15 Steps to a Private Home Detox
EHD’s 15 Steps to a Successful Home Detox
Private Home Detox is the medical management of withdrawal symptoms associated with alcohol, opiates, and/or benzodiazepine dependence in the comfort of one’s home. Moderate to severe medical detoxification requires medication management and close medical supervision to minimize or eliminate the risk of medical complications. Our private addiction treatment is for the high end client who prefers privacy and convenience. It may include executive men and executive women, professional athletes, celebrities, and everyday people that feel they can benefit from this type of model. EHD uses evidence-based treatment and medication to safely detox the client.
The only nationwide service that provides 24/7 nursing care in your home. We are confidential, discreet and private.
Step 1: Contact Executive Home Detox
Privacy is highly respected and we do not ask you for any identifying information.
Phone contact may be made by calling (888) 9-Detox-9 or (888) 933-8699. A representative is usually available by phone unless they are interacting with a client. Please leave a short message and we will get back to you as soon as possible, usually within an hour.
The use of the website’s confidential response form is also a convenient and effective way to contact EHD. We receive the email in real time and respond rapidly to all our emails. It would be helpful to know the geographic area (what state) and the substance you are inquiring about.
Step 2: Brief Confidential Drug or Alcohol Abuse History
Access to timely treatment is essential when a client determines he or she is ready to do something about their alcohol or opiate dependence. After contacting Executive Home Detox, we do a quick health screen and history to determine the likelihood of success for a home detox treatment model. The information we ask is pretty basic and includes:
- Substances being used. How much, how often, for how long?
- History of substance use.
- History of substance treatment, history of complications.
- Current medical concerns.
- Current medications.This quick screen allows EHD and the client to move forward in planning an individuated plan of care.
Step 3: Signing a Treatment Contract
Executive Home Detox prefers simplicity to complexity. Therefore we have a one-page contract and a one-page ‘Terms and Conditions’. Our usual contract is for a minimum of five days with additional days being further negotiated. An Alcohol detox can usually be achieved within five days, while an opiate detox takes anywhere between four to ten days.
The contract is straightforward and the terms and conditions are common sense. Of course, EHD is willing to amend the contract to better fit the client’s needs when this is mutually beneficial. The contract can be reviewed online and an agreement can be communicated via fax or an email arrangement.
Step 4: The EHD Detox Nurse Travels to the Client
EHD provides a private nurse treatment model anywhere in the US. We travel to the client. Once a determination is made that the client is a candidate for an alcohol withdrawal program or opiate withdrawal program, and an agreement has been made to enlist EHD’s services, the nurse specialist travels to the client. The nurse often travels to the client within twenty-four to forty-eight hours of the initial call.
This is often the first time the client and nurse meet face to face. The nurse clinicians for EHD are screened for their presence, demeanor, tact, and skill level. This is often a time of crisis or upheaval in the client’s life and the nurse will assist to provide stability during this time.
Step 5: Importantly, the Clinician and Client see a Qualified Physician togther.
Executive Home Detox always works with a qualified physician or nurse practitioner. Your Physician , a consulting physician, or an NP is the prescriber of medication for alcohol withdrawal or opiate withdrawal. It is important for the client, nurse, and prescriber to be on the same page. Meeting together with the nurse and physician is a very important step.
EHD prefers to work with the client’s current primary care practitioner. If the client does not have a PCP, or the client does not want their PCP involved then EHD can access a qualified physician who will serve as your Home Detox Physician to provide this necessary medical detox function. Alcohol detox and opiate detox often require medication to successfully move the client toward a life of recovery. The client, nurse, and physician partner to make this happen.
EHD has working relationships with a number of physicians throughout the United States. Many of these physicians are ASAM certified. EHD utilizes these physicians, along with therapists, and other treaters to create a team of professionals to guide the client through a home detox and early recovery from substances.
Step 6: Creating the Custom Home Detox Program
All home detox programs are not created equal. Executive Home Detox will take a number of variables into consideration and plan a medical detox specific to your needs. The variables are:
- Substance being used or misused
- Length of use
- Prior medical detoxes
- Prior medical detox medications
- Effectiveness of prior medical detox medications
- Current medical condition
- Wishes of the client, and
- Wishes of the physician that is prescribing medication.
This is a long list of variables, but a determination of a detox agent or medication can be determined fairly quickly. Often a tentative plan can be determined over the phone prior to the arrival of the nurse to the client’s home.
