What Medications Are Used During Detox?

Illicit drug use is a common issue in this country. The CDC estimated that in 2012, 9.2 percent of people over age 12 abused drugs in the previous month. There is also a massive treatment gap with only 2.3 million of the 21.6 million people over age 12 in 2011 needing treatment for substance abuse actually receiving it, according to the National Institute on Drug Abuse.

Often the first step down the road to recovery is purging these unhealthy substances through detox. The process of removing toxic or harmful substances from your body is called detox, which is short for detoxification. Substance abuse can lead to both a physical and emotional dependence, or addiction, making chemical changes in your brain and body.

An alcohol or drug dependency can be a difficult habit to break, and many times withdrawal symptoms can be painful and even dangerous. Detox should be medically supervised in a safe and secure environment. The two main types of detox are natural and medical detox. Both can be facilitated in either an inpatient or outpatient capacity. An approach that doesn’t introduce any medications is considered natural, while medical detox often introduces the use of pharmaceuticals.

The type of medication used for detox and the duration of treatment depends on the type of substance abused and the severity of the addiction.

Benzodiazepines and Antidepressants

The National Institute on Alcohol Abuse and Alcoholism estimated that in 2012 approximately 7.2 percent of adults in America over age 18, around 17 million people, suffered from an alcohol use disorder (AUD).

DTs can be a severe symptom of alcohol withdrawal and can be fatal without proper treatment. Alcohol alters brain chemistry by stimulating certain neurotransmitters, the brain’s chemical messengers, and suppressing others. Benzodiazepines are psychoactive drugs that work to slow down the central nervous system, helping to relieve alcohol withdrawal symptoms with tranquilizing and anticonvulsant effects. Benzodiazepines, including Valium and Librium, are often used in alcohol detox programs.

Due to their own potential for abuse, however, benzodiazepines are mainly recommended for short-term use. Benzodiazepines, like Diazepam, are also used to counteract the anxiety produced as a withdrawal symptom of some stimulants including cocaine. Currently, there are no medically approved pharmaceuticals for detox from stimulants; however, some withdrawal symptoms can be managed medically.

Withdrawal symptoms from many different illicit substances include anxiety and depression. These can be dangerous emotions that can lead to suicidal tendencies if not managed properly. Antidepressants are often used in detox in order to counteract these symptoms. Desipramine, fenfluramine, and phentermine, or a combination of these antidepressants, are often used to aid in cocaine detox for example.

Opioid and Non-Opioid Agonists

Opioid drugs are derived from the opium poppy plant and, with the exception of heroin, are typically prescription painkillers like morphine, hydrocodone, oxycodone, and codeine. Opioids attach to opioid receptors in the brain and body, thus reducing the sensation of pain. Opioids also stimulate the brain’s reward system, producing a euphoric effect that can be addicting.

The misuse of prescription drugs is an epidemic in the United States, second only to marijuana use, with one in 22 people over age 12 admitting to using prescription pain relievers for nonmedical purposes in the past year, according to the National Survey on Drug Use and Health.

There are several types of medications that can help relieve these symptoms as well as help you detox from opioid addiction. These medications usually fall into one of two categories: opioid agonists and opioid antagonists.

An opioid agonist binds to opioid receptors in the brain and mimics and heightens the naturally occurring neurotransmitters’ effects. Methadone, often dispensed in clinics, is an opioid agonist commonly used to detox from heroin. It stays in your system longer than street drugs and can relieve withdrawal symptoms and cravings.

Other non-opiate agonists have shown some success in managing opioid withdrawal symptoms and may be effective during detox as well. One such alpha-adrenergic agonist is clonidine which works to suppress opioid withdrawal symptoms by stimulating alpha receptors in the brain and reducing nerve signals sent to blood vessels.

Clonidine is a blood pressure medication that helps reduce the flood of adrenaline, which causes the “fight-or-flight” response, a common withdrawal symptom. Clonidine can assist in detox from narcotics, methadone, and sometimes even alcohol. Another high blood pressure drug with similar effects that acts as a beta-blocker, propranolol, may help with severe cocaine and alcohol withdrawal symptoms as well.