Sanford Founder’s Reflections on Advancements in Medical Detox
My family has a story we tell about the time my grandfather went to alcohol detox at Deaconess Hospital in Detroit. It was back in the 1970s when the approach was “white knuckle.” He was tied to the bed with straps. While his sons held vigil, he stayed awake for an entire week, riding the horrible crest of the DTs and suffering without medication or comfort.
Today, I am the co-founder of Sanford Behavioral Health. With one year of the Sanford Detox Center under our belts, we are pleased to be able to offer a full continuum of care for our addiction treatment patients. We have also learned a lot about the fear that keeps many individuals from coming through our doors. One of our primary goals as we go forward is to reduce the anxiety of detox through education.
One Year of Drug and Alcohol Detox Reflections
The name “detox” is the same, but the detox experience is vastly different today than my family’s dated memories. These days, drug and alcohol detox comprises a sophisticated combination of medication and testing. From a therapeutic standpoint, it is a time of emotional reassurance. It is also a time to educate those who enter detox that addiction is a disease.
“At Sanford Behavioral Health, we want to see our patients succeed and create a better life for themselves in recovery. Our detox team helps patients decrease cravings for addictive substances while also trying to understand how symptoms may tempt them back to increased use. Our clinical and medical team ensures that our patients have a safe and comfortable withdrawal from drugs/alcohol. It is a rigorous experience, but well worth achieving.” Chief Medical Officer Gilbert Masterson, M.D.
The Purpose of Detox
The purpose of detox is to rid the body of alcohol or drugs in a physically safe way. Not everyone who goes into treatment needs to go to detox. But in some cases, medical stabilization is necessary to admit someone into an addiction treatment program safely. Factors that play into the need for detox include the amount, frequency, and duration of substance use. We make these determinations at the screening and assessment stages at Sanford Behavioral Health,
Detox is not treatment. In the simplest sense, detox deals with the physical aspect of addiction. Conversely, treatment addresses the emotional aspect and the emotional pain that underlines substance use. Drug and alcohol detox usually follows unsuccessful attempts to stop using. And when people come to the Sanford Detox Center, they are relieved because they are getting professional help. A more controlled environment is often needed based on science to safeguard against physical risk. And it should provide comfort while doing so.
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What to Expect
Detox is conducted at Sanford West Behavioral Health Campus, 12 minutes from downtown Grand Rapids, Michigan. When entering treatment, you are assigned a comfortable bed and can wear your own clothes. You can expect to stay 2 to 4 days for alcohol detox. And a week or sometimes longer for substances such as heroin, oxycodone, or cocaine. Every attempt to provide comfort and distraction is made. You will also be assigned a case manager. The case manager will help to determine what type of treatment is most appropriate for you after detox.
Communication is Essential!
Michigan requires an assessment to ascertain if a patient is appropriate for medical detox. Accordingly, the first interaction is with a nurse, who will ask questions that determine readiness. During that time, the Chief Medical Officer or a Physician Assistant introduces themselves to the loved ones in the waiting room. After hours, or if Dr. Masterson is at another site, he chats with family members using a robotic telehealth device. Communication is essential because loved ones are fearful too. Similarly, an opportunity to ask questions of the medical staff is an excellent way to set minds at ease and impart essential information to the Sanford team.
COWS and CIWA
Several scales or inventories are used to evaluate a person in detox. The first is the Clinical Institute Withdrawal Assessment (CIWA), and the second is the Clinical Opiate Withdrawal Scale (COWS). These scales determine what medications are given to ease withdrawal. Abrupt withdrawal from alcohol can result in seizures, cardiovascular events, excessive anxiety, and agitation. The CIWA rates nausea, tremors, anxiety, agitation, sweating, disorientation, numbness, hallucinations, the ability to startle, and headaches. On this scale, the severity of withdrawal is scored. And medications such as benzodiazepines are given as a short-term relief to ease symptoms and make the experience more tolerable.
Body temperature; bone, joint, and muscle aches; and sleeplessness are measured with COWS. Medications such as buprenorphine can help ease these symptoms. Withdrawal symptoms such as lethargy, memory loss, and depression can be related to Vitamin B deficiency. A regimen of vitamin B is often initiated; vitamin B plays a role in turning sugar into energy.
A Warning and the Next Steps in Recovery
Withdrawal reduces tolerance. Those who have been through the process can become affected more quickly and intensely by their substance of choice. And they can overdose on a much smaller amount than before detoxing. Therefore, it is crucial to go from drug and alcohol detox to intensive therapy or a program. My friend and Sanford Clinical Director Emeritus, Christine Walkons, said something to me the other day that struck home. She said, “Addiction treatment is like ice thawing. You begin to feel all these emotions, and there are a lot of tears… which is part of the process of warming up.” The thaw begins in drug and alcohol detox and continues through treatment.