As of October 16, 2017, the US Government declared the opioid epidemic a public health emergency. The medical community, and particularly pain medicine practitioners, have been active participants and fully aware of the development of the current state. Prescription drug monitoring programs (PDMPs) and the National All Schedules Prescription Electronic Reporting Act (NASPER) have effectively contributed to the reduction in opioid prescriptions by 8% and prescription opioid overdose death rates by 12%.
Despite these substantial reductions in opioid prescriptions in the USA, deaths by opioid overdose continue to escalate at alarming rates: 64,000 people died from drug overdoses in 2016; over 42,000 of those were opioid deaths. This represents a 20% increase from the total of 52,000 drug overdose fatalities in 2015. Overdoses related to illegally manufactured fentanyl represent the greatest contribution to the increase, accounting for 20,000 deaths in total; heroin accounted for 15,000 deaths; and prescription drugs for less than 15,000. Source.
The Opioid Epidemic has Exploded, So Have Treatment Options
In the desperation of being personally trapped by addiction or having a loved one on the brink of losing everything, it can be quite overwhelming to make an informed choice about the most appropriate treatment.
There are plenty of good, solid treatment programs out there, but how is it possible to make the best decision? A person can’t possibly vet every place they find on-line. Word of mouth can be helpful and, sadly, it is easier and easier to find people with personal testimonies to share.
The Easiest, Fastest Way to “Get Off” Opiates
Unfortunately, this crisis has also driven sub-par treatment programs to arise. It has become very simple for providers to pass a test, hang out their shingle, and prescribe Suboxone, a long-acting partial opiate blocker, to people to help them “get off opiates”. This option is now so accessible, many people are left with the impression it is the only and the ultimate choice to treat their opioid addiction. And although it is fast and it is easy to prescribe Suboxone or one of the other buprenorphine products, most clinics require weekly visits for the first month, and bi-weekly visits thereafter, including random urine screens and pill counts.
Suboxone can be the right treatment choice for some patients with a Substance Use Disorder, but we frequently meet with patients who strongly believed they would be on this medication for a very short time, and now realize they are on ‘maintenance’ therapy, unable to stop it without extreme withdrawal symptoms.
Quitting Opiates While Working a Full Time Job
One of the reasons people stay addicted to opiates is being able to find the time to stop taking them. This may sound nonsensical to someone who doesn’t understand what opiate withdrawal looks like—“Just stop! This takes no time at all!” But the side effects of opiate withdrawal are definitely not consistent with being a productive employee. In fact, I can’t think of any jobs that one could maintain while vomiting, sweating, having diarrhea, and basically, writhing in agony.
This may be one of the biggest reasons people choose to detox at the Coleman Institute. You are able to participate in an Accelerated Opioid Detox without putting your entire life on hold.
While plenty of people with flexible schedules benefit from our unique detox procedure, we also fill a need for people who simply can’t miss work for more than a few days. Once the detox is over, most patients return to work within 48 hours. Our program includes a naltrexone implant that will block opiates for about two months for most patients. This allows them to make a quick return to their responsibilities and commitments, free from the dark cloud of physical craving.
UNDERSTANDING ACCELERATED OPIOID DETOX
Rapid Opiate Detox Timeline
This timeline is based on someone using high dose pain medication or street heroin/fentanyl.
The first step in the process is to contact a care advocate. This can be done by calling 804-294-2212 or by requesting a callback here. Your care advocate will provide you with a link to our online screening form and help you fill it out. They will also verify your insurance or other financial arrangements, and schedule you at one of our treatment locations. Depending on a mutually agreeable start date, you can usually be seen within the week. Some patients opt to take advantage of holiday or vacation time to schedule their detox in the near future.
Detox Day One: You and your support person come to our office. You will receive instructions, medications, and our 24 hour on-call phone number. We will also answer all of your questions. Plan on 2-3 hours for this visit.
Detox Day Two: You and your support person come to our office. We will review any issues, decide if the prescribed medications are adequate and adjust as necessary. You may also receive a low dose of naltrexone. The total visit is about 1 hour.
Detox Day Three: You and your support person come to our office. We will review any issues, decide if the prescribed medications are adequate and adjust as necessary. You may also receive a low dose of naltrexone. The total visit is about 1 hour.
Detox Day Four: We will review any issues, decide if the prescribed medications are adequate and adjust as necessary. You may also receive a low dose of naltrexone. Together, we will review instructions for tomorrow, completion day. The total visit is about 1 hour.
Detox Day Five: Completion Day: You and your support person come to our office and relax in one of our comfortable suites. Your support person will order lunch off the menu. We will start an IV. The final, gentle removal of opioids off the receptors is completed with a combination of Narcan and naltrexone. Next, your Naltrexone implant is placed. The total visit is about 4-8 hours.
Detox Days Six and Seven: We ask that you continue to have a support person with you for 48 hours following the detox. Most patients return to work by Day 8.
Two Month Follow Up: Implant. Plan for a 2-3 hour appointment.
Four Month Follow Up: Implant. Plan for a 2-3 hour appointment.
With a naltrexone implant, six appointments a year is the norm.
The Proven Coleman Method for Detox
Dr. Coleman, in recovery himself for over 35 years, is an adamant believer that a detoxed person needs a strong recovery program. However, for patients who are ready to be off short or long-acting opiates, the first priority is a safe and effective detox.
For over 15 years, the Rapid Opioid Detox at the Coleman Institute has allowed people to quickly, comfortably, and confidentially get off pain medications or street drugs like heroin, usually in 3-5 days. (People who come for a buprenorphine or methadone detox can usually finish in 8 days.) Our patients love that they have a support person by their side at all times and that the medications we provide will keep the worst of the withdrawal symptoms manageable. They do not have to be in the impersonal environment of a hospital and, after meeting daily with an experienced provider, they are free to return to the comfort of home, local AirBnB, or hotel.
The follow-up plan to keep people sober and in recovery is an equally important aspect of our treatment program. Each patient, along with their support person, who completes a Rapid Opioid Detox at the Coleman Institute meets with our Recovery Specialist to create a customized treatment plan to address their unique needs.
Safely Detox During COVID-19
We have also adopted a COVID-19 Safe Care Protocol, including virtual meeting, to adapt to patient’s needs so anyone can still detox during the COVID-19 pandemic. We’re taking extra care—so you don’t have to delay your treatment.
We have some of the most experienced and compassionate people on our staff. Any one of us would be very willing to spend some time to help you navigate through the maze of decisions inherent in treating an opiate addiction.
Joan Shepherd, FNP
