Detoxification is a set of interventions aimed at managing acute intoxication and withdrawal. Detoxification seeks to minimize the physical harm caused by the abuse of substances. Supervised detoxification may prevent potentially life-threatening complications that might appear if the patient were left untreated. At the same time, detoxification is a form of palliative care for those who want to become abstinent. For some patients, it represents a point of first contact with the treatment system and the first step to recovery. Detoxification alone is not defined as substance abuse treatment and rehabilitation per se, but it is a basic component of the substance abuse treatment system. Treatment and rehabilitation involves a constellation of ongoing therapeutic services ultimately intended to promote recovery for substance abuse patients. Therefore, a critical component of the detoxification service, in addition to evaluation and stabilization, is preparing the patient for entry into substance abuse treatment by stressing the importance of following through with the complete continuum of care
Social detoxification is an organized service that is delivered by appropriately trained staff, who provide 24-hour supervision, observation and support for patients who are intoxicated or experiencing withdrawal from alcohol and/or sedative-hypnotics, and who are not in need of emergency medical or psychiatric care. Social detoxification adheres to the criteria of an ASAM Level III.2-D. It does not involve the administration of pharmacologic interventions to manage the detoxification protocol. It is characterized by its emphasis on social and emotional support, including availability of specialized clinical consultation and supervision for biomedical, emotional, behavioral and cognitive problems. If at any time during the course of the patient’s stay in this component complications arise requiring admission to a hospital, that transfer shall be coordinated by staff, including transportation.
Medical detoxification is an organized service delivered by a multi-disciplinary team of medical, nursing and clinical professionals, which provides for 24-hour medically supervised evaluation and withdrawal management in a secure (locked) facility. Medical detoxification adheres to the criteria of an ASAM Level III.7-D. A physician is available to assess the patient in person within 24 hours of admission and thereafter as medically necessary. Psychiatric services are available through consultation within 8 hours by telephone or 24 hours in person. A registered nurse conducts an alcohol or other drug-focused nursing assessment at the time of admission. An appropriately credentialed and licensed nurse is responsible for monitoring the patient’s progress and for medication administration. The intensity of nursing care and observation is sufficient to meet patient needs. Clinical staff are knowledgeable about the biological and psychosocial dimensions of substance dependence and mental disorders and have specialized training in behavior management techniques.