The Coleman Institute for Addiction Medicine Blog

What Is Pseudo?

Mitragynine Pseudoindoxyl (also known as Pseudo or MP) is one of the most powerful compounds linked to kratom and its opioid-like effects. It is created when 7-hydroxymitragynine (7-OH), one of kratom’s strongest active ingredients, is rearranged into an even more potent form.

Certain kratom products are now marketed as containing concentrated 7-OH and Pseudo, usually in tablet or liquid forms. Kratom and its enhanced versions act much more like traditional opioids. People who use them often find themselves developing dependence quickly and experiencing withdrawal symptoms as severe as quitting fentanyl or other opioids.

For individuals using Pseudo products, and for loved ones watching their struggles unfold, understanding what makes these products so dangerous is the first step toward finding and getting help.

How Pseudo Is Different From Regular Kratom

Standard kratom leaves mostly contain mitragynine, the plant’s primary compound. Mitragynine can create dependence over time and can lead to Kratom Use Disorder (KUD).

Pseudo and other 7-OH enriched products are in a different category than typical kratom, especially when the two are mixed. 7-OH, 7-Hydroxy, or 7-Hydroxymitragynine, is an even more potent opioid-like compound that is present in small amounts naturally but often concentrated in extracts. Pseudo, MP, or Mitragynine Pseudoindoxyl is a rearrangement product of 7-OH that is formulated to be even stronger, now appearing in some marketed kratom products in stores as well as online.

These factors make Pseudo potentially even more addictive and more difficult to stop using, especially alongside 7-OH. Many people don’t even realize they’ve moved from standard kratom into using synthetic products that are even more potent.

What Pseudo Withdrawal Feels Like

Because Pseudo acts like a strong opioid, withdrawal symptoms often mirror opioid withdrawal.

Physical symptoms:

• Severe muscle & bone pain
• Nausea, vomiting, & diarrhea
• Restlessness & fatigue
• Sweating, chills, & goosebumps
• Increased heart rate or blood pressure

Psychological symptoms:

• Overwhelming cravings
• Anxiety or panic attacks
• Depression & hopelessness
• Irritability & agitation
• Difficulty sleeping

Many people describe Pseudo withdrawal as even harsher than expected, especially if they believed the kratom they were ingesting was just a safe herbal product.

Why Quitting Alone Is Dangerous

A common myth is that kratom is easy to quit. It’s not, especially when you’re using an enhanced version. Because of how it taps into the same receptors in the brain as opioids do, stopping suddenly without medical help often leads to:

• Intense withdrawal symptoms
• Higher risk of relapse
• Increased overdose risk

Medical Detox is vital for people struggling with Pseudo withdrawal.

Outpatient Detox for Pseudo Withdrawal

The Coleman Institute for Addiction Medicine has been saving lives for over 25 years, and we’ve been helping people detox from kratom since 2018. Our Kratom Detox program safely manages withdrawal while allowing patients to return home each day. This makes recovery more accessible for people who can’t put their lives completely on hold or afford to stay in a 30-day residential rehab.

Our Kratom Detox Approach:

• Short Treatment Timeline - Most detoxes are completed in just a few days instead of having to face withdrawals for weeks.
• Comfort-Focused Care - We use non addictive medications to help reduce withdrawal symptoms and cravings.
• No Hospitalization Needed - Our process is safe and outpatient-based with no inpatient stay required.
• Relapse Prevention - Many patients opt for Naltrexone Therapy to reduce cravings and protect against relapse.

The Coleman Institute is Here to Help

If you or a loved one is abusing kratom products, you may notice mood swings, anxiety, or repeated failed attempts to quit. It can be confusing and painful (mentally and physically), especially as these products are sold legally and often marketed as ‘safe’.

But Mitragynine Pseudoindoxyl is not harmless. It acts like an opioid, and withdrawal can be extremely challenging. The good news is that with professional help, recovery is possible. Many people who once felt trapped by kratom addiction have broken free and started a new chapter in life.