Step 7: Starting the Detox in the Comfort of Your Own Home
The emphasis on an alcohol detox will be comfort. Medication will be given that will manage the withdrawal symptoms and sedate the client. The usual medication for alcohol withdrawal is a benzodiazepine. Emphasis on an opiate detox will be comfort as well and an ongoing assessment as to when to begin the detox agent, usually suboxone.
Step 8: The Home Detox Nurse Monitors the Client
Comfort, Competence, Continuity; With an expert nurse on site the medical detox is initiated, evaluated, and completed in a comfortable, convenient, and most confidential manner possible. The client is reassured by having a medical resource immediately at their side. The Home Detox Nurse is expert in providing close observation while also respecting privacy. Medication can be given appropriately and quickly to manage the alcohol withdrawal or opiate withdrawal symptoms.
Close one-to-one observation is not needed for every person undergoing an outpatient detox. It is recommended for clients that may have fears about their detox, clients with current medical conditions, and clients who would benefit from an inpatient stay but refuse to consider inpatient.
The on-site nurse will maintain a low profile and can assume an inconspicuous identity when needed. Executive Home Detox is the only program of its kind. We travel to the client, wherever the client may be. The Home Detox nurse expert remains on site twenty-four hours a day until the medical detox is completed. EHD is well regarded by physicians, interventionists, and others who require alternative programs to satisfy their client’s needs.
Step 9: Assessment of Detox Patient Vitals
The supervision and monitoring of a client in a medical detox is a serious endeavor. The Home Detox Nurse almost immediately take the vital signs of the client. Vital signs include; Blood Pressure, Pulse, Respirations, and Temperature. Vital signs are not just numbers. They tell us if the client is stable or if the client is moving toward distress. The nurse can interpret the vital signs and intervene with appropriate medication and/or notify the prescribing physician if necessary.
The use of valid detox scales such as the CIWA scale to assess alcohol withdrawal or the COW scale to assess the withdrawal of opiates ( Heroin, Oxycontin, Hydrocodone) is a very important step in the competent treatment for medical detoxification. These scales take into consideration multiple symptoms the client may be having and quantifies these symptoms into a number.
In addition to Vital Signs and the CIWA or COW scales, the nurse will be able to assess the client’s overall health status by listening to the lungs, bowel sounds, and assessing the overall circulatory system.
The consistent use of vital signs and detox scales will give the clinician a clear clinical picture of the client. The clinician will be able to interpret the data and determine if the detoxification is moving in the right direction.
Step 10: Ongoing Sleep and Nutritional Assessments
The use, abuse, and withdrawal of alcohol, opiates, and benzodiazepines contribute to sleep and nutritional problems. The live-in nurse clinician will assess sleep and nutritional needs throughout the medical detox.
A good night’s sleep is extremely important for anyone interested in getting healthy and improving their day to day function. The use of alcohol and opiates will initially help one to sleep, but will impair any restful sleep. The result is a chronic low energy due to a lack of healthy adequate sleep. The Executive Home Detox clinician will utilize the prescribed medication to not only assist with the alcohol withdrawal or opiate withdrawal, he or she will utilize the medication to foster sleep with the goal being the client is having a relatively comfortable sleep by the end of their detox.
Nutrition is sacrificed with the use and abuse of alcohol and opiates*. It is not uncommon for the alcohol abuser to cease any nutritional intake for days on end. Alcohol provides carbohydrates, essentially sugar, and the Alcoholic feels satisfied and has no desire to eat. In addition, the stomach lining is often deteriorating and this causes the client to not want to eat, food is unappealing. The initial nutritional focus for the client in alcohol withdrawal is on hydration. The nurse clinician monitors the vital signs and the skin turgor to determine the degree of dehydration and begins the hydration process immediately. Hydration is accomplished through the use of water, juices, and Gatorade or Powerade. Ongoing assessment, intervention, and evaluation is a primary function of the clinician.
Opiate use, abuse, and withdrawal seriously impacts nutrition as well. Opiate use directly affects the smooth muscle of the abdomen. The use of opiates cause constipation, the withdrawal causes diarrhea. The general use of opiates contributes to a lack of attention to one’s diet as the primary priority in life is to guarantee the continued use of the opiate. The first 24 hours of opiate withdrawal will cause stomach cramping and even the thought of eating can cause nausea. Again, as in Alcohol withdrawal, the focus is on fluid replenishment. After the induction of Suboxone, the client quickly develops a healthy appetite.
Executive Home Detox provides discreet one-to-one in home detox and early recovery coaching for the client who prefers privacy or convenience. We actually live with the client for the duration of the medical detox. Our goal is to leave the client in a healthier position than we find the client. The attention to sleep and nutrition are key in moving the client toward health.
* Heroin, Oxycontin, Oxycodone, Oxy’s, Percocet, Perc’s, Roxicodone, Roxies, Roxy’s, Roxicets, Hydrocodone, Vicodin, Lortabs, Vikes
Step 11: Starting Early Alcohol and Addiction Recovery Education
Executive Home Detox provides more than “just” a detoxification. EHD provides education and coaching to the client in early recovery. The education is negotiated with the client and based on their comfort zone, the education and coaching is delivered in an informal and non-threatening manner, and may focus on:
- The role the substance plays and has played in the client’s life, physically, emotionally, and spiritually.
- The impact the substance has on relationships.
- The impact the substance has on employment or vocation.
- The impact the substance has on the client’s current physical condition, and consequences of continued substance use.
- Options available to the client to sustain recovery:
- Resources in their community, resources in general, and recommendations to sustain recovery including medical therapies and talk therapies.
- Obvious pitfalls within the client’s environment that negatively impact the client’s goal to sustain recovery.
- Assessment of the client’s current coping mechanisms and suggestions to utilize or enhance alternative coping mechanisms.
- Education regarding the current use of medications the client may be on or may be prescribed.
Executive Home Detox works with the client’s treatment team to provide the early recovery education and assists in the further development of a comprehensive treatment team to sustain recovery.
Step 12: The Client, Nurse, and Clinician Meet Whenever Needed
Step twelve is a natural progression from step five “The nurse and client will see a prescribing physician together”. Once the medical detox begins, an agreed upon communication and follow up is established with the prescribing physician. The communications may be by phone, email, or text, and often includes a follow up visit. The nurse will accompany the client to any medical appointment the client may have. The purpose of this accompaniment is to promote a high quality private communication between the client, the physician, and the nurse.
The communication between the nurse and physician will include the ongoing vital signs assessment, detox scale scores, (CIWA, COWS) general health issues, medication evaluation, and assessed needs that will sustain recovery. The communication almost always includes the client; privacy and confidentiality remain a priority during any communications with other health care givers.
Step 13: Planning Discreet and Private After Care
Discreet and private aftercare planning and implementation will begin as negotiated. Aftercare planning may be the most important part of the alcohol home detox or opiate home detox. Aftercare planning begins very soon after the client contacts Executive Home Detox. Aftercare plans will ideally include a full treatment team, including: physician aftercare (primary care and / psychiatry), appropriate medications, therapy, early recovery groups, and positive connections to healthy individuals. Additionally aftercare plans may include a sober companion or coach, a comprehensive clinic, acupuncture, massage therapy, and other treatments.
Aftercare plans are negotiated with the client. There are clients who negotiate a full range of aftercare treatments and there are clients who prefer a very limited aftercare plan. EHD attempts to assist the client in creating an aftercare plan that will assist in sustaining sobriety.
In addition to aftercare with specific caregivers, the EHD clinician will arrange communication with the client post discharge daily x 7 days, weekly x 4 weeks, and monthly x 4 months.
Step 14: Client and Nurse Attend the First Aftercare Appointment Together
It is imperative for the client to begin aftercare prior to the EHD nurse leaving the client. The nurse will accompany the client to each planned aftercare caregiver and, with the client, assess the comfort level and efficacy between the client and caregiver.
Studies have demonstrated consistently that clients who are able to attend their first planned aftercare appointment are much more likely to continue to attend future appointments. Therefore, the EHD nurse makes every effort to successfully get the client to their first appointment.
In addition, this gives the nurse the opportunity to deliver a verbal report to the therapist in front of the client. This assures there is an accurate and agreed upon sharing of information in handing off the care of the client from the nurse to the therapist or physician.
Step 15: The EHD Nurse Remains On-Site as per the Aftercare Agreement
The Executive Home Detox Nurse will remain on site to monitor aftercare per agreement of the client and physician. It is very important for the client to commit to, and follow through with aftercare. Almost everyone is successful in their medical detox from alcohol or opiates. Relatively speaking, Detox is the easy part, sustaining recovery is the hard part. The EHD nurse will remain for as long as the client requests to monitor and solidify aftercare plans.
These plans may include attendance at self-help groups, therapy meetings, physician based meetings, and possibly early recovery groups. In addition, the nurse can observe everyday life with the client and provide coaching that will assist the client in managing life in sobriety.
The average length of time the nurse stays with a client is 7-10 days, however there have been stays between 10 and 90 days as well.