Daily users of drugs which produce physical dependence like the opioids (e.g. heroin) and the sedative-hypnotics (e.g., benzodiazepines and barbiturates) almost always require medical assessment and detoxification with medications. Withdrawal from opioids is extremely unpleasant but not life-threatening; on the other hand, withdrawal from sedative-hypnotics can be extremely dangerous as it can cause seizures may be life-threatening.
In general, people have an easier time curtailing intermittent or sporadic use than daily use. In particular, people who on a daily basis use opioids, sedative-hypnotics, stimulants like cocaine, or marijuana have a great deal of difficulty stopping. And when they stop, they typically struggle to “stay stopped.” For most daily drug users, frequent relapses are the rule rather than the exception. For this reason, the rehabilitation process should include extensive training in “relapse prevention.” As with alcohol, medical detoxification is merely the first step of a long and arduous process.
When a drug-dependent person continues to relapse in spite of serious efforts to get clean and to stay clean, it is time to reach for the heavy artillery. The heavy artillery includes intensive involvement in self-help groups, longer-term residential treatment, and the judicious use of medications such as methadone and LAAM.
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