What is drug detox?
Drug detox at the clinic is symptomatic treatment given intravenously over several hours. It replaces fluids and electrolytes, dampens the harshest effects of withdrawal, allows the patient to sleep, and keeps blood pressure, pulse and level of consciousness under watch throughout. Assessment, infusion and discharge all fit into a single day.
The line an infusion does not cross
How fast a substance leaves the bloodstream is set by its half-life and by liver and kidney function. A drip does not speed this up, and no honest offer will claim otherwise. Nor does it end the addiction, because it is a starting point for addiction therapy rather than a substitute for it.
What the infusion offers during the first day after withdrawal
The first hours after withdrawal tend to be the worst: exhaustion, vomiting, anxiety, insomnia, dehydration after several days without food or water. The infusion lets the patient get through that stretch in a setting where somebody is watching the readings and reacts before the patient notices anything going wrong.
What do we establish by phone before booking a detox?
The call before the visit settles whether the patient should come to the clinic at all or be referred elsewhere. Three pieces of information carry the most weight: what was taken, for how long, and at what hour the last dose fell.
Questions that always come up
- The substance and everything alongside it - alcohol, sleeping pills and prescription medicines included, because a mixture changes the picture of withdrawal
- Duration and regularity of use - a few days of continuous use is a different situation from several years of daily use
- Seizures, fits and loss of consciousness - happening now or at any point in the past
- Chronic illness and psychiatric treatment - heart, liver, kidneys, diabetes, epilepsy, medicines taken permanently
- Conditions after discharge - whether a sober person will collect the patient and stay at home through the first night
What rules out an outpatient infusion
Opioid addiction excludes this procedure absolutely. Withdrawal from benzodiazepines and from GHB or GBL requires hospital conditions. Pregnancy calls for specialist care: in opioid addiction the withdrawal itself endangers the foetus, and the standard of care is substitution treatment. In each of these cases we end the call by naming a specific place that will handle the situation better than we can.
Why does the type of drug change the whole procedure?
Callers ask about the length of the infusion more often than about the substance, and the second question settles far more. Withdrawal from each class of compounds runs differently, starts at a different moment and calls for different facilities.
Four classes of substance, four withdrawal scenarios
- Stimulants, meaning amphetamine, cocaine and mephedrone - exhaustion, a need for long sleep, low mood, dehydration. No recognised pharmacotherapy for this withdrawal exists, so we work on the symptoms and say as much openly
- Benzodiazepines - symptoms appear with a delay, usually after two to seven days, and drag on for weeks. The safe route runs through gradually reducing the dose, not through stopping abruptly in a single day
- GHB and GBL - a course resembling alcohol withdrawal and responding poorly to standard sedative treatment, which is why the place for it is a hospital ward
- Cannabis products - complaints are mainly psychological, sleep and irritability. Medical detox is not indicated here
When the substance is an unknown
With legal highs and new psychoactive substances the composition is often unknown even to the patient, and the course of withdrawal is hard to predict. In that case we narrow the range of what can be done on an outpatient basis rather than widening it.
When is an infusion enough and when is a hospital ward needed?
This split is decided by the risk of complications in the coming hours, not by how badly the patient feels. Someone in a dreadful state after amphetamine may be safer at the clinic than someone who feels tolerable but is coming off benzodiazepines.
Outpatient infusion
It works where withdrawal is severe but predictable: a stimulant crash, dehydration after several days of continuous use, insomnia and anxiety without neurological complications, stable circulation, no history of seizures. The patient spends a few hours at the clinic and goes home.
Hospital conditions
These are needed wherever withdrawal may run a stormy course and demand continuous supervision over many days: benzodiazepines, GHB and GBL, seizures in the past, delirium, serious somatic illness, alcohol withdrawal running in parallel. We then point to inpatient treatment and explain why, while what such a ward is and what a stay involves is described by the treatment centre pages for individual cities.
When should you skip booking a visit and seek help immediately?
Some enquiries reach us at a moment when discussing an appointment date wastes time. The situations below call for urgent medical help rather than an infusion booked for tomorrow.
