Detoxification at home has always been a concern for patients and their families, and many patients look forward to an effective method of detoxifying themselves without the hassle and fear of inpatient treatment. On the one hand, many patients have stable and decent jobs and face the risk of losing their jobs and source of income once they undergo 1-2 months of inpatient treatment; on the other hand, many patients are concerned that inpatient treatment may be known to the outside world and that it may cause unnecessary distress to their lives and work once it is known to their acquaintances; finally, the cost of detoxification treatment is indeed much lower than inpatient treatment. Finally, the cost of self-medication is indeed much lower than that of inpatient treatment, which is a suitable option for families who are not financially well-off.
The benefits of home detoxification are obvious, but in practice it is not as easy as it should be, and most patients are not suitable for this mode of treatment. I will discuss a few of the requirements necessary to be suitable for self-directed home detoxification treatment in the following ways.
1. Level of addiction
The level of addiction is a key factor in deciding whether or not inpatient treatment is appropriate. Self-detox is only appropriate for patients with mild addiction, and is not effective for patients with severe addiction. Both patients and family members tend to underestimate the dangers of drugs, especially patients, even those who smoke every day, will not think that they are not addicted and can stop anytime they want, without realizing or avoiding the fact that they can no longer get rid of drugs.
Patients with mild addiction have less withdrawal symptoms after they stop using drugs, their craving for drugs is small, and the pain is still tolerable, so giving certain doses of antagonistic drugs can reduce the symptoms to a very low level so that patients can go through withdrawal with less pain, and the success rate of detoxification is greatly improved. For patients with moderate to severe withdrawal reactions, even with the use of oral medication it is still difficult to tolerate, showing extreme anxiety and irritability, general discomfort, and then drug-seeking behavior leading to drug withdrawal failure. If forced restraint is used, these patients may have violent conflicts with their families and cause accidents. These patients can be treated in the hospital with intravenous medication and combined medication to reduce their reaction and thus smoothly transition to withdrawal.
2.Supervision
Many patients’ families believe that patients lack perseverance, which leads to failure in drug treatment, but they do not know that drugs damage the nerve cells of the patient’s brain, and once addicted, getting rid of the control of drugs can never be accomplished simply by perseverance. During the withdrawal period, patients will experience a variety of discomforts that will drive them to seek drugs, which is medically called “drug-seeking behavior”. At this point, relying on drugs can alleviate this discomfort to some extent, but some supervision is necessary. Supervision means that the patient’s family has one or more people who have a deterrent effect, and the patient is willing to follow his supervision and discipline. For example, to be able to undergo regular urine tests, to be able to go home at the appointed time, to be able to take the medication on time, to be able to follow up with the hospital regularly, etc. In actual life, a drug addict is often the backbone of the family, the main source of income, and the dominant and decision maker within the family, which determines that he is also a patient who lacks supervision, and the likelihood of successful drug rehabilitation is naturally not high.
3. Self-knowledge
Self-knowledge is the patient’s ability to correctly understand his or her own situation, and in many drug addicts, self-knowledge is incomplete or even completely lost. Patients do not think that drugs have caused damage to their body and mind, do not think that the changes in their current job and extremely family situation are drug related, and are not willing to accept any drug treatment or even just advice. Obviously, since the patient has no self-knowledge and therefore no subjective will to treat, any treatment is imposed on him, so treatment at home, even if effective, is hardly sustainable. In contrast, treatment in the hospital is not only medication, but also cognitive therapy and peer therapy, which are the most effective weapons to help patients regain their self-knowledge and make them see themselves through others, far more effective than the bitter words of family members a thousand times.
4.Psychiatric symptoms
Due to the special psychiatric effects of amphetamine-type drugs (marijuana, methamphetamine), more than 20% of abusers will sooner or later experience significant psychiatric symptoms, while a significant number of abusers experience significant psychological problems personality changes. (For more information on psychiatric symptoms see my article: “Psychotic Symptoms Due to Meth and Meth Explained”)
Once a patient is found to have psychotic symptoms, especially the severe positive symptoms of hallucinations and delusions, it is not something that the family can control at home on their own. Hallucinations and delusions can lead to impulsive self-injury and other harmful behaviors, and there are often reports in the media of such patients injuring others (even family members) with knives, dangerous driving, and self-inflicted injuries. These behaviors are sudden and unpredictable, and the consequences can be very dangerous, and due to the lack of professional medication and equipment, family members are unable to cope with the patient at home. Many families mistakenly believe that if they stop using drugs, these symptoms will naturally disappear, but in reality, they will only diminish and not disappear completely. Symptoms such as delusions, for example, are strongly believed by the patient and require medication supplemented by cognitive psychotherapy to eradicate in order to achieve complete treatment.
5.Medication
The purpose of drug treatment is probably the following.
(1) To speed up the metabolism of drugs in the body (commonly known as detoxification), for the initial stage of treatment, intravenous administration of drugs is required.
(2) To combat the withdrawal symptoms caused by drugs, used in the early and middle stages of treatment, mainly oral drugs.
(3) To combat drug-induced psychiatric symptoms, oral medications are mainly used, depending on the patient’s actual condition.
(4) For treatment of physical illness, oral medication is the mainstay.
It can be seen that only the first point of treatment at home is difficult to achieve because of the use of intravenous drug delivery, while the last three points can be carried out at home because oral drugs are the mainstay. However, it is worth noting that the clinical use of drugs is not static, but needs to be adjusted gradually with the changes in the patient’s condition, which requires patients to visit the hospital outpatient clinic on a regular basis, preferably with a regular doctor, so as to have a comprehensive dynamic understanding of the patient’s condition and help to adjust the drugs more carefully.
In summary, patients need to have the following conditions if they want to be treated at home.
(1) The patient’s addiction level is mild.
(2) The patient’s family has the ability to supervise the patient and the patient submits to supervision.
(3) The patient is self-aware of his or her condition and has a desire for treatment.
(4) The patient has no obvious psychotic symptoms.
(5) The patient is able to go to the hospital outpatient clinic regularly for examination and treatment.
The methods of self-treatment at home are briefly described as follows.
(1) Isolation from all unhealthy contact with the outside world during the treatment period.
(2) No going out at night and regular work and rest time.
(3) Visit the clinic once a week at the beginning of the treatment period, once every two weeks at the middle of the treatment period, and once every 1-2 months at the end of the treatment period.
(4) Take medication in a standardized manner, strictly take medication time and dose, do not increase or decrease the dose without authorization.
(5) Prohibit the consumption of alcohol, coffee, tea and other stimulant beverages, and weight loss drugs.
(6) Receive a urine test every 3-4 days.
(7) If you find that you have relapsed into drug use in the middle of treatment, you should inform the doctor and arrange for medical treatment.