Detoxification or detoxication is the physiological or medicinal removal of toxic substances from a living organism, including the human body, which is mainly carried out by the liver.
Detoxification is a set of interventions aimed at managing acute intoxication and withdrawal. It denotes a clearing of toxins from the body of the patient who is acutely intoxicated and/or dependent on substances of abuse. Detoxification seeks to minimize the physical harm caused by the abuse of substances. The acute medical management of life-threatening intoxication and related medical problems generally is not included within the term detoxification.
Detoxification as Distinct From Substance Abuse Treatment
Detoxification is a set of interventions aimed at managing acute intoxication and withdrawal. Supervised detoxification may prevent potentially life-threatening complications that might appear if the patient was left untreated. Detoxification is a form of palliative care (reducing the intensity of a disorder) for those who want to become abstinent or who must observe mandatory abstinence as a result of hospitalization or legal involvement. Treatment/rehabilitation, on the other hand, involves a constellation of ongoing therapeutic services ultimately intended to promote recovery for substance abuse patients.
The consensus panel built on existing definitions of detoxification as a broad process with three essential components that may take place concurrently or as a series of steps:
Evaluation entails testing for the presence of substances of abuse in the bloodstream, measuring their concentration, and screening for co-occurring mental and physical conditions. Evaluation also includes a comprehensive assessment of the patient's medical and psychological conditions and social situation to help determine the appropriate level of treatment following detoxification. Essentially, the evaluation serves as the basis for the initial substance abuse treatment plan once the patient has been withdrawn successfully.
Stabilization includes the medical and psychosocial processes of assisting the patient through acute intoxication and withdrawal to the attainment of a medically stable, fully supported, substance-free state. This often is done with the assistance of medications, though in some approaches to detoxification no medication is used. Stabilization includes familiarizing patients with what to expect in the treatment milieu and their role in treatment and recovery. During this time practitioners also seek the involvement of the patient's family, employers, and other significant people when appropriate and with release of confidentiality.
Fostering the patient's entry into treatment involves preparing the patient for entry into substance abuse treatment by stressing the importance of following through with the complete substance abuse treatment continuum of care. For patients who have demonstrated a pattern of completing detoxification services and then failing to engage in substance abuse treatment, a written treatment contract may encourage entrance into a continuum of substance abuse treatment and care. This contract, which is not legally binding, is voluntarily signed by patients when they are stable enough to do so at the beginning of treatment. In it, the patient agrees to participate in a continuing care plan, with details and contacts established prior to the completion of detoxification.
All three components (evaluation, stabilization, and fostering a patient's entry into treatment) involve treating the patient with compassion and understanding. Patients undergoing detoxification need to know that someone cares about them, respects them as individuals, and has hope for their future. Actions taken during detoxification will demonstrate to the patient that the provider's recommendations can be trusted and followed.