Detox- no meds?

[GardenDove]

Anyone here know anything about detox/rehab places? I went to visit my ETOH tenent who I am evicting, the one with the meth head wife who is mandatory rehab. He's been taking the vitamins I gave him and states he is going to detox tommorrow (not after I had to pay a lawyer to serve the second step of papers on him, to formally evict him, which I will pay through the nose for).

He apologized for the other day, saying that he had run out of money and booze and had had some sort of seizure, until his DIL across the street brought him some booze. I told him that if this happened again, that he needed to get himself to the ER and be admitted to the hospital to detox, that it wasn't safe to do it without meds.

He said that this place he's going to to detox doesn't give out meds. I told him that you have to have meds in order to withdraw from alcohol, that it was for his safety. He gave me the number of his wife's drug counselor, who has been also unofficially helping him out, and I spoke to her. Yes, she told me that the detox center doesn't do meds, they just transfer to the hospital if the pt needs it.

How can a detox center not give meds? Is this the norm? The guy drinks 24 beers a day, he states. I told the drug counselor about the seizure and she will pass that along.

[Levin]

I'm not aware of any alcohol detox units that don't use things like Vallium.

Well until your post anyway. Sounds a bit odd to me.

Levin.

[traumaRUs, MSN, APRN]

Nope - very common. I worked as a case manager for a couple of years in a big city ER and part of my job was to place folks in detox if they needed/wanted it. Our area detox (and we have only one for folks w/o insurance) uses librium only. If the pt does go into dt's and seizes, they transfer them to the ER. However, that happens rarely. For drug detox (like heroin), they give clonidine and that is it.

[NurseCard, ADN]

Yeah.... I have actually never heard of this either, but I would think it logical that a detox center might want to avoid as much as possible, the heavy duty drugs until they are absolutely, physically necessary. OTOH, you would think that they would at the very least have them on hand just in case. *shrugs*

[elkpark]

There is medical detox from alcohol, and then there are lots of "social detox" centers, which provide support/comfort measures, information, and supervision, but in a non-medical setting (non-medical staff) with no drugs. In my experience, they do not provide any medical treatment, but watch people closely and call 911 to send them to an ER if they start developing significant sxs.

Not everyone needs medical detox with lots of drugs -- in Europe, for many years (I don't know what they're doing these days), it was standard practice to detox people from ETOH with just vitamins (inc. in hospitals), and I've worked in the past in a hospital-based detox unit where we gave only vitamins and sweetened orange juice (OJ with Karo syrup mixed in -- referred to as the "Dr. (X) cocktail," after the unit's MD) until clients had measurable, objective sxs of detox -- which lots of our clients never did.

[NurseCard, ADN]

Yeah, see I've actually worked with quite a few patients, both in med/surge and in psych, who were "supposed" to go into withdrawal but never did.

[GardenDove]

Thanks for the replies. I had always assumed that 'detox' meant medical assistance and monitoring during withdrawel from drugs or alcohol. I more thought of 'rehab' being something without that, for people who just need counseling and support groups.

This guy will definately have withdrawel. He's totally broke obviously, but at least the pipes didn't break at the house, it's been in the 0-20 degrees for a week and he's been heating the house with the electric stove.