Drug withdrawal is usually treated with a combination of medications and psychological methods. The type of medication used depends on the type of drug to which the person is addicted. The two most common types of withdrawal treated in a hospital are addiction to nervous system depressants, such as alcohol and benzodiazepines, and addiction to opiates, which include common pain medications as well as street drugs.
Nervous System Depressant Withdrawal Medications
Central nervous system depressants include alcohol and benzodiazepines, such as valium and alprazolam. After prolonged use at high doses, withdrawal from these drugs will lead to excitation of the nervous system, causing symptoms such as high blood pressure, seizures, hallucinations and even death. Treatment consists of replacing the addictive substance with a similar drug, monitoring for signs of withdrawal, and tapering the medication slowly until the patient is symptom-free. Commonly used medications include oxazepam and librium, both types of benzodiazepines. If severe withdrawal symptoms do appear, such as severe tremors and hallucinations, the patient needs treatment in an intensive care unit. Treatment there includes higher doses of benzodiazepines, fluids and elctrolytes, along with careful monitoring of the patient's respiration and heart rate.
Opioid Withdrawal Medications
Opioids include heroin, morphine, oxycodone and similar painkillers. According to "Harrison's Principles of Internal Medicine," withdrawal causes symptoms that are the opposite of the effects of the drug. Nausea, diarrhea, sweating, a runny nose and generalized pain are some of the symptoms. Treatment consists of alleviating discomfort by using clonidine, a blood pressure medication that blocks the over-excitation of the sympathetic nervous system, which underlies many of the withdrawal symptoms. Decongestants and anti-diarrheal agents such as loperamide are additional comfort measures. Buprenorphine, or Suboxone, is an opiate that doesn't cause a "high," and can help shorten the length of withdrawal and decrease symptoms.
Psychological Measures
Craving is part of the symptoms of withdrawal, as "Kaplan and Sadock's Comprehensive Textbook of Psychiatry" explains. Treatment of the physical withdrawal decreases craving to some extent, but without psychological treatment, withdrawal symptoms can be more severe, and the risk of relapse greater. Treatment includes group and individual alcohol and drug counseling sessions, which should be held several times a day. Helping the patients to identify craving and to learn methods to deal with it, such as calling a sponsor and avoiding tempting situations, should start form the first day of withdrawal. Occupational and art therapy groups such as painting and crafts can take the patient's mind off of withdrawal symptoms.
References
- "Kaplan and Sadock's Comprehensive Textbook of Psychiatry;" Virginia Sadock and Pedro Ruiz (editors); 2009
- "Harrison's Principles of Internal Medicine;" Anthony Fauci et al.; 2008
