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Dr. Steve Frisch, Psy.D. is a clinical psychologist in private practice in
Chicago, Illinois and Northfield, Illinois.

You can contact Dr. Frisch, Psy.D. at
(847) 498-5611.

Learn how to prevent and recover from chemical dependency as well as the aftereffects of chemical dependency on you and your family. Read Dr. Frisch’s, Psy.D. series of Recovery books.

What is Medically Supervised Detoxification?

ear Dr. Steve:

Can you please explain to me what supervised medical detoxification is?

Medically supervised detoxification is the first step in the treatment process. The purpose of medically supervised detoxification is to alleviate the short-term physical and psychological symptoms associated with withdrawal.

Medical detoxification is necessary because most, but not all, mood-altering substances have characteristic withdrawal syndromes. These withdrawal syndromes may become present when an individual discontinues their chronic consumption of large quantities of alcohol and other drugs. Because of potential medical complications caused by discontinuing one’s use of alcohol and other drugs, a chronic heavy consumer of alcohol and other drugs should seek the assistance of a qualified doctor to medically manage their withdrawal from their drug(s) of choice. Supervised detoxification is the process of monitoring and managing the onset of alcohol and other drug withdrawal symptoms. Through the use of medications a doctor is able to first moderate and eventually eliminate withdrawal symptoms.

Symptoms of withdrawal can range from flu like symptoms such as getting hot, sweaty and flushed, and developing nausea with or without vomiting to experiencing tremulousness, seizures, and hallucinations. There are many variables that impact how severe an individual’s symptoms might become. For this reason, it is best to first consult a doctor in order to be evaluated and monitored over the course of the first 4-6 days that an individual is attempting abstinence.

The goals of supervised detoxification are: (1.) Elimination of medically dangerous withdrawal symptoms, (2.) Reduction of the physical discomfort associated with withdrawal, 3.) Medically managing any co-existing medical disorders, 4.) Developing a long-term plan to remain abstinent from all mood-altering substances.  

The goals of treatment are to treat the immediate withdrawal symptoms, to prevent complications, and to begin long-term preventive treatment. Immediate treatment involves symptom relief, constant observation, and frequent monitoring of physical functions and condition. Hospitalization is often required. Heart function, respiratory function, and general physical condition are monitored by frequent measurements of vital signs (temperature, pulse, rate of breathing, blood pressure) and fluids and electrolytes (chemicals in the body such as sodium and potassium).

Symptoms may progress rapidly and become an emergency condition. Central nervous system depressants and sedatives may be required, often in moderately large doses, to reduce symptoms. Treatment may require maintenance of a moderately sedated state for a week or more until withdrawal is complete. Benzodiazepine medications such as diazepam are often useful to reduce symptoms. Clonidine may reduce cardiovascular symptoms and helps reduce anxiety (this medication is commonly used for symptoms of narcotic drug withdrawal).

After successfully undergoing a medically supervised detoxification, there are different choices to consider as to how to continue long-term treatment. Those choices are:

1.) Doing nothing more at all and white knuckling it
2.) Only attending Alcoholics Anonymous or Narcotics Anonymous
3.) Attending Alcoholics Anonymous or Narcotics Anonymous and working with a qualified psychotherapist
4.) Attending an intensive outpatient treatment program
5.) Attending an intensive day hospital program
6.) Attending an intensive inpatient or residential treatment program

For a more detailed explanation of treatment options available to somebody who wants to quit drinking and drugging, read my column that discusses in more detail treatment options for alcoholism and drug addiction.

Take advantage of your honesty and get help. Contact a qualified healthcare provider so that you properly evaluated. Go to Alcoholics Anonymous or Narcotics Anonymous.

You can contact Alcoholics Anonymous at:
In the U.S./Canada: Look for "Alcoholics Anonymous" in any telephone directory. In most urban areas, a Central A.A. office, or "Intergroup," staffed mainly by volunteer A.A. s, will be happy to answer your questions and/or put you in touch with those who can. Or, you can write to: A.A. World Services, Inc., P.O. Box 459, New York, NY 10163 - (212) 870-3400. www.alcoholics-anonymous.org

Outside of U.S./Canada, write or call the General Service Office located closest to you.

You can contact Narcotics Anonymous at:
World Service Office in Los Angeles
PO Box 9999
Van Nuys, California 91409 USA
Telephone (818) 773-9999
Fax (818) 700-0700
Business hours are Monday through Friday, 8:00 AM to 5:00 PM local time

Learn how to prevent and recover from chemical dependency as well as the aftereffects of chemical dependency on you and your family. Read Dr. Frisch’s, Psy.D. series of Recovery books—From Insanity to Serenity.

Pathfinder’s Checklist

1.) Contact a qualified healthcare provider.
2.) Contact your local chapter of Alcoholics Anonymous or Narcotics Anonymous.
3.) Read as much as you can about the disease of alcoholism.
4.) Read as much as you can about Recovery.
5.) Meet as many people as you can at Alcoholics Anonymous or Narcotics Anonymous meeting.
6.) Integrate the Twelve Steps of Alcoholics Anonymous or Narcotics Anonymous into your life.



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