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Tag Archive: substance use disorder

What is Social Detox?

Social detoxification is a non-medical type of detox program and involves the individual stopping the use of the drugs entirely while under the care of treatment professionals. While being a social method, it involves professionals providing the patient with emotional and psychological support throughout the withdrawal process without any therapeutic intervention.

This method has shown some degree of success but it’s not without its challenges. There remains a significant potential for a withdrawal syndrome and given the lack of a proper setting, may be difficult to manage. The spectrum of withdrawal symptoms varies depending on the specific drug and can be severe and potentially life-threatening. Furthermore, there is a chance that a user who is going through detox in this method may relapse in an effort to relieve their symptoms and cravings for the drug. What’s worse yet is that these individuals have a propensity to overdose when relapsing, making it an even more critical situation.

These management programs can handle serious conditions such as seizures, which is a withdrawal symptom for a number of commonly abused substances
Another aspect of substance use disorder recovery management to keep in mind is that significantly long period of abstinence leads to a marked decrease in the patient’s tolerance level, which can be extremely dangerous as it predisposes to inadvertent potentially lethal overdosing.

Social detox approaches are also poorly equipped to address potential development of psychological issues over the course of withdrawal. These include mental health issues such as depression, suicidal ideation or attempts, anxiety, delirium, and insomnia. Apart from psychological issues, medical complications may also arise during withdrawal. Therefore, it is not advised to perform social detox for the management of withdrawal from alcohol, benzodiazepines, barbiturates, or opioids.

Conversely, these patients need to properly diagnosed and a personalized detox and recovery program needs to be designed keeping their personal, medical and social needs in mind. Medical detox provides patients with a structured environment, proper medication and full ancillary support to address all aspects of substance use disorder recovery. These management programs can handle serious conditions such as seizures, which is a withdrawal symptom for a number of commonly abused substances. Furthermore, if the patient were to become delirious you are able to provide optimal care right away. Confused, agitated states can lead to accidents, erratic behavior, and possibly violence. Being unsupervised in social settings while in that condition is dangerous.

In many of these settings, pharmacologic intervention is necessary, whether it is for the pain, other symptoms or for choosing a drug of lesser strength to avoid a dangerous withdrawal syndrome. This is true for heroin addiction for which methadone is used. Methadone is a full opioid agonist that attaches to and activates opioid receptors in the brain, which decreases cravings and reduces unpleasant withdrawal symptoms. This requires careful monitoring and assessment on a regular basis and can only be dispensed by opioid treatment programs (OTPs). Buprenorphine is another such example where a partial opioid agonist is given to produce a less pronounced opioid effect than a full agonist, such as methadone. Suboxone is a formula containing a combination of buprenorphine and naloxone, a medication that blocks opioid effects.

Using these therapeutic options can be necessary for the right patient given his/her situation and administering these drugs requires a controlled environment and supervision by experienced staff, none of which a social detox method provides.

Drug Detox for Women

While it is true that men in the United States report higher rates of drug abuse (7.7% of American men vs. 5% of American women), substance use disorder is a significant problem for women as well. A woman goes to the emergency room after abusing prescription painkillers every 3 minutes in the USA. There are approximately 15.8 million adult women per year reported to be using illicit drugs. The most commonly used substance is alcohol (33.3%), followed by heroin (15.3%), marijuana (14.6%), prescription painkillers (13.8%), cocaine (9.3%), methamphetamine/amphetamines (8.6%), etc.

Women have a different clinical presentation of their substance use disorder. They tend to have a shorter history of abusing alcohol and drugs than men, yet they are likely to develop more severe physical, emotional, behavioral, and social problems compared to men. The spectrum of symptoms and signs may also differ between women and men in any given substance use disorder. Women are also more likely than men to suffer from comorbid mental health issues, including depression, anxiety, post-traumatic stress disorder (PTSD), panic attacks, eating disorders and particularly polysubstance abuse. It has also been noted that many women begin abusing drugs as a means of self-medication for these disorders.

Women with substance abuse problems may be more susceptible to rape, given their vulnerable state overall
All patients of substance use disorder, regardless of their gender, suffer from social problems, financial issues, mental and behavioral health disorders, malnutrition, hepatitis, AIDS, and other sexually transmitted diseases. However, female patients have these additional unique challenges, including having a higher rate of adverse physical effects on their cardiovascular system. They are also more likely to overdose and more sensitive to certain substances. Women with drug and alcohol addiction may be more likely to face certain financial and legal problems. This becomes even more problematic when they have children. Women with substance abuse problems may be more susceptible to rape, given their vulnerable state overall. A recent study reported that approximately 73% of female drug abusers that were surveyed had a history of rape, of whom 35% were raped while under the influence of drugs or alcohol. To makes matters worse, women engaging in substance abuse may face unplanned pregnancies as a result of poor safe sex practices due to lack of awareness/resources or while under the influence.

Female patients are also prone to pregnancy complications, leading to negative outcomes for both the mother and the developing baby. These women who abuse drugs during pregnancy are more likely to experience high blood pressure, migraines, and seizures. Their fetuses are prone to having low birth weight, birth defects, developmental delays, etc. There is a 2-3 times higher risk of stillbirths in these cases.
All of these problems are made worse by several barriers to treatment faced by women. To begin with, women are generally less likely to seek treatment than men, which may be in part due to social stigmas, childcare responsibilities, financial difficulties, transportation issues, lack of interpersonal or familial support, just to name a few.

Special care should be provided to female patients in order to improve compliance, comfort and overall chance of recovery. Some female-specific supportive approaches include onsite childcare, parenting classes, special care for pregnant/nursing mothers or those who are victims of rape, domestic violence, etc. In addition, vocational training, income support, housing assistance, social services, family and couples therapy are also very useful in helping these patients.