Brazos / Drug detox
Adult withdrawal management
Drug detox in Texas follows 26 TAC 564.902 staffing hours
Updated
For admission to a detoxification program, the screening will be conducted by a physician, the physician's designee, physician assistant, nurse practitioner, registered nurse, or licensed vocational nurse (LVN). An LVN may conduct a screening when the LVN has completed detoxification training and demonstrated competency in the detoxification process. The training and competency verification is documented in the LVN's personnel file. Drug detox in Texas on Adult Substance Use Withdrawal Management Services uses that screen.
What to expect during drug detox
Every individual admitted to a detoxification program meets the DSM criteria for substance intoxication or withdrawal. The LVN conveys in person or via telephone the medical data to a physician or the physician's designee, who shall determine the appropriateness of the admission and authorize the admission or give instructions for an alternative course of action. The physician or the physician's designee shall examine the client in person and sign the admission order within 24 hours of authorizing admission. A detoxification program shall not offer screenings through electronic means.
Residential and ambulatory (outpatient) detoxification programs shall provide monitoring to manage the client's physical withdrawal symptoms. Monitoring shall be conducted at a frequency consistent with the degree of severity of the client's withdrawal symptoms, the drug(s) from which the client is withdrawing, and/or the level of intoxication of the client. Use of the "clinician's assessment" in the Behavioral Health Integrated Provider System (BHIPS) is recommended. The information will be documented in the client's record and reflected in the client's orders.
How long does drug detox take
Clients who are not in withdrawal but meet the DSM criteria for substance dependence may be admitted to detoxification services for 72 hours for crisis stabilization. Crisis stabilization is appropriate for clients who have diagnosed conditions that result in current emotional or cognitive impairment in clients such that they would not be able to participate in a structured and rigorous schedule of formal chemical dependency treatment. The specific client signs and symptoms that meet the DSM or other medical criteria for the disorder must be documented in the client record. Documentation must also include what symptoms are precluding the client from participating in treatment and the manner in which they are to be resolved.
For a person already in withdrawal, the physician or designee documents that symptoms are or are expected to be of a severity that necessitates a minimum of once a day monitoring on the ambulatory line. Residential programs monitor at least every four hours for the first 72 hours and as ordered by the medical director or designee thereafter, dependent on the client's signs and symptoms.
Medical drug detox
The program shall have a medical director who is a licensed physician. The medical director shall be responsible for admission, diagnosis, medication management, and client care, including drug detox medication. A licensed vocational nurse or registered nurse shall be on duty for at least eight hours every day. A physician or designee shall be on call 24 hours a day. Detoxification services shall be accessible at least 16 hours per day, seven days per week. Direct care staff in a residential program shall be on duty where the clients are located 24 hours a day. Safe drug detox on a licensed site uses those hours.
The program shall have a protocol or standing orders for each major drug category of drugs (opiates, inhalants, stimulants, hallucinogens) that are consistent with guidelines published by nationally recognized organizations (e.g., Substance Abuse and Mental Health Services Administration, American Society of Addiction Medicine). Medication should be available to manage withdrawal/intoxication from all classes of abusable drugs. Medication "regimens", "protocols" or standing orders can be used, but detoxification should be tailored to each client's need based on vital signs and symptom severity (objective and subjective) and noted in the client's record.
Drug detox at home and natural drug detox use a licensed site. Ambulatory means travel there daily. Residential means a stay that has 24-hour monitoring.
Drug detox process
Ambulatory detoxification shall not be a stand alone service and services shall be provided in conjunction with outpatient treatment services. When treatment services are not available in conjunction with ambulatory detoxification services, the ambulatory detoxification program shall arrange for them.
In addition to the management of withdrawal and intoxicated states, detoxification programs shall provide services, including counseling, which are designed to: assess the client's readiness for change; offer general and individualized information on substance abuse and dependency; enhance client motivation; engage the client in treatment; and include a detoxification plan that contains the goals of successful and safe detoxification as well as transfer to another intensity of treatment. At least one daily individual session by a registered nurse, QCC or counselor intern with the client will be conducted.
Drug detox cost
Eligibility for state financial support based on income, expenses, and other resources. In some cases, a person may be required to pay a portion of the services cost. The local Outreach, Screening, Assessment, Referral Service, the Local Mental or Behavioral Health Authority, or the treatment program itself takes the first call. Find State Funded Substance Use Programs in Texas lists contractors. The OSAR in the region takes the regional call. A person may also request help by contacting 211 Texas or calling 877-541-7905. Brazos answers (844) 833-0738.