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Notes on Detox Centres

Notes on Detox Centres

From the FAQ

 SHOULD I CONSIDER GOING INTO AN IN-PATIENT DRUG REHABILITATION FACILITY OR DETOX CENTER TO GET OFF MY BENZODIAZEPINE?

 Only in a relatively small percentage of cases do people have successful experiences withdrawing from benzodiazepines on an in-patient basis. 

The problems with detoxification centres are multi-fold.  First and foremost, detox facilities are geared towards treating drug abuse behaviors, not providing support for withdrawal.  The facilities often do not understand the necessity of tapering your benzodiazepine slowly. Often, they will require you to taper over a 3-6 week period.  Some will even take you off your benzodiazepine over a one week period with a Valium or Phenobarbital substitute.  These facilities usually will not keep you in-patient for more than about 6 weeks.  The result is that you may end up being detoxed in an overly rapid fashion, while receiving classes on drug abuse but no specific support for managing benzo withdrawal. The experience after leaving the facility can often be very rough, as you may be left in a state of fairly intense withdrawal that can persist for a long while.  In short, people with benzodiazepine dependencies often feel worse after they leave these facilities than before then entered. 

Clinical experience suggests that benzodiazepine detoxification works best where the patient controls his or her own taper schedule in conjunction with the advice of a physician knowledgeable about benzodiazepine dependency.  Detoxification centres, even where they might permit a relatively slow taper, will usually take the control of the process away from the patient and force the patient into a rigid protocol. 

However, detox centres should be considered in two very rare circumstances. First, if you have a problem abusing benzodiazepines either alone or in combination with other drugs, an in-patient setting is often appropriate to enforce the discipline of tapering the drug, and to educate you on how to avoid drug abuse.   If you feel that you lack the necessary self-discipline to taper yourself slowly and gradually and have no spouse or other caretaker who will manage your taper for you, you may wish to consider a facility. 

Second, in the rare circumstance where your withdrawal syndrome is so severe that you are unable to take care of yourself and you have no live-in spouse or other caretaker, you may wish to consider the in-patient option.

The most likely outcome of going to a detox centre for benzo withdrawal is an over rapid withdrawal, being dismissed feeling very unwell and needing one or more other psyche drugs to cope. These other drugs will then need to be tapered in there turn.

Some member’s descriptions of how they experienced detox.

 Person One

 ” I thought I'd post my detox story so people who are thinking about going to a detox center/rehab can THINK AGAIN.

I had been on Klonopin (3mg) and Parnate (40mg) for many years. I was originally prescribed them for depression and social anxiety. I was going to do a slow taper and I knew I should do a slow taper but the withdrawal was going to be bad anyway and I thought I would suck it up and get it over with - KNOWING it would be bad, but NOT knowing it would be like (literally) going to hell and being stuck in hell.

On my first day in rehab I was humiliated but did not think much of it. Bags searched, clothing searched, anything with alcohol taken away (even hair gel) and lots of interviews and intakes. I didn't seem that bad at first although I was a little suspicious when they immediately threw out my bottle of Klonopin. It was okay I thought because these were medical doctors and they knew my story. WRONG, for all they knew and cared I was taking 30 pills a day, they did not care. They gave me a 7 day taper of phenobarbitol and told me the parnate would have to be weaned off in 4 or 5 days. For some reason I knew it would be a little fast but I thought if I just sucked it up I would be fine in a couple of weeks.

The first couple of days I felt really drugged up but not too bad. The phenobarbitol felt like getting a little drunk, the feeling of being slightly euphoric, a little off balanced but not bad.

Then the hell began, they treated me pretty much like you would treat a piece of garbage. I absolutely felt like I was in prison. I was expected to be up at 6am, dragged myself to group meetings, AA meetings, and expected to socialize no matter how I felt. I was yelled at and told I was no good and I would "be back on the streets" (I was a successful mortgage underwriter who was never on the streets but the ex-addict counselors ALL treated every single person as if they were selling crack on the streets before they came there) and after 4 days I told them I wanted to go home. I had enough TORTURE, they said NO WAY. The doctor, talking to me like I was something between a person who sold crack to kids and a 3 year old retarded child, told me that there is no way he would let me go and that if I wanted to leave it meant I was suicidal since I could have seizures. I asked if they could just give me enough phenobarbitol so that I could get home safely and I was yelled at (YOU’RE NOT A DOCTOR...THAT IS YOUR ADDICTION TALKING...WE'RE DONE HERE).

They called my parents and told them every single bit of confidential information I had told them. They also lied and said I was "talking to the walls" and that I "had not eaten in 2 days". I became scared and hostile. I had severe agoraphobia/social phobia and could barely leave my room. I also had severe DP/DR and felt like I was in hell and in a nightmare I could not get out of.

