Drug detox in Słupsk

Drug detox at our clinic is an intravenous infusion lasting several hours, supervised by medical staff. It works on symptoms: it rehydrates, corrects electrolytes, lowers anxiety, allows the patient to sleep, and eases nausea and muscle pain. Blood pressure, pulse and level of consciousness are monitored throughout.

What it does not do is the thing half the internet promises. An infusion does not remove the drug or its breakdown products from the body, because the speed of elimination is set by the half-life of the substance and by liver and kidney function, not by the volume of fluid given. It also does not shorten the effect of whatever the patient took, and it is not an antidote.

Nor is it treatment for addiction. It closes the worst thirty-something hours and provides a starting point; the rest belongs to addiction therapy in Słupsk. Anyone who treats the infusion as the whole of treatment will end up back where they started.

Because with opioids the dangerous part is not the withdrawal itself but what follows it. A few days without the substance lower tolerance, and a dose the body handled last week can stop breathing after a break. Work by Strang (BMJ 2003, PMID 12727768) and Merrall (Addiction 2010, PMID 20579009) shows the risk of fatal overdose to be roughly three to eight times higher in the first weeks after detox, with the first fourteen days being the worst.

An outpatient infusion does nothing about that risk. It would create the state and send the patient home, so the honest answer is this: with dependence on heroin, methadone, morphine or oxycodone we refer the patient to opioid substitution treatment, which we do not provide ourselves.

This is also why we ask separately about tablets during the assessment. Counterfeits that look like an ordinary painkiller or sedative increasingly reach the market containing nitazenes, opioids often stronger than fentanyl. Someone taking such a tablet is formally in the opioid group even though they do not think of themselves that way, and that changes the entire conversation about the procedure. For the family of such a patient it is worth having naloxone nasal spray at home, available on prescription.

A patient describes tremor, sleeplessness and anxiety over the phone, but the same symptoms mean completely different plans depending on the substance. That is why the first question is what was taken and for how long.

• Amphetamine, cocaine, mephedrone: the area where an infusion genuinely helps. There is no recognised medication for this withdrawal, so we work on sleep, hydration and calming things down. We say so plainly rather than promising more.
• Benzodiazepines: an infusion is the wrong tool. Symptoms start late, usually after two to seven days, and drag on for weeks; the safe answer is a gradual reduction of the dose, not an abrupt stop.
• GHB and GBL: withdrawal can be violent and responds poorly to the usual sedative medication. We do not accept such patients on an outpatient basis.
• Cannabis products: the complaints are mainly psychological, so an infusion changes little. A conversation about therapy makes more sense.
• New psychoactive substances: the contents are often unknown even to the seller, so the course is unpredictable and calls for a more cautious assessment.

An infusion of several hours makes sense when withdrawal is severe but predictable and fits inside one day: the crash after stimulants, exhaustion after several nights without sleep, dehydration, vomiting, mounting anxiety. The conditions are stable circulation, preserved consciousness, and a sober person who will stay with the patient afterwards.

Round-the-clock supervision is required whenever the risk does not end with the infusion. Withdrawal from benzodiazepines or GHB, seizures in the past, confusion, severe polysubstance use with alcohol, serious heart or respiratory disease: in these cases there is no point buying a few hours and going home. We then refer the patient to inpatient care, which is the job of the addiction treatment centre in Słupsk.

We make that distinction before admission, not during the procedure. A refusal at the phone stage costs everyone less than an interrupted infusion.

In 2021 the city commissioned a diagnosis of addiction problems, carried out on a sample of 1,585 people, including 743 pupils in years six to eight of every primary school in Słupsk. 26.7% of primary school pupils answered that someone had offered them a drug and they refused. The authors read this as a sign of easy availability rather than effective prevention. Among secondary school pupils, almost 40% said obtaining a drug would give them no trouble.

A second picture comes from a local consultation point run by a non-governmental organisation. In 2022 it was approached by 28 people with a cannabis problem, 16 with amphetamine, 4 with new psychoactive substances and 3 with heroin. That proportion matches what we see: a detox infusion in Słupsk almost always concerns stimulants and mixtures, while opioids remain a margin that we refer onwards anyway.

