Fear of Detox? “Get Out of the Car,” says Dr. Gilbert Masterson
There is a big parking lot outside the welcoming entrance to Sanford Behavioral Health’s Detox Center. A scenario often takes place when our clients and their families arrive. We can only imagine what is being discussed or the second thoughts being expressed. However, it usually takes time for them to leave the car and make their way to the door. Understandably, detox can be a scary prospect. No wonder our clients need to gather their courage (or be convinced) to walk through the door. At Sanford Detox Center, the empathetic providers are ready to address the fear of detox and make the experience safe and comfortable.
Facing Fear of Detox
Fear of detox may be well-founded for some. Sanford Chief Medical Officer Gilbert (Al) Masterson, M.D., says, “When a patient tries to detox themselves from alcohol and has a seizure, they might end up in a hospital, or panic and return to using alcohol. It is scary and dangerous. So, we want to know if they have had a seizure before and act accordingly. I try to reassure all our patients that we are committed to providing a safe and comfortable detox from drugs and alcohol. Within 24 hours, they should be feeling much better.”
Combatting Fear of Detox at Sanford Detox Center
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.
Medical and Psychiatric Evaluation
At Sanford, we provide a medical evaluation within 24 hours of admission, including a physical examination, orders for appropriate service, face-to-face consultation, and a risk assessment with a personal safety plan. We also complete a comprehensive biopsychosocial assessment as soon as we admit someone. In other words, we get to know our patients, helping them determine the next steps after detox.
Dr. Masterson says, “At Sanford, we use medications to replace drugs or alcohol, which last longer than the drugs of use and are easier to taper down. As a result, patients do not feel the lows or scattered feelings they might have felt with self-detox. Those with a history of seizures also have anti-seizure medications for a few days as a safe method of detoxing from alcohol.”
For opioids, the fear of withdrawal is visceral. But, Dr. Masterson says, “Opioids are a different animal. So even though the fear of detoxing is at the same level as alcohol, the physical danger is less. Our role is to reassure our patients that we can make them comfortable. We make a point of explaining the supportive medications that take the edge off. And we stay in front of the symptoms to make the experience more acceptable.”
Medication-Assisted Treatment (MAT)
Sanford’s MAT program helps patients get through the discomfort of opioid withdrawal, and it also helps to reduce cravings. MAT is primarily used for the treatment of addiction to opioids and alcohol. The prescribed medications normalize brain chemistry, block the euphoric effects of alcohol and opioids, and relieve physiological cravings.
Those who meet the criteria for medical detox are experiencing severe withdrawal symptoms. Some patients have gone through withdrawal previously and hate the thought of going through it again. Consequently, they need 24-hour nursing care and regular physician visits. The detox team comprises Sanford’s Chief Medical Officer, licensed physicians, physician assistants, nurse practitioners, clinical directors, registered and licensed practical nurses, medical assistants, clinicians, dietitians, and case managers.
A Beautiful Place to Heal
Sanford provides a beautiful space in which to heal. Our restored mid-century modern facility has restful colors, original artwork, and comfortable furniture. The shared spaces encourage community when wanted and tranquil solitude when needed. In short, the detoxification program provides a safe, secure setting conducive to withdrawal management, personal privacy, and the security of personal belongings. Detox treatment also prepares and motivates our patients to continue therapy after discharge. In fact, they begin addiction treatment while in detox. Think of it like this: detox addresses the physical aspect of addiction; treatment addresses the emotional pain that underlies substance use.
Dr. Masterson says, “At Sanford Behavioral Health, we want to see our patients succeed and improve their lives in recovery. It begins by getting out of the car and trusting the process. Next, our detox team helps patients decrease cravings for addictive substances while also trying to understand how symptoms may tempt them back to increased use. Finally, our clinical and medical team ensures patients have a safe and comfortable withdrawal from drugs/alcohol. It’s a rigorous experience, but well worth achieving.”