Rapid Detox: What it is and why it's been discredited by all the experts

Rapid Detox: What it is and why it's been discredited by all the experts

There are several basic elements that make up the widely discredited detox method called “rapid opioid detox” or just “rapid detox”:
  • Technically there are two basic forms of rapid detox:
    • Patients are heavily sedated but technically still conscious (rapid opioid detox or ROD) during the detox, and narcotic sedatives, opioid antagonists and other drugs are administered either orally or intravenously.
    • Patients are unconscious under a general anesthetic (ultra rapid opioid detox or UROD) during the detox, patients are under general anesthesia and all drugs are administered intravenously.
    • These days, both methods are usually just called “rapid detox”.
  • In all cases, detox is artificially induced and accelerated by administering large amounts of opioid antagonist drugs, such as naloxone or naltrexone. Opioid antagonists block the opioid receptors in the brain and thereby induce withdrawal. Additional drugs, such as clonidine and nausea suppressors, are given to suppress side effects.

These points basically describe all there is to rapid detox. It may sound straightforward but there is a lot more to know about this tricky subject. Rapid opioid detox has been around for quite some time – decades in fact. Yet after all that time, there still isn’t enough evidence of its safety or effectiveness to convince the various federal, state and local health agencies across the country.

Cochrane Reviews, an internationally recognized medical research company, has concluded after two thorough studies of the medical literature that there isn’t enough evidence to support rapid opioid detox. Cochrane concluded that the chances are far higher for rapid detox patients to be forced to keep taking naltrexone or other such drugs long after the detox is supposedly finished, than detox patients at a medically supervised detox center who seldom or never have to keep taking drugs following their detox. This, and several deaths, have resulted in rapid detox being discredited by the U.S. Centers For Disease Control and Prevention (CDC), the CDC’s National Center for Injury Prevention and Control, the American Society of Addiction Medicine (ASAM), and numerous state and local agencies.* The New York City Department of Health and Mental Hygiene, for example, wants to see rapid detox out of the city because of two recent deaths at a single New York rapid detox clinic. The deaths were only the tip of the iceberg. Detox clinics normally don’t treat patients with complex medical situations that can make detox potentially harmful. Yet this clinic was accepting patients with complex medical situations. The investigation revealed that 55 percent of the 75 patients treated at the clinic also had psychiatric illnesses, 23 percent were suffering from chronic medical problems and 35 percent had been abusing multiple substances. Such situations are red flags for any detox clinic and often mean a hospital is the only appropriate setting for detox, and the detox should be very gradual, as gentle as possible. Rapid detox is just the opposite. Any doctor will tell you that heavy narcotic sedation and general anesthesia both carry risks of catastrophic injury or death.

These can’t be predicted, and no one can guarantee safety during either procedure. The bottom line is this: A detox clinic is not a hospital, so there’s no excuse for exposing people to the known risks of heavy sedation and general anesthesia. It’s also questionable ethics to promote and deliver such treatment when the risks are clearly so high. There’s nothing wrong with the use of helpful drugs during detox, but only when medically required and appropriate, not given to every patient who walks in the door. Detox patients should only receive an individualized detox plan that addresses each patient’s unique medical situation, just the way we do at Novus Medical Detox Center. * Centers for Disease Control and Prevention (CDC): Deaths and Severe Adverse Events Associated with Anesthesia-Assisted Rapid Opioid Detoxification — New York City, 2012. Other citations available on request.

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