TREATMENT OF ADDICTIONS AND DETOXIFICATION
“I have to go out by myself.” “I can with this.” “I leave it whenever I want.” These are phrases we hear frequently. But time passes and they continue to use drugs. Because a safe, planned and judicious detoxification program is needed. In certain cases the addiction detoxification phase can be performed on an outpatient basis. However, on many occasions, hospital admission is necessary.
WHAT IS SUBSTANCE ADDICTION?
For the World Health Organization (WHO), addiction is a brain disease like other recognized neurological or psychiatric disorders, such as Alzheimer’s disease or schizophrenia. In addition, it equates to other chronic diseases such as diabetes or high blood pressure. So, isn’t it a vice? Isn’t it a depravity? Isn’t it a moral problem? Well, no.
Specifically, addiction is a disease in which the ability to control the urge to consume alcohol or other drugs is lost. People who are addicted are unable to stop, stop using these substances, even when they are already faced with a serious health problem, or the harmful repercussions at the psychological, family, social or occupational level that the dependency entails. The more time elapses, the harder it is to treat. Therefore, the sooner we try to remedy the better results we will obtain. Many people with this disease deny being addicted, and often minimize their problem by claiming they can leave it whenever they want or that their friends also consume.
For someone to become addicted it takes time. The drug directly affects the brain and damages it causing us to respond in that way to the effect of it. One of the great difficulties when considering a detoxification process is the perverse mechanism of addiction, not only psychological but also physical, that these substances generate.
We call “craving” the intense desire, the craving, to use drugs. These powerful desires are part of the human condition, because our brains are designed to appreciate and pursue natural rewards, such as food or sex. Drugs consumed by addicted people activate the same neural circuits that motivate pleasurable behaviors. Cravings for alcohol or other drugs can be even stronger than those aimed at food or sex. And so, on a day-to-day basis we often observe, for example, an oversight in food secondary to alcohol abuse.
There comes a time when more doses of the drug are needed to achieve the same effect (tolerance) and when it is stopped using and the body is lacking, it responds with a withdrawal syndrome. Many times the person drinks or takes the drug already in the morning to avoid the appearance of withdrawal symptoms, mainly malaise and tremor. When withdrawal syndrome appears, it should be treated conveniently, because apart from the fact that the person has a very bad time, sometimes symptoms of sufficient severity may appear to require medical attention by itself.
The physical symptoms of withdrawal syndrome may vary according to the substance consumed and its severity. It can be complicated by seizures and the presence of delirium tremens. This is a toxic-metabolic disorder that could be considered the maximum degree of withdrawal syndrome and is a vital emergency, as it endangers life. It usually begins with anxiety, insomnia, trembling and dilated pupils. Feeding may not be tolerated, nausea, vomiting or diarrhea appearing. Subsequently there is an obnubilation of consciousness, with a confusional state and disorientation, hallucinations, delusional ideas, psychomotor agitation, inversion of the sleep-wake cycle, profuse sweating and generalized tremors.
There is scientific unanimity in that drug use damages neuronal connections and the functioning of the brain. In fact, alcohol consumption can lead to severe neurological disorders such as Wernicke’s encephalopathy and Korsakoff syndrome. The first, fortunately, has pharmacological treatment in early stages, the second, no longer.
In general, we can differentiate three stages in the treatment of addiction:
In this first step many addicted people must enter the center. It is about eliminating alcohol or other drugs outside the body and achieving physical stability, without the body already missing the substance. It should always be carried out under the watchful eye of the doctor and the psychiatrist, since intense discomfort may appear and become dangerous. In this way, detoxification will be carried out safely and possible symptoms of physical withdrawal will be managed. Doctors will indicate drugs to avoid the effects of withdrawal and make this process safer and easier. Occasionally, sueroterapia will be required given the food intolerance and the severity of the condition. The specialized treatment tries to avoid the appearance of complications. For it,
The evolution that occurs in these days of hospital admission is very significant and, in a high percentage of patients, the change is radical. The first 48 hours of the hospital phase are crucial. We must, by all means, avoid the appearance of the dreaded withdrawal syndrome and if it appears, make it as bearable as possible. The patient is feeling calmer, begins to see things differently, improves sleep and appetite and, in general, they are much better. Analytical (biochemical, neurobiological and nutritional parameters) and electrocardiogram are performed to monitor the physical state.
