Home Detox Options

Home Detox Options

Home Detox for alcohol or opiate dependence is an option for consumers looking for an alternative to an inpatient setting. There are a number of options to choose when considering Home Detox.

1. An Intense Supervised at home medical detox. 
2. A Supervised at home medical detox.
1. Nurse and Physician supervised
2. Physician only supervised. 
3. An Office based Outpatient medical detox.
4. A prescribed medical detox with a layperson present.
5. Cold Turkey

1. An Intense Nurse Supervised at home medical detox. A nurse is present 24 hours a day for as long as the alcohol detox or opiate detox requires. One model has the same nurse present 24 hours a day for as long as the detox takes - this is the model for Executive Home Detox - this model assures the utmost in continuity of care, privacy, and convenience. Another model has rotating nurses coming into the home. 
2. A Supervised at home medical detox.
1. Nurse and Physician supervised: A nurse visits the client at least once a day and the physician maintains some degree of daily contact - either with the client, or through the nurse.  An aide or companion may assist on site. 
2. Physician only supervised: The prescribing physician maintains daily contact with the client. It is rare that a physician visits the client in the home on a daily basis, but there are some physicians that provide this service. 
3. An Office based Outpatient medical detox: The client would be expected to make daily or some regularly negotiated visits to the physician to monitor and to receive medication for the medical detox.  Most physicians would rightly require another person to be present in the home in case there were problems with the detox. 
4. A prescribed medical detox with a layperson present: This type of home or outpatient detox may occur if a client went to an emergency room and received medication or if a primary care physician was confident the detox was going to have mild symptoms.  
5. Cold Turkey: This home detox does not have the medical support the above options have. The person in detox attempts to stop using alcohol or opiates on their own without prescribed medications. This option is not recommended by anyone in the medical establishment. At a minimum, anyone attempting to detox on their own should have a responsible sober / clean person in the home observing or helping them.  

Home Detox Phoenix and Scottsdale

Home Detox Phoenix and Scottsdale: Dr. Yasinsky

I had the good fortune to meet with Dr. Michael Yasinsky (www.YasinskyPsychiatry.com) in Scottsdale, Arizona.  Dr. Yasinsky has taken the "concierge" level of care to a new extreme. In a good way!

Dr. Yasinsky does not have an office. He sees his clients in the comfort of their home. He provides medication evaluation and assessment, as well as psychotherapy. I found Dr. Yasinsky to be thoughtful and professional in his approach to care.  He is the first physician I have met that sees clients 100% in their own home.

Since Dr. Yasinsky sees clients or patients in their own home it makes sense he would also support a client going through a medical detox for alcohol or drugs in the home as well.  Dr. Yasinsky does do home detox .  He is not a suboxone provider and prefers to detox the client from opiates using Clonidine and comfort medications.

Home Detox looks forward to working with Dr. Yasinsky in providing private home detox to that rare client who knows they need additional medical supervision but for some reason will not or cannot go into an inpatient setting.

Home Detox of California

Home Detox of California has been in business since the mid 1990's.  I met with Mike Ezell, the owner of Home Detox, this past week. Home Detox of California provides home based medical detox primarily from Alcohol and Opiates. Their treatment model provides for a physician's examination and daily visits from a nurse, often Mike himself, until the medical detox is complete.

Home Detox of California provides a good service at a relatively reasonable price. Like so many Home Detox programs, it is not covered by insurance.

Home Detox of California is similar to Norman Shewman's program; Home Detox Inc. of Venice California. Both programs use a daily home visits by RN's expert in the field of medical detox.  These Home Detox models differ from the model of Executive Home Detox. EHD places an expert RN in the home for 1:1 supervision throughout the entire medical detox. This intense model is more expensive than the above programs, however it can be argued that it provides a greater safety net as well.

Additionally, Home Detox of California and Home Detox Inc. of Venice Florida are community based or region based.  Executive Home Detox travels anywhere in the US to provide private duty nursing services to clients in need of supervised medical detox.

Home Detox of California: www.HomeDetox.org
Home Detox Inc:. www.HomeDetoxInc.com
Executive Home Detox: www.ExecutiveHomeDetox.com

Home Detox: Anti-craving medication: Naltrexone

Executive Home Detox comes to the client. Wherever they live, EHD travels to the client and manages the alcohol detox in the comfort of the client's home. But what happens after the alcohol home detox? EHD works with the client to create an aftercare plan to sustain sobriety. One specific treatment option is the use of medication. Anti-craving medications include Naltrexone (Revia, Vivitrol) and Acamprosate (Campral)).

Naltrexone is a medication that, in theory, decreases the cravings for alcohol. Naltrexone works by interacting with the brain to interrupt the messages the brain gives the alcoholic to make him or her drink. The Naltrexone may interrupt the 'cues' the brain gives to the person to make them drink.

Oral Naltrexone (Revia, and generics) is usually given in a 50 mg dose each day. Naltrexone can cause some GI upset the first few days but then has minimal to no side effects. It is very important to know that Naltrexone will trigger opiate withdrawal in anyone that is dependent on opiates and have used opiates in the past seven days. Additionally, Naltrexone attaches itself to opiate receptors and blocks opiate effectiveness.

Intra-Muscular Naltrexone (Vivitrol) can be given every three to four weeks in the gluteal maximus - the backside - this method of Naltrexone delivery provides a steady therapeutic dose and eliminates the need to take the pill (oral Naltrexone) every day. This form of medication is expensive and has it's own side effects, namely the possibility of an abscess at the injection site.

The use of Naltrexone alone may assist in decreasing cravings for alcohol. The use of Naltrexone, Campral, and Antabuse altogether increases the likelihood of maintaining sobriety compared to using any of those medications alone.

Home Detox Physician

Executive Home Detox has a unique treatment model that compliments the home detox physician who treat the alcohol dependent or drug dependent patient on an outpatient basis. EHD places one expert addictions nurse in the home of the client to monitor the detoxification of the patient.  This treatment model provides for a relatively safe, comfortable detox and decreases the liability for any physician who treats addicted patients on an outpatient basis.

The Certified Addictions Registered Nurse (CARN) is a private duty nurse who stays with his or her client 24 hours per day for as long as the medical detox requires. The physician / nurse communication can be daily or every couple days depending on the comfort level of the physician and the condition of the client.

The prescribing physician is the lead clinician in treating the patient or client. The nurse monitors vital signs, monitors signs and symptoms of alcohol withdrawal and evaluates the effectiveness of medication management. The certified nurse uses the CIWA scale and COWS scale to assist in the measurement of withdrawal symptoms. The nurse communicates his or her findings to the physician as necessary.

EHD utilizes the client's current physician or accesses a physician to assist in the client's care. EHD prefers to use physicians affiliated with ASAM (American Society of Addiction Medicine) or the AAAP (American Academy of Addiction Psychiatry).

Executive Home Detox has worked with highly reputable physicians throughout the United States.