Drug dependence is generally a side effect of addiction and chronic substance use. Once someone is dependent on a mind-altering substance, detox is the method of processing the toxins from the body.
There are many facilities that provide drug detox services. Not all drug detox centers are equal, however. As addiction is a highly personal disease, what works best for one person may not be what works best for someone else. In general, there are several things to consider when looking for a detox facility, including:
- Location and ease of access
- Programs offered and personal suitability
- Staff credentials and qualifications
- Credibility of program
- Duration of program
- Aftercare services and transition to a comprehensive treatment program
Individual insurance companies as well as primary care providers or mental health professionals can offer referrals to a drug detox center and may also be able to provide reviews or critiques on specific programs. Talking to others who have personal experiences with particular detox programs or centers can be useful. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a behavioral health treatment services locator tool that can help individuals to find detox services in their area as well.
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Questions to Ask When Seeking a Detox Center
- Do they accept insurance and if so, what/how much is covered? Each individual insurance plan is different, and insurance can greatly help to defray the potential costs. The Affordable Care Act (ACA) classifies treatment for substance use disorders as one of the 10 essential health benefits and requires that plans purchased through the national healthcare Marketplace cover addiction and drug dependence treatments that often include detox.
- What are the payment options? If a detox center doesn’t accept insurance, or if insurance only covers part of the services needed, what are the payment options? Do they accept private pay or offer payment plans or loans? Sometimes, individuals may need to pay for services up front and then be reimbursed by insurance or by an employer later.
- How long is the stay? Detox generally lasts between 5-7 days on average, though sometimes a slightly longer stay may be ideal. Rapid detox, where an individual goes under anesthesia while the drugs are processed from the body, is not accepted in the medical community as a viable or safe option. Any centers offering ultra rapid detox programs should be avoided.
- What is the admissions process? A detox facility may require a referral from a primary care or other health provider before providing services. They may also wish to do a full mental health assessment, medical evaluation, and drug screening prior to admission. This can help to ensure that all treatment methods and medications will be effective, without negative interactions.
- Is there currently space in the program? Once the need for detox is recognized, it is important to get someone into a facility as soon as possible.
- Is the detox center private or public? Addiction services provided by the state or through federal funding are open to the public and often offer services at a low cost or free of charge. These facilities may be outpatient in nature and fill up quickly. Private facilities may be able to provide a higher level of care and be more rapidly accessible.
- What types of services are offered? Often, stopping a drug “cold turkey” after long-term use or abuse is not advisable and may even be life-threatening. Detox facilities should take this into account and offer tapering schedules, medication replacement therapies, or other methods to safely manage withdrawal.
- Do they offer medical detox? Medical detox is a form of detox that commonly uses medications to alleviate some of the uncomfortable and even potentially dangerous side effects of drug withdrawal. During medical detox, vital signs are closely monitored 24 hours a day. Mental health support is often a vital part of medical detox and can help to ensure a person’s personal safety and security.
- Is the detox program inpatient or outpatient? Residential detox programs are generally considered to be more comprehensive, as medical detox provides around-the-clock care, treatment, and supervision.
- What kind of supportive care is given? The environment should be calm, quiet, and provide a space for individuals to recover in relative peace and comfort. Encouragement and emotional support during detox are important as well.
- Is the facility licensed? Detox facilities are often licensed by the department of health in a particular state, city, or county. Some centers may seek additional credentials and certifications, proving excellence above and beyond what is required as well.
- What types of staff members are employed? A detox center providing the highest level of care will staff medical, mental health, and substance abuse treatment providers that are all available to clients. These providers should regularly check in with individuals and evaluate that the care being provided is sufficient and beneficial. All care providers should be appropriately licensed and credentialed.
- What happens after detox? Detox is generally considered to be the first step in a treatment program and should be followed with a complete substance abuse treatment program. Many detox centers can move individuals seamlessly through this transition.
Understanding Professional Staff and Facility Credentials and Qualifications
At a detox center, a team of trained professionals should work together to devise and carry out a treatment plan. This team may be made up of physicians, social workers, nurses, psychologists, and counselors. Physicians should be available, at least by phone, around the clock at a residential detox center, the Detoxification and Substance Abuse Treatment Improvement Protocols (TIP) publishes. Clinicians, such as registered nurses (RNs) or licensed practical nurses (LPNs) who are authorized to dispense medications, should be on hand as well as staff trained to carry out physicians’ orders and treatment plans. Mental health professionals like psychologists and counselors should be onsite regularly as well.
In order to treat clients at a specialized substance abuse and addiction treatment facility, including a detox center, individuals must be licensed by the state. Within the state of Nevada, this means that licensed clinical social workers, psychologists, physicians, and nurses, as well as drug and alcohol abuse counselors may be employed at a detox center as long as they have a certificate or license from the Nevada State Board of Examiners. The National Certification Commission for Addiction Professionals (NCC AP) provides certification for three different types of credentials for addiction counselors above and beyond the standard license and credential as an addiction or substance use disorder counselor provided by the state.
Detox centers can also carry accreditations and certifications themselves. They are required to be licensed by the particular state they are in, for example. Within the state of Nevada, the Nevada Division of Public and Behavioral Health (DPBH) under the Department of Health and Human Services (DHHS) provides state-level licensure for detox centers and facilities offering treatment for drug and/or alcohol abuse. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provides accreditation to behavioral health centers and those providing addiction services. This shows that a facility has a high standard of care for safety, treatment, and services offered. The Commission on Accreditation of Rehabilitation Facilities (CARF) also provides accreditation for addiction treatment centers, showing a commitment to excellent care and quality of treatment services beyond just what is expected at the state level.