There is currently a general tendency to reduce entry times. Pharmacology makes it possible. In our case, the hospitalization time ranges from 48 hours to 7 days. Previously, seclusion was the norm and was admitted for much longer periods.
However, we must not forget that detoxification is the initial phase of the process, the beginning of the path, of the new life. Immediately you have to start the detoxification to ensure definitive abstinence.
The cessation is carried out in patients who are already detoxified, that is, who do not suffer the effects of drug withdrawal. This stage must be done without admission. It is a process in which the person tries not to return to the consumption of the substance, mainly with psychotherapeutic treatment, with the objective of living without consuming, improving their psychosocial functioning and having healthy habits. To do this, professionals must promote certain personal and social skills in order to achieve these achievements.
At this stage the change is consolidated and future plans and life projects are carried out. Professionals must remember the commitment to new life, that re-living, and support their needs at all times.
THE ALCOHOL AND THE ALCOHOLISM
Alcohol is a legal drug, normally consumed “normally” in a social way. It is a central nervous system depressant such as tranquilizers.
When consumed, initially, we noticed feelings of euphoria, optimism and increased sociability, subsequently lack of muscle coordination, vision disturbances, psychomotor excitation, and depending on the dose, respiratory depression and coma.
Alcohol is a toxic that when consumed in excess and for a while impairs the functioning of our body causing damage to the central and peripheral nervous system, in the cardiovascular, digestive system, in the liver (cirrhosis) among others.
In the long run, alcohol abuse impairs interpersonal relationships, family environment, academic and work performance, with the disastrous repercussions at all levels of the subject’s life.
The rehabilitation process begins by accepting that there is a problem, appreciating the dire consequences it produces, to initiate detoxification and detoxification.
We can consider that a person has problems with alcohol when he continues to drink even though he is interfering negatively in his life, whether in his health, in his psychological balance, in his work, in his family life, in his social image, etc. It is as if the control of one’s own behavior and, ultimately, of life are progressively lost.
Cocaine is a potent central nervous system stimulant, generating a huge sense of gratification. It fundamentally affects the central nervous system.
The effects it produces at the affective-behavioral level, and which are generally the ones sought, can be elevation of mood, decreased appetite, decreased feeling of fatigue, reduced need for sleep and/or insomnia, motor hyperactivity, Verbal and quick thinking. We are as more productive or creative and for longer, without feeling tired.
The physical signs that appear when consuming are dilation of the pupils, tachycardia and palpitations, sweating, tremors, increased blood pressure, alterations in the regulation of body temperature, deterioration of the nasal septum.
Other effects that sometimes, given its severity, may require admission to Psychiatry Units are paranoia, distrust, ideas related to jealousy or frank psychosis.
After a period of consumption, inappropriate behaviors may appear, including violent ones, with a negative impact on a personal, family, social and labor level, and neglect of daily obligations. We can also put the integrity of other people at risk, for example by driving recklessly, legal problems arise with relative frequency.
Otherwise, cocaine use is often associated with alcohol abuse.
Cocaine withdrawal syndrome is commonly manifested with symptoms such as irritability, dysphoria (unpleasant mood), anxiety, nervousness, nightmares and insomnia.
Cannabis is also known as porros, marijuana, hashish,… It is a drug consumed with relative frequency and, although it is illegal, in certain areas it is accepted and mistakenly considered as a soft, low-risk drug. When we abuse it, as with all drugs, we can develop an addiction.
Cannabis abuse can lead to a series of psychopathological symptoms that include decreased attention, impaired intellectual performance, memory impairment, amotivational syndrome (disinterest, inability to develop future plans, indifference, neglect of personal hygiene), depressive disorders and psychosis.