I had a great visit with my patient, Edward (not his name) earlier this week. Edward grew up in West Virginia and started using Oxycontin toward the end of his high school years. He got hooked and when pills became expensive, he started using heroin.

Edward is kind, smart, shy, funny and a talented chef. Heroin robbed him of all those things.

He spent several agonizing years avoiding relationships, betraying close friends and family, crashing anywhere he could, and basically cutting off any opportunity he had to continue to develop into the person he was capable of being.

He just couldn’t stop using heroin; he became so sick when he tried. When he lost his oldest and dearest friend to an overdose, he didn’t want to live anymore if it meant being addicted to opiates. He found a Suboxone clinic near his home. The clinic was packed with people who seemed to be getting their lives back together. He knew some of the people were selling or trading their Suboxone for other opiates, but for several months he enjoyed the relief of having a legitimate and legal way to deal with his addiction.

He was working steadily and began to date a girl who never touched drugs. He talked to the clinic about getting off the Suboxone and they suggested a tapering process. He did pretty well until he tried to get off the last 2 mg dose; he had underestimated the prolonged and difficult withdrawal off this long-acting partial agonist treatment.

He tried hard to stop the Suboxone but on a particularly stressful workday, a coworker with a ready supply of heroin made it all too easy for Edward to resist. The wretched cycle resumed. First he lost his job, then his girlfriend.

Edward had visited The Coleman Institute website over the years but was skeptical of doing a ‘rapid detox’ which seemed too good to be true, and besides, he didn’t have much money. Seeing his desperation and despair, Edward’s mother called our office.

Our Intake team was able to get Edward on the schedule that week and in four days, with minimal discomfort, not only were the opiates completely out of his system, but he had a long acting implant already releasing the opiate-blocking agent, naltrexone. He and his mother came for daily office visits and then were free to return to a comfortable, nearby AirBnB that they had rented during the detox.

It took about two weeks for Edward to really be able to sleep well, but we helped him out with some extra medication. (All our patients are sent home with medication to help with Post Acute Withdrawal Syndrome (PAWS), symptoms which happen to a greater or lesser degree to anyone detoxing from opiates. Trouble sleeping and low energy are the most common complaints.)

This all happened about 6 months ago, and that’s why when I saw Edward this week, it was so gratifying to hear about his life.

He has found a small group of guys who attend recovery meetings, and he has also found a church that caters to people in recovery. He has been asked to share his story with some of the other people who are wrestling with the disease of addiction. He has been promoted to the head chef position at a popular farm-to-table restaurant, and (fingers crossed) he had a date set up for that night with someone he’s been talking to for a while. (Can’t wait for the next visit to hear about all that.)

Edward is in a good phase right now. It is so important in the early stages of recovery to have a lifeline to quality services. Staying engaged in meetings and checking in with addiction specialists helps keep people on track. The brain in early sobriety is still not always making good decisions and can be extremely vulnerable to triggers, thoughts, and situations that can result in relapse.

Edward is committed to returning for two more naltrexone implants. (He can come by himself for these visits, since no sedation is needed to quickly insert the naltrexone pellet.) This will equal a year of abstinence from opiates. As we near the 12-month mark, our staff will work with Edward to formulate an on-going plan for continuing his sobriety.

Addiction is a complex disease. Treatment options vary widely and the best choice for one person can look quite different than for another person. For some people, like Edward, using Suboxone for a few months was a good idea; when he knew he was ready to stop opiates all together, long acting naltrexone was an excellent choice for him. Luckily his relapse between getting off Suboxone and getting a naltrexone implant didn’t kill him.

Our area of expertise at The Coleman Institute for over fifteen years has been to gently detox people off opiates (long or short acting) in an outpatient setting and safely get them onto naltrexone, which is a non-addictive opioid blocker.

Please call our office if you have any questions about medically assisted detox and using long acting naltrexone. To this day, we know of no other clinic that does what we do!

Joan Shepherd, FNP