Symptoms that allow no delay
- Seizures - happening now or occurring within the past few hours
- Confusion and delirium - the patient does not know where they are, sees or hears things that are not there
- Breathing and consciousness disturbed - drowsiness the person is hard to rouse from, slowed breathing, blue lips
- Suicidal thoughts - voiced directly or in the form of saying goodbye to relatives
- Abrupt withdrawal from benzodiazepines or GHB - especially after long, daily use
- Withdrawal with alcohol in the background - this combines two withdrawal profiles at once
What to do until help arrives
Do not leave the person alone, do not give sedatives on your own initiative, and remember what was taken and at what hour. That information helps whoever takes over the treatment, ourselves included, if the patient comes to us once the condition has been stabilised.
Why do we not run heroin and opioid detox on a drip?
This is the most common question from people who reach this page after searching for heroin detox. The answer is not that we cannot relieve the symptoms. It is that in this addiction the dangerous part is what happens after the detox.
Loss of tolerance
A dozen or so hours without an opioid lowers the body's tolerance. If the patient returns to the pre-break dose after leaving the clinic, that same amount may prove fatal. Cohort studies show that in the first weeks after detox the risk of fatal overdose rises several times over, on the order of three to eight, with the first fortnight the most dangerous (Strang, BMJ 2003, PMID 12727768; Merrall, Addiction 2010, PMID 20579009). An outpatient infusion creates that risk without managing it.
Where we refer patients
To substitution treatment, run by facilities holding the appropriate contract. Its effectiveness is documented, unlike that of a one-off detox. People in this group also do well to keep naloxone nasal spray at home, available on a prescription a doctor can write.
Tablets of unknown origin
A separate risk concerns people buying tablets outside a pharmacy in the belief that they are taking oxycodone or a sedative. Counterfeit tablets are sometimes filled with nitazenes, opioids frequently stronger than fentanyl. If that describes the patient's situation, assessment follows the same route as with heroin.
What does the visit look like and where do the 3, 6 and 12 hour variants come from?
The visit opens with an examination and a conversation at the bedside that confirms or corrects what was established by phone. Only then do we insert the cannula. The length of the infusion is decided by medical staff on the basis of hydration, severity of symptoms and how the body responds to the first hours, so the variant from the price list is a starting point rather than a final arrangement.
An infusion after a stimulant crash
This is the most frequent reason anyone calls. After several days on amphetamine, cocaine or mephedrone come exhaustion, irritability, low mood and a craving for sleep that cannot be satisfied. The infusion rehydrates, corrects deficiencies and lets the patient sleep through the worst of it. It does not shorten the drug's action and it does not treat the addiction, and that is exactly how we describe it to patients.
Where the three variants come from
A shorter infusion suffices where symptoms are moderate and general health is good. A longer one gives time for slow fluid replacement, observation after symptomatic medicines have been given, and sleep at the clinic. Sometimes we extend the variant midway, if the readings return to normal more slowly than the assessment assumed.
What goes into the detox infusion?
The contents are set by medical staff after examination, which is why two people admitted on the same day may receive different infusions. What can be listed, however, are the elements such a mix is built from.
Fixed elements of the detox infusion
- Rehydrating fluids - the basis of the infusion, particularly after several days without food or water
- Electrolytes - magnesium, potassium and sodium, whose deficiencies cause palpitations, cramps and weakness
- Glucose - matched to the patient's condition and to the measured result
- B vitamins, thiamine among them - relevant where nutrition has been neglected
Symptomatic treatment
What gets added is whatever answers a specific complaint: something for vomiting, something for pain, something for restlessness and insomnia. Medical staff select these one at a time and only where there is an indication, never as a package administered just in case.
What this infusion is not
It is not an antidote neutralising the drug, nor a vitamin drip from the wellness range. The aim is narrower and more down to earth: to carry the patient through the first day without complications.
Where does the detox take place and what does the choice of location change?
This page describes the procedure, while the visit always happens at a specific clinic. The list of cities appears below and leads to pages with the address, opening hours and local phone number.
Assessment is identical in every city
The scope of the assessment, the exclusion criteria, the way the infusion is run and what a patient may expect from it. The city changes not a single medical criterion. Nor does it change the answer to the question about opioids.
What the choice of clinic does change
Available appointment slots, opening hours, and whether a given city also offers detox with a home visit, used when the patient's condition allows the procedure but travelling to the clinic is a genuine obstacle. The assessment criteria stay identical, and the home-visit variant offers a broader range of durations: 1, 2, 3, 6 or 12 hours.
If there is no clinic of ours nearby
It is still worth calling. The assessment call is free, and it may end with directions to the nearest facility or with the information that this situation calls for inpatient or substitution treatment, which we do not provide.