Our clinic operates at Marszałka Józefa Piłsudskiego 2. The assessment is arranged by phone, usually within days, and anything longer than a single procedure is covered by drug addiction treatment in Słupsk.

The assessment starts with the substance, the doses and the time of the last use, then moves through chronic conditions, current medication, and previous withdrawals and how they went. On site we check blood pressure, pulse, oxygen saturation and level of consciousness.

We will not perform the procedure when opioids, benzodiazepines or GHB are involved, when the patient has a history of seizures or delirium after withdrawal, when circulation or breathing is unstable, when no sober adult will be at home, or when the patient is under the influence of alcohol at that moment.

Pregnancy is an absolute disqualification. In opioid dependence, withdrawal itself endangers the foetus, and the accepted approach is substitution treatment combined with obstetric care, not an infusion lasting a few hours. We refer such patients to specialist care and explain why, instead of admitting them for an infusion.

There are states in which waiting for an appointment is itself a risk. If a person in withdrawal or after taking a substance shows any of the following, what is needed is emergency care, not an infusion:

• seizures, including single and brief ones,
• confusion, failure to recognise the surroundings, seeing or hearing things that are not there,
• persistent chest pain, a very fast or irregular heartbeat,
• drowsiness from which the person cannot be roused, slow or broken breathing, bluish lips,
• high fever with muscle rigidity after stimulants,
• expressed suicidal thoughts or a suicide attempt.

The same list applies when symptoms appear at home after our infusion. There too what counts is contact with emergency care rather than waiting until morning.

There is no single ready-made mixture that we connect to everyone. Medical staff choose the contents after the assessment, based on the substance, the symptoms and the measurements, and the mix is sometimes changed during the infusion.

• rehydrating fluids, because after several days without food or drink they bring the fastest improvement,
• electrolytes, above all magnesium, potassium and sodium, whose deficits cause cramps and heart rhythm disturbances,
• glucose, when the patient has not eaten for a long time,
• B vitamins, including thiamine,
• medication chosen for a specific complaint, each one separately and only when that complaint is genuinely present: one thing for persistent vomiting, another for muscle pain, another for insomnia lasting several days. No standing sedative set given in advance.

This is not a vitamin infusion and not an antidote. A detox infusion is symptomatic treatment and has nothing in common with a wellness offer where the contents follow the chosen package rather than the patient's condition.

After the assessment the patient lies down at the clinic and is connected to the infusion. Staff are present throughout, monitor the readings and respond to changes. We choose the three-hour option for milder, recent symptoms. Six hours allow larger deficits to be corrected and give real sleep. Twelve hours cover the most severe cases that still fit outpatient care, after long binges.

Afterwards the patient goes home the same day, accompanied by someone sober. That day they do not drive and do not return to work.

Can the same procedure be done with a home visit?

We also give the same infusion with a home visit, at the address indicated, when the patient qualifies for outpatient detox but reaching the clinic is a genuine problem, for instance extreme weakness after a crash or a lack of transport. The qualification criteria and the list of exclusions then stay identical to the in-clinic variant, while a wider range of procedure lengths is available: 1, 2, 3, 6 or 12 hours, which the medical staff match to the patient's condition. The exclusions themselves work the same: opioids are still referred to substitution treatment, and benzodiazepines, GHB, a history of seizures, delirium, pregnancy or the absence of a sober companion rule this option out just the same. It is a separate item on the price list, at a rate different from the in-clinic procedure, and we confirm its price and availability at booking or by phone.

An infusion after a stimulant crash

The most common reason people call us is not the word detox but the sentence "he has not slept for three days". After amphetamine, cocaine or mephedrone come exhaustion, irritability, low mood, loss of appetite and dehydration. The infusion shortens that worst stretch and lets the patient lie down, but it does not remove the substance and does not treat addiction. If the crash returns every few weeks, the crash is no longer the problem.