Currently, the American Society of Addiction Medicine and the American Society of Anesthesiologists do NOT offer specific guidelines to consumers or providers of the one day detox method. Therefore, I will offer these guidelines to consumers in an attempt to help you in asking important questions from providers and choosing an appropriate one day detox facility.

Other physicians have offered their own suggested guidelines.  Click here to view these comments.

Guidelines for One Day Detox programs.

  1. An anesthesiologist or nurse anesthetist should be by the patient's bedside during the entire detoxification period. Some providers will try to call the procedure "sedation" instead of "anesthesia." This is only a play with words in an attempt to save total costs. In all cases of one day detox, the patient is unconscious, does not respond to verbal commands, and is at risk for aspiration unless an endotracheal tube is placed (the patient is pre-disposed to vomiting and may have stomach contents enter the lungs if appropriate precautions are not taken). Anesthesiologist and nurse anesthetists are the only professionals specifically trained to manage patients in this state of consciousness. I refer you to general guidelines adopted by the American Society of Anesthesiologists. Specifically noted are 1) "Qualified anesthesia personnel shall be present in the room throughout the conduct of all general anesthetics, regional anesthetics and monitored anesthesia care". 2) During all anesthetics, the patient's oxygenation, ventilation, circulation and temperature shall be continually evaluated" (note the word "continually" - this is a basic standard of care).
  2. One day detoxification programs should have linkage to post-detox rehabilitation services. It is clear that detoxification without rehabilitation results in poor long-term abstinent rates. Scientific studies will need to be done to evaluate whether or not simple referral to a rehabilitation program is efficient. I recommend that specific rehabilitation is linked directly to the detox program.
  3. A medical professional specifically trained in the management of addictions (preferably a member of the American Society of Addiction Medicine) should have oversight of the entire detoxification and rehabilitation program. This statement is self-explanatory and underscores concerns regarding providers who offer one day detox without having education and experience in treating opiate dependency.
  4. Providers should make an attempt to select patients who show evidence of maintaining long term abstinence from opiates. The one day detox procedure should not be a revolving door detoxification.
  5. No patient should be forced to participate in one day detoxification. The procedure is potentially beneficial only for those patients who want to quit using opiates.

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