The use of naltrexone has been a cornerstone of the treatment for Substance Use Disorders at the Coleman Institute for Addiction Medicine in Richmond, Virginia, since its inception over 20 years ago.

Naltrexone is an opioid antagonist with no opioid agonist properties. It is, essentially, a blocker on the opioid receptors. While it sits on these receptors, it does not create euphoria or physical dependence or tolerance or addiction. Instead, it prevents opioids from landing on the receptors.

In our patients who use naltrexone to help with an Alcohol Use Disorder, the impulse and pleasure for drinking are diminished. For our patients addicted to opiates such as heroin, codeine, and morphine— or synthetic versions such as Percocet and other oxycodone products, Vicodin and other hydrocodone products, Dilaudid (hydromorphone), Opana (oxymorphone), Tramadol, as well as kratom and poppy seed addictions, naltrexone simply blocks the receptor.

Stopping an addictive drug at any time is a difficult proposition. As I have learned from my patients over the many years I have been working in this field, my patients do not use alcohol, pills, injections or herbs because they are stupid or morally bereft. These substances have reliably helped to relieve pain or anxiety, boredom or loneliness, depression or insomnia. For many, these substances have helped to numb intolerable memories.


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Symptoms of Opioid and Alcohol Withdrawal

It takes courage on many levels to stop using these substances, and to stay off them. On a physical level, abrupt cessation of opioids causes well known symptoms:

  • Muscular pain
  • Diarrhea, vomiting, or nausea
  • Restlessness or sweating
  • Anxiety
  • Dilated pupils or watery eyes
  • Cramping abdominal pain
  • Fast heart rate
  • Excessive yawning
  • Goosebumps
  • Insomnia
  • Tremors

People dependent on alcohol who stop drinking abruptly may experience:

  • Sweating
  • Fever or water-electrolyte imbalance
  • Restlessness or irritability
  • Delirium or hallucination
  • Fast heart rate
  • Tremor
  • Anxiety
  • Dilated pupil
  • Insomnia
  • Seizures
  • Shallow breathing

Choosing to stop using addictive substances during the COVID-19 pandemic adds another whole layer of challenge. How can I do this safely? How can I get the support I need? Is there a place near me to detox off opioids or alcohol to minimize travel?


Why Using Naltrexone is a Good Idea During the Pandemic?

Perhaps one of the most compelling reasons to choose naltrexone as your Medically Assisted Treatment (MAT) —particularly for an opioid use disorder— is that unlike buprenorphine (i.e. Suboxone®, Subutex®, Zubsolv®, etc.) or methadone, naltrexone does not create a physical dependence or tolerance. Both methadone and the buprenorphine-types of medications necessitate multiple appointments, and because by law, urine drug screens are required, some of these will have to be live appointments.

At the Coleman Institute in Richmond, Virginia, we use a long acting form of naltrexone which will last approximately two months. As far as making plans, this means completing the actual detox in 5-8 days and having all follow up appointments with our staff virtually, until the next naltrexone implant is due in two months. (Suture removal is necessary 10-12 days after the implant.)

If the first step toward recovery is to physically stop using the addictive substance, the Coleman Institute provides one of the safest and most efficient methods to do so. Our program is an outpatient process allowing the patient and their support person to stay together during the entire treatment. We have limited the number of patients going through detox to achieve safe distancing and have instituted other measures to keep staff and patients safe. Our trained social workers will continue to follow up regularly and virtually with our patients to help them personally navigate their unique path of recovery.

If you or your loved one is looking for a safe, convenient option for detoxing during the COVID-19 pandemic that specializes in naltrexone therapy, we are here for you. Schedule a call back with one of our Care Advocates today.

Joan R. Shepherd, FNP


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