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Inpatient Detox: The Complete Guide To Finding a Center

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 09/14/2020

Number of References: 2 Sources

Inpatient detox centers provide a higher level of care than other types of detox. They are intended to help patients anticipating moderate to severe withdrawal symptoms and safely getting through detox is the primary purpose of these programs. These programs have shown the highest success rate out of the major detox types, and are an effective introduction to recovery.

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What Is Inpatient Detox?

Inpatient detoxes are a type of medical detox facility which provides monitoring 24 hours a day. It differs from other levels of care in that they provide the full spectrum of care to patients including medical supervision, therapy, and support services. Someone in an inpatient program will live at the facility for several days. Meals and in some cases clothing are provided in a short term residential setting.

Aside from a strictly medical approach, inpatient detox programs typically include further treatment therapies such as group and individual therapy, outside support groups, and case management sessions to develop an aftercare treatment plan. These programs are on the expensive side due to the full range of medical and therapeutic treatments provided.

Is Inpatient Detox Right For You?

Inpatient detox is a more intense approach to detox which is intended for people who have a severe physical dependence on their substance of choice, be it alcohol, painkillers, or other drugs. Anyone who begins to feel physically or mentally unwell or begins to suffer severe withdrawal symptoms after less than 24 hours without using is most likely a candidate for an inpatient program.

Some criteria to consider which may indicate an inpatient style detox as an appropriate choice includes:

  • IV Drug Users
  • Long Time Drug Users (1+ years)
  • Poly-Drug Users (tandem use of more than 1 drug such as benzos and opiates)
  • Those With A History of Relapse
  • Someone with Co-Occurring Mental Health Issues

Additionally, due to the comprehensive approach to detox and treatment, the chances of successful detox and recovery are much higher when attending inpatient detox. If someone has tried to quit on their own or even gone to an outpatient detox or treatment program before and has relapsed, then inpatient treatment may be a more effective treatment approach for them. The relapse rates are lower for inpatient program patients as opposed to outpatient or self-detox individuals.

Types Of Inpatient Detox Centers

Some of the most common inpatient detox programs these days are for alcohol and opioids. While some of the medications may vary, the overall approach to treatment is similar. In both detox programs, medications are used to treat the symptoms while therapies are used to treat the underlying behavioral and emotional issues.

While detox from different drugs can be performed at the same facility, the different types of inpatient can be categorized into 3 distinct groups:

Residential

These residential detox programs are usually for those who will experience mild to moderate symptoms during detox. While they do use medications and have medical monitoring, these are fairly non-invasive and intermittent; maybe seeing a nurse once a day or so. There are still daily groups, meetings, and therapy sessions and the approach is more reliant on the psychological aspects since the people attending these types of detox programs are not suffering life-threatening symptoms.

Inpatient

This is a step up from residential and offers more vigilant medical supervision. Inpatient programs are intended for those who will experience moderate symptoms during detox and thus require close monitoring. Medications are dispensed liberally and medical checks will be done at least once per day. In addition, the daily focus on therapy, groups, and support meetings will help with the psychological issues that someone may experience during detox.

Hospital/Acute Inpatient

This type of detox is reserved for those who will experience severe, and possibly life-threatening symptoms during detox. Several drugs produce potentially fatal side effects during detox, and extensive medications and monitoring will be used to ensure the safety of patients in this setting. These are commonly, but not always, held in hospitals so there is easy access to equipment and trained professionals, if a life-threatening emergency were to arise. Therapy, groups, and support meetings may be used in this setting as well, but some acute inpatient programs will strictly focus on the physical aspects, as oftentimes their patients are in no shape to take in what is being discussed in these groups.

What To Expect

To enter an inpatient detox, someone must first undergo an assessment. Here it will be determined the exact substance that someone needs to detox from as well as the duration and quantities of use. Likewise, sometimes people need to detox from multiple substances at once and a unique treatment plan will be determined during, or shortly after, the initial assessment. Depending on their use history and the severity of their symptoms, someone may expect to spend between 7 to 14 days at an inpatient program. Some detox centers offer longer programs, but these are less common and often quite expensive.

Inpatient detox is much more standardized than other types of detox, due to the comprehensive care that every patient will receive. There are risk differences between different substances, therefore the monitoring approach may be slightly altered depending on someone’s drug of choice. Some of the differences between different drug detoxes include issues such as:

  • Alcohol or Benzodiazepine Detox: There is a much higher risk of seizure and cardiovascular complications, including death, during detox from these substances. Due to this, the first 72 hours will warrant more intense monitoring and symptom management so as to prevent serious health issues.
  • Opioid Detox: While not fatal on its own, opioid detox is nonetheless very painful. There are FDA approved medications specifically used for opioid detox as well as supplemental care in the form of frequent counseling and psychiatrist appointments.
  • Other Drug Detox (Cocaine, Kratom, etc.): Typically not dangerous, the main issue with treating stimulant or other drug addictions is that much less is known about how individual people respond to the usual detox medications. Since people respond in unique ways to different medications there is a little more guesswork in finding the right medication for each person, thus more care may be taken early on in the detox process.

Once admitted to inpatient detox, someone may be shown to their room (either shared or individual) and tour the lounge area. Medication management will occur at least once per day but maybe more often as withdrawal symptoms require. There are groups most days including group therapy, individual counseling sessions, doctor and psychiatrist appointments, and oftentimes there are outside meetings brought in by volunteers. These can be 12 step meetings such as Alcoholics Anonymous or Heroin Anonymous, but there are many such groups that commonly visit inpatient detox programs.

In addition to groups, someone will meet regularly with their caseworker and begin to develop an aftercare treatment plan. This is a roadmap for continuing care after detox has been completed and includes setting goals for support group meetings, finding a sponsor, and entering a sober living facility.

Continuing Care

After inpatient detox is completed it is highly recommended to continue treatment and counseling. The physical symptoms of withdrawal may be gone, but the psychological patterns developed through chronic use will require professional help to overcome. Having worked with a caseworker during an inpatient program to develop an aftercare treatment plan, someone will now need to put that plan into action. This means developing a social group in the recovery community, continuing with treatment through 12 step meetings or outpatient treatment, and possibly continuing medications for a while until the worst of the residual symptoms have passed.

Some common and effective next steps include becoming involved in the recovery fellowship of someone’s choice (AA, HA, CA, CMA, NA) and further professional help. Some good choices of professional programs include:

Intensive Outpatient Treatment (IOP) or Partial Hospitalization Program (PHP)

Residential Treatment

Sober Living Programs

While it’s true that inpatient treatment results in lower relapse rates than other types of detox such as outpatient, it still requires work. The higher success rates are mainly due to the increased number of resources for continuing care that is provided by inpatient detox centers. Someone may have more tools at their disposal after an inpatient program, but it is their responsibility to pick them up and use them.

Outpatient Detox Guide

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