SAMHSA Details Detoxification Role in Addiction Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) released a Treatment Improvement Protocol (TIP) on detoxification and substance abuse treatment in July.

The detoxification TIP, which is the 45th in the SAMHSA series of best-practice guidelines for the treatment of substance use disorders, provides information about the role of detoxification in the continuum of services for individuals with substance use disorders. It includes pharmacological advances in the management of withdrawal, patient-placement procedures, and new issues in the management of detoxification services within comprehensive systems of care.

The TIP was based on a review of clinical and health services research findings and the experiences of a panel of nonfederal researchers, clinicians, program administrators, and patient advocates.

“Detoxification is one component of the array of services that should be available to patients with substance use disorders,” said Eric Strain, M.D., chair of APA's Council on Addiction Psychiatry. “This TIP provides a valuable resource guide for clinicians.”

SAMHSA is the lead federal agency for improving the quality and availability of prevention and treatment services for mental illness, including substance abuse.

In addition, the TIP provides information on administrative, legal, and ethical issues commonly encountered in the delivery of detoxification services. It suggests performance measures for detoxification programs, discusses the primary goals of detoxification services, and clarifies the distinction between detoxification and substance abuse treatment.

The guidelines address issues that may affect detoxification and ensuing treatment, including evaluation procedures for patients undergoing detoxification, preparing patients for substance abuse treatment, and providing linkages to other services. Highlights include treatment regimens for specific substances and guidance on the medical, nursing, and social-service aspects of these treatments.

TIP 45 presents an overview of special conditions, modifications in protocols, and the use of detoxification medications in patients with co-occurring conditions or disorders.

Strain said that the TIP is a resource that psychiatrists should keep nearby for reference because it addresses a topic relevant to many patients.

“Even if the psychiatrist is not providing direct detoxification services, many of our patients may need such treatments at some point in their lives, and this TIP provides information that will assist the psychiatrist in treatment planning and patient care,” Strain said.

A free copy of TIP 45, “Detoxification and Substance Abuse Treatment,” is available from the National Clearinghouse for Alcohol and Drug Information at (800) 729-6686; the publication inventory number is BKD541. It can be ordered online at<http://store.health.org/catalog/productDetails.aspx?ProductID=17398>.▪