forms of treatment are.
I hope I can answer some questions you may have and help you make an educated decision on getting clean.
Inpatient Opioid Detox
Inpatient detox is a process which includes a stay at medical facility for 3-10 days. You are assigned a room and are monitored by medical professionals 24/7. A variety of drugs are used, called “comfort meds,” to assist with irritability, restlessness, insomnia, depression, cravings, nausea, anxiety, and any other feelings that come with opioid withdrawal.
In addition to comfort medication, typically buprenorphine is used as a taper. This is a partial agonist opioid that is used in smaller increments every day to bring you off opioids slowly.
The most common forms of buprenorphine are Suboxone or Subutex. In more rare cases methadone is used.
Buprenorphine “tricks” the body to think it has its drug of choice and withdrawal symptoms are not as severe. This drug also significantly curbs cravings.
Many times therapists are on site as well and can give talk therapy as well as test for underlying mental health conditions. Sometimes even people in recovery come in to talk with the patients and share their experience, strength, and hope.
Pros of Inpatient Detox
- Very safe
- Medication can be changed at any time
- Tests for blood borne disease or liver dysfunction
Cons of Inpatient Detox
- Must take time off work or school
- Usually share a room
- Sometimes “cookie cutter” treatment
Outpatient With a Doctor
Another option is to go to a specialized opioid addiction doctor that typically prescribed Suboxone. They evaluate your use and determine your dose
These doctors can prescribe many of the same medications used in an inpatient detox. This can be risky if you have substance abuse problems because it is up to you to take the prescribed amount and medicate responsibly.
With these doctors, you can determine whether it would be best to go on a taper or maintenance for a while before detoxing. This means instead of your drug of choice you would continue to take suboxone long term.
This can also be risky if not done correctly because Suboxone is also addictive. It can quickly turn into a substitute for your drug of choice.
With a doctor, you can also get a drug to help further curb cravings like Vivitrol or Naltrexone. These drugs also prevent you from getting high if you relapse and can also prevent overdose.
There are also more experimental options like Suboxone implants that go into the skin so that you do not need to remember, or choose, to take your dose every day. The buprenorphine is already in your system (whether you like or not).
Pros of Seeing a Doctor Outpatient
- Comprehensive and personalized
- More experimental methods
- Can go after work or school
- May get addicted to medications
- Can skip doses of Suboxone so that you can relapse
- Do not have 24/7 care when more severe symptoms arise
Methadone clinics are becoming rarer but are still used. This may be a viable option if you are on a budget or do not have insurance. It can also be more convenient.
Methadone clinics typically are open certain times of day, and you would go and get your dose of a cough syrup like drink. It is administered at the clinic to prevent patients from abusing the drug.
Methadone is also commonly used as a maintenance drug first to replace more harmful drugs like heroin. After some time the patient is detoxed slowly so that that least amount of symptoms possible are felt.
A problem with Methadone is sometimes people get on it too long and it becomes a replacement addiction. It also has a very long half life, and if a dose is missed the withdrawal can be very long and painful.
Most clinics require you to go every day, and if you miss doses they can cut you off. If you go on Methadone you must be very determined to get off opioids because it can be a long drawn out process.
Sometimes people get tired of going to the Methadone clinic and stop, then return to their drug of choice. When decides to quit this decision can be short lived if not taken through the process of detoxing quickly.
Pros of Methadone Detox
- Can be more convenient
- Withdrawal process is much slower so fewer symptoms are felt
- Can have long lines
- Not personalized
- Can be very addictive
When deciding to quit get clean, know your options for opioid detox. Call your insurance provider and find out what they will cover. If they will cover inpatient, and you can afford taking time off, then this may be the most effective option.
Know what you can afford and talk with a doctor and your insurance provider to find out the most efficient option for you
If you do not have insurance do some research. Find organizations or state run facilities that will provide financial assistance or a scholarship for treatment. Call detox centers in your area and find out if they offer any type of financial assistance. Some detox facilities offer scholarships themselves, so it is important to scope out those options as well.
There is also the option of paying out of pocket for opioid detox, which can be pricey. Inpatient opioid detox can cost thousands of dollars per day.
Outpatient doctors can also be very expensive, not to mention the price for prescriptions without insurance.