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.
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.