Contents

• What Is a TIP?
• Consensus Panel
• KAP Expert Panel and Federal Government Participants
• Foreword
• Executive Summary
• 1 Overview, Essential Concepts, and Definitions in Detoxification
  • Purpose of the TIP
  • Audience
  • Scope
  • History of Detoxification Services
  • Definitions
  • Guiding Principles in Detoxification and Substance Abuse Treatment
  • Challenges to Providing Effective Detoxification
• 2 Settings, Levels of Care, and Patient Placement
  • Role of Various Settings in the Delivery of Services
  • Other Concerns Regarding Levels of Care and Placement
• 3 An Overview of Psychosocial and Biomedical Issues During Detoxification
  • Evaluating and Addressing Psychosocial and Biomedical Issues
  • Strategies for Engaging and Retaining Patients in Detoxification
  • Referrals and Linkages
• 4 Physical Detoxification Services for Withdrawal From Specific Substances
  • Psychosocial and Biomedical Screening and Assessment
  • Alcohol Intoxication and Withdrawal
  • Opioids
  • Benzodiazepines and Other Sedative-Hypnotics
  • Stimulants
  • Inhalants/Solvents
  • Nicotine
  • Marijuana and Other Drugs Containing THC
  • Anabolic Steroids
  • Club Drugs
  • Management of Polydrug Abuse: An Integrated Approach
  • Alternative Approaches
  • Considerations for Specific Populations
• 5 Co-Occurring Medical and Psychiatric Conditions
  • General Principles of Care for Patients With Co-Occurring Medical Conditions
  • Treatment of Co-Occurring Psychiatric Conditions
  • Standard of Care for Co-Occurring Psychiatric Conditions
• 6 Financing and Organizational Issues
  • Preparing and Developing a Program
  • Working in Today's Managed Care Environment
  • Preparing for the Future
• Appendix A: Bibliography
• Appendix B: Common Drug Intoxication Signs and Withdrawal Symptoms
• Appendix C: Screening and Assessment Instruments
• Appendix D: Resource Panel
• Appendix E: Field Reviewers
• SAMHSA TIPs and Publications Based on TIPs

This publication was produced under the Knowledge Application Program (KAP) contract numbers 270-99-7072 and 270-04-7049 with the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). Andrea Kopstein, Ph.D., M.P.H, Karl D. White, Ed.D, and Christina Currier served as Government Project Officers.

Suggested citation:

Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.

The views, opinions, and content expressed herein are those of the consensus panel and do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. No official support of or endorsement by SAMHSA or HHS for these opinions or for particular instruments, software, or resources is intended or should be inferred.