Find Help for Pseudo Withdrawal

At our Virginia headquarters, The Coleman Institute accepts Anthem Blue Cross Blue Shield and Sentara Health Plans, along with self-pay and financing options. We also provide treatment in Colorado, Florida, Georgia, and California.

Call us today at 540-253-1029 or schedule a callback to learn more about outpatient detox for Pseudo withdrawal. Whether you’re struggling yourself or supporting someone you love, you don’t have to face addiction alone.

A powerful and dangerous synthetic opioid is making headlines, and it's far deadlier than many people realize.

Isotonitazene, often referred to as 'ISO', belongs to the nitazene class of opioids, a group of synthetic drugs that can be multiple times stronger than morphine and significantly more potent than fentanyl.

Since its emergence in the U.S. illicit drug supply in 2019, ISO has been linked to an alarming number of medical emergencies and overdoses. Part of what makes it so dangerous is how it can go under the radar; it's often mixed into counterfeit pills or street drugs without the user knowing. Even experienced opioid users may not realize they've taken it until it's too late.

At The Coleman Institute for Addiction Medicine, we know how urgent it is to act when dealing with substances such as Isotonitazene. Our Accelerated Outpatient Opioid Detox program can help you safely and comfortably eliminate opioids from your system in days without the need for hospitalization.

What Is Isotonitazene?

Originally synthesized for pharmaceutical research but never approved for medical use, Isotonitazene acts on the opioid receptors in the brain. These are the same receptors activated by heroin, oxycodone, and fentanyl; ISO binds to those receptors, despite being synthetic.

Why Is It Dangerous?

• Extreme potency: Even tiny amounts can suppress breathing, cause unconsciousness, or lead to death.
• Unpredictable risk: Since ISO is often combined with other substances, people may unknowingly ingest dangerous doses.
• Difficult detection: Standard drug tests may not pick it up, delaying critical care in overdose situations.

Why Quitting ISO Is Difficult

Because Isotonitazene is so potent, the body quickly becomes dependent. Stopping cold turkey can trigger severe withdrawals.

Signs & Symptoms May Include:

• Muscle aches & body pain
• Intense cravings
• Restlessness & insomnia
• Nausea, vomiting, & diarrhea
• Anxiety, irritability, & depression
• Sweats, chills, & flu-like symptoms

For many, these symptoms are unbearable without medical intervention, making relapse common and recovery feel out of reach.

How Accelerated Outpatient Detox Works

Traditional detox programs may require weeks in a hospital or inpatient facility. Our Accelerated Outpatient Opioid Detox is different; it's faster, more comfortable, and helps you recover without putting your life completely on hold.

Our Treatment Program Includes:

1. Comprehensive Assessment: We evaluate your health, history, and usage to create a personalized treatment plan.
2. Medically Supervised Detox: Over a few days, we gradually and safely remove opioids from your brain's receptors, reducing the intensity of withdrawal.
3. Non-Addictive Medications: We use medications that control cravings and discomfort without creating new dependence.
4. Relapse Prevention: Once the opioids have been flushed out of the system, we can start Naltrexone Therapy with Vivitrol injections, which block opioid effects and reduce the risk of relapse.
5. Case Management: You'll have access to support during and post-detox, including follow-ups with your medical provider and referrals to continue addiction treatment (PHP, IOP, etc).

The Importance of Naltrexone Therapy

Detox is the first step, but we believe relapse prevention is critical for lasting recovery. Naltrexone works by binding to opioid receptors and blocking the effects of opioids if they are used again. This means that even if a slip occurs, the user won't experience the euphoric high that fuels the cycle of addiction.

By incorporating Naltrexone after detox, we help patients:

• Reduces opioid cravings
• Supports early recovery
• Lowers relapse risk

Why People Choose The Coleman Institute

• Faster Detox: Complete the detoxification process in days, not weeks.
• Outpatient Convenience: Return home or to a supportive environment each night.
• Comfort-Focused Care: Minimize withdrawal symptoms in a safe, supportive environment.
• Proven Success: Over 25 years of experience with a 95% completion rate and thousands of patients helped across the country.
• Naltrexone Therapy: Transition into Naltrexone Therapy for long-term sobriety right after detox.
• Nationwide Access: Locations available in multiple states with our detox protocol.