It got worse, the doctor, after 10 days, finally wrote an order to have me committed to the psychiatric ward of a local hospital for a 72 hour hold for (and this is a complete lie) "refusing to eat for 2 days" and being "a danger to myself". The hospital gave me a small dose of Klonopin and kept me there for 3 days. The klonopin got me well enough to fly home (I had flown from California to Florida). I got home and was a complete mess.

 I have the trauma of detox/rehab to get over along with the horrible and severe withdrawal I am in right now. After all I went through, I saw one of the "benzo-wise" doctors and to my shock, he told me "you know, it’s not an addiction if you need the drug”, wow!

 So here I am, 2 months from the December 6th- December 19th 2006 hell of rehab and I had to move in with my parents in their small apartment. I was making a very good salary and had a very very good job and career. I now have nothing and I can barely leave the apartment. I have managed to go for a little jog in the past 2 days which is encouraging. The DP/DR is really bad still and the worst part, worse than the worst symptoms is NOBODY BELIEVES ME. "The drug is out of your system so you should be ok" - I hear that from everyone. I'm fighting to be rid of these horrible horrible drugs yet they are being pushed at me. I would rather die than take another mind altering drug..EVER... “

Person Two

“I was cold turkey’ed in 7 days from benzos in a locked psych unit in March 2005. I went to a rehab for 28 days after that.  I was racked with panic, anxiety, was constantly crying, experienced intense muscle spasms, blurred vision, tingling in my arms and legs, muscle weakness, feeling like I was walking "on the moon" and way too much more.  I did not have this group to help me ‘reality test’ what I was going through then.  The staff and patients at the rehab thought that I was complaining in an effort to seek attention, making up my symptoms and crazy.  After I left the rehab, I checked myself in another psych unit.  I did not know what else to do at the time. I honestly thought that I was having a psychotic break.  Why else would I have been experiencing such strange and horrific symptoms?”

Person Three (Genie)

“Detox is definitely NOT the way to get off benzos -- tapering is. I only went to detox because I didn't have a choice. My former excuse for a doctor cut me off and refused to give me any more Ativan, and I figured that a medically-supervised detox would be better than going cold turkey on my own. In addition, the water titration method didn't exist back then.

While I was in detox, I felt just fine, and I thought I had made the right decision.

However, after I came out of detox, I was fine for a week, and then the proverbial sh*t hit the fan. If I thought I was sick BEFORE entering detox, the way I felt a week post detox was about 100 times worse. I couldn't walk without a cane. I didn't get any sleep at all. I had to take blood pressure pills. I couldn't eat and I lost 35pounds. My head was splitting, my body was burning up, and I had the shakes and non-stop panic. I urinated about 50 times a day.

I became suicidal as a result of detox, and then the hospital personnel had the nerve to accuse me of smuggling benzos into the psych ward because they found traces of it in my urine! They were clueless. They had no idea that benzos can remain in one's system for weeks, even months. They treated me like a hard core addict, and here I was an accidental addict who had never even smoked grass in the sixties when everyone else was getting high! They locked me up in that psych ward and refused to let me out, and it was only because of my attorney husband that I got out of that nuthouse!

They put me on all kinds of psych meds and other meds there --Clonidine (blood pressure pills), Neurontin, Trazadone, Remeron andeven Ambien. All these meds just made me sicker”

After I was released from the loony bin, I had a number of hospitalizations for MEDICAL problems. Because I was in acute withdrawal, the doctors in one hospital had problems diagnosing me. My blood work was very abnormal, as were my CAT scans. They misdiagnosed me with everything from pancreatic cancer to hepatitis. Finally, I was sent to New York Presbyterian Hospital, where they diagnosed me with kidney stones and pyelonephritis, and they told me that my kidneys were shutting down. This all was the result of the rapid detox, and, if they hadn't found out that I had a serious kidney problem, I probably would not have been alive to tell my story. I never had any problems with my kidneys prior to going to detox. As a result of this experience, I now call detox "dietox."

 

Summary

  1. All the information we have available suggests that the best way to get off benzodiazepines is with a slow patient controlled taper.
  2. Detox centres are not able to allow people enough time (months or years) to withdraw slowly and they impose a rigid tapering schedule.
  3. While in the centre a person may receive inappropriate lessons and counseling on not abusing drugs but receive no help on how to cope with benzo withdrawal once they leave.
  4. People may leave the centre feeling much worse than when they went it and face months of recovery with no support.
  5. Other drugs may be used and these will then have to be withdrawn at a later date.
  6. Detox centres may be appropriate where someone is abusing the drugs and has no one to help them control their taper or where a withdrawal is making them so sick that they cannot look after themselves and they have no one to help.

 

 

 

Disclaimer:  The information contained in this website was not compiled by a doctor or anyone with medical training. The advice contained herein should not be substituted for the advice of a physician who is well-informed in the subject matter discussed. Before making any decisions about your health or treatment you should always confer with your physician and it is always assumed that you will do so.

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Last updated 22 July 2015