Outpatient detoxification begins when initial contact is made by telephone. Drug(s) of abuse, medical status and availability of one or more SSPs is ascertained. Patients are not admitted if they have an acute medical issue such as a gastrointestinal bleed. 除非病人携带SSP，否则不能入院. Every effort will be made to schedule admissions within 24 hours of a request for help; ideally on the day of the call for help. The prospective patient needs to be willing to make treatment his or her full-time activity for at least a week. They must arrive in early withdrawal (not intoxicated) and have a SSP who will take at least one full day to be with them, 然后在第一周的治疗中很容易得到. 例如，父母可以请一天假, 第一晚接待病人的赞助人, or a group of friends who will all take turns being with the detoxifying patient.

Within an hour of the patient's arrival they have a brief assessment and medication prescribed if needed. 全面的精神病学评估, 生命体征和体格检查(HEENT, 胸部, 腹部, 四肢, 皮肤, 神经, 总体印象)是由精神病医生在第一天完成的. 任何急性病都由精神科医生处理, or the patient is referred to University Hospital's Emergency Department. 病人, SSP and psychiatrist make a plan together; with parameters for calling the psychiatrist, 谁是每周7天，每天24小时都在的人. 病人 continues in treatment daily until both the withdrawal syndrome has ended, and the patient is judged stable enough to tolerate a lower level of care in safety. The initial planning meeting of the first day serves as orientation of the patient and SSP to the program; rules, 程序, 活动, 政策与理念.

酒精和尿液药物检查 are NOT done because the treatment is based on the withdrawal symptoms observed and not the history or urine results. 例如, a positive urine for opiates does not lead to prescription of Suboxone for opiate withdrawal; the positive urine result could represent a single use. A patient may have been using a drug such as clonazepam that will not show up on a urine screen, 但仍有被抓住的危险. The results of a breathalyzer screen for blood alcohol will not help determine the course of alcohol withdrawal. The focus of treatment is objective signs of withdrawal rather than subjective reports.

实验室测试 are available for every patient and are done WHEN INDICATED for some useful purpose. 例如, 对服用丙戊酸盐的患者随访肝功能, 有消化道出血风险的病人的全血细胞计数, 糖尿病患者的血糖监测, PPD for patients who may be at risk for tuberculosis or needing referral to a residential program. Blood is drawn at the University Hospital laboratory, sited one block away. The goal of laboratory testing during the withdrawal period is to insure the safety of the patient during withdrawal.

初级保健评估(综合医疗保健)没有完成. Patients are referred for primary care evaluation when they are stable enough that their initial primary care evaluation appointment is likely to be kept, and is likely to result in a partnership between our treatment of the addiction, 和内科医生治疗所有的医疗问题 .

酒精解毒 is accomplished with valproic acid, chlordiazepoxide and disulfiram as the main agents. Valproic acid is not addictive, is not very sedating, and minimizes the need for chlordiazepoxide. A "loading" approach is taken on the first treatment day to arrest symptoms. Concomitant use of disulfiram means that the patient is unlikely to drink while at home; they are required to take an observed dose on day one to be allowed back for day two.

苯二氮卓类药物解毒 is accomplished with valproic acid and chlordiazepoxide as the main agents. 苯二氮卓类药物的戒断比酒精戒断要慢, and patients can be loaded on valproic acid prior to the emergence of withdrawal symptoms in most cases. When valproate is used, blood levels and liver function tests are monitored.

鸦片撤军 is accomplished with Suboxone and adjunctive medications such as clonidine, 二环胺和曲唑酮. Suboxone competes with abused opiates and make the addition of heroin, oxycodone, etc. 无效的. As soon as possible the patient is switched to naltrexone, the non-agonist opiate blocker.

In unusual cases of withdrawal that cannot be managed with this support system, 病人接受24小时住院戒毒治疗. Otherwise, the physician confers with the patient or SSP by phone if needed. In all cases the SSP involved with the treatment is informed of the need for the patient to stay on the blocker; disulfiram for alcohol and naltrexone for opiates, 戒酒的第一年. 在很多情况下, the rule will be suggested that if the family member in recovery (patient) will not take the blocker observed by the SSP or a family member; that the addicted person not be allowed to live at home because they are likely to use the home as a base for dangerous behaviors. We anticipate that changing the setting of detoxification from an inpatient ward that isolates severely ill addicted persons from their supports, to including a SSP as a central actor in detoxification and continuing their involvement over time that outcomes will be improved. The detoxification phase of treatment is usually accomplished within a week, except in the case of long-acting benzodiazepines such as clonazepam or diazepam, where the acute symptoms of withdrawal do not remit until two weeks after the drug is stopped.