Insurance & Payment Options

Our philosophy is that life-saving addiction treatment should be accessible.

At Our Richmond, VA Facility, We:

• Accept Insurance
  • Anthem Blue Cross Blue Shield
  • Sentara Health Plans
• Accept third-party financing
• Offer self-pay rates

At our other locations in Georgia, Colorado, Florida, and California, treatment is available on a self-pay basis, with third-party financing options for those who qualify.

The Coleman Institute’s Locations

The Coleman Institute offers Accelerated Outpatient Opioid Detox at:

• Richmond, Virginia
• Atlanta, Georgia
• Denver, Colorado
• Tampa, Florida
• Orange County, California

The Risk of Waiting to Stop

Every day with Isotonitazene use is a gamble. Because it's so potent and often hidden within other drugs, the risk of fatality is high, even for people with high opioid tolerance. The sooner you stop, the sooner you can protect yourself from becoming another statistic.

Choose Recovery Today

Recovery is possible, and it can start now. The Coleman Institute's Accelerated Outpatient Opioid Detox offers a safe, fast, and comfortable way to break free from Isotonitazene and start a new, healthier, happier chapter in life.

Call us at 877-773-3869 to speak with a recovery expert. We'll answer your questions, verify your insurance, and help you take the next step toward a brighter future.

Nitrous oxide, commonly referred to as whippets, NOS, or Galaxy Gas, has become an increasingly misused substance, particularly among younger individuals. A now common party drug, repeated use can quickly spiral into dependence, brain damage, and emotional instability.

At The Coleman Institute, we understand the dangers of nitrous oxide and have seen it firsthand. Although not classified as an opioid, nitrous oxide activates the opioid system and primarily exerts its effects through non-competitive antagonism of NMDA receptors. It being somewhat similar to opioids opens the door to an innovative detox solution, our Accelerated Outpatient Opioid Detox program.

Let's break down what nitrous oxide is, why it's addictive, and how our outpatient detox treatment can provide a safe, comfortable, convenient, and effective path to recovery.

What Is Nitrous Oxide?

Nitrous oxide is a dissociative anesthetic with both medical and recreational use. In hospitals, it's administered as 'laughing gas' for pain relief and sedation. Recreationally, it's inhaled through balloons, dispensers, or tanks, producing a short-lived sense of euphoria, dizziness, giddiness, and even auditory and visual distortions.

Common street names of nitrous oxide include:

• Whippets
• NOS
• N2O
• Laughing Gas
• Galaxy Gas
• Hippie Crack
• Canisters/Chargers

Its popularity stems mostly from its accessibility, as smoke shops will have it in stock for sale. Commercially, they’re available as steel aerosol whipped cream dispensers.

But its legality has fueled a widespread misconception, leading many to believe it's harmless. Nitrous oxide is not safe when used recreationally, frequently, or in high doses.

Why Nitrous Oxide Can Become Addictive

Unlike substances such as heroin or fentanyl, nitrous oxide isn't physically addictive in the classic opioid sense. However, many people find themselves using it compulsively, unable to stop even as their health deteriorates. Let’s explore why that is.

Activation of Opioid Receptors

Nitrous oxide involves the opioid receptor system, primarily through the release of endogenous opioids. These receptors are tied to pain relief, reward, and euphoria, making them foundational to the development of addiction. Although NOS does not cause typical opioid withdrawal, repeated stimulation of these receptors may create a feedback loop of emotional cravings, dysphoria, and compulsive use.

Psychological & Neurological Dependency

Nitrous oxide misuse can lead to:

• Brain fog & dissociation
• Depression & anxiety
• Irritability or apathy
• Peripheral neuropathy
  • Symptoms include numbness, tingling, & nerve damage
• Vitamin B12 depletion
  • This can lead to irreversible brain & spinal cord damage

These negative effects can make attempting to quit even more difficult, especially without medical support.

