Detox and Withdrawal Management
Detox and Withdrawal Management provides safe, structured protocols for alcohol, opioids, benzodiazepines, and stimulants across ED, inpatient, and community settings. This page turns guidance into action: triage to the right level of care; symptom-triggered vs fixed-dose regimens; thiamine and seizure precautions; and immediate transition to maintenance therapy. If you are comparing a medical detox conference, you’ll find practical order sets, escalation criteria, and warm handoffs that prevent rebound and readmissions. Because continuity saves lives, we link to Alcohol Withdrawal Protocols and Opioid Use Disorder for post-detox pathways.
Detox is a door, not a destination. We emphasize low-threshold access, same-day inductions for MOUD, and naltrexone/acamprosate starts for AUD when appropriate. Sleep, nutrition, and hydration are stabilized early; co-morbid pain, anxiety, and depression receive non-sedating care to avoid relapse. Teams coordinate discharge with peers, housing, and primary care; families receive education and safety plans (including naloxone). Dashboards track severe events, LOS, and linkage rates, while equity measures ensure language and cost are not barriers.
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Triage and setting
- Stratify seizure/delirium risk and social supports to choose ED, inpatient, or community.
- Use structured tools (CIWA-Ar, COWS) and vitals to guide monitoring.
Alcohol and sedative withdrawal
- Symptom-triggered benzodiazepines or phenobarbital where indicated.
- Parenteral thiamine before glucose; correct electrolytes and sleep.
Opioids and stimulants
- Initiate buprenorphine/methadone; manage stimulant crash with sleep and nutrition.
- Avoid sedative stacking; plan post-acute cravings care.
Discharge and linkage
- Book follow-ups pre-discharge; provide bridge scripts and naloxone.
- Connect to counseling, peers, and social supports.
Implementation, Equity, and QA
Order sets and checklists
Standardize dosing, assessments, and escalation steps.
Tele-bridges and peers
Virtual follow-ups and navigators reduce drop-off.
Pregnancy/older adults
Adjust protocols for physiology and polypharmacy.
Pain and surgery
Coordinate multimodal analgesia with MOUD continuity.
Equity and access
Language services, transport, and low-cost meds.
Staff training
Micro-learning and debriefs; address stigma explicitly.
Quality metrics
Severe events, readmissions, and linkage to maintenance care.
Learning loops
Update protocols based on outcomes and patient feedback.
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