Steps Of De-addiction; How Does De-addiction Work?

So you’re finally ready to quit. But what’s the process? What do you need to know before you finally take the plunge into a life of sobriety? Today we will talk about how the ideal de-addiction process works.

The de-addiction process can broadly be divided into OPD based, that is, outpatient based, or IPD based, that is inpatient based. Your psychiatrist will advise you what is best for you, but as a general rule, remember that IPD based de-addiction is far superior to OPD based de-addiction. That’s because of the following advantages:

  1. The patient is under constant medical supervision, and withdrawal symptoms can be better monitored and managed.

  2. The patient experiences a change of environment, and so the cues that cause craving leading to relapse, are not present. This allows the patient to get desensitised to those cues.

  3. Regular, intensive psychotherapy, particularly, motivation enhancement therapy and cognitive behaviour therapy, can be easily administered 2-3 times / week, since the patient does not have to travel distances to reach the therapist.

  4. Certain neuro-modulation procedures for craving management that need to be administered daily, such as tDCS, CES etc., can be administered easily, again because there is no distance barrier between the patient and the de-addiction facility.

  5. A therapeutic environment in the IPD setting ensures that the patient interacts with others going through the same struggle, thereby drawing motivation to change from one another.

  6. An IPD setup ensures a regular, balanced activity schedule and meal plan, which is essential to bring the patient back into the routine of daily life.

  7. De-addiction can be emotionally taxing, and sometimes it is best to take some time off from loved ones. An IPD de-addiction facility offers just that. Family members are usually allowed no more than once a week to visit the patient, and this gives the patient time for self reflection and self discovery.

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Now that you are ready to get admitted to a de-addiction facility, you need to know what kind of de-addiction facility suits you best. There are essentially 2 types of facilities:

  1. Psychiatric Hospital; which offers physician assisted withdrawal management or detoxification, and psychotherapy and neuro-modulation procedures such as tDCS, CES etc. A psychiatric hospital is the ideal setting to start the de-addiction process. A psychiatric hospital will have you admitted from anywhere between 10-90 days, depending on the substance you are addicted to, and the extent of your dependence. As a general rule, always go for a comprehensive de-addiction program that includes hospital stay with medications, psychotherapy and neuro-modulation, since a combination of these will almost always give you better results.

  2. Rehabilitation Centre; here the patient usually stays for 3-6 months after the initial detoxification and de-addiction is complete. Bear in mind that not all addicts need to be admitted to a rehab centre. In a lot of cases, home based relapse prevention after a 30-90 day program in a psychiatric hospital is enough. In a rehab centre, the focus is more on finding purpose, and learning to deal with life sober.

Let’s focus on the gold standard for detoxification and de-addiction, that is, a psychiatric hospital based comprehensive program. I’m going to now take yo step by step into what you should expect once you have decided to enrol yourself.

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Step 1: OPD consult with your psychiatrist. In this visit, your psychiatrist will take your detailed history, and depending on your case severity, advise you inpatient treatment.

Step 2: Before you get admitted, a toxicology report is mandatory for all patients. In addition, a full panel of investigations will be advised by your psychiatrist including ECG, without which, you cannot be admitted. These investigations are necessary while starting any detoxification medicines for patient safety.

Step 3: Once admitted, the detoxification and de-addiction process starts. The first step is to get comfortable with your new home for the next month. Make sure to keep your valuables to a minimum, since no hospital will take responsibility for any thefts. Also, ask the management if they allow cellphones and other gadgets, since some hospitals do and others do not.

Step 4: Your psychiatrist will likely have already started you on withdrawal management medications, and you are probably already feeling better by now. Expect some initial side effects with the medicines, but if they are intolerable, get in touch with your psychiatrist or nurse immediately.

Step 5: Your investigation reports will be available by the day after admission, and assessed by a general physician, who you will also consult, to make sure everything is okay physically. If you have a pre-existing medical condition like diabetes, heart disease or hypertension, this is the time to tell the general physician everything, and the physician will medicate you for that accordingly.

Step 6: You will now meet your counsellor, who will in the first session, take your detailed history, to formulate a case report. This first contact with the counsellor is the most important, since this forms the basis of your entire treatment course, so make sure you are open and honest while telling your story.

Step 7: Based on your case report, your psychiatrist will initiate you on the neuro-modulation procedure that suits you best. These procedures are not only used in craving management, but also in cases of anxiety, depression, insomnia and other psychiatric issues. With neuro-modulation, you can expect an amplified response to your existing treatment.

Step 8: You will likely have a regular schedule of the medical management of your condition, but still not have a schedule of activities you should do to make your time at the facility productive and worthwhile. This activity scheduling should be a joint effort between you and your counsellor, doctor, attending nurse and other allied staff at the facility. Try to make friends with other patients during your time, and strengthen your resolve to change.

Step 9: Once the initial detoxification is complete, you will then be initiated on anti-craving medicines. These can be in the form of oral tablets, or implants. Anti-craving tablets once started, will continue for 6-12 months, whereas implants are administered in the lower abdomen area 1-2 times, and their effects last up to a period of 6 months. Remember that although implants are more expensive than oral medications, implants are the gold standard for management of substance craving. The other advantage with implants is that you will not need other oral anti-craving medications.

Step 10: You are discharged and now have 2 options; either continue home based relapse prevention with regular OPD follow ups and psychotherapy, or get admitted to a rehab facility for another 3-6 months. Although relapse rates are lower in those who stay in a rehab for the allotted time, most people simply cannot afford to spend 6 months worth of time and money in a rehab facility. If you choose to continue home based relapse prevention, you will have to consult your psychiatrist and counsellor regularly to keep your substance use at bay.

If you or your loved ones are looking for an extraordinary detoxification and de-addiction facility, do get in touch with The Happy Tree for their unique 10 day, 20 day and 30 day programs.


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