How Our Accelerated Detox Protocol Can Help

The Coleman Institute specializes in outpatient, comfort-focused detoxification for opioid use. Given nitrous oxide's effect on the opioid system, our protocol can be helpful for individuals dependent on NOS and other substances. 

Are you wondering what to expect at The Coleman Institute's detox program for nitrous oxide?

Comprehensive Medical Evaluation

Not all NOS users are alike. Some use occasionally; others inhale countless canisters a day.

Our clinical team starts with a full assessment of:

• Your nitrous oxide use history
• Physical & psychological symptoms
• Any co-occurring substance use
• Mental & physical health concerns

We personalize each treatment plan based on our patients unique needs.

Non-Addictive Comfort Medications

During detox at The Coleman Institute, patients are supported with:

• Expert treatment to help with withdrawal & cravings
• Medications that help reduce anxiety & mood swings
• Supplements to support neurological healing
• Close clinical monitoring to ensure safety & comfort

Our approach is abstinence-based, allowing you to detox safely without replacing one addiction with another.

Outpatient Flexibility

Unlike inpatient rehab, our detox is done on an outpatient basis. That means no hospitalization, just daily visits to our facility. Our detoxes are completed in only a few days, with a 95% completion rate.

Naltrexone Therapy for Long-Term Sobriety

Because NOS affects the mu opioid system, patients may benefit from Naltrexone Therapy.

Naltrexone is a non-addictive medication that:

• Blocks the euphoric effects of opioids
• Reduces withdrawals & cravings
• Can be administered as a monthly injection (Vivitrol)

Naltrexone may not directly block nitrous oxide consumption, but by stabilizing the opioid system, it helps reduce cravings, being extremely helpful in recovery from N2O.

What Recovery Looks Like After Detoxing

At The Coleman Institute, we believe that detox is just the beginning; recovery is a journey, not a destination. That's why we work with you and your support network to create a continuing care plan tailored to your sobriety goals.

Our case management connects you with:

• Therapy for trauma, anxiety, or depression
• Neurological rehabilitation for cognitive symptoms
• Recovery coaching or support groups

We also offer Naltrexone Therapy as an aftercare option, with monthly Vivitrol injections at our facility.

Why Choose The Coleman Institute?

With thousands of patients treated over the past 25 years, we are one of the nation's most experienced providers of detoxification services. We are the only detox program in the country offering this outpatient approach for substances acting on the mu opioid receptors, like nitrous oxide.

Ready to Break Free From Addiction?

If nitrous oxide use has taken control of your life, or someone you love is struggling, it's never too early (or too late) to get help. Call us today, let's reclaim your life together.

Kratom is often marketed as a 'natural' alternative for managing pain, boosting energy, or easing opioid withdrawal. But what many people don't realize is that one of kratom's most potent ingredients, 7-hydroxymitragynine (also known as 7-OH), can be highly addictive and lead to serious withdrawal symptoms.

If you or someone you care about is struggling to stop using kratom, you're not alone. At The Coleman Institute, we specialize in helping people detox from kratom and 7-OH safely, quickly, and more comfortably, usually in just 5 days, through our unique Outpatient Kratom Detox Program.

What Is 7-Hydroxymitragynine (7-OH)?

7-hydroxymitragynine is a naturally occurring alkaloid found in the leaves of the kratom plant (Mitragyna speciosa). Although it makes up a small percentage of the plant's total alkaloid profile, it's responsible for the majority of kratom's opioid-like effects.

Why? 7-OH has been shown in studies to be up to 13 times more potent than morphine in terms of how it interacts with the brain's mu-opioid receptors. This makes 7-hydroxymitragynine highly addictive.

While kratom products were once limited to raw leaf powder, today's market includes highly concentrated extracts, enhanced blends, and other labeled 7-OH products, many of which are openly marketed in smoke shops and online. These versions can contain significantly more 7-OH than occurs naturally in the plant, increasing the risk of dependence and making quitting even more challenging.

