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AMBULATORY DETOXIFICATION FIRST STEP ON THE ROAD TO RECOVERY
Posted by:Ken Sutton--Friday, January 26, 2007

(Article provided by Annie Hahn RN Addiction Medicine Service’s Center for Psychiatric and Chemical Dependency Services (CPCDS). This is a must read.)

...Persons interested in the Ambulatory detox program will need to have an initial evaluation in the DEC (Diagnostic and Evaluation Center/Emergency Room WPIC) The DEC is operational 24/7 and an evaluation can be done at any time. The DEC is located on the first floor of Western Psychiatric Institute and Clinic 3811 Ohara Street Pgh,Pa 15213 Patients will have a complete psychiatric evaluation, physical exam and test doses of detox medications. Patients are then sent home with appropriated detox medication and referred the next day to the Ambulatory Detox Clinic at the Oxford Building 3501 Forbes Ave 9th floor...


His baby face, ball cap slung sideways on his head, and baggy pants belied his age. Matt was 29 but looked 16 years old when he went to the DEC (Diagnostic and Evaluation Center/Emergency Room WPIC) asking for help to quit using heroin. He had been using the drug for the past six years. “I’ve tried to quit before but I just could not make it through the withdrawal cold turkey.” In the DEC he was evaluated and started on an ambulatory detoxification protocol to help him safely withdraw from opiates.




His story was a familiar one to the staff at the DEC and Addiction Medicine Service’s Center for Psychiatric and Chemical Dependency Services (CPCDS). This innovative detoxification program is a collaboration between the DEC and CPCDS staff and has been operational since March 2003. The detox staff at CPCDS includes Annie Hahn RN, Rodney Williams MD and several other physicians, nurses and therapists who help out from time to time.

The next day, Matt continued his detoxification at CPCDS. He told the staff “I’m really glad you’re here. Drugs are ruining my life. I want to stop shooting dope. I tried to quit on my own a couple times, but just couldn’t.” Annie smiled, as she always does. She understood what Matt meant. During the detox visit, Annie checked Matt’s blood pressure, assessed withdrawal symptoms and initiated a discussion about “recovery” to let him know that getting sober was a lot more than simply stopping the drug use. Annie then consulted with Dr. Williams who examined Matt for medical and psychiatric co morbidity, and determined medication needs.
Matt’s father had come with him to the appointments. He was upset, worried and angry, which are common reactions of parents when a child becomes addicted. Annie listened to what Matt’s father said. She could hear the stress. She provided empathy, support, education and a sense of hope that his son could recover
On day 3 of detox both Annie and Dr. Williams re-evaluated Matt’s symptoms and motivation to change. Since he was feeling much better, Annie suggested he begin participation in the Partial Hospital program on site. Matt accepted and began that day. Some of the topics explored in the groups he attended over the next few weeks included – the disease concept of addiction, identifying and managing triggers, using the support of others, the availability of the community support system of NA/AA, learning to managing emotions and developing a long-term relapse prevention plan. Matt said it best about what he learned, “ I learned things could get better and I could have a life without drugs.”


WPIC has the only Ambulatory Detoxification program offered in Allegheny County. However, detox in and of itself is of limited value. All ambulatory detox patients are encouraged to continue treatment in a Partial Hospital or outpatient program as Matt did.

The majority of the 2000+ patients seen in the program thus far were addicted to opiates such as heroin and Oxycontin. While withdrawal from opiates is uncomfortable, it is usually not dangerous. Patients experience “flu-like” symptoms: chills, sweating, diarrhea, abdominal cramps and general body aches. Medications are given to ease the symptoms, reducing the experience to low-grade anxiety and restlessness. Detox is usually completed within 5-7 days. According to Annie Hahn RN, the “most serious complication” seen during detox is relapse and discouragement. The staff addresses these issues in their daily meetings with patients. A major goal is to help motivate the patient to engage in continued care, and participate in AA or NA meetings in the community.

If found to be medically appropriate patients may also be detoxed from alcohol or benzodiazepines in the Ambulatory Detox Program

Outcomes of the detox program have been encouraging. Of the patients who came for detox, over 60% completed the process. Among these completers, 70% participated in ongoing treatment.

The numbers of patients seeking Ambulatory Detox continue to increase. The increase speaks to the growing epidemic of opiate addiction in both the inner city and the suburbs, without regard to race, gender, age, or socioeconomic status. One of the most important goals of the staff who work with the ambulatory detox patient, is to decrease the numbers of those patients who use detox as an end in itself, but use it as the first step on that road called “recovery.”


Persons interested in the Ambulatory detox program will need to have an initial evaluation in the DEC (Diagnostic and Evaluation Center/Emergency Room WPIC) The DEC is operational 24/7 and an evaluation can be done at any time. The DEC is located on the first floor of Western Psychiatric Institute and Clinic 3811 Ohara Street Pgh,Pa 15213

Patients will have a complete psychiatric evaluation, physical exam and test doses of detox medications. Patients are then sent home with appropriated detox medication and referred the next day to the Ambulatory Detox Clinic at the Oxford Building 3501 Forbes Ave 9th floor

Further information about the Ambulatory Detox Program may be obtained by calling Annie Hahn RN (412) 246-5278. Questions about the program are welcome.



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