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
"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>.▪