How Is 7-OH Consumed?

7-OH is commonly consumed in forms such as:

• Kratom capsules or powder - containing trace amounts of 7-OH
• Concentrated extracts or shots - significantly more potent
• 'Enhanced' kratom blends - fortified with added 7-OH
• Smoke shop products - often marketed specifically for 7-OH content
• Synthetic blends - sometimes found in unregulated online supplements

While some people use kratom occasionally, many find themselves needing to use more, and more often, to achieve the same effects, a sign of increasing tolerance and dependence.

What Do 7-OH Withdrawals Feel Like?

As the body adapts to the presence of 7-hydroxymitragynine, quitting kratom can cause a wide range of opioid-like withdrawal symptoms, including:

• Anxiety, restlessness, & irritability
• Insomnia & racing thoughts
• Muscle aches, chills, & tremors
• Nausea, vomiting, & diarrhea
• Depression & mood swings
• Fatigue & intense cravings

Many people attempt to quit 'cold turkey' and find themselves overwhelmed by how difficult it is, especially if they've been using high-potency products.

Outpatient Kratom Detox at The Coleman Institute

At The Coleman Institute, we've developed a specialized outpatient detox program that is tailored specifically to people dependent on kratom and 7-OH. Our Kratom Detox Program typically takes just 5 days to complete without the need for inpatient rehab or hospitalization.

What to Expect:

• Medical Safety & Comfort
  • Your detox is managed by experienced medical professionals using non-addictive comfort medications that significantly reduce the discomfort of withdrawal.
• Outpatient Convenience
  • Most patients complete detoxification in five days, instead of struggling with withdrawal for weeks or months. No overnight stay is required with our accelerated method.
• Customized Protocol
  • Every detox we perform is tailored to the individual's needs. We'll assess your health history, usage patterns, and recovery goals to design the safest, most effective approach.
• Naltrexone Therapy (Optional Post-Detox)
  • After detox, we offer the option to begin Naltrexone Therapy, a non-addictive, FDA-approved medication that helps reduce cravings and support long-term recovery. It can be delivered as a daily tablet or a monthly injection.

Why Choose The Coleman Institute?

We understand how isolating and frustrating it can be to feel stuck in a cycle of dependence.

Our Kratom Detox Program is designed to be:

• Fast - Most detoxes are complete in just five days
• Safe - Medically supervised & individualized care
• Comfortable - Non-addictive, comfort-based medications are used
• Outpatient - No residential rehab or hospital stay required
• Evidence-Based - Backed by over 25 years of clinical experience and a 95% completion rate

The Coleman Institute focuses on helping you move forward from addiction with confidence, clarity, comfort, and compassion.

Ready to Break Free from Kratom & 7-OH?

Kratom may be legal and plant-derived, but 7-hydroxymitragynine (7-OH) acts on the brain like a powerful opioid, and quitting without help can be extremely hard. You don't have to navigate this alone.

At The Coleman Institute, our team is here to support you every step of the way with a 5-day outpatient detox program that's safe, comfortable, effective, and non-disruptive to your life.

Learn more about our Kratom Detox by visiting our webpage or calling to speak with a compassionate member of our team.

Benzodiazepines, commonly known as benzos, are medications frequently prescribed to manage anxiety, panic disorders, and sleep issues. Drugs such as Xanax, Ativan, Klonopin, and Valium can be helpful in the short term, but prolonged use can lead to dependence and, for many people, a difficult road when it's time to stop.

If you've tried to reduce or stop your use of benzodiazepines and experienced distressing withdrawal symptoms, you're not alone. We've worked with thousands in similar situations at The Coleman Institute. That's why we developed our Rapid Benzo Detox program, which includes a unique and highly effective component, Flumazenil.

The Coleman Institute is the only provider in the United States offering this Flumazenil-assisted protocol.

This treatment is available exclusively at our Richmond, Virginia, and Denver, Colorado, locations.

Understanding Benzo Withdrawal

People often begin taking benzodiazepines under a doctor's care, with good intentions and a valid need; whether it's to treat anxiety, get sleep under control, or manage symptoms of panic disorder. But over time, the body becomes dependent, and stopping the medication abruptly, or even tapering slowly, can lead to overwhelming withdrawal symptoms.

Common benzo withdrawal symptoms include:

• Intense anxiety or panic attacks
• Insomnia or disrupted sleep
• Muscle stiffness, tremors, or spasms
• Light, sound, or touch sensitivity
• Mood swings or irritability
• Poor concentration or brain fog
• Nausea, dizziness, or heart palpitations

These symptoms can range from mild to severe and may last for weeks or even longer after stopping. The fear of going through withdrawal is often what keeps people stuck in a cycle of continued use. This is where Flumazenil can make a real difference.

What Is Flumazenil & How Does It Help?

Flumazenil is a medication that was originally developed to reverse the effects of benzodiazepines in emergency overdose situations. However, when administered in a slow and controlled way, it has a unique benefit: it can help the brain reset its sensitivity to benzodiazepines.

Benzodiazepines act on the brain's GABA receptors, which regulate feelings of calmness, sleepiness, and relaxation. Long-term use of benzos can desensitize these receptors over time.

When you suddenly stop taking the medication, the brain becomes overstimulated, leading to the intense symptoms of withdrawal. Flumazenil helps gently re-regulate these receptors, which can ease the symptoms of withdrawal and shorten the detox process.

The Coleman Institute's Flumazenil-Based Detox Protocol

At The Coleman Institute, we've developed a structured, medically supervised outpatient program that combines Flumazenil with comfort medications and compassionate care. This approach allows patients to stop benzos quickly and safely, without the need for hospitalization or inpatient rehab.

Key benefits of our Rapid Benzo Detox program:

• Detox in as little as 8 days
• Outpatient care with no overnight stay
• Effective Flumazenil infusion protocol
• Daily clinical monitoring & comfort medications
• Compassionate, experienced medical team
• Aftercare planning to support your long-term recovery

This program is carefully customized for each individual and includes daily IV Flumazenil infusions along with medications to manage symptoms like sleep disturbances, anxiety, and physical discomfort.

You won't find this protocol anywhere else in the country.

Why Choose The Coleman Institute?

Since 1998, The Coleman Institute has helped thousands of patients nationwide detox from substances including opioids, alcohol, benzodiazepines, and more. We're known for our compassionate, evidence-based outpatient programs prioritizing comfort, safety, and effectiveness.

Whether you've been taking benzos for a few months or many years, we're here to help you take the next step toward healing, without judgment and with support every step of the way.

Who Is a Good Fit for This Program?

Our Flumazenil-based detox is ideal for people who:

• Have been taking benzodiazepines regularly & want to stop
• Tried tapering off benzos in the past without success
• Experienced intense withdrawal symptoms during previous attempts
• Are seeking a discreet, non-residential treatment option
• Want a faster & more comfortable alternative to long-term tapering

Whether your use started with a prescription or otherwise, our priority is to help you detox safely and begin your recovery with confidence.

What to Expect During Your Detox

Your treatment experience is tailored to your individual needs, but here's what most patients can expect:

1. Pre-detox medical evaluation to assess health history & current usage
2. Daily clinic visits for IV Flumazenil infusions & symptom management
3. Comfort medications to reduce physical & emotional distress
4. Medical supervision & monitoring throughout the process
5. A personalized aftercare plan to promote long-term success

Many patients report improved clarity, reduced anxiety, and better sleep even before detox is complete.

Recovery is Possible & We Can Help

Benzodiazepine dependence can feel isolating, but we're here to help you along your recovery journey. Our unique Flumazenil-assisted outpatient detox program can help you reclaim your life with fewer withdrawal symptoms and a much smoother transition off benzos.

We are the only treatment center in the U.S. offering this Flumazenil-assisted outpatient detox protocol.

Call us today at 571-620-5985 to speak with a recovery expert.