Substance abuse costs American society upwards of 600 billion annually, as published by the National Institute of Drug Abuse (NIDA). These costs come from lost workplace production, as well as health care costs, crime, and legal expenses. Opioid drugs are some of the most abused substances in America and even in the world, as an estimated 26.4 million to 36 million people abuse opioids globally, according to the World Drug Report of 2012.
Opioid drugs include illicit street drugs such as heroin as well as prescription narcotics like OxyContin and Vicodin. Opioid painkillers specifically were involved in 71.3 percent of pharmaceutical overdose deaths in 2013, as reported by the Centers for Disease Control and Prevention (CDC). The CDC lists drug overdose as the leading cause of injury death in America in 2012, surpassing even car crashes.
Opioid addiction is a complex and chronic brain disease, requiring specialized treatment. It should come as no surprise then that people are often searching for a “cure” or quick fix for this rising epidemic. Several years ago, medical professionals created a procedure called ultra-rapid opiate detoxification (UROD), also called anesthesia-assisted ultra rapid detox. Though it promises a quick fix to the detox process, it comes with risks.
Anesthesia-assisted ultra rapid detox is relatively new and not offered at very many places due to high risk factors and questions about its safety and effectiveness. The Journal of the American Medical Association (JAMA) reports that studies do not support using general anesthesia for heroin detox, stating that there is no evidence that it is effective long-term.
Opioid and substance abuse withdrawal and recovery are complex and different for everyone. UROD is highly variable, and each person may have a different result, depending on factors such as the last dose of opioid, the type and method of sedation [i.e., intravenous (IV) or a nasogastric tube (NG), which is inserted through the nose and down into the stomach], and the type of opioid antagonist or follow-up medications used.
During UROD, patients may be hooked up to an ECG machine in order to monitor heart rate for cardiac complications. Sedated patients also need to be monitored closely for signs of delirium, vomiting, or diarrhea that can occur after inducing rapid opioid withdrawal through opioid antagonists.
Those undergoing UROD need to be extensively prescreened for any and all underlying medical conditions as well. The National Institute on Drug Abuse (NIDA) reports that three of the 35 patients studied who underwent UROD suffered from severe adverse reactions due to underlying and preexisting medical conditions that were not divulged or discovered prior to the procedure. Furthermore, an investigation was done on a New York City clinic that performed 75 anesthesia-assisted ultra rapid detox procedures between January and September of 2012, and the Centers for Disease Control and Prevention (CDC) published that of these procedures, there were five adverse reactions requiring immediate hospitalization and two deaths, making the serious adverse event rate 9.3 percent.
Another risk factor to UROD is the rate and potential danger of relapse after detox without proper follow-up care. Relapse after detox can be especially hazardous as users who return to previous levels of drug abuse may not have the same tolerance levels as before, which can result in a life-threatening overdose.
Anesthesia-assisted ultra rapid detox is rarely recommended and often not supported by insurance. A successful recovery program often includes a detox protocol, but general other methods are considered safer and more effective long-term. Partial opioid agonists, such as methadone or buprenorphine, may be used to help wean off opioids in a more gradual way that can help smooth withdrawal symptoms and combat drug cravings. Partial opioid agonists act on the same receptors in the brain as full agonists do, although to a lesser effect. They also usually have longer half-lives, meaning they stay in the system longer and are dispensed under the supervision of a medical professional who can monitor progress and ensure the continued success of the treatment program.
The use of medications in treatment should be considered adjunct to behavioral therapies. Addiction has emotional components that need to be cared for during treatment. Psychotherapies, such as cognitive behavioral therapy, can help to identify potential stressors or triggers in one’s environment, social circle, or personal psychology that may create drug-seeking and compulsive behaviors. Behavioral therapies provide tools for coping with these situations and helps to turn negative thought and behavior patterns into positive ones.
A positive self-image and healthy self-esteem are additional important aspects of recovery. Support groups and counseling sessions help to form positive connections and social networks that can enable success and a substance-free future.
There is no “magic bullet” when it comes to substance abuse treatment, but with commitment and the right specialized care provided by compassionate and professional staff members, you can find a healthy and safe balance in life. Call